If your child has ASD, autism or Aspergers you most likely wonder what is the most useful, powerful and successful treatment for him or her? How can you help your child meet their potential? Simply, what is the most effective Aspergers treatment and help for aspergers? Many parents of aspergers children worry that their child will never be able to develop strong friendships let alone a human-romantic relationships that could eventually lead to marriage and children and a full life. Relationships during childhood, who you have as friends and how well you get along and attach, as Dr., John Gottman has pointed out, are the #1 factor in determining outcome later in life. They correlate to employment success, to later relational success and even to life span. People who related better in the 4th grade earn more money, are happier and live longer. It's more important that academic grades, prizes in science or awards in sports.
So can your child with Asperger's do well in relationships? The truth is, it is possible, but it takes a lot of work, the right advice, access to the right information and treatment interventions. Which ones work best? Regretfully, the answer is "it depends." What we do know is there are treatments know to work, and those for which there is no scientific support.
Here are the top 4 methods of aspergers treatment:
1. Applied Behavioural Analysis
2. Floor Time
3. Speech Therapy
4. Social-Cognitive Therapy (training in theory of mind)
Notice "social skills" isn't in this list. We are always teaching social skills, but there is a difference between a lack of social skill knowledge and the social-cognitive deficits children and adults with Asperger's suffer from. (I recently posted two great videos that explain "theory of mind" and urge you to watch those. Understanding the difference between a social skills deficit and a deficit in theory of mind is critical for successful treatment for you or your child. And many schools and therapists don't understand the difference.
At different times your child my need one or all of these treatment interventions. They each have their place at the appropriate developmental time, and can be adapted to use at different developmental moments. Heres a little more detail on each:
1. Applied behavioural analysis (ABA)
ABA is a method of teaching that involves breaking tasks into small, discrete 'teachable' steps. At each step appropriate behaviours are reinforced. ABA selects developmentally appropriate behaviours as teaching targets. These can range from maintaining eye contact to complex responses such as social interaction. The child is given enough support to ensure success, which is then positively reinforced by consequences that are reinforcing for that child. Gradually the amount of support and reinforcement is reduced.
Early intervention programmes for children with autism and Asperger's have the potential to produce positive changes in development and consequently reduce the need for later interventions. Therefore in many ABA programmes parents are trained to become the primary therapists and their children receive one-to-one tuition in their own homes. There is evidence that intervening in a child's development in this way can help children with autism to be more successful in mainstream schools (Keenan et al., 2000). Often parents want to avoid this step, especially if their child is a little most socially developed, verbal etc. DON'T AVOID ABA! ABA training is necessary for you as a parent to understand the basics of behavioural interventions. Exposing your child to good, competently taught ABA prepares them with tools you can use later to teach new skills. It's a tool best learned young, and then used again and again.
ABA is not everything, however, and for some schools and intervention programs it seems to be. There are other, more complex skills that cannot be taught through ABA. But ABA is the foundation of your future work.
2. Floor Time
Here is one description of ABA I really like, "During floor time, your child will stretch his imagination and logical understanding of the world as he stages make-believe games and locks horns with you over rules. He'll use gestures and words to express his needs and to explore a broad range of emotions, from exhilaration to anger. He will also hone his physical skills as his muscles strengthen and grow." Yes, floor time means getting down on the floor and MODELLING appropriate make believe games, using your imagination, and exposing your child to the idea of "sharing the floor" with another person. It's the environment you use to generalize behavioural skills you have taught. Later Floor Time can be thought of as becoming Social Cognitive Therapy I mention below in 4. Floor time has not been shown to change "autistic" behaviours (self stimulation etc.) but it has been shown to improve the quality of the relationship between the child and parent. I expect research will show it does the same with the child and therapist, teacher, teacher aide and so on. Some positive play time involving the reciprocal interactions between the child and adult needs to be part of any program. And it needs to be fun, reinforcing and relaxing!
3. Speech Therapy
Speech Therapy may help their child with communication difficulties. The difficulties are not in how the child speaks or pronounces words, but rather in how the child perceives the meaning of other people's speech. A speech therapist focuses on issues of social reciprocity, understanding the second level of communication in speech. Often this is more about what is not said than what is said. In speech therapy I would expect a child to learn to understand how what he or she says effects others. And in addition, a speech therapist is able to measure our overall progress in terms of "pragmatic language and help with simple speech difficulties that make communication, already difficult, even more difficult. Every child with Asperger's should be seen by a speech pathologist.
4. Social Cognitive Therapy
The I-LAUGH Model of Social Cognition developed by Michelle Garcia Winner is a framework of social cognition designed to explain the multiple skills and concepts that we must process and react to in order to succeed at social interaction and personal problem solving. Each of these elements of social cognition affects not only our ability to make and keep friends, but also our ability to process complex information in the classroom and the workplace. The I-LAUGH Model is evidence-based in that each aspect of it has been researched and defined as a trait of persons with social relatedness issues. A brief summary of the I-LAUGH framework from her web page is below. You can find out more about here work at her website at www.socialthinking.com:
I = Initiation of Communication (Kranz & McClannahan, 1993)
Initiation of communication is the ability to use one’s language skills to establish social relations and to seek assistance or information from others. Many students with autism spectrum disorders have significant problems initiating communication in stressful situations or when information is not easily understood. Language retrieval is difficult in anything other than calm, secure situations. Even within the higher functioning population with autism spectrum disorders, the student’s ability to talk about a favourite topic of interest can exist in sharp contrast to how that student communicates when needing help or when attempting to gain social entry into peer groups. Yet, these two skills – asking for help and understanding how to join a group for functional or personal interaction - are paramount for any student’s future success.
