Autism Therapy: Classic and New Interventions

A sad commentary

2008-05-24T21:27:00.000-07:00

It remains to be seen just how much truth there is to this event, however, I hope this article at least serves to shed some light on autism spectrum disorders (ASD). I regularly hear stories from families about their children with ASD being ostracized in the community: they're worried about going shopping, going to restaurants, going on trips, etc... because they don't want to deal with the looks they get--or even the comments they get--when their child gets overwhelmed. I certainly can't expect every person in the grocery store to automatically think that a child throwing a tantrum has autism (though a little sympathy to all parents wouldn't hurt :D). I do, however, think that educators have a responsibility to understand and be familiar with the differences between purposeful "willfulness" in a child and symptoms of more serious underlying difficulties for that child. I personally am very surprised at the type of punishment described in this article--for any child, ASD diagnosis aside. You can come to your own conclusions about what the school district should do. There are so many wonderful,caring educators out there. Hopefully stories like this one will happen less and less often.

Chromosome 16

2008-02-05T20:44:00.000-08:00

Now that they have identified that some types of autism may be caused by changes in chromosome 16, I can't help but think that genetic testing is not far behind. On the one hand, this may help prepare families to look for early signs of autism and set up therapies as soon as possible. On the other hand, knowing the burden--both financially and emotionally--that comes with autism, will some parents choose to terminate the pregnancy?
This identification may increase the prevalence of children with autism, which has already gone up within the past 10 years, from 1 in 166 to 1 in 150. It may also be the key to more accurate diagnosing, with better-tailored therapies. Time will tell.

Mercury Ruled Out Again

2008-01-08T08:13:00.001-08:00

A new study has just come out in California dismissing the hypothesis that mercury causes autism. In particular, thimerosal, a preservative that was used in vaccines in the last century, was suspected to cause autism. This was a popular belief because children's symptoms frequently became evident between 18 and 24 months of age, just after they received a big round of vaccinations. Those whose children have the type of autism that is regressive (typical development followed by loss of language and motor skills) were often most convinced of this correlation.
The belief that immunizations cause autism is so strong that there are a number of law suits and class-action suits making this claim. But thimerosal was removed from most vaccinations in the early 2000s and this study states that there has been no decrease in the diagnosis of autism.

So many families that I work with are strong believers that immunizations caused their child to have autism. So many more refuse to immunize their child out of fear that they will 'lose' their child to autism. So now children are exposed to illnesses that can easily be prevented. In the past couple of years we've seen a resurgence in some of those illnesses, including smallpox and the mumps.

It must be one of the hardest decisions to make as a parent: deciding whether to risk exposing your child to developing autism, or to other serious illnesses that could be prevented. Hopefully this new study will allow parents to weigh their options with more confidence.

Mirror, Mirror in the Brain...

2008-01-03T19:07:00.000-08:00

New research on the neurocognitive front involves the imaging and modeling of "mirror neurons". I first heard about this at an augmentative communication conference last year, but there is more talk on the horizon.
These neurons give us the ability to mimic or mirror actions that we see others do. We set what we see against the information that we already know, and integrate both pieces. This is how we build on current skills and learn new ones. Researchers are hypothesizing that if we can't imitate then, in a sense, we can't learn; or at the very least, learning is more challenging. Brain imaging also seems to be showing that people with autism seem to make very strong, local connections within the brain, rather than associating new information with old.

This all makes sense to me when I start thinking about a boy I worked with who would only eat McDonald's fries in the red "large fries" box, but would not eat any that were out of the box because they were no longer the "right" fries. This example will likely ring true with many who care for children with autism, whether it's a french fry, a stuffed animal, a pair of shoes, a movie, or a car. Object permanence seems unattainable, staying at the level of object transience, e.g. not knowing that the fries are the same, that a ball is still on the table even though a blanket covers it. Personally, I think that this research will ultimately give more ammunition to all of us early intervention proponents because we know that these mirror neurons must function on some level because of course our kiddoes with autism DO learn. And, the more practice given these neurons during the critical learning period (0-3 years old, when the brain is MOST plastic), the better chance a child has to strengthen the connections of all the neural pathways.

One of my favorite writings

2007-12-29T21:07:00.000-08:00

When I was in grad school I was shown something written by Emily Perl Kingsley, a mom whose child was born with a developmental disability. It's called Welcome to Holland. It's a beautiful analogy about diligently planning for a trip to Italy (read: a "typical" child) and winding up in Holland (having a "non-typical" child). While the geography and lifestyle is not what was expected, the new landmarks and experiences can be just as interesting and enriching. Click on the link to read Welcome to Holland.

What of the "Mind"?

2007-12-29T21:05:00.000-08:00

As we learn more about the minds of those with autism, keep this in mind: Do we need to change the way they communicate, or is this a chance for 'neurotypicals' to visit the world of autism and open ourselves up to new ways to connect with others?

