Medication Considerations

What do you do when your doctor recommends medication? In this month’s ASAT feature, Megan Atthowe, RN, MSN, BCBA, offers insight on a variety of approaches parents can take when medication is recommended for children exhibiting aggressive behaviors. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!


My son with autism has developed aggressive behavior, and his doctor is considering whether medication could help. What can I do to prepare for this conversation?
Answered by Megan Atthowe, RN, MSN, BCBA

doctor-563428_960_720First, you should know that there is no medication that specifically treats autism. Medications approved by the United States Food and Drug Administration (FDA) for other conditions can be useful only to lessen symptoms. That said, off-label use of pharmaceuticals is by no means unique to autism and is common practice for many health conditions. So while research on the use of particular psychotropic medications in the autistic population is growing, our body of knowledge is still limited. In addition, medications can and do affect every individual differently, and children can respond differently as they develop, so it is likely to take time to find the best medication at the appropriate dose. Medication management, in other words, is a complex and an ongoing process and one that is highly individualized. It is a good idea, then, to be prepared with the right information before every visit to your health care provider.

Do you know how often the aggression actually occurs? Bringing data like this to the visit can be very helpful. You may want to ask your son’s teachers to share any information they have about the aggression with your health care provider, too. (They would need your consent to talk with him/her or to share any confidential information such as behavior data.) If you have not been keeping track of the aggression, now is a good time to start, even if there are only a few days until your visit. An easy way to do this is to use a calendar. Record specifics about when the aggression happens, what the behavior is like, how long it lasts, and whether you have noticed any recent changes. It is difficult for anyone to recall these details accurately, especially if the behaviors happen frequently, so writing them down will help you to share the most meaningful information you can with your health care provider. If your son’s school team is not already collecting data, perhaps they should start as well.

In addition to information about the current levels of the behavior, be prepared to describe how the school and your family are addressing the behavior and how long that plan has been in place. Has your son’s team considered or tried Applied Behavior Analysis (ABA) to treat the behavior? Research supports ABA as an effective intervention for decreasing problem behaviors such as aggression as well as for teaching children with autism new skills. It is important to be sure that a qualified behavior analyst is supervising any ABA interventions, as they must be implemented correctly to be effective. Your health care provider may be able to refer you to a local ABA provider, or you can find a list of board certified behavior analysts at the Behavior Analysis Certification Board’s website.

Before your visit, prepare a list of the names and doses of any medications your son takes, as well as any over-the-counter medications, vitamins, or other supplements. If your son receives other therapies, share what they are with your health care provider. He or she will want to ensure that any new medication is safe to take and will not interact with other medications.

If you and your health care provider decide to start your son on a medication, decide what the goal is. How will you know when the medication has been effective? How will you know if it is ineffective? Be specific and write the goal down. Schedule a date when you will check in with your health care provider on your son’s progress. He or she may have specific suggestions about what type of data to keep.
Finally, there are some important questions that you should have the answers to before you leave. Make sure that you ask any questions you have—a responsible health care provider will want to know that you understand how to use the new medication correctly. If you think of questions later, do not hesitate to call and ask your physician, nurse, or pharmacist.

Key Questions:

  • What is the name of the medication?
  • What is the medication used for?
  • When and how should I give it to my son, and how much do I give?
  • Should I give this medication with food?
  • What effects should I expect to see?
  • What are common side effects?
  • How long will it be until I notice the desired effects and side effects
  • What side effects are serious, and what should I do if I notice them?
  • Will side effects lessen over time?
  • Is there anything I should avoid giving my son while he is on this medication?
  • If I decide that I would like to stop giving him the medication, what should I do?
  • What should I do if I miss a dose?

Please note that there is information about research related to medications elsewhere on the ASAT website.

ABOUT THE AUTHOR

Megan Atthowe, MSN, RN, BCBA, LBA, is a registered nurse and behavior analyst who has worked with people with autism and other special needs in educational, home, and healthcare settings for over 15 years. Currently she consults to educational teams who serve students with autism in public schools.

“Cooperating with Dental Exams” – Strategies for Parents, by Jennifer Hieminga, MEd, BCBA

This month’s featured article from ASAT is by the Associate Director of the New Haven Learning Centre in Toronto Jennifer Hieminga, MEd, BCBA, on several research-based strategies for parents to encourage cooperative behavior in their children with ASD during routine dental visits. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

My daughter with autism was very resistant during her first dental visit. Are there any steps we can take to help her tolerate a dental exam? We were actively involved in her home-based early intervention program for the last two years and have a working knowledge of ABA. Our daughter’s program is overseen by a board certified behavior analyst.

Answered by Jennifer Hieminga, MEd, BCBA
Associate Director, New Haven Learning Centre, Toronto, Canada

Boy Dental VisitFor many individuals with autism, routine appointments such as medical, dental and haircuts can be extremely difficult to tolerate. There are many factors that may contribute to this intolerance such as novel environments, novel adults, novel or aversive sounds, bright lights, foreign tastes, painful sensations, sitting for long periods of time and physical touch. As a result, many children with autism display noncompliant or avoidant behavior in response to these stimuli or events. Fortunately, there is a growing body of research published in peer-reviewed journals describing effective strategies to target dental toleration. Several different behavior interventions and programs have been used to increase an individual’s tolerance or proximity to an avoided stimulus or event, such as a dental exam. For example, the use of escape and reward contingent on cooperative dental behavior was shown to be effective for some individuals (Allen & Stokes, 1987; Allen, Loiben, Aleen, & Stanley, 1992). Non-contingent escape, in which the child was given periodic breaks during the dental exam, was also effective in decreasing disruptive behavior (O’Callaghan, Allen, Powell, & Salama, 2006). Other strategies such as using distraction and rewards (Stark et al., 1989), providing opportunities for the individuals to participate in the dental exam (Conyers et al., 2004), and employing systematic desensitization procedures (Altabet, 2002) have been shown to be effective. Most recently, Cuvo, Godard, Huckfeldt, and Demattei (2010) used a combination of interventions including, priming DVD, escape extinction, stimulus fading, distracting stimuli, etc. The board certified behavior analyst overseeing your daughter’s program is likely familiar with these procedures.

Clinical practice suggests that dental exams can indeed be modified to teach children with autism component skills related to dental exams (Blitz & Britton, 2010). However, a major challenge to implementing such skill-acquisition programs is the reduced opportunities to actually target these skills. One highly effective way to address this is to create a mock dental exam scenario in your home, as it provides opportunities to teach and practice the skills consistently and frequently. These scenarios should emulate, as best as possible, an actual dental office (e.g., similar tools, sounds, light, reclining chair), making it easier for the skills mastered in the mock teaching scenario to generalize to the dental office exam later on.