L= Listening With Eyes and Brain (Mundy & Crowson, 1997; Kunce and Mesibov, 1998; Jones & Carr, 2004)
Many persons with autism spectrum disorders and other social cognitive deficits have difficulty with auditory comprehension. From a social perspective, listening requires more than just taking in auditory information. It also requires the person to integrate information seen with that which is heard, to understand the full meaning of the message being conveyed, or to make an educated guess about what is being said when one cannot clearly understand it. For example, classroom teachers expect students to “listen with their eyes” when they point to information that is part of the instruction. They also indicate to whom they are speaking in a class, not by calling the student’s name but instead by looking at the student or moving closer. Students repeatedly relate to their peers through nonverbal cues, ranging from rolled eyes to signal boredom, to raised eyebrows to indicate questioning, to gazing at a particular item to direct a peer’s attention. Clearly to “listen with one’s eyes” requires students to have mastered the concept of joint attention – a skill that seems to effortlessly develop by the time a child is 12 months to 15 months old in neurotypical children, but may be missing from the social repertoire of the student with autism spectrum disorders, ADHD and similar challenges. Instruction in this essential and fundamental function of social interaction begins with teaching students that eyes share social information. Not all students understand this concept, nor do they grasp that listening requires full attention to both verbal and nonverbal cues. It can then expand to teaching students to relate to each other’s thoughts through play and other activities of social relatedness, followed by extending the student’s realm to attending to and processing increasingly complex cues that help students “listen with their whole bodies.”
A = Abstract and Inferential Language/Communication (Minshew, Goldstein, Muenz & Payton, 1992)
Most of the language we use is not intended for literal interpretation. Our communication is peppered with idioms, metaphors, sarcasm and inferences. Societies around the world bestow awards to writers, and even comedians, who are most creative with language. Each generation of teens creates its own slang; kids who follow along are in; those who don’t, are often out. Advertising and other forms of mass media follow these cues. The abstract and inferential component of communication is huge and constantly in flux. It is a mistake to assume that our students with social thinking deficits understand our society’s non-literal use of language. In fact, most of them don’t! Literal interpretation of language is a hallmark characteristic of individuals with ASD. Yet, as educators and parents, we either miss this impairment entirely – thinking our smart kids must understand our nuanced communication - or we address it in the briefest of ways, with instruction dedicated only to explaining idioms, irony and metaphors as part of English class.
U = Understanding Perspective (Baron-Cohen & Jolliffe, 1997; Baron-Cohen, 2000)
To understand the differing perspectives of others requires that one’s Theory of Mind (perspective taking) work quickly and efficiently. Most neurotypical students acquire a solid foundation in ToM between the ages of 4 to 6 years old. Perspective taking is not one thing, it represents many things happening all at once meaning it is a synergistic and dynamic process.
G=Gestalt Processing/Getting the Big Picture (Shah & Frith, 1993; Fullerton, Stratton, Coyne & Gray, 1996)
Information is conveyed through concepts, not just facts. When involved in conversation, the participants intuitively determine the underlying concept being discussed. When reading a book of literature, the purpose is to follow the overall meaning (concept) rather than just collect a series of facts. Conceptual processing is a key component to understanding social and academic information. Difficulty developing organizational strategies cannot be isolated from conceptual processing. Students with conceptual processing challenges often have difficulties with written expression, organizational skills, time management and being overly tangential in their social relations. (All of these concepts require us to stay focused on a central theme or main idea and to keep our writing, discussions or planning focused to this central point. Many of our folks struggle with this, over-focusing on details and not focusing in the concept (an intuitive skills for neurotypicals).
H= Humor and Human Relatedness (Gutstein, 2001; Greenspan, & Wieder, 2003; Prizant, Wetherby, Rubin, Laurent & Rydell, 2006)
Most individuals with autism spectrum disorders, Asperger’s and similar challenges have good senses of humour, but they feel anxious since they miss many of the subtle cues that help them understand how to participate successfully with others. It is important for educators and parents to work compassionately and with humour to help minimize the anxiety these children are experiencing. At the same time, many of our clients use humour inappropriately; direct lessons about this topic are needed and relevant.
Human relatedness - the ability to bond emotionally with others - is at the heart of human social relationships and the fuller development of empathy and emotional regulation. Teaching students how to relate and respond to other people’s emotions as well as their own, while also helping them feel the enjoyment that arises through mutual sharing, is critical to the development of all other aspects of social development.
Michelle Winner's "Social Thinking" approach may sound overwhelming, but it is in reality simply, fun and reinforcing for children. She has numerous books, workbooks, videos and other resources for use at home and in the school. One of my favourite is a book called "Superflex," a book for kids/students that teachers about the way the mind of a person with Asperger's works, and steps you can take to overcome many of the problems this brings. She demonstrates this through an exciting and funny set of stories involving super-heros battling super villains like "RockBrain," an evil doer who keeps you from using your brain in a flexible manner. If you have a teen, or are an adult with Aspergers, you'll understand and like this story.