Monthly Book Review

2007-12-29T20:23:00.000-08:00

The first book I'm reviewing is Ten Things Every Child with Autism Wishes You Knew, by Ellen Notbohm. Mrs. Notbohm is a mom of a teenage boy with autism. Her writing style is honest and down-to-earth. It feels like you are sitting down with her over a cup of coffee, swapping stories about your kids. She discusses the different therapies her son has had, and the fact that she never imposed limitations on him because of his diagnosis. She acknowledges the challenges that she and her family have faced and celebrates the successes (and there are many) that her son has achieved, including going on dates with girls.

This book is clearly laid out and easily navigable. The information is concise and provides a nice insight into the lives of those living with autism. A must-read for anyone who wants to improve their understanding of--and communication with--people with autism.

The Tried and True Therapies for Autism

2007-12-29T16:10:00.000-08:00

Most professionals agree that sensory therapy, speech-language therapy, physical therapy (or physiotherapy) and behavior therapy are crucial in helping children diagnosed with autism achieve the most success in understanding and interacting with the world around them. Virtually ALL professionals agree that early intervention is key. While many parents notice changes in behavior and language patterns around their child's second birthday, some children begin to show symptoms of autism by 6 months of age.

Sensory therapy is provided by an occupational therapist, who helps children cope when they are overwhelmed by the textures, sights, sounds, smells and tastes in their environment (e.g. the 5 senses). This is only a portion of an occupational therapist's job, which is to help an individual gain skills to function in his daily life. To find an occupational therapist in the United States, click here. To find a therapist in Canada, click here. All occupational therapists require a minimum of a bachelor's degree to practice, and many states and provinces require a minimum number of continuing education hours each year in order to maintain certification.

A Speech-language pathologist helps a child communicate in a way that decreases his frustration and the frustration of those around him. This may include training in verbal language, signed language, picture boards, voice output devices or any combination of the three.

An example of some common manual signs from Mayer Johnson site.

An example of a picture communication board from Different Roads to Learning.

An example of a voice output device by Dynavox.

To find a speech-language pathologist in the United States, click here. To find one in Canada, click here. All speech-language pathologists hold master's degrees to practice, and many states and provinces require a minimum number of continuing education hours each year in order to maintain certification.

A physical therapist (physiotherapist) helps your child develop the motor skills necessary to reach important milestones in his life, such as crawling and walking, and later maintaining the flexibility and stamina to perform academic, athletic and social activities. To find a physical therapist in the United States, click here. To find a physiotherapist in Canada, click here. All physical therapists require a minimum of a bachelor's degree to practice, and many states and provinces require a minimum number of continuing education hours each year in order to maintain certification.

A behavior therapist works with your child to analyze the functions of his behaviors--which may at times be aggressive, destructive or just confusing--and teach him more socially accepted ways to achieve his goals. The most popular behavior therapies prescribed by doctors is Applied Behavior Analysis (ABA). One of their basic tenets is that we all behave for one of three purposes:

1. To receive something: tangible (e.g. a cookie) or attention (positive or negative)
2. To delay or escape something, e.g. having a bath, being in an overcrowded store
3. Because it feels good or attenuates pain, e.g. swinging, bouncing, grinding teeth

ABA is believed to be effective only when it is consistently applied to all of a child's environments, so that he can anticipate what is expected of him in a situation, regardless of the person interacting with him. Proper ABA therapy focuses on rewards, rather than punishments. It is important that those looking for ABA therapists find those that have academic training. There are many wonderful therapists who have received graduate training in behavior therapy and require a minimum number of continuing education hours each year in order to maintain certification.

If you are looking for a therapist, your local university's psychology department is a good resource, as many have training programs supervised by professors. If you are in the United States, another option is to find a Board Certified Behavior Analyst. For a list of therapists in your area, you can go to the BACB website and click on "Certificant Registry".

Not letting autism define him

2007-12-29T15:50:00.000-08:00

So often we see that children with autism are marginalized due to their difficulty interpreting the social cues needed to create relationships with their peers. This local news story gained nationwide attention when it was picked up by the big newscasters and YouTube. Jason McElwain, a teenage boy with autism worked on the sidelines of his high school basketball team, until his coach had him suit up for the final game. I dare you not to get misty watching this video :)

Autism Awareness in the media

2007-12-29T15:07:00.000-08:00

With celebrities the likes of Doug Flutie, Jenny McCarthy, Holly Robinson Peete and Toni Braxton speaking openly about their experiences with their children's diagnoses, we are currently in the thick of Autism Awareness. Music superstars are lending their voices to the cause in T.V. and print ad spots. Probably most notably, Oprah has had several shows dedicated to Autism Spectrum Disorder (ASD).
The purpose of this blog will be to explore what therapies are available, both old and new, article and book reviews and recommendations. Discussions are welcome!