Developing a “Cooperates with a Dental Exam” Program
Following is a detailed example of the components involved with creating and implementing a “Cooperates with a dental exam” program.

  1. Speak to your family dentist to identify all the components of the exam with which your child will be required to participate.
  2. Based on the dentist’s input, develop a detailed task analysis outlining each step of the dental exam. See sample task analysis provided in the next section below.
  3. Collect necessary materials required for the exam. Many of these items may be obtained or borrowed from your dentist and may include:
    • Reclining chair (e.g., lazy boy)
    • Dental bib
    • Flouride foam dental plates
    • Electric Toothbrush with round head (to ensure polishing)
    • Dental mask
    • Dental mirror
    • Plastic gloves
    • X-ray plates
    • Flossing pics
  4. Take baseline data to determine your child’s ability to cooperate with each step of the exam and to identify skills that need to be taught. For example, baseline data may indicate there is a skill deficit with tolerating novel noises at the dentist and not with the exam itself. In this situation, a specific program for tolerating novel sounds found in the dental office should be introduced. It cannot be overstated that an intervention to address this area would need to be individualized. However, for the purpose of this reply it will be assumed that your daughter presents with difficulty in all, or the majority of the steps involved in a dental exam.
  5. Lastly, before starting the program, establish highly-potent reinforcers which your daughter will access for correctly responding within this program, and collect the items that you will need to teach this skill.

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Interview with Lisa Carling, Director of the Theatre Development Fund’s Accessibility Programs

Lisa Carling is the Director of the Theatre Development Fund’s Accessibility Programs in New York City. Recently, she sat down to speak with BCBA Sam Blanco about their Autism Theatre Initiative. TDF’s next autism-friendly performance will be The Lion King on Sunday, September 27, 2015 at 1PM. The Lion King was the first autism-friendly performance TDF organized back in October 2011, and has been so popular that it is now an annual event each fall at the end of September. Read on for Lisa Carling’s inside scoop on the Autism Theatre Initiative!

SAM BLANCO: Tell me a little bit about how the Autism Theatre Initiative came about.

LISA CARLING: It came about because we had a very successful program for students in the District 75 schools who had hearing loss and vision loss. We would schedule Wednesday matinee performances of Broadway shows, and bring these kids with their teachers to see Broadway performances. We were hearing more and more from special ed teachers, “This is great, but what can you do for all the kids in the District 75 schools that are on the autism spectrum.” We didn’t know, because the more we talked to parents, educators, therapists, the more we realized that this population would probably benefit more from a designated performance, being able to come to a show and be themselves. It wouldn’t be fair to mix them with typical audiences that may not understand atypical behavior. We also realized from talking with parents that they’re very few opportunities for families to do something together if you have a child or adult on the spectrum, what can you do together with siblings, grandparents, aunts and uncles. So we wanted to create an opportunity for families to come to the theatre together and have a terrific time in a judgment-free, welcoming environment where the children or adults on the spectrum could just be themselves, and the parents and siblings would not have to explain a thing. Anything goes. No judgments.

SB: Do you feel that judgment-free aspect is what has really drawn people in?

LC: I do. We’re very careful with the material, what productions we choose. We go after what most families want to see, family-friendly productions, big musicals, easy storylines, colorful costumes, dancing and singing, what everyone loves. And then we will ask the production if they are able to make slight modifications in sound and lighting. We rely on specialists in the autism community who can come and take a look at a production and then say, here are maybe a dozen places where it would really be beneficial if the sound could be turned down a level, we usually say not above 90 decibels, or the lighting is just too intense. We always stress when we talk to a show that these are suggestions and if they can make them that would be great. If not, we will warn the parents ahead of time at point-of-purchase. And we always emphasize we want it to be the same great show, the same terrific Broadway musical that families all over the country want to see when they come to New York.

We tried something different in December by doing a play for the first time, The Curious Incident of the Dog in the NightTime. We were very leery of that. We didn’t know what it would be like for families to come and see a serious drama, albeit with very funny moments in it, about situations that they may live with 24/7. But it was an opportunity to stretch our expectations and to offer something newer to the autism community, to identify older people in the community, college-aged students on the spectrum, older adults.

SB: What was the response to that?

LC: It was unbelievable. It was very moving to all of us. The cast, every cast member, had tears in his eyes at the curtain call. And there was a very moving moment at the end of the play, where Christopher, after he’s told his teacher all the things he’s accomplished: he found his mother, he wrote a book, he solved the mystery of who murdered Wellington, and he says something to the effect, he asks her, “This means I can do anything, can’t I?” And he asks her three times, and that question just hangs there unanswered by the teacher. But for our autism-friendly performance, there was a teenager who shouted right back at him, “yes, you can!” And it was such an affirmation of the impact of that show on this audience.

There was a time when we would have shied away from offering a performance where there was strong language in it, or violence. There’s a scene where the father strikes his son. The show worked with us on that and it was choreographed in a different way. It was more suggestive and not as startling. But we did it. And we’re not afraid anymore to just put opportunities out there. Parents know their kids the best, and if they think their child or adult can’t handle something then they’ll let us know or they won’t buy tickets.

SB: Are you involved with other theatres who are putting on autism-friendly performances?

LC: This year’s National Autism Theatre Initiative advisory partnerships varied in scope from Stages St. Louis’s 235 seat Playhouse at Westport Plaza in Chesterfield, MO that offered a sensory-friendly performance of The Aristocats in June for groups of school children on the spectrum in the St. Louis area; to The Big Apple Circus in Brooklyn, NY which presented a total eight autism-friendly performances of Metamorphosis throughout the year in up to 1,700 seat tents in Manhattan and Queens, NY; Boston, MA; and Bridgewater, NJ. The impact on attendees with autism or with other developmental or cognitive disabilities was immeasurable. From a mother at Stages St. Louis, “My daughter is in this show. Until today, her younger brother had never seen her perform because he is autistic and needs to get up and walk around every now and then and can be loud when he’s excited. Today, he not only saw his sister perform but he felt he was in a safe space, and he gave her a standing ovation every time she walked on stage.”

SB: With the partnerships, what resources do you provide?