This is a lot to think about, and most parents need to find someone to guide them through this maze of techniques, programs and new language. Often I see parents jump at quick and easy answers that make promises based upon "testimonials" of others. These include the use of "brain tuning," "hearing training," ""sound tuning," biofeedback or neuro-therapy and many miracle diets and supplements. None of these have any scientific basis, and many plainly don't make sense. These four treatment methods should be the foundation of your plan. They are supported by research, used in most schools and intervention programs, and are accepted by the professional community. If you insist on "testimonials" I can even say, although I am reluctant, that these are the programs most highly recommended by parents.
..........................................
My web page lists a number of resources you can make use of yourself in dealing with Autism Spectrum Disorder and Asperger's, as well as many other social-cognitive deficits and learning disabilities. Please visit it at www.socialcognitivetherapy.com, or one of my other sites at: Psychology Today, AAMFT, PSYRIS or my professional site or www.adhdhelp.ca.
Autism assessment and treatment services are offered for individuals, couples, families, children, adolescents and adults in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education assessments, autism assessments as well as behavioural and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.
Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com
Showing posts with label Port Moody. Show all posts
Showing posts with label Port Moody. Show all posts
Tuesday, December 28, 2010
Friday, November 12, 2010
Autism study reveals how genetic changes rewire the brain
ScienceDaily (2010-11-08) -- Using a blend of brain imaging and genetic detective work, scientists have illustrated how genetic variants rewire the brain. The discovery offers the crucial missing physical evidence that links altered genes to modified brain function and learning.
"In children who carry the risk gene, the front of the brain appears to talk mostly with itself," explained first author Ashley Scott-Van Zeeland, now a Dickinson Research Fellow at Scripps Translational Science Institute. "It doesn't communicate as much with other parts of the brain and lacks long-range connections to the back of the brain."
Researchers could test whether specific therapies actually change brain function by measuring connectivity of patients before and after therapy, she added.
The authors emphasized that the patterns of connectivity found in the study still fall along the spectrum of normal gene variation. "One third of the population carries this variant in its DNA," noted Geschwind. "It's important to remember that the gene variant alone doesn't cause autism, it just increases risk."
The story can be found by following this link CLICK HERE
For information about my private practice you may go to my website at www.relatedminds.com and look for autism services. You can also find out more about my services for children, adolescents and adults with autism or Asperger's Disorder at my PsychologyToday website or my BCAMFT/AAMFT website.
"In children who carry the risk gene, the front of the brain appears to talk mostly with itself," explained first author Ashley Scott-Van Zeeland, now a Dickinson Research Fellow at Scripps Translational Science Institute. "It doesn't communicate as much with other parts of the brain and lacks long-range connections to the back of the brain."
Researchers could test whether specific therapies actually change brain function by measuring connectivity of patients before and after therapy, she added.
The authors emphasized that the patterns of connectivity found in the study still fall along the spectrum of normal gene variation. "One third of the population carries this variant in its DNA," noted Geschwind. "It's important to remember that the gene variant alone doesn't cause autism, it just increases risk."
The story can be found by following this link CLICK HERE
For information about my private practice you may go to my website at www.relatedminds.com and look for autism services. You can also find out more about my services for children, adolescents and adults with autism or Asperger's Disorder at my PsychologyToday website or my BCAMFT/AAMFT website.
Thursday, September 23, 2010
What services are available to my child with autism or Aspergers in BC schools?
I am often asked this very simple question by parents of children who come in for assessments of autism and Aspergers. And the answer is: It depends.
It depends on your specific school district, it depends on the funding the school has in total (your child's funding is often put in a big pot by the school district and divided up between several different children with special education needs...yes, it's hard to believe but in many districts this is true), and finally, it depends upon the training and availability of staff.
For the next few posts I'm going to try and walk you through this process as best I can. We will start with information about getting your child services at all. That means having him or her "designated" with a "code." And from their I will talk about what you should expect, and what you might actually get.
The process begins with a diagnosis. Depending upon your child's age he (I will be using he from now on to make this simpler to understand, although I know girls are OFTEN overlooked in this process) needs to diagnosed by an appropriately registered and trained professional. This can be done for free through several provincial services, however there is a waiting list. You start with a referral from your medical doctor. Usually the referral is to your regional autism program, and your MD should know how to do that. Start on this process early, as there is a significant wait and early treatment is important.
Children under 6 need to be assessed by a "team" including a medical doctor, speech pathologist and usually a psychologist. Children over six need only one professional, either a medical doctor or psychologist. Whoever does this needs to use two important assessment tools. These are the ADOS (Autism Diagnostic Observation System) and the ADI-R (Autism Diagnostic Interview-Revised. YThey may use additional tools, but the MUST use these, and they need to have appropriate training and experience using these. These assessment take a few hours to complete. In addition to these tools/tests the team or individual professional needs to do other investigations as well in order to rule out other possible causes of your child's behaviour of concern. This includes a cognitive test (intelligence), an academic assessment (usually the WIAT or WRAT-4) and speech/language assessments (sometimes the Test of Pragmatic Language or a similar test). Finally, you will need to complete some form of behaviour evaluation such as the ABAS. There may be other tools/tests used, but these are the basics. Depending on the age of your child and the complexity of the assessment the cost can run from $1,800 to $2,400 or higher. It usually takes three, four or five sessions to complete the assessment.
