Pilot Study Finds that Parent-led Early Intervention Can Reduce Autism Symptoms in Babies

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Autism symptoms can display in babies as young as 6 months old. A new pilot study at the UC Davis MIND Institute found that parents could reduce symptoms of autism in babies under 12 months by using intervention treatments in the home as detailed in the Early Denver Start Model.

As reported in a recent Huffington Post article, the study involved parents and their babies between 7 and 15 months of age in a 12 week-long treatment conducted by parents in home-like environments. The treatment was based on the Early Denver Start Model and revolved around parent-child interactions, such as bathing, feeding, playing, and reading. Four comparison groups were also included: Those who were at a higher risk for autism because of an affected sibling; those who were at low risk; those who had developed autism by age 3; and those with early symptoms who received treatment at a later age.

At the start of the study, all babies displayed early signs of autism, such as low interest in interactions and repetitive behaviors, which increased by around 9 months. However, by 18 to 36 months of age, the children in the treatment group produced lower autism severity scores than the comparison groups who did not go through the treatment.

The Huffington Post article “Pilot Intervention Eliminates Autism Symptoms In Babies” highlights the importance of early intervention in autism treatment. While this research is highly preliminary, the findings show that therapy and early intervention are key factors in treating infants and children with early signs of autism, and possibly in reducing them altogether. This study offers hope for parents and professionals in helping their children succeed with more tools and resources for the earliest stages of autism.

Read more about the pilot study on Huffington Post here.

Pick of the Week: “The Asperkid’s Secret Book of Social Rules” – A teen’s guide to not-so-obvious social codes

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It’s not easy for any teen or tween to fit in, but it can be especially tough for Asperkids. Jennifer O’Toole knows this first-hand, and has written a book she only wishes she had when she was a teen with Asperger Syndrome.

This week only, save 15%* on The Asperkid’s (Secret) Book of Social Rules by entering promo code ASPERKID at check out!

In The Asperkid’s (Secret) Book of Social Rules, O’Toole doesn’t offer advice on what Asperkids should not do, but on what they should do with witty and wise insights into baffling social codes. With helpful tips, practice scenarios, checklists, and quizzes, Asperkids will learn how to:

  • Thank people, apologize, and offer compliments
  • Build and maintain genuine friendships and how to deal with bullying
  • Actively listen and have a meaningful conversation
  • Step back and see the “big picture” instead of focusing on the details
  • Make a correction and let go of the need to be right

With over 30 social rules and logical explanations, this illustrated handbook offers information that tweens and teens can truly digest. And having been there herself, the author shares her experience and points out the potential pitfalls with humor and sensitivity.

Don’t forget to save 15%* on The Asperkid’s (Secret) Book of Social Rules this week by using our promo code ASPERKID at checkout!

*Offer is valid until 11:59pm EDT on September 16th, 2014. Not compatible with any other offers. Be sure there are no spaces or dashes in your code at check out!

How to Manage and Reduce Classroom Tantrums—A Response to a Teacher’s Question

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Sometimes we get questions from school teachers and parents about managing problem behaviors. Our BCBA Sam Blanco recently received a question from a school teacher in Alabama about her tantruming student in the classroom. We thought this was a perfect opportunity to share Sam’s response to her question as it may often apply to other parents and teachers. Read on below for the question and Sam’s response!

Tantrum Question

Addressing difficult behaviors in the classroom environment presents some unique challenges. It’s also challenging to provide accurate advice without directly observing the behavior. Instead, here are a few questions to consider and potential resources.