LC: Conference calls. We help them in the planning. We recommend give yourself first time six months to a year to plan for this. We show them examples of the social narrative, character guides, video of what it’s like to walk inside the theatre, various supports day-of, what works out the best for us in terms of the koosh balls and stress stars. Just essentially, share our play book, what worked well for us and we always emphasize adapting for your community. And that goes for what you call the performance as well. In New York, we use the term autism-friendly because our community wants that and because in the initial planning they wanted to own that word and raise the awareness. Other parts of the country might use the term sensory-friendly, in the U.K. they like relaxed performances. But it doesn’t matter. The thought process is the same, you’re welcoming people on the autism spectrum as well as individuals with other developmental or cognitive disabilities and making slight adjustments that make the experience more comfortable.

SB: What advice do you have for theaters or other organizations who want to create autism-friendly events?

LC: Jump in and do it. Don’t be afraid because you will learn every time you do it; you’re going to do it better. Opening up accessibility for people on the spectrum as well as for other individuals with cognitive and developmental disabilities is where the need is right now. All theaters get it about providing captioning and audio description, but they are neglecting a huge audience in their communities. So, make the effort. Reach out there, you will not regret it.

I would advise choosing the first production (or productions) that are going to be successful. Particularly the first one. Make sure it’s a positive experience because this is a new audience. So look for a show that would be engaging to all families. Please do a weekend matinee. Scheduling this on a weekday. About 90% of the people on our surveys say they want a Saturday or Sunday matinee. They cannot come during the week. Again, this is geared for families. If you’re working with school groups, that might be different. Oh, an advisory group. Three is a good number. Make sure you get some outside input, someone who’s looking at the production you’re considering with an autism eye. Because what an artistic director might think is a good choice is not necessarily what someone who works with people on the spectrum, or someone on the spectrum. Don’t discount the value of having someone on the spectrum as one of your advisors.

SB: Can you describe some of the feedback you have received from participants?

LC: The overwhelming feedback we’ve received again and again is how wonderful it is to be in a judgment-free environment, where parents and siblings can just relax. They don’t have to worry about explaining behavior, they don’t have to feel that they’re being stared at. One very telling comment came from a mother last April after our Disney Junior show, who said, “Here I am, sitting in a theater with 2,000 strangers, and yet I feel we’re all part of the same family.” She’s right. They all understand each other. So a child who’s stimming or needs to get up, is singing along, it’s wonderful. There’s no difference. It’s not bothering anyone.

SB: Are you always able to offer the tickets at 40-50% off or is that the goal?

LC: That’s the goal. We hit that most of the time. If you have a family of four that you want to bring to a Broadway show, and you’ve got parking involved and public transportation, it’s important to keep the cost low. And then you get into all the additional expenses parents have: medical expenses, schooling, one-on-one therapists.

SB: Can you tell me anything about future direction of ATI?

LC: We are interested in working with off-off Broadway companies and consultancies where we will help them provide autism-friendly performances during the summer which is a hard time for us to book an autism-friendly Broadway show so we have our summers to help smaller theaters that might be willing to open their shows to the community.

SB: Is there anything I left out?

LC: I want to cite National Theater America Office with Curious Incident. They recognized that they wanted to make the show as affordable to the autism community as possible, so they went out and sought funding to underwrite the cost. So all of our Curious Incident tickets we were able to sell for $25. Orchestra to balcony, $25 thanks to the National Theater’s funding to help underwrite the cost. I wish more producers thought in terms of providing these affordable opportunities. It’s in the nature of the commercial theater that it’s very expensive to do shows, but if occasional opportunities could come along like this, we could reach so many more people. I remember getting e-mails from parents who were saying, “This is the first time I’ve ever been able to sit in the orchestra.”

ABOUT LISA CARLING

Lisa CarlingLisa Carling is Director of TDF Accessibility Programs (TAP) at Theatre Development Fund where she runs a department of services for people with physical disabilities as well as individuals on the autism spectrum or with other developmental or cognitive disabilities. She has spoken on accessibility panels for the Broadway League Education Forums, Association of Performing Arts Presenters, Americans for the Arts and the Kennedy Center’s Leadership Exchange in Arts and Disabilities (LEAD) conferences. Lisa received a “Distinguished Leadership in Hearing Accommodation Award” from the Hearing Loss Association of America New York City Chapter in 2015 and a “Community Hero Award” from Best Buddies New York in 2014. TDF has won seven accessibility awards honoring her department achievements, including the “Excellence in Accessibility Leadership Award” at the 2006 LEAD conference. Her credits include: launching the “Autism Theatre Initiative” (2011) which makes theatre accessible to children and adults on the spectrum and their families; designing TDF’s “National Open Captioning Initiative” (2004) that partners with regional theatres across the country to expand audiences of people with hearing loss; and establishing TDF’s open captioning on Broadway program (1997). Lisa created “Access for Young Audiences” (1995), a service that provides sign language interpreting, open captioning (added, 1998) and audio description (added, 2008) for students with hearing and vision loss who attend specially scheduled Wednesday matinee performances on Broadway. Lisa holds an MFA from Yale School of Drama.

Autism Awareness Month Interview Series: Creating Positive Change in ASD Treatment Through Science, Support and Education with David Celiberti, PhD, BCBA-D

We couldn’t be more thrilled to wrap up our Autism Awareness Month Interview Series with David Celiberti, PhD, BCBA. Dr. David Celiberti is the Executive Director of the Association for Science in Autism Treatment (ASAT) and provides consultation to public and private schools and agencies in the U.S. and Canada. Here, Dr. Celiberti shares his wealth of knowledge and experience in creating positive change in autism treatments through scientific research and high-quality education and support.

Don’t forget to check out the other interviews from our Autism Awareness Month Interview Series here!


Creating Positive Change in ASD Treatment
Through Science, Support, and Education
with David Celiberti, PhD, BCBA-D

SAM BLANCO: I consider the Association for Science in Autism Treatment (ASAT) to be an invaluable resource for both parents and practitioners. You serve as the Executive Director. Before we discuss ASAT, can you tell us a bit about your background?

DAVID CELIBERTI: First and foremost, thank you for the opportunity to participate in this interview, particularly as you are asking about topics that are near and dear to my heart. I have been fortunate to have a career in the treatment of autism spectrum disorders (ASD) where the journey has been just as reinforcing as the destination. I continually urge young people to work hard at finding a career path consistent with their passions. Among my many reinforcers in the field of ASD treatment are interactions with parents and siblings who did not choose a life that included ASD, but still love unconditionally, roll up their sleeves and embrace powerful roles as agents of change. Additionally reinforcing has been my collaboration with myriad professionals, particularly those who are grounded in, and informed by, science. Perhaps most inspiring, though, are the individuals with ASD themselves who work so hard to acquire new skills, learn effective strategies for negotiating their experiences, and remind us daily that science-based treatments, such as applied behavior analysis (ABA), truly make a difference.