IF the assessment leads to a diagnosis of autism or Asperger's Disorder (the final diagnosis is not made by the numbers and scores but by the professional's overall judgement of your child) you will need to complete an application for funding from the Ministry of Children and Family Development if you are seeking provincial funding. You can click here and download a brochure from the ministry that takes you through all these steps. I would download this in any case.
After the assessment is complete you should get funding form completed by the professional, and he or she will attached a written report that goes with the application. You should also get a report to take to your school. Your report needs to clearly state your child's diagnosis.
The Ministry issues above are unrelated to school services and funding, they are totally separate issues and should not be confused.
Now take a copy of your report and a cover letter requesting that the school's Committee on Special Education or Support Team (different names are used in different district) evaluate your child for coding. Coding is a process where the School Based Support Team, usually, meet and determine what is going to happen about coding and what services your child will get. You should request that you be informed of ALL MEETINGS at which your child is discussed, and make sure you are asked to attend. Do this in writing even if you already know you work and can't attend these meetings. Insist on your right to be informed and attend.
I would give a copy of the report to the school based team or principal, and bring a copy to your school district's Support Services or Special Education department. Get a dated note that says they have received this, or send an email and ask for acknowledgement that it has been received. This things get lost, overlooked and forgotten, don't let that happen!
You should not be asked to attend a Support Meeting where your child is "coded," that is, given a special education designation, (for Autism the coding is G) and at that meeting an IEP or Individual Education Plan should be written. This plan looks at your child's needs and should say how they will be addressed, and how they will measure the effectiveness of their interventions (not how your child is doing!). If there are significant behaviour problems you should also request a Functional Behaviour Analysis take place by someone trained to do it and a formal Positive Behaviour Support Plan be written from that. In later posts I will go into detail about what those look like and what you should expect.
What next? Your child should be getting INDIVIDUALIZED services to help with their deficits and needs. This should include, at the least, someone supervising your child's program who has training and experience in the field of autism. The most appropriate person would be his or her teacher. The province provides training for teachers through workshops during teacher training days, and through certificate programs at POPARD, the Provincial Outreach Program for Autism and Related Disorders. Someone woking with your child should have attended these workshops - at a minimum.
When a child is "coded" for autism the school district receives money to help support that child. This is not enough money to do the job so school districts need to take those funds and combine them to create staff positions that are then shared by several children. Yes, some children with more severe behaviour problems get more staff time. You can be aware of this, monitor it, and make sure your child is getting the support they need, but also be sensitive to the fact that there is not enough funding to do what needs to be done, and districts are doing the best they can. You can make sure that funds for children with an autism coding isn't moved over to deal with children with other coding that didn't get enough funds. This does happen.
Once your child is found eligible for autism services in school you should ask to meet with the schools autism team, or with the staff member in charge of students with autism. Often there is a staff member assigned to work as a partner with the Provincial Outreach Program for Autism and Related Disorders (POPARD). This person usually has the title of "POPARD District Partner." Find this person and immediately request a consultation from the POPARD consultant. Always put your request in writing, and send a copy to the Director of Support Services or Special Services in the district.
The POPARD consultant can come to the school, review your child's case, do an observation of your child in the classroom and then meet with the staff and present a written support plan. Often they also come to the school and provide direct training to staff, as well as observation and consultation. Each school district has a specific number of hours of POPARD consultation time, it gets used fast, and there is never enough, so get on this early! If all the time that is allotted by Ministry funding is already use remember, school districts can pay for extra time, consultation and training! These are excellent professionals, highly trained with years of experience. You can find out more about POPARD by clicking here and going to their site. They have an abundance of information and videos demonstrating the services and techniques you should be seeing in your child's class.
So to review: to obtain services for your child with autism or Asperger's Disorder in British Columbia you first need to have your child diagnosed. This can be done either through a referral from your family doctor to an appropriate provincial program (such as Children's hospital) or through a private practitioner if you don't want to wait or simply want to use your own professional. The ministry website for information on this process can be found above. Next, you bring your assessment and diagnostic letter to the school and request a meeting to discuss "coding" for your child. The school should code your child, write an IEP and if necessary a behaviour plan. Finally, you should check to see that the staff working with your child are properly trained and receive appropriate supervision and consultation. Try to get your school's POPARD consultant involved.
In the next few weeks I will discuss the IEP process, writing behaviour plans, and where to go for help with curriculum. I hope this has been helpful.
For information about my private practice you may go to my website at www.relatedminds.com and look for autism services. You can also find out more about my services for children, adolescents and adults with autism or Asperger's Disorder at my PsychologyToday website or my BCAMFT/AAMFT website.
It depends on your specific school district, it depends on the funding the school has in total (your child's funding is often put in a big pot by the school district and divided up between several different children with special education needs...yes, it's hard to believe but in many districts this is true), and finally, it depends upon the training and availability of staff.
For the next few posts I'm going to try and walk you through this process as best I can. We will start with information about getting your child services at all. That means having him or her "designated" with a "code." And from their I will talk about what you should expect, and what you might actually get.
