Wednesday, May 28, 2014

Autism | Asperger's | Behaviour

Many parents with children on the autism scale find themselves at a crossroad and need to address inappropriate behaviours which are preventing their child from succeeding at school or at home- social or academically and come to see me. Many already use a "behavioural interventionist" from the ACT referral services, but find that they just can't get a plan and intervention together for their child in spite of already having a behaviour interventionist on their team. While I am a member of the ACT Behaviour Interventionist list (the "RASP") I am also a Registered and Licensed Psychologist with a speciality in behaviour management and behaviour therapy. This is a different field which goes beyond dealing with symptoms normally thought of as relating to ASD.

ABA training in itself often doesn't provide a wide enough background in psychology to help these children, as their underlying problems can be depression, anxiety, OCD and other related disorders. And ABA, as helpful as it is, isn't designed to work with these kinds of problems. So, first of all we need to really understand and diagnose the problem. This is usually done through a process called a functional behaviour assessment or FBA. An FBA may include school and home observations, data collection and testing, but it also can be a much shorter and contained process. An FBA is about the "process." We look at what the child is doing, and the child's environment to find out what the function of the behaviour is. "What function does X have for this child?" I often teach FBA development to teachers and psychologists, and it can range from a comprehensive several page written report, to a 3X5 card with some notes jotted down. What's important is that we consider the situation to understand the function, and then move on from their to 1) make environmental changes so the child doesn't need to engage in the behaviour as the sam frequency or severity, and 2) teach new appropriate skills so that the child now has a new appropriate behaviour that meets the SAME function as the original behaviour. The most comprehensive system for completing FBA's and writing these intervention plans for children and adolescents with autism and Aspergers can be found at the California website PENT. Click here: http://www.pent.ca.gov   What's great about the PENT website is how comprehensive it is, and how much training materials are available to school staff - psychologist, teachers, administrators- to make sure a school is performing these procedures correctly. A key component to the California PENT program is a system that checks the QUALITY of the process and intervention. A quality control system is built right in. I've taught this system in several districts and those that adopt it improve the quality of there interventions for children with behaviour problems and autism/Aspergers significantly.

The other issue that seems to come up and keep individuals from providing good evidence based interventions is the general lack of experience most teachers, behaviour interventionists and general psychologists have in old fashioned behavioural therapy. Too often I hear that a token system didn't work for a child with ADHD (although we have 40 plus years of research supporting the use of token reinforcement systems with children with ADHD!) or that planned ignoring or exposure programs have failed. Usually they are implemented straight from a book, and when they don't work everyone quickly gives up. These systems have a long history of working, but, if you ever watched "Super-Nanny" on television you know ever week she has to come back, look at the data, watch the parents implementing the program and make changes. You always need some feedback from a third party ...always. And if someone has never had success implementing such a behaviour program, then maybe they shouldn't be doing this without supervision. Token systems and other behaviour management practices are complicated and tricky. If they don't seem to be working at first, don't give up!  Consult!

Finally, it's a tricky issue to implement a behavioural intervention program to deal with difficult behaviours when at the sam time your dealing with the symptoms of Asperger's or autism. Many parents I see come to me after many unsuccessful attempts on their own. Again, get consultation from an expert!

Where can we learn about this? Well, I think you need a multitude of handy interventions and plans. Not just one. I tell most of the parents I work with we are about to start a graduate degree in behaviour management, so hold on.  Some good books to start with are these:

First: Read or watch Raising an Emotionally Intelligent Child: The Heart of Parenting by John Gottman. This is NOT a book on behaviour management, nor is it a book about behaviour problems. However, when your done you will feel better about all the other part s of parenting, and you'll understand the concept of being a "coach" for your child. I usually suggest the video which is available at the local library or John Gottman's website.

If your child is really a handful - EXPLOSIVE! Then I'd read or listen to "The Explosive Child," by Ross W. Green, PhD. This is a great book on parenting and dealing with really difficult behavioural problems. What it is not is a book on behaviour management from a behaviourist point of view. Instead it gives you a place to start, and a "style" to do it in. Dr. Greene also has a wonder website. Go check it out.

For the behavioural (didn't think I'd get to that did you?): The two best books I know of are "Your Defiant Teen: 10 steps to resolving conflict and rebuilding your relationship," by Dr. Russell Barkley and "Your Defiant Child: 8 steps to better behaviour," also by Dr. Barkley. These two books prove everything you need to start using time tested, evidence based behavioural interventions in your home.

These are the best places to start, but be warned: Children with Asperger's Disorder and autism spectrum disorder (ASD) do not react the same as other children to these or any interventions. For a multitude of reasons, sone biological, some cognitive, some relational, these children may react poorly to something that another child would react well to. So again, get advice and consultation from an expert.

These four resources, plus those available on child behaviour issues from the PENT website are a good place to start. If you would like to contact me and visit my office for a consult, please follow one of the links below:







KEY WORDS: Behavioural Interventionist, Behavior Therapy, Autism, Asperger's, Therapy, Vancouver, Burnaby, Psychologist

Monday, May 26, 2014

Testing and Treatment for Asperger's and Autism | Children, Adolescents and Adults

Testing, Assessment and Treatment for Autism and Aspeger's Disorder

Dr. Jim Roche provides testing and diagnostic services, as well as therapy, for children, adolescents and adults with autism spectrum disorder, Aspeger's Disorder and related cognitive deficits. For more information please visit my web page at: http://www.relatedminds.com/autism/ 
or http://psychologists.bc.ca/users/jimroche or www.relatedminds.com

Dr. Roche also sees adolescents and young adults for therapy and social cognitive therapy in his office, and accepts BC Ministry payments for these services. Services are also covered by your extended health care plan. He has over 20 years experience with children, adolescents and teens with autism spectrum disorder, non-Verbal Learning Disorders, Social Cognitive Disorders and Asperger's Disorder.

Please feel free to examine the web page or call doctor Roche with questions about assessments, testing and treatment for autism and Asperger's Disorder.

His offices are located in Burnaby and Vancouver and are close to Port Coquitlam, New Westminster, Port Moody and Maple Ridge.