  • What does the tantrum look like when it begins? Is he screaming? Crying? Throwing items? Banging his desk? Try to define the behavior so it is observable and measurable. If it’s observable, then everyone who interacts with the child will agree with exactly what behavior requires intervention. If it’s measurable, you will be able to easily note progress. An observable and measurable definition of a tantrum could be “Screams and cries for 10-12 minutes” or it could be “Stomps his feet on the ground 20-30 times.”
  • What is typically happening directly before a tantrum takes place? What typically happens directly before it escalates? Can you change something about what happens directly beforehand that might impact his behavior?
  • What is different about the environment on days/class periods in which he does not tantrum? Is it something you can replicate on other days/class periods?
  • 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 Analysis 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).
  • Frequently, tantrums in classrooms start when a demand has been placed. This may be because they are attempting to escape the demand, but it may also be because the demand is a signal that attention may become available (Repp & Karsh, 1994). If you determine that it is, in fact, for attention, are there things you can do to provide high quality attention prior to the tantrum? Perhaps you find that he usually works for about three minutes before he starts to tantrum. You can then provide high quality attention for successfully working for three minutes and label his appropriate behaviors. Over time, you systematically increase the number of minutes he works before accessing that high quality attention. The goal is to provide him with plenty of opportunities for success before he begins to tantrum.
  • A strong classroom token economy may be more successful than “good ignoring coupons.” For example, when I was a classroom teacher, I used paperclips for the tokens. Each student had a bag on the chalkboard with his/her name on it and they earned paperclips throughout the day for a variety of positive behaviors. At the end of the day, we counted paperclips and students could choose to save them or spend them on one of the items on a student-created menu of choices. The paperclips worked because they weren’t designed for a specific behavior. In the instance you described, the boy is put in a position where he has no chance to earn a coupon. However, if the language is changed so that when other students earn for ignoring, you say, “You’re earning a coupon/paperclip/token for sitting quietly at your desk,” the boy now has a decision to continue his inappropriate choices, or work to earn the same coupon the other kids are earning. He may still choose to tantrum, but at least now he has options!
  • The Lovaas Institute blog has a great post about addressing challenging behaviors in the classroom. You can view that here.

Hopefully this information has helped! And good luck as you plan 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.

How a Special Needs Mother Does It On a Typical Day

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Nicole Zeitzer Johnson and her family. (NY Times)

How do so many special needs parents do it? We were incredibly moved and inspired by the story of one special needs mother, who explained a typical day with her 7-year-old son and 2-year-old daughter who suffers from FoxG1, a rare genetic neurological condition associated with seizure attacks and impaired development.

This article reminded us of the bravery and commitment of all the parents in our community, and how positivity is really the best way to “do it all.”

How Nicole Zeitzer Johnson, Communications
Director and Special Needs Parent, Does It

Pick of the Week: Audible Time Timers – For Smooth Transitions Back to School

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Transitions back to school can be difficult after a summer of changed routines. When it’s time to go back to school and reset day-to-day routines, a visual timer can make all the difference in timekeeping and easing the stress of structuring activities for your child or student. This week only, we’re taking 15%* off your order of the 3-inch, 8-inch, and 12-inch Audible Time Timers to help you help your learner with their transitions. Just enter promo code TIMETIMER at checkout to redeem your savings!

Recommended by Autism and ADHD experts, the Time Timer is entirely intuitive to use. This visual timer is great at solving time perception problems at all ages and ability levels, and is perfect for easy portability and in one-on-one and group settings.

 

 

 

 

 

 

 

A graphic clock-face gives the child visual understanding of time elapsing. This is ideal for timed activities and for getting ready. When the colored portion elapses, time is up. There is also an optional audible component that you can turn on so that the timer BEEPS when time is up. All Time Timers run on battery-operated quartz movement, and can be free standing or hung on a wall.

Don’t forget to save 15%* on your purchase of the 3-inch, 8-inch, and/or 12-inch Audible Time Timers this week only by using promo code TIMETIMER at checkout!

Read “Time Timer: Time to Build Independence,” an exclusive article by a parent about how she used the Time Timer to help her son challenge himself to get through a timed activity.

*Offer is valid until 11:59pm EDT on September 9th, 2014. Not compatible with any other offers. Be sure there are no spaces or dashes in your code at check out!

Guest Article: “Seamless Separation: Transitioning to School” by Bridge Kids of New York

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As our kids and students prepare to go back to school, we thought it was the perfect time to share this wonderful guest post on transitioning into a new school or classroom, submitted to us by Bridge Kids of New York. Read on below for exclusive tips on how to best help you and your child have a smooth transition back to school.

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Seamless Separation: Transitioning to School
by Bridge Kids of New York, LLC

When your young child enters into a school or daycare setting for the first time, the transition can be challenging for both you and your child!  This may be the first time your child has had to navigate a new environment without your support and it may be the first time you have had to entrust your little one to someone else.  Of course this has the potential to be stressful for everyone involved!