The process begins with a diagnosis. Depending upon your child's age he (I will be using he from now on to make this simpler to understand, although I know girls are OFTEN overlooked in this process) needs to diagnosed by an appropriately registered and trained professional. This can be done for free through several provincial services, however there is a waiting list. You start with a referral from your medical doctor. Usually the referral is to your regional autism program, and your MD should know how to do that. Start on this process early, as there is a significant wait and early treatment is important.
Children under 6 need to be assessed by a "team" including a medical doctor, speech pathologist and usually a psychologist. Children over six need only one professional, either a medical doctor or psychologist. Whoever does this needs to use two important assessment tools. These are the ADOS (Autism Diagnostic Observation System) and the ADI-R (Autism Diagnostic Interview-Revised. YThey may use additional tools, but the MUST use these, and they need to have appropriate training and experience using these. These assessment take a few hours to complete. In addition to these tools/tests the team or individual professional needs to do other investigations as well in order to rule out other possible causes of your child's behaviour of concern. This includes a cognitive test (intelligence), an academic assessment (usually the WIAT or WRAT-4) and speech/language assessments (sometimes the Test of Pragmatic Language or a similar test). Finally, you will need to complete some form of behaviour evaluation such as the ABAS. There may be other tools/tests used, but these are the basics. Depending on the age of your child and the complexity of the assessment the cost can run from $1,800 to $2,400 or higher. It usually takes three, four or five sessions to complete the assessment.
IF the assessment leads to a diagnosis of autism or Asperger's Disorder (the final diagnosis is not made by the numbers and scores but by the professional's overall judgement of your child) you will need to complete an application for funding from the Ministry of Children and Family Development if you are seeking provincial funding. You can click here and download a brochure from the ministry that takes you through all these steps. I would download this in any case.
After the assessment is complete you should get funding form completed by the professional, and he or she will attached a written report that goes with the application. You should also get a report to take to your school. Your report needs to clearly state your child's diagnosis.
The Ministry issues above are unrelated to school services and funding, they are totally separate issues and should not be confused.
Now take a copy of your report and a cover letter requesting that the school's Committee on Special Education or Support Team (different names are used in different district) evaluate your child for coding. Coding is a process where the School Based Support Team, usually, meet and determine what is going to happen about coding and what services your child will get. You should request that you be informed of ALL MEETINGS at which your child is discussed, and make sure you are asked to attend. Do this in writing even if you already know you work and can't attend these meetings. Insist on your right to be informed and attend.
I would give a copy of the report to the school based team or principal, and bring a copy to your school district's Support Services or Special Education department. Get a dated note that says they have received this, or send an email and ask for acknowledgement that it has been received. This things get lost, overlooked and forgotten, don't let that happen!
You should not be asked to attend a Support Meeting where your child is "coded," that is, given a special education designation, (for Autism the coding is G) and at that meeting an IEP or Individual Education Plan should be written. This plan looks at your child's needs and should say how they will be addressed, and how they will measure the effectiveness of their interventions (not how your child is doing!). If there are significant behaviour problems you should also request a Functional Behaviour Analysis take place by someone trained to do it and a formal Positive Behaviour Support Plan be written from that. In later posts I will go into detail about what those look like and what you should expect.
What next? Your child should be getting INDIVIDUALIZED services to help with their deficits and needs. This should include, at the least, someone supervising your child's program who has training and experience in the field of autism. The most appropriate person would be his or her teacher. The province provides training for teachers through workshops during teacher training days, and through certificate programs at POPARD, the Provincial Outreach Program for Autism and Related Disorders. Someone woking with your child should have attended these workshops - at a minimum.
When a child is "coded" for autism the school district receives money to help support that child. This is not enough money to do the job so school districts need to take those funds and combine them to create staff positions that are then shared by several children. Yes, some children with more severe behaviour problems get more staff time. You can be aware of this, monitor it, and make sure your child is getting the support they need, but also be sensitive to the fact that there is not enough funding to do what needs to be done, and districts are doing the best they can. You can make sure that funds for children with an autism coding isn't moved over to deal with children with other coding that didn't get enough funds. This does happen.
Once your child is found eligible for autism services in school you should ask to meet with the schools autism team, or with the staff member in charge of students with autism. Often there is a staff member assigned to work as a partner with the Provincial Outreach Program for Autism and Related Disorders (POPARD). This person usually has the title of "POPARD District Partner." Find this person and immediately request a consultation from the POPARD consultant. Always put your request in writing, and send a copy to the Director of Support Services or Special Services in the district.
The POPARD consultant can come to the school, review your child's case, do an observation of your child in the classroom and then meet with the staff and present a written support plan. Often they also come to the school and provide direct training to staff, as well as observation and consultation. Each school district has a specific number of hours of POPARD consultation time, it gets used fast, and there is never enough, so get on this early! If all the time that is allotted by Ministry funding is already use remember, school districts can pay for extra time, consultation and training! These are excellent professionals, highly trained with years of experience. You can find out more about POPARD by clicking here and going to their site. They have an abundance of information and videos demonstrating the services and techniques you should be seeing in your child's class.