I currently serve as the halftime Executive Director of ASAT. I view this role not as a job but as a “lifestyle”, and I am so proud of what ASAT accomplishes every year, even with a tiny operating budget. We have an incredible board of directors from diverse professional backgrounds such as special education, behavior analysis, psychology, social work, sociology, law, medicine, speech-language pathology, computer science, family advocacy and business. Many of our board members have family members with ASD. Their commitment to helping other families and professionals find a clearer path to effective intervention is astounding to me. We also have scores of volunteer coordinators, externs, and an active Media Watch team who do much of the “heavy lifting”, helping ASAT remain productive, current, and responsive to the needs of the autism community.

SB: For those out there who aren’t familiar with ASAT, can you talk a little bit more about the organization’s mission and why it continues to be such an essential resource?

DC: With respect to our mission, we improve the quality of life for individuals with ASD and their families by promoting the use of safe, effective treatments, which are grounded in science, for people with ASD. As you know, there are over 400 treatments for autism, with the vast majority lacking any semblance of scientific support. We achieve our mission by sharing accurate, scientifically-sound information with professionals, parents and journalists; and by countering inaccurate or unsubstantiated information regarding autism and its treatment as it comes up. Unfortunately, there is so much out there which distracts consumers from making the best possible choices. Our overarching goal is to help parents and providers become savvy consumers of information who can truly discriminate science from pseudoscience. This means being armed with the knowledge to ask practitioners and marketers of ASD interventions critically important questions related to the state of their science, consult with knowledgeable and impartial professionals about potential treatments, and establish methods for assessing the benefits of treatments when they are adopted by the family and their intervention team. It is absolutely heartbreaking that autism treatment has become the type of business in which parents of children with autism must work so hard just to sort through so many options and mixed messages just in order to help their sons and daughters.

For more information, your readers can visit ASAT’s comprehensive website at www.asatonline.org. On the website, they will find extensive information about the scientific support (or lack thereof) behind the full array of treatments proposed for autism; resources and guidelines on how to make informed choices and weigh evidence in selecting treatment options, and information for various groups such as parents of newly diagnosed children, parents of older individuals, teachers, medical providers, and members of the media community. We encourage people to revisit ASAT’s website often, as information about autism treatments is frequently updated to reflect the latest research, and new content is routinely added.

ASAT also publishes a free quarterly newsletter, Science in Autism Treatment. Sign-up information is available at http://asatonline.org/signup. The quarterly e-newsletter features:

  • Invited articles by leading advocates of science-based treatment;
  • A Clinical Corner which responds to frequently asked questions about autism treatment;
  • A Consumer Corner which recommends resources that can guide and inform treatment decisions;
  • A Focus on Science column which is designed to empower families to make educated treatment decisions by highlighting those elements that constitute science-based interventions as well as warning signs of unsubstantiated treatment;
  • Detailed summaries of specific treatments for autism;
  • Book reviews;
  • Highlights of our Media Watch efforts and discussion of accurate, and inaccurate, portrayals of autism and its treatment by the media;
  • Reviews of published research to help consumers and professionals understand and gain access to the science;
  • Critiques of policy statements related to autism treatment; and
  • Interviews with those who advance science-based treatment and confront pseudoscience.

Finally, your readers can also follow us on Facebook and on Twitter at @asatonline.

SB: You have dedicated a lot of your time to providing services for underserved populations, from direct services to organizing fundraisers that support organizations that serve economically disadvantaged children. Why is this an important area of work for you?

DC: When I was in graduate school in the late 1980s and early 1990s at Rutgers University under the mentorship of Dr. Sandra Harris, I was struck that only a tiny percentage of students with ASD were receiving the lion’s share of the available expertise and resources. This disparity was troubling to me as I recognized that there were scores of other children with ASD who were receiving “generic” special education services which did not yet incorporate state-of-the-art behavior analytic intervention. My hope was to one day dedicate a portion of my time to supporting students with ASD in inner city communities. As my career unfolded, I had the opportunity to work at the Rutgers Autism Program, where part of my duties focused on outreach. I started working in rural Maine in 1997, helping public schools develop and implement educational programs to students with ASD, and have now returned over 110 times! It is not that urban setting that I had envisioned as an idyllic graduate student; however, I quickly realized how rewarding it was to provide services in geographic areas that did not have the existing resources, and to assist public schools in providing high quality educational experiences.

Hoboken, New Jersey, where I live, is home to a significant number of economically disadvantaged students. I began to seek collaborative relationships between ASAT and other local organizations which focused on poverty. The common thread was the importance of providing children with meaningful, socially valid and effective opportunities to realize their fullest potential despite the myriad obstacles that they face. That resonated well with me as someone whose career focuses on the treatment of ASD. To date, my fundraising efforts have benefited four Hoboken-based organizations combating the barriers associated with poverty.

SB: I would like to go back to your reference about public school programs. In your view, what are some of the key elements of a high quality education for students with autism?

DC: This is such an important question! In a nutshell, a high-quality education would include the following elements:

  • Be truly individualized – An educational plan should truly fit the child like a glove fits a hand. Services should not be about what a provider likes to do, but rather what the student needs, as determined through ongoing, valid assessment.
  • Be comprehensive – A high quality education targets the full array of skills that will promote success at home, school and community and uses a wide range of techniques based on science that are well fitted to the skills being targeted.
  • Keep the future in mind when selecting goals – The skills needed to be successful and marketable in the next setting (be that a particular job or even Mr. Walker’s 4th grade classroom) must be identified and addressed.
  • Use well conceptualized behavior management strategies – When addressing challenging behavior, these strategies should take into account the underlying function of the behavior, include carefully selected antecedent and consequence based supports, and build skills to help students better meet their needs in a way which promotes their day-to-day independence and opportunities.
  • Consider and offer inclusion opportunities carefully – Ensure that it occurs with the appropriate supports and is delivered by adequately trained staff. Social skill development does not occur through pure exposure alone; rather, skill acquisition occurs when inclusion is approached as a systematic, individualized process, with proper supports, monitoring of data, and a goal of challenging the individual with ASD while not overwhelming them, or inadvertently creating isolation.
  • Carefully implement instruction, including modifications and accommodations – Promote early success and carryover, identify and use powerful motivators, and consider how to motivate students to work hard, to learn new skills, and to minimize frustration.
  • Allocate resources thoughtfully – Intervention and teaching-team members need solid training in order to implement teaching procedures and services. Regularly scheduled team meeting promote coordination, particularly when multiple disciplines are involved.
  • Engage parents – Not only is it important to continually seek input from parents about treatment priorities and goal selection, parents benefit from the training, collaboration, and information that will enable them to embrace their role as a co-pilot in their child’s intervention. This support should include siblings, grandparents, and other significant individuals for whom parents consent to their involvement. Engagement should occur throughout the educational journey and be adjusted to face the unique needs and challenges at each point in time.
  • Take data collection seriously – Ongoing data collection enables one to objectively assess progress, make timely adjustments, and remain accountable to those we serve. No provider should get a “pass” on data collection.
  • Start early and get it right from the start! – We know that early intervention can make an incredible difference. Don’t squander precious time on interventions that are not time-tested and research based.

