The Shafer Center Webinar with Autism NOW May 10, 2011
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Transcript of The Shafer Center Webinar with Autism NOW May 10, 2011
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Early Detection and Intervention:
Best Practices from a Care Center
Christine Accardo, Ph.D., BCBA-D
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Before we start- My disclaimer
No one can be an expert on all of these methods- make
sure to have experts working with the child
Varying levels of science behind each of them
My areas of expertise and experience
The Shafer Center
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Autism- What is it- now..
(A) Qualitative impairment in social interaction
(B) Qualitative impairments in communication
(C) Restricted repetitive and stereotyped patterns of behavior
(D) Presents before age 3
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Diagnosis- when and how
Diagnostic tools becoming more sophisticated and
children are diagnosed earlier
More people are aware of autism
Rates have significantly increased- more treatments
available
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From birth to at least 36 months of age, every child should bescreened for developmental milestones during routine well visits.
If there are issues an evaluation should be done.
Who can do the evaluation: School system:
Educational Evaluation- OT- Speech- Psychological
Developmental Pediatrician
Neurologist
Psychiatrist Psychologist
Hearing testing
Lead testing
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Why diagnosis early?
The goal is to catch up and stay on track
The earlier you start the less there is of a gap in skills
The quicker you catch up- the more likely you will stay on
that path
Children with autism often do not know how to learn
from the environment- the goal of all treatment is to not
need the treatment and to be able to learn from the
environment
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Treatments
When there is no cure, there are 1000 treatments
(Donald Cohen)
choose interventions which have been documented inscientific studies and published in professional journals
if results of treatment has not been thoroughly studied,
remain open-minded, analyze potential risks, implement
systematically so that results may be objectivelyevaluated
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Autism Treatments Current most popular treatments
Special Education Services
Speech Therapy
Occupational Therapy
Sensory integration therapy
TEACCH
F
loor Time Relationship Development Intervention (RDI)
Dietary interventions
Applied Behavior Analysis/Verbal Behavior
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Autism Treatments Alternative Treatments
Facilitated Communication
Holding Therapy
Auditory Integration Therapy
Neurofeedback
Son-Rise
Detoxification
Magnet therapy
Dolphin Therapy
Hydrotherapy
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Autism Treatments
What we do at The Shafer Center
Special Education Services Speech Therapy
Occupational Therapy/ Sensory integration therapy
Relationship Development Intervention (RDI)/ Floor time
Applied Behavior Analysis/Verbal Behavior
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Special Education Group learning is essential for generalization and future
success
Children with autism often do well with early academics
Social skills are important area of focus
We have group experiences from young age with increasingamounts as skills increase
We create groups based on skills rather than age
Heavy data collection Heavy on language and behavior issues
Work collaboratively with other departments
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Speech Therapy
Communication is one of the most salientfeatures in autism
Many children have articulation issues
Most have language issues
Many have motor planning issues
Many have processing issues Works best when they work collaboratively
What to look for in a good speech pathologist
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Occupational Therapy
Can work on gross motor issues (although doneby PT in schools)
Can work on fine motor issues
Can work on self help issues
Can work on motor planning issues
Can help work with sensory issues Work best when work collaboratively
What to look for in a good occupational therapist
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Sensory Integration Therapy
The process in which the brain organizes and
interprets extra stimuli such as touch
smell
sight
sound
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Sensory Integration Therapy Sensory Integration Dysfunction(SID)
Difficult for them to process information through their
senses Goal is to facilitate the development of the nervous systems
ability to process sensory input in a more typical way
Can increase attention, concentration, listening, balance,
coordination and impulsively in some children
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Sensory Integration Therapy
Techniques used are:
Brushing Joint compressions
Weighted vests
Chewing tubes
Full body movements (jumping)
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Floor Time
Stanley Greenspan
treatment method and philosophy for interactingwith children with autism
Goal: to move the child through the 6 basic
developmental milestones that need to be
mastered for emotional and intellectual growth
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Floor Time
Self- regulation and interest in the world
intimacy- human relations
two-way communication
complex communication
emotional ideas emotional thinking
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Floor Time The parent engages the child at the level the child currently
enjoys, enters the childs activities and follows the childs lead.
From the mutually shared engagement the parent isinstructed on how to move the child toward more increasing
complex interactions- this is called Opening and closing
circles of communication
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Relationship Development Intervention (RDI)
6 aspects of dynamic intelligence
emotional referencing
social communication
declarative language
flexible thinking
relational information processing
foresight and hindsight
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Applied Behavior Analysis (ABA)
What is ABA?
B.F. Skinner a science with roots in psychology
based on principles of behavior (e.g.,
positive and negative reinforcement)
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Applied Behavior Analysis (ABA)
systematically apply principles of behavior to
improve students behavior procedures thoroughly described
behavior is observable and measurable
data recorded
data analyzed frequently modifications made as necessary
(Cooper, Heron, & Heward, 1987)
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Applied Behavior Analysis (ABA)
Lovaas and ABA and autism
Skills are broken down into small pieces and taughtsystematically
Increase positive skills- decrease negative skills
Intensive- 20 to 40 hours per week on average
Goal is to teach the child concepts so they canlearn to learn
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Applied Behavior Analysis (ABA)
What can ABA do for me and my child?
teach academic/cognitive skills
discrete trial instruction
prompting techniques
teach social skills/facilitate inclusion
teach self-help skills
task analysis
decrease maladaptive behaviors (more info. later in
training)
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ABA vs Verbal Behavior
Verbal Behavior, B.F. Skinner
Vince Carbone
Sunburg and Partington
The ABLLS
Manding, Tacts, Intraverbals, RFF
C Teaching in the Natural Environment
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Take home message
Important to diagnose and start treatment early
There are a wide variety of treatments out there
No one person can do everything- make sure your
professionals work together
Take data whenever you can- it will let you know if what
you are doing is working