So to review: to obtain services for your child with autism or Asperger's Disorder in British Columbia you first need to have your child diagnosed. This can be done either through a referral from your family doctor to an appropriate provincial program (such as Children's hospital) or through a private practitioner if you don't want to wait or simply want to use your own professional. The ministry website for information on this process can be found above. Next, you bring your assessment and diagnostic letter to the school and request a meeting to discuss "coding" for your child. The school should code your child, write an IEP and if necessary a behaviour plan. Finally, you should check to see that the staff working with your child are properly trained and receive appropriate supervision and consultation. Try to get your school's POPARD consultant involved.
In the next few weeks I will discuss the IEP process, writing behaviour plans, and where to go for help with curriculum. I hope this has been helpful.
For information about my private practice you may go to my website at www.relatedminds.com and look for autism services. You can also find out more about my services for children, adolescents and adults with autism or Asperger's Disorder at my PsychologyToday website or my BCAMFT/AAMFT website.
Wednesday, August 18, 2010
Tips for School: Getting your child with Asperger's / Autism Ready for School.
Yes, it's almost time for the school sales, and along with it it's time for parents to start thinking about getting their child ready for school, and making sure their school is ready for their child. Children with Asperger's and autism (ASD) are at special risk at the beginning of the year, as schools are full of changes, excitement and confusion. Nothing our kids deal with very well.
So here we go with some school tips for children with Asperger's or ASD:
1. First, get to know who's who in your school, and your district. Prepare a contact list of everyone you might need to work with during the year. The time to do this is now, while there are no problems, and there is time. Your phone calls and initial contacts will also be more welcomed as your a parent trying to be prepared, rather than a parent with a complaint.
These individuals might include the Director of Special Education or Support Services (whatever your district might call this person), the supervisor of the program your child is in (there may be one in the school, and one in the district office), the chair of the special education or support committee at the school, the head of your school's parent group, your local schools school psychologist, counsellor and of course the school principal, secretary and if its an older child there may be a department head or dean you should know. Also, you may want to get the contact information for your schools Ot or PT, who often can be very useful with developing plans and interventions. Get their phone numbers, and school emails. The emails are very important because you may use those to leave important messages, and especially messages that might need to be revisited later. Remember, if it wasn't in writing, it didn't happen.
2. Has your school set up a consultation with POPARD, the Provincial Outreach Program for Autism and Related Disorders? Every school district in BC has a "POPARD Partner" who can arrange for these consultative services. Find out who this person is and see if you can get an appointment. POPARD can provide your child's teacher with excellent feedback, suggestions and most of all, a plan!
2. Gather copies of last years IEP (individual education plans), behaviour plans of FBAs (Functional Behaviour Analysis) school grades, previous correspondence, doctor's diagnosis and psycho-educational assessments. Clearly mark any suggested interventions you find on your child's IEP or behaviour plan. Never go to a meeting without these documents in hand. After every meeting take a few minutes to write up a short summary note for yourself. Especially note who was suppose to do what, by when, and how they were suppose to measure success. I recommend punching holes in them and putting them together in a binder so that they never get lost. (And you thought kids were the only ones who lost important papers!).
3. As soon as you can meet with the classroom teacher and whoever is the supervisor of your child's program. Remember, the classroom teacher is SUPPOSE to be the person designated to implement an Individual Education Plan (IEP). That's not always the way it is, and often classroom teachers have not even read the child's IEP.
Now, let's address some strategies that should be seen in use in the classroom:
4. Make sure there are classroom rules posted prominently somewhere. If appropriate, have your child repeat the rules back to you to make sure he or she understands them. These rules should be stated in the positive. We do this, or do that. Not in the negative. We don't do this or that. Have them written down separately and included in your child's notebook. For children with Asperger's and autism there should be a set of rules with visual supports. No matter how functional you may feel your child is, there needs to be a continuation of universal visual supports for your child in the classroom.
5. Your child's schedule needs to be posted on the board, on their desk, and if they use a PECS system, on the PECS booklet. While some parents want to get their kids away from visual supports as they grow older, the real key is to get your visual support system to change and be developmentally appropriate for your child. The usefulness of visual supports never goes away, just ask anyone with a date book, iphone or checklist in their pocket!
5. Make sure your child will be seated close to the teacher, and away from distractors such as doors, windows, pencil sharpeners and so on. In no way should your child be seated separately, or made to feel different or pointed out. If there are times your child needs to be seated separately there are positive ways to do this that don't make your child stick out like the kid with problems!
6. The most effective means we have of modifying behaviour with students with Aspergers or Autism is through immediate feedback and consequences. Consequences should be positive and reinforcing rather than punitive and reactionary. Make sure there is a way to monitor how many positive reinforcing statements are made, compared to corrections. If corrections worked, you would have no worries and their would be no IEP for your child.
7. Positive point systems are the most effective means we have to teach new skills to children with Asperger's and autism. Make sure there is one in place in class. It should be a system that always get's your child closer to his or her goal, rather than one that leaves them two points short at the end of the day. (Hey, you earned 98 points! Only two more to go, bet you'll earn those early in the morning!)
8. Make sure your child is allowed physical breaks, is allowed to walk around (with permission) and stand if necessary to do work. Many of these breaks can be built into your child's day with tasks like handing out papers, erasing the board and so on.
9. Use visual cues to help your child follow rules, switch activities and transition throughout the day. Visual supports are less likely to make your child prompt dependent than verbal reminders (which quickly become nagging and turn a child off). Ask to meet with last year's teacher and teacher aide and make up a list of what worked, and what made things better. MAke sure the school does more of those things this year.