SB: You’ve been instrumental in implementing change in many aspects of our field of ABA and ASD treatment in general. Do you have your thoughts on two or three areas that you think need to be addressed differently? How can we improve our work there?

DC: There is certainly room for improvement. Promoting science and science-based interventions such as ABA is not an area in which we have been very successful. Media representations tend to favor less science-based treatments, perhaps because their promoters use more sensationalized language when describing both their methods and their outcomes. Behavior analysts must take a closer look at how they market their work so that their outcomes can be more understandable and appreciated by various stakeholders (e.g., media, funding sources, consumers). We must also be more proactive in helping the media approach autism treatment in a more accurate manner.

Autism is clearly a spectrum disorder. In recent years, we have seen many higher functioning persons with ASD who have been very vocal; generously sharing their views about the appropriateness of treatment. Although their views and perspectives are important, I worry that the public, policy makers, and other important stakeholders may take these views as applicable to the entire spectrum. I believe this has the potential to do parents a tremendous disservice when they try to acquire the resources, tools, and experiences which will enable their son or daughter (who may not be on the upper end of the spectrum) to realize his or her fullest potential. On the other hand, one important take-away message is the importance of cultivating and celebrating the strengths of individuals with ASD rather than approach our work from a pure deficit model.

Another significant concern is that the hundreds of thousands of children with ASD who were diagnosed in the last two decades are growing up and becoming hundreds of thousands of young adults with ASD; as a society, we are failing them. When children with ASD turn twenty-one, funding for services drastically changes. As a result, there are very few quality programs for adults. We are facing a crisis in the field, with a scarcity of services for adults with ASD and the absence of a clear strategy for closing the gap between the ever-increasing need, and an unprepared supply of resources. Autism awareness must include important conversations about how we can help adults with ASD live and work independently, develop meaningful relationships, reduce challenging behaviors that may limit opportunities, access faith communities, and enjoy the array of recreational pursuits which are available within their communities. Those are important conversations to have and these conversations should translate into actionable items at every level of service delivery.

SB: With Autism Awareness month drawing to a close, what would you like the general public to know about autism treatment?

DC: Even though ASD is no longer the rare disorder it once was, each person with ASD is unique. Efforts to help them realize their fullest potential should be individualized to meet the specific needs of each individual with ASD across settings such as home, school, community and the workplace; and informed by input from the individual, as well as his or her family.

Do not believe everything you hear. There are dozens of purported “miracle cures” and “breakthroughs” for ASD which receive widespread media attention, even if they have not been proven effective. Sadly, effective treatments rarely gain media attention.

On a related vein, do not believe everything you read. Not all information on the internet is reliable and accurate, and celebrities are neither trained nor equipped to define or guide ASD treatment even though many appear comfortable in that role. On the other hand, there is a large body of research published in peer-reviewed scientific journals which should guide autism treatment. Visit our website to learn more at www.asatonline.org.

Lastly, there is hope and tremendous opportunity. With the right treatment, individuals with autism can lead happy and fulfilling lives. Research indicates that interventions such as ABA can effectively help children and adults with ASD realize their fullest potential. As stated earlier, we know that early and intensive behavioral intervention can make a huge difference, both with respect to human potential and significant cost savings across the lifespan.

SB: How can the general public make a positive difference?

DC: It cannot be overstated that it takes a village to help individuals with ASD learn to enjoy and benefit from all that their communities have to offer. Every member of the public can make a difference in supporting individuals with ASD and their families. There are so many positive ways the public can help. Although I will share several examples here, this list is by no means exhaustive:

  1. If you have a family member or a neighbor who has a child with ASD, ask specifically how you may be helpful (e.g., assist with siblings, offer play dates, help with transportation to therapies, or provide an empathic ear).
  2. If you see a family struggle in the community, do not stare, comment, or judge. In some cases, it may be appropriate to go over and assist (e.g., “I see you are helping your little guy, may I help you put your bags in the car?”). Family members may take you up on your kind offer or may just decline.
  3. If your children are interested, inquire if there are opportunities for them to help classmates with ASD at their school (e.g., becoming a lunch buddy, peer tutor). This is particularly beneficial in the later grades when opportunities for students with ASD to interact meaningfully with their typically-developing peers is lessened.
  4. At school board meetings encourage board members to learn about best practices in special education which are scientifically validated. Inquire if special education resources are being spent on interventions that lack scientific support or are not being spent on those that do possess such support (e.g., ABA). In fact, a research basis should inform most decisions.
  5. Some faith communities are very welcoming to families of individuals with ASD, whereas others are not. Discuss this within your place of worship. Identify steps that can be taken to help individuals with ASD participate in their religious communities in a positive and meaningful manner. This applies to both religious ceremonies, as well as day to day participation.
  6. Encourage organizations to be more accepting of persons with ASD and to take appropriate steps to learn how to create meaningful inclusion opportunities (e.g., seeking out information, soliciting training and education, learning from others who are doing this with success).
  7. If you are involved with youth sports or other extracurricular activities, offer to coach and/or mentor a player with ASD.
  8. Encourage your town or city to provide and/or create recreational opportunities that include individuals with ASD as there is often a tendency to focus only on separate experiences.
  9. Support ASD organizations that put science first. Research how your donations are used.