Here are a few proactive tips to help both you and your child have a smooth transition:

  • Try to meet with your child’s teacher prior to the first day of class.  Discuss your concerns, goals, and values.  Share important information about your child and ask the teacher to fill you in on any key information you should know about the classroom and/or the teacher’s approach. This conversation may help to ease your anxiety and build trust between you and your child’s new teacher.
  • Establish a communication system.  Talk to the teacher and/or the school’s administration to determine the best means of exchanging important information and find out how frequently you can expect communication.  This will help to establish trust, create consistency between home and school, and keep you informed as to all of your child’s triumphs!
  • Have a game plan for the first week of school.  Although we certainly hope you and your child will transition to school without any difficulties, we always advise that you be prepared just in case!  Expect that the separation may initially be challenging for your child.  Talk to the teacher and school administration ahead of time and develop a plan for how you can help your child to be successful.  Rather than waiting for a difficult and emotionally-charged situation to arise and then reacting to it, we suggest that you take proactive measures and develop a plan when both you and your child are calm.  We highly recommend that you consult with a Board Certified Behavior Analyst when developing this plan to ensure its integrity as well as the safety of all involved.
  • Try to remain calm and confident for your child.  Children are often very good at reading our moods, emotions, and energy.  If you enter into the school transition with outward uncertainty and nervousness, you may send your child the message that he should feel the same way.  Instead, try to remain calm and positive about the change—model the behavior you want to see.
  • Prepare your child for the transition to school.  Discuss this new chapter in a way that expresses excitement and positivity.  Provide your child with clear information on what to expect.  Surprises or confusion can make this process more challenging for your child so do your best to help him understand what will happen.
  • Create a “Going to School” storybook.  Consider creating a fun storybook to help your child get ready for this new transition.  Your storybook can include both text and pictures of the school, your child’s teacher, your family, and even some of his classmates (with consent from those parents, of course).  You will want to provide your child with a step-by-step guide for what to expect.  Using actual photographs may help your child to feel familiar with the school environment before the first day.  We suggest reading this storybook to your child for at least 1-2 weeks prior to starting school, in the morning before school, and again after school until he/she is adjusted.  You may even send the storybook to school with him.  These types of books help to provide important information and also serve as a cue to remind us to talk about it!
  • Do a dry run.  Ask the school for permission to bring your child for a visit before school starts.  Allowing your child to see the classroom and meet the school staff may help him to feel more comfortable on the first day.  You may even consider taking pictures of your child in the school building or with her teacher to post in her bedroom or to include in your storybook.  If school is in session and the administration gives you permission, you may even consider trying to walk out of the room for a few minutes during the visit to assess how your child will adapt to you leaving later on.  (As a pointer, try not to make a huge production out of leaving!  A dramatic exit may lead to a dramatic response!)
  • Practice separating from your child in familiar environments.  If separation is very challenging for your child, you may want to consider practicing this separation in a familiar environment.  It may be overwhelming for your child to adjust to separation from you and the introduction of a new environment and new people all at the same time.  In preparation for school, try separating from your child in environments where she already feels safe and secure (e.g. in your home).  Provide your child with lots of praise and reinforcement for separating from you calmly and successfully!
  • Gradually increase the length of separation.  Some children benefit from gradual and systematic separation.  You may initially just try walking out of the room for 10 seconds, then 30 seconds, then 1 minute, and gradually increase from there.
  • Try to engage your child in a favorite activity before separating.  By doing this, you are pairing the separation with something your child enjoys, which may make the separation itself less aversive.  It may also serve as somewhat of a distraction, so your child is less likely to focus on your absence.  Remember to do this proactively, not in response to problematic behavior.

Important Note:  The tips outlined in this post are proactive measures only.  We hope that applying this advice will help to prevent or reduce interfering behavior and set your child up for success.  However, despite these proactive measures, some children may engage in interfering behavior that is dangerous to themselves and/or to others.  We do not recommend implementing a procedure that may result in an unsafe situation.  For this reason, we highly suggest you consult with a Board Certified Behavior Analyst (BCBA) prior to implementing intervention procedures.  A properly trained professional can assist you in keeping the situation safe while helping your child to be successful.

We hope these pointers will help to make the school transition smooth for both you and your child!  Of course this list of tips is not comprehensive and our behavior team is full of other suggestions, so feel free to contact us for support!  You may find our upcoming Seamless Separation Workshop to be helpful!  Click here to register for this FREE workshop.  We understand that every child and family is unique and that successful transitioning may need to be individualized based on your unique needs.  We are always here to help!

For more information about Bridge Kids of New York, please email info@bridgekidsny.com or visit www.bridgekidsny.com.

Pick of the Week: EasyDaysies Magnetic Schedule Plus Add-On Kits—Get off on the right start for school!

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Help your child structure their daily routines to get off on the right start for school with the EasyDaysies Magnetic Schedule. Teach independence, responsibility, self-discipline, and sight-word recognition with this handy magnetic chart.

And you can save 15%* on your order of the EasyDaysies Magnetic Schedule, along with its three add-on kits: Chores & Special Times, Family & Extracurricular Activities, and Get Dressed & Bathroom Routines, when you enter promo code EASYDAYS at check-out online.