10. Make sure there is a "time away" program for your child, that is, a positive time, scheduled if need be, when they can get out of the larger social world and be by themselves to relax and calm down. Time away is not "Time Out," which is used as a punishment or removal or reinforcers with children. Those interventions are inappropriate with children with Asperger's or ASD / autism.
11. Reduce the total workload, and reduce homework! There are numerous papers out there about the need to reduce homework for children on the autism spectrum. The goal is to work hard, not to finish everything. It's to make a good effort, the best effort you can. And that's enough.
12. Make sure when giving instructions the teacher get an initial recognition from your child (hey, look here for a minute. Great. ....) and then repeats back the instructions. This will vastly increase the chances a task will actually get done. And any task with more than 3 steps, should be written down.
13. Reduce (get rid of) copying from the board! This is one of the most difficult tasks there is for a student with Asperger's or high functioning autism. There is simply no reason to insist on this.
14. Use visual timers, not just clocks, to help your child stay focused and understand how long a task will take to complete. There are a number of these available commercially (Time-Timer) or you can make one with a few pieces of tape and coloured paper around your clock.
15. Do not use loss of recess or any social time as a punishment for a student on the ASD spectrum. Why would you remove an activity that will most likely lead to the child doing better the rest of the day?
16. Schedule the difficult tasks and subjects early if you can. The more tired your child is, the more difficulty they will have with focus and attention. Do the hard stuff first, then take it easy. Just like adults do!
17. Use a peer buddy. Yep, someone for your child to look at, follow, get social cues from. He or she should be allowed to look at that student's work as an example, and ask that student questions to clarify.
18. Remember to use visual supports as much as possible. They help with anxiety, switching mental sets, changing tasks and schedule changes. And make sure the staff is trained in using them. If last year the teacher or aide were good at using PECS or other appropriate visual supports, arrange a time to meet with them and this years staff to discuss how they implemented these strategies. Focus on successes, what made things better, and what worked!
19. Visit the school before school starts. Even if your child attended there last year. Visit the building, walk around, find his or hers new rooms, walk from their to the library and cafeteria.
20. Practice the drop off and pick up routine prior to the first day, and try to practice it three or four times. This will make a difficult day go smoother.
If you have time for a little reading before school starts, two books I would suggest are: "The Incredible 5-Point Scle" by Buron and Curtis and "Social Behavior Mapping" by Michelle Winner. Other reading suggestions can be found on my web site.
For more information about child and adolescent parenting you can visit my web page at www.relatedminds.com, for information about services I provide for families and children with Aspergers or autism spectrum disorder, click here, for children with ADHD click here, and for adults with ADHD click here (ADHDHelp.ca) or my Psychology Today Website. You can also call my office at 778.998-7975 to make an appointment for a consultation. My AAMFT listing (Registered Marriage and Family Therapist) can be located by clicking here.
So here we go with some school tips for children with Asperger's or ASD:
1. First, get to know who's who in your school, and your district. Prepare a contact list of everyone you might need to work with during the year. The time to do this is now, while there are no problems, and there is time. Your phone calls and initial contacts will also be more welcomed as your a parent trying to be prepared, rather than a parent with a complaint.
These individuals might include the Director of Special Education or Support Services (whatever your district might call this person), the supervisor of the program your child is in (there may be one in the school, and one in the district office), the chair of the special education or support committee at the school, the head of your school's parent group, your local schools school psychologist, counsellor and of course the school principal, secretary and if its an older child there may be a department head or dean you should know. Also, you may want to get the contact information for your schools Ot or PT, who often can be very useful with developing plans and interventions. Get their phone numbers, and school emails. The emails are very important because you may use those to leave important messages, and especially messages that might need to be revisited later. Remember, if it wasn't in writing, it didn't happen.
2. Has your school set up a consultation with POPARD, the Provincial Outreach Program for Autism and Related Disorders? Every school district in BC has a "POPARD Partner" who can arrange for these consultative services. Find out who this person is and see if you can get an appointment. POPARD can provide your child's teacher with excellent feedback, suggestions and most of all, a plan!
2. Gather copies of last years IEP (individual education plans), behaviour plans of FBAs (Functional Behaviour Analysis) school grades, previous correspondence, doctor's diagnosis and psycho-educational assessments. Clearly mark any suggested interventions you find on your child's IEP or behaviour plan. Never go to a meeting without these documents in hand. After every meeting take a few minutes to write up a short summary note for yourself. Especially note who was suppose to do what, by when, and how they were suppose to measure success. I recommend punching holes in them and putting them together in a binder so that they never get lost. (And you thought kids were the only ones who lost important papers!).
3. As soon as you can meet with the classroom teacher and whoever is the supervisor of your child's program. Remember, the classroom teacher is SUPPOSE to be the person designated to implement an Individual Education Plan (IEP). That's not always the way it is, and often classroom teachers have not even read the child's IEP.
Now, let's address some strategies that should be seen in use in the classroom:
4. Make sure there are classroom rules posted prominently somewhere. If appropriate, have your child repeat the rules back to you to make sure he or she understands them. These rules should be stated in the positive. We do this, or do that. Not in the negative. We don't do this or that. Have them written down separately and included in your child's notebook. For children with Asperger's and autism there should be a set of rules with visual supports. No matter how functional you may feel your child is, there needs to be a continuation of universal visual supports for your child in the classroom.