ABOUT DAVID CELIBERTI, PHD, BCBA-D

DCelibertiDr. David Celiberti is the Executive Director of the Association for Science in Autism Treatment (ASAT). He previously served as the President of the Board of Directors of ASAT from 2006 through 2012. In response to the increasing number of parents attending professional conferences to learn about applied behavior analysis, he also founded the Parent-Professional Partnership SIG for the Association for Behavior Analysis International in 2000 and served as its Co-President until 2014. He had also served as President of the Autism Special Interest Group (SIG) from 1998 to 2006. He currently sits on a number of Advisory Boards in the area of autism, as well as in early childhood education. He has organized fundraising initiatives to support afterschool programming for economically disadvantaged children in Northern New Jersey. Dr. Celiberti is in private practice and provides consultation to public and private schools and agencies in the U.S. and Canada. He received his Ph.D. in clinical psychology from Rutgers University in 1993. He has authored several articles in professional journals and presents frequently at regional, national, and international conferences. He has taught courses related to ABA at both the undergraduate and graduate levels, supervised individuals pursuing their BCBA and BCaBA, and in prior positions had conducted research in the areas of applied behavior analysis, family intervention, and autism.

Autism Awareness Month Interview Series: Developing Social Skills With Young Learners with Mary Jane Weiss, PhD, BCBA-D

This week, we’re excited to share the second installment in our series of exclusive interviews with autism experts for the month of April, featuring Mary Jane Weiss, PhD, BCBA-D. In this interview with BCBA Sam Blanco, Dr. Weiss discusses some of the most effective ways for parents and practitioners to develop social skills in young children, as well as some of the most common errors that are made in teaching these important skills.


Developing Social Skills with Young Learners
with Mary Jane Weiss, PhD, BCBA-D

SAM BLANCO: What advice do you have for parents of young learners who are concerned about social skills?

MARY JANE WEISS: Well, we all need to be concerned about social skills. One related issue is social motivation. If a learner is socially interested, social skill training is considerably easier. If not, we need to work on making social interaction meaningful and rewarding. What are the favorite activities of this child? How can we embed ourselves into them? Can we teach manding for them so that we grant access? Can we create social routines within them? How can we make something that is not yet social begin to be social?

SB: What are activities parents can engage in to help their learners develop stronger social skills?

MJW: Parents are in a great position to teach social skills, because there are endless opportunities to use as teaching moments.  Think of requesting: there are countless moments in every day to work on requesting – food, drinks, snacks, tissues, a ball, to go outside, to play a game, to make a silly face…Imitation too is so easy to work on and the list of things to imitate is long.  Can your child imitate how you clean the table, sweep the floor, load the dishwasher, open the mail, help a younger sibling do a puzzle? And joint attention: capture the unusual moments in every day and create a social exchange around them!

SB: When considering social skills for young learners, what are the first skills you focus upon?

MJW: Imitation, Joint Attention, Manding… I think we have to start with these.  They are core socio-communicative skills.  Many higher order skills require these foundations.  And I think we need to focus on pairing ourselves with great things to naturally build approach behaviors and naturally reduce avoidance behaviors.

SB: Many parents and practitioners are concerned about eye contact. Can you talk about that skill? Why is it important? Do you start with eye contact? 

MJW: There are many opinions about this.  I was trained to be aware of the ways in which eye contact can be trained to be non-functional.  For example, if we ask for eye contact before every instruction, we run the risk that learners will depend on that cue in order to attend/be ready for ANY OTHER instruction.  That is not a desired outcome.  On the other hand, the absence of eye contact is very stigmatizing, and does not invite social bids.  Here are some ideas for making it functional:

  • Build eye contact through engaging playful interaction.
  • Try not to over-rely on any attentional cue (but especially not “look at me”).
  • Experiment with more natural ways to get eye contact on command (e.g., in response to name or given as a group instruction to all).

SB: Are there any common mistakes you see in teaching social skills?

MJW: YES, thanks for asking that question! The biggest mistake I have seen is teaching social skills in rote and contrived situations that do not represent natural experiences. When we teach a list of social questions, we are not necessarily helping learners to develop social conversation skills. We do not ask people their name, address, favorite food, and siblings’ names as conversation (beyond the first day of meeting someone!). We need to teach CONTEXT. We do not ask someone about their weekend each time we see them on Monday. We only do that the FIRST time.  Sensitivity to context is often absent from social skill instruction.

Also, I see people focusing on responsivity to questions.  We need to broaden the responsivity training.  In fact, many social exchanges start with comments.  Someone comments about something, and we respond with comments or questions.  Most children with autism are taught to respond to questions.  Sometimes, they do not even realize that a comment is a social opportunity.

Finally, we need to teach INITIATION skills.  How do we start a conversation, ask someone to play with us, ask for something we need, request to join a game?  We have to balance our instruction in responding with instruction in initiation!

SB: There’s a common misconception that ABA is solely teaching skills at a table in discrete trials. How can ABA be useful in teaching social skills?

MJW: ABA can be useful in teaching a wide variety of social skills well beyond DTI!  I really like the work on scripts.  I also like the way Jed Baker has outlined social skills training for non-vocal learners.  I absolutely love the Crafting Connections curriculum; it is so focused on socially valid skills.

SB: What resources do you recommend to parents?

MJW: There are several curricular resources that I think can be useful.  Some of my favorite books are:

The Social Skills Picture Book: Teaching play, emotion, and communication to children with autism
Jed Baker (Author)
ISBN: 978-1885477910, Publication Date: 2003

Building Social Relationships: A Systematic Approach to Teaching Social Interaction Skills to Children and Adolescents with Autism Spectrum Disorders and Other Social Difficulties
Scott Bellini (Author)
ISBN: 978-1931282949, Publication Date: 2006

Social Skills for Teenagers with Developmental and Autism Spectrum Disorders: The PEERS Treatment Manual
Elizabeth A. Laugeson and Fred Frankel (Authors)
ISBN: 978-0415872034, Publication Date: May 20, 2010

Teaching Conversation to Children With Autism: Scripts And Script Fading
Lynn E. McClannahan and Patricia J. Ph.D. Krantz (Authors)
ISBN: 978-1890627324, Publication Date: 2005

Crafting Connections: Contemporary applied behavior analysis (ABA) for enriching the social lives of persons with Autism Spectrum Disorder
Mitchell Taubman, Ron Leaf, and John McEachin (Authors)
ISBN: 978-0975585993, Publication Date: 2011

I also really like the book series below:

  • Joy Berry series of books (Help Me Be Good series)
  • Cheri Meiners series of books (Learning to Get Along series)

SB: Is there any particular assessment you recommend practitioners use to assess social skills?

MJW: There are a variety of assessments that target social skills. Some are useful for group interaction (e.g., the ABLLS-R has a section on classroom relevant skills……).  The VB-MAPP has some elements that are very socially relevant, including the Barriers Assessment and the Transitions Assessment.  Those assessments help to identify individuals that may be ready for more group instruction or more naturalized instruction.

