The Shafer Center Webinar with Autism NOW May 10, 2011

8/6/2019 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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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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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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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

Documents

The Shafer Center Webinar with Autism NOW May 10, 2011