The EasyDaysies Magnetic Schedule comes with 18 magnets covering everyday activities such as “get dressed,” “do homework,” and “bath time.” You can also use the “To Do” and “Done” columns as a reward system.

The add-on kits offer an easy way to schedule daily chores, routines, and events, and helps to keep track of a child’s earned special times.

 

Chores & Special Times Add-On Kit comes with 21 amazing and durable illustrated magnets: Book/Quiet Time, Clean Bathroom, Clean Bedroom, Computer Time, Dishes, Feed Pet, Field Trip, Garbage/Recycling, Help Set Table, Put Clothes Away, Sweep/Vacuum, TV Time, Walk Dog, 2 blank magnets, and 6 blank clock magnets.

 

Family & Extracurricular Activites Add-On Kit comes with 18 durable illustrated magnets: Dance, Dentist, Doctor, Gymnastics, Martial Arts, Movie Night, Music, Party, Play Date, Play Outside, Shopping, Skating/Hockey, Soccer, Sports, Swimming, and 3 blank magnets.

 

 

Get Dressed & Bathroom Routines Add-On Kit comes with 18 helpful, prompting magnetic components, such as: Coat, Comb Hair, Dress/Skirt, Dry Hands, Flush, Lights Off, Pants, Pull Down Pants, Pull Up Pants, Sit on Toilet, Shirt, Shoes, Sock/Stockings, Underwear, Wash Hands, Wipe, and 2 blank magnets.

 

Don’t forget to redeem your savings this week on the EasyDaysies Magnetic Schedule and the supplemental packs for chores, family and extracurricular activities, and getting dressed and bathroom routines by entering our promo code EASYDAYS at check-out!

*Offer is valid until 11:59pm EDT on September 2nd, 2014. Not compatible with any other offers. Be sure there are no spaces or dashes in your code at check out!

ASD Brains Show Decrease in Neuronal Autophagy, Underlying Oversensitivity and Deficits in Social Interaction

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SOURCE: New York Times article by Pam Belluck

A recent study led by David Sulzer at Columbia University Medical Center showed that in children and adolescents with autism, brain tissue within the temporal lobe exhibit a decrease in neuronal autophagy (the brain’s process of clearing out old and degraded cells), which underlies oversensitivity and deficits in social interaction.

NY Times: Guomei Tang, PhD and Mark S. Sonders, PhD/Columbia University Medical Center

In early development, synapses—connections that allow neurons to communicate with each other—allows for infants to develop with as much external stimuli and information as possible. However, in childhood and adolescence, these synapses are gradually “pruned” so that the brain can develop more specific and advanced functions by not being overloaded with stimuli. As one can imagine, brains of children with autism fail to “prune” these synapses, causing them to be constantly overloaded with stimuli. In this study, young children with and without autism show roughly the same number of synapses, suggesting a “pruning” problem in autism, rather a problem with overproduction. Dr. Sulzer’s team also found biomarkers in the brains of children and adolescents diagnosed with autism, which suggested malfunctions in the process of autophagy (the neural degradation of old cells and damaged cell organelles). Without autophagy, the synaptic pruning process can’t occur.

These findings give us some insight into how autism develops from childhood onward, and help explain symptoms like oversensitivity and deficits in social interactions. Whether autism is a problem of brains with too little connectivity or too much of it has been of debate in recent years in the field of autism research. Ralph-Axel Müller, at San Diego State University, found in his studies that there was too much connectivity within brains of individuals with autism. “Impairments that we see in autism seem to be partly due to different parts of the brain talking too much to each other,” he reported to the NY Times. “You need to lose connections in order to develop a fine-tuned system of brain networks, because if all parts of the brain talk to all parts of the brain, all you get is noise.”1

Eric Klann, a professor at New York University, also acknowledged an autophagy decrease in ASD brains. “The pruning problem seems to happen later in development than one might think,” Dr. Klann informed the Times. “It suggests that if you could intervene in that process that it could be beneficial for social behavior.”1 With further research into how this decrease in autophagy—and thus the synaptic pruning process in brains of children with autism—can be addressed earlier in a child’s development, there is hope that symptoms of autism may be preventable in the future.

1 “Study Finds That Brains With Autism Fail to Trim Synapses as They Develop.” New York Times. 21 Aug. 2014. Web. <https://www.nytimes.com/2014/08/22/health/brains-of-autistic-children-have-too-many-synapses-study-suggests.html>.