SB: Are there any particular studies you direct practitioners to that are related to social skills training for individuals with autism?

MJW: I really like the work of Justin Leaf and his colleagues at Autism Partnership.  Their elegant studies have been real contributions to the empirical literature.  Bridget Taylor has also done some excellent work, including in some centrally important areas such as joint attention.

ABOUT MARY JANE WEISS, PHD, BCBA-D

Mary Jane WeissMary Jane Weiss, Ph.D., BCBA-D has been working as a behavior analyst serving people with autism for over 25 years. She received her Ph.D. in Clinical Psychology from Rutgers University in 1990, and became a Board Certified Behavior Analyst in 2000. She is currently a Professor of Education at Endicott College, where she directs the graduate programs in ABA and Autism. She previously served as an Associate Professor at the Graduate School of Applied and Professional Psychology at Rutgers University, and as Director of Research and Training and as Clinical Director of the Douglass Developmental Disabilities Center at Rutgers University for 16 years. Her clinical and research interests center on defining best practice ABA techniques, on evaluating the impact of ABA in learners with autism spectrum disorders, and in maximizing family members’ expertise and adaptation. She is a regular presenter at regional and national conferences on topics relevant to ABA and autism. She is a past president of the Autism Special Interest Group of the Association for Behavior Analysis, a former member of the Association of Professional Behavior Analysts Board of Directors, and she currently serves on the ethics review committee of the Behavior Analyst Certification Board, on the Scientific Council of the Organization for Autism Research, on the Legislative Affairs Committee of the New Jersey Association for Behavior Analysis, and on the Board of Trustees of Autism NJ.

How to Assess and Address Pants-Wetting Behavior—A Response to a Teacher’s Question

Sometimes we get specific questions from teachers and parents about managing problem behaviors that are quite common. In these cases, we think it can be helpful to share the question and response, so that others in similar situations might benefit from the suggestions offered. Bed and pants-wetting can be an enormously challenging issue both at home and at school, so when we received the following question from a teacher in Australia about her student, we thought it was a great opportunity to offer some suggestions and strategies on how to address the behavior.

PantsWettingQA

This is definitely a difficult behavior to address. It’s also challenging to provide accurate advice without directly observing the behavior, instead here are a few questions to consider and potential resources.

  • First and foremost, this is a behavior in which you should consult with a Board Certified Behavior Analyst for assistance. You can find BCBAs in your area by going to this webpage: http://www.bacb.com/?page=100155. If possible, reach out to more than one to find the BCBA who is the best fit for you and your learner.
  • Second, you should conduct a functional assessment to clearly determine the reason for the behavior. It may be for attention, but you may discover there is a different cause. It is best to perform a formal functional analysis, but if that is not possible, you may consider using the Functional Assessment Screening Tool (FAST). To get the best results from this, you should have more than one person fill it out, and, if possible, one person who observes the behavior but is unfamiliar with the child. Compare results to see if you are in agreement, then make a behavior intervention plan based on the function of the behavior. For more information about the FAST and its reliability compared to a formal functional assessment, you should refer to the study by Iwata, Deleon, & Roscoe (2013).
  • If indeed the behavior is for attention, consider how to provide minimal attention for pants-wetting. You mention that he receives high-level attention right now. What qualifies as high-level for him? Is it eye contact? Physical touch? Proximity? There are ways to remove each of these types of attention while also making sure you address the behavior hygienically.
  • While your son is continent, some of the strategies that are used in toilet training may prove helpful in intervening with this behavior. Take a look at this article by Kroeger & Sorenson-Burnworth (2009), which “reviews the current literature addressing toilet training individuals with autism and other developmental disabilities.” It may provide potential solutions that you have not attempted.

I hope this information is helpful! And good luck as you plan and implement your intervention.


WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

Here’s What Was in YOUR ABA Toolbox

Thank you to all who participated in our ABA Toolbox giveaway last week! We’ve received some wonderful responses and feedback from parents, teachers, and therapists on their favorite products from our catalog and how they are using it with a special child, and we are thrilled to be sharing them with you!

Our biggest goal in this endeavor was to share with you the unbelievable wealth of experience and knowledge our community of parents, teachers, and therapists have in using our products in innovative and creative ways for their ABA programs.

 

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Join us TONIGHT for an ABA Q&A with Sam Blanco, BCBA

Join us for a live ABA Q&A with Sam Blanco, BCBA TONIGHT from 7:00 to 8:00pm ET! Our primary focus will be on Managing Difficult Behaviors. Here is a chance to get your specific questions answered in real time by a Board Certified Behavior Analyst. Just visit our Facebook page and post your question here. For details of the Q&A, visit the event page here.

If you can’t make the live Q&A with us on tonight, you can post your questions in advance, and we’ll make sure your questions are answered. Don’t forget to check back to the app for Sam’s answer!

Q&A with Sam_Revised 04.15.14

Different Roads to Learning reserves the right to remove or delete any questions and comments deemed to be of an inappropriate, offensive, and discriminatory nature. All answers are intended as suggestions only. Programming decisions and interventions should always be discussed with trained professionals prior to implementation. All programs should be individualized for a particular child or student and overseen by a qualified behavior analyst.

Interview with Alex Jackman, Creator of “A Teen’s Guide to Autism”

Alex HeadshotOur consultant Sam Blanco recently had the opportunity to talk with Alex Jackman about her  video, A Teen’s Guide to Autism. Alex created this film when she was in eighth grade to educate high school students about autism. You can view the 15-minute film here. For those of you in Florida, the film is going to be showing this weekend at the Palm Beach International Film Festival in the short documentary category. There will be a Q&A afterwards. For more information, click here.

Here is Sam’s interview with Alex about her experience making the film, as well as her thoughts on teaching kids about people with special needs.

Q: What inspired you to make the film?

What inspired me mainly was how people in my school, how little they knew about autism. I realized that a lot of people, because they don’t know what makes people with special needs different, they don’t take the chance to get to know them. I’ve met really incredible people with special needs and I thought it was so unfortunate for both the people with special needs and everyone else who wasn’t getting to know them because they are missing out on this opportunity. I looked up stuff, but I hadn’t seen anything that was geared towards teens about it.

Q: What kind of sources did you use to find the statistics and information you presented?

That was definitely difficult because there are different statistics for the same [information], like for how many people have autism. There were conflicting sources, and with new research, it’s changing. (All information from the film clearly states “as of 2012.”) I used very respectable, well-known, large organizations that I, or groups, like medical groups, that have really researched to get statistics.