5. Your child's schedule needs to be posted on the board, on their desk, and if they use a PECS system, on the PECS booklet. While some parents want to get their kids away from visual supports as they grow older, the real key is to get your visual support system to change and be developmentally appropriate for your child. The usefulness of visual supports never goes away, just ask anyone with a date book, iphone or checklist in their pocket!
5. Make sure your child will be seated close to the teacher, and away from distractors such as doors, windows, pencil sharpeners and so on. In no way should your child be seated separately, or made to feel different or pointed out. If there are times your child needs to be seated separately there are positive ways to do this that don't make your child stick out like the kid with problems!
6. The most effective means we have of modifying behaviour with students with Aspergers or Autism is through immediate feedback and consequences. Consequences should be positive and reinforcing rather than punitive and reactionary. Make sure there is a way to monitor how many positive reinforcing statements are made, compared to corrections. If corrections worked, you would have no worries and their would be no IEP for your child.
7. Positive point systems are the most effective means we have to teach new skills to children with Asperger's and autism. Make sure there is one in place in class. It should be a system that always get's your child closer to his or her goal, rather than one that leaves them two points short at the end of the day. (Hey, you earned 98 points! Only two more to go, bet you'll earn those early in the morning!)
8. Make sure your child is allowed physical breaks, is allowed to walk around (with permission) and stand if necessary to do work. Many of these breaks can be built into your child's day with tasks like handing out papers, erasing the board and so on.
9. Use visual cues to help your child follow rules, switch activities and transition throughout the day. Visual supports are less likely to make your child prompt dependent than verbal reminders (which quickly become nagging and turn a child off). Ask to meet with last year's teacher and teacher aide and make up a list of what worked, and what made things better. MAke sure the school does more of those things this year.
10. Make sure there is a "time away" program for your child, that is, a positive time, scheduled if need be, when they can get out of the larger social world and be by themselves to relax and calm down. Time away is not "Time Out," which is used as a punishment or removal or reinforcers with children. Those interventions are inappropriate with children with Asperger's or ASD / autism.
11. Reduce the total workload, and reduce homework! There are numerous papers out there about the need to reduce homework for children on the autism spectrum. The goal is to work hard, not to finish everything. It's to make a good effort, the best effort you can. And that's enough.
12. Make sure when giving instructions the teacher get an initial recognition from your child (hey, look here for a minute. Great. ....) and then repeats back the instructions. This will vastly increase the chances a task will actually get done. And any task with more than 3 steps, should be written down.
13. Reduce (get rid of) copying from the board! This is one of the most difficult tasks there is for a student with Asperger's or high functioning autism. There is simply no reason to insist on this.
14. Use visual timers, not just clocks, to help your child stay focused and understand how long a task will take to complete. There are a number of these available commercially (Time-Timer) or you can make one with a few pieces of tape and coloured paper around your clock.
15. Do not use loss of recess or any social time as a punishment for a student on the ASD spectrum. Why would you remove an activity that will most likely lead to the child doing better the rest of the day?
16. Schedule the difficult tasks and subjects early if you can. The more tired your child is, the more difficulty they will have with focus and attention. Do the hard stuff first, then take it easy. Just like adults do!
17. Use a peer buddy. Yep, someone for your child to look at, follow, get social cues from. He or she should be allowed to look at that student's work as an example, and ask that student questions to clarify.
18. Remember to use visual supports as much as possible. They help with anxiety, switching mental sets, changing tasks and schedule changes. And make sure the staff is trained in using them. If last year the teacher or aide were good at using PECS or other appropriate visual supports, arrange a time to meet with them and this years staff to discuss how they implemented these strategies. Focus on successes, what made things better, and what worked!
19. Visit the school before school starts. Even if your child attended there last year. Visit the building, walk around, find his or hers new rooms, walk from their to the library and cafeteria.
20. Practice the drop off and pick up routine prior to the first day, and try to practice it three or four times. This will make a difficult day go smoother.
If you have time for a little reading before school starts, two books I would suggest are: "The Incredible 5-Point Scle" by Buron and Curtis and "Social Behavior Mapping" by Michelle Winner. Other reading suggestions can be found on my web site.
For more information about child and adolescent parenting you can visit my web page at www.relatedminds.com, for information about services I provide for families and children with Aspergers or autism spectrum disorder, click here, for children with ADHD click here, and for adults with ADHD click here (ADHDHelp.ca) or my Psychology Today Website. You can also call my office at 778.998-7975 to make an appointment for a consultation. My AAMFT listing (Registered Marriage and Family Therapist) can be located by clicking here.
Monday, June 14, 2010
Social Skills and Social Thinking for Student's With Asperger's and High Functioning Autism
Again today a patient asked me what book or video product they should get to start to understand their child's Asperger's disorder. The answer was easy: Thinking About YOU Thinking About ME, 2nd Edition by Michelle Garcia Winner
This is the best book I have found to start to understand how to help a child or student with Asperger's, high functioning autism, ADHD or a "NVLD. " This is where to start to learn more about social interaction and social awareness. It demonstrates how understanding the perspectives of others is key to all interpersonal relationships. It gives wonderful examples, and had easy to use charts, graphs, photo and