Tip of the Week: 6 Ways to Get the Most Out of Your Home ABA Program

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CHILD IN SPEECH THERAPYWhile an ABA professional should be coming in to organize and run your ABA program, as a parent or guardian, there are some simple things you can do to make the time your child spends in a home session more effective. Several tips are here, but it may be unrealistic for you to follow ALL of these tips. Consider your home environment and family’s needs, then implement the tips that are the most feasible for your situation.

Following even one of these tips can make a big difference in your child’s sessions!

1)    Make sure all ABA materials are accessible. It’s important to have a system for storing the materials and the binder the ABA providers use. Some families I work with put everything into a box, a dresser drawer, or on a shelf the child cannot reach which is great. If the child utilizes an iPad for communication or reinforcement, be sure it’s available and charged. If any other items are necessary, such as edibles for reinforcement, make sure those are available at the beginning of the session. One parent I worked with used a craft organizer container with a clear plastic lid to store edibles, so when sessions began she’d set it on the table. All the different snacks were already broken into small pieces and organized in the box, freeing up more time for teaching during the session.

2)    Keep the area for ABA therapy free from distraction. Remove any items that are highly distracting for your student. Shut windows if you live on a noisy street. Make sure your cell phone is with you. This tip is especially challenging for families that live in studio apartments or have loud neighbors.

3)    Limit the number of disruptions from siblings or other family members. As an ABA therapist who is focused on increasing my students’ opportunities for social interaction, I don’t want to discourage the siblings and other family members from coming in. Interruptions should happen from time to time, and it’s important that my students learn to refocus after an interruption. But sometimes it becomes an obstacle to learning when there are consistent interruptions, or if I have to continue to redirect a sibling to other activities.  Instead, it’s better to structure activities with siblings and other family members, perhaps by teaching the learner with autism to request the sibling come play or adding it to the student’s activity schedule.

4)    When possible, reserve one or more highly motivating activities for ABA sessions. If a child has free access to all his/her motivating activities, then those activities are not as valuable when used in a session, and therefore less motivating. Sessions are most effective when the learner is working for something that they’re highly motivated by. It’s important to note here that I don’t want the child to only have access to fun things during sessions. I also don’t want the parents miss out on opportunities to enjoy motivating activities with the learner. The idea is to save a small number of motivating activities for sessions so the child maintains motivation and focuses on learning. This tip is especially challenging for families when the learner with autism is motivated by only one or two activities or items.

5)    Don’t allow the child to engage in their highest motivating activities right before an ABA session. I’ve had more than one case in the past in which I would get to the home and find my student watching his favorite TV show or playing his favorite game on the iPad. What would typically happen is that my student would associate my arrival with the end of his favorite activity, which would lead to crying, refusal to work, and/or attempts to escape. I want my students to be able to watch their favorite shows and play with their favorite games, but our sessions are more effective when those activities don’t take place immediately beforehand.

6)    Ask your provider if there are any changes you can make to improve sessions. Every home is different and every child’s needs are different. Your provider may be able to identify small changes for your specific situation that are not mentioned above. Opening that dialogue can be a powerful way to improve your child’s learning outcomes.  

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.

Federal Ruling Ensures that Insurers Must Cover ABA Therapy

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GavelFederal Judge Michael H. Simon in Oregon ruled last week that insurance providers cannot deny coverage of Applied Behavior Analysis (ABA) therapy for children diagnosed on the autism spectrum. The ruling was in response to a lawsuit against Providence Health Plan, an insurance provider that denied coverage of ABA therapy for children diagnosed with autism, while simultaneously granting coverage for children without a diagnosis. ABA therapy, which can cost over $50,000 a year, involves a behavioral interventionist working with a child in the family’s home or in his school to address behavioral deficits for up to forty hours a week.

Oregon State Governor John Kitzhaber also agreed with this ruling and will adjust state health plans to reflect Judge Simon’s decision. The discrepancy between insurance policies and what providers actually cover arises because the medical community views ABA as “a medically necessary treatment of autism,”1 whereas some insurance providers accept it as an educational service that is provided in schools. Since autism is also classified as a “developmental disability,” instead of a mental health disorder, insurers exclude ABA coverage for those with autism, which is also a violation of mental health parity laws.

In some states like California, several warnings have been issued to insurance companies after several denials of ABA coverage had been overturned on appeal. Regional centers now fund ABA therapy by service providers, as well as insurance companies. With President Obama’s signing of Autism CARES last week, the federal ruling will hopefully set a precedent for insurance companies across the country to allow coverage of ABA therapy for families of children diagnosed with autism. ABA therapy is the most influential and widely cited form of therapy for autism, showing the most promise and efficacy in the treatment of autism.

1 https://exm.nr/1oJvnxa