Q: If you could narrow it down to one thing, what did you learn from making this film?

That’s so hard.  I think I’ll have to say two.  For kids, I think that teens especially, are so willing to learn and are willing to take in this information they just haven’t been given the opportunity to.  And then, the other thing was just that adults and people are so much more supportive than I thought and it’s not an uphill battle for everything.  People really want to help.

Q: Bullying in schools is a big concern for parents and educators. Do you think providing information about what special needs could have an impact on bullying?

Yes.  Because – well, I do think there are resources, but it’s not taught in schools and it’s not really thrown in their faces, which I kind of tried to do – get teens to watch. Where it’s not something they have to search for, t’s right in front of them… I think that a large part of bullying is misconception and ignorance.  I don’t understand the bullying, of course, but I understand why people would be a little bit confused and would look at someone a little bit differently, if they don’t know why they’re doing something differently from them. If they have never learned, then I can’t blame anyone for being confused and not knowing how to respond.

Q: In the process of making the video, what was one of the more common misconceptions you found high school students had about autism.

Well, one thing I was so surprised by was how many people just didn’t know what it was.  I was really surprised when I thought about it, we never really learned about it in school…You know it’s a big part of my life now, and so I kind of assume that more people know about it, but there were just so many people who didn’t know.

Q: In the process of making the video, you talk with high school students who have autism. What type of questions did you ask them to be a part of the video?

I said, “What’s something cool about you”, “What’s something interesting about you”, “What do you want to be when you grow up”, “Do you have a favorite song.”  Kind of based on their responses, I just kind of started with one question and then I didn’t have anything planned.  I just kind of went off of their answers, and whatever they wanted to talk about, that’s what they talked about.  This was the part I really loved.  It was so much fun.

Q: For me it was very refreshing to see people interviewed who really had autism or Asperger’s and were representing themselves. Do you have any thoughts about depictions of autism in popular culture?

I think there are some good and some bad because, as the quote goes “If you know one person with autism, then you know one person with autism.”  I think that’s hard especially if you don’ t know anything else about it and you don’t have any interactions or knowledge on autism and special needs.  It can be a bit misleading when the media portrays someone who is specifically high-functioning. Then everyone thinks that’s what all people with autism are like or vice versa, if someone’s low-functioning or somewhere in the middle.

Q: How has your video been used?

I’m really excited because it’s been – even though I directed it towards teens – it’s really been shown to people of all ages. People have used it for anti-bullying, people have used it for training, people have used it for class and it’s just been used in so many different ways than I expected. It kind of took on little legs of its own.

Q: When you first started this, what would you have described as your goal with it?

To make a relatable guide for teens letting them know what autism is in a positive way – something that was relatable for teens, and that kind of was very interactive and engaging. I was just thinking locally.  If I could get it shown in like Roosevelt, which was my middle school at the time, if it could’ve been shown in some classes there, that would’ve been kind of what I was hoping.

Q: It sounds still very it sounds like your video is still doing that, but it’s done more. Has the goal changed?

I just want as many people as possible to watch it in hopes that they’ll learn from it.

Q: How do you think this video might be beneficial for parents?

I just speak from what parents have told me.  One parent of a child with autism has told me that their child watched it and said “Yeah, I do that, that’s why I do that.”  And another mom said that the video helped her child understand himself, because he was just kind of coming to terms with his special need and learning a little more about it.  It kind of showed him, helped him to know why he does that and that’s it okay and there’s a reason for it and he’s not just, he shouldn’t feel isolated because of that.

Q: Do you have ideas for further exploring the subject of Autism Awareness in the future?

I’m looking at ways to kind of direct better resources on available information and events because… there are so many amazing events and there are so many people who want to go to these amazing events, but they just don’t know about it.  And I’m also doing something at my school probably starting next year, but I’m kind of getting it organized this year that would be like a peer system – some sort of club after school where kids who are in school who are neurotypical and kids who have special needs get together.

Q: Can you just tell us about the film festival? It’s showing April 6th.

It’s the Palm Beach International Film Festival and it’s going to be in the short documentary category shown with some other shorts – some other short films.  And there is a Q&A afterwards. (The film is showing on April 6th at 12:00. For more information, click here.)

Q: Do you think you’ll work with people with special needs as an adult?

When someone asks me what I want to be, I, you know, if I’m not working and interacting with people with special needs as my job, I’m 100% doing it on the side. It’s definitely going to be a part of my life.

You can also follow the film on Facebook.

Meet Julie Azuma, President & CEO of Different Roads

Julie Azuma, Founder & CEO

Julie Azuma, Founder & CEO

We start our introduction to the Different Roads to Learning staff with no other than our President, founder and force extraordinaire, Julie Azuma. Julie is an incredible, tireless force, an advocate for families and an activist who never ceases to share her knowledge and expertise. Julie started Different Roads to Learning in 1995, a few years after her daughter Miranda was diagnosed with autism at the age of 6. Back then, autism was already rising with rates jumping from 1 in 2500 in 1985 to 1 in 500 in 1995, but well below the current estimates of 1 in 88 children, and 1 in 54 boys. In the maze of appointments, therapy sessions and doctors, she kept being told to find materials like 1-inch color cubes with no numbers or writing on them, or a specific non-distracting flashcard. As hard as she scoured the resources in New York City and on the web, she had an incredibly difficult time locating the materials that would help Miranda learn. With true entrepreneurial spirit and a fierce devotion to helping her daughter, Different Roads to Learning was launched in May of 1995 with about 30 products.

Julie started the company on the premise that parents who had home ABA programs needed help in finding the products for their children on the spectrum.  Since that time, schools across the country are now supporting Applied Behavior Analysis and Verbal Behavior teaching.  Tens of thousands of children have been mainstreamed by the age of five.  Our children are more capable in every way.

Today, Julie is proud that the mission of Different Roads has not changed. The goal remains to provide the most effective, affordable and appropriate materials out there to support students with Autism Spectrum Disorder in their social and academic growth.

Fun Fact:  Our URL is www.difflearn.com because back in the dark ages of the internet, you couldn’t string more than 9 digits together.

After 18 years, what do you look forward to every day?

Looking for new ways to connect with our kids. Whether it’s researching new products with Abigail at Toy Fair or looking for a way to create a new app….I love the idea of giving  our kids new opportunities to learn language and social skills.

What’s your hope for Different Roads in the next few years?

It’s my hope that Different Road endures in the years to come while giving kids the skills to mainstream.  We hope to help more children in Early Intervention and reach across the spectrum to support social skills for our students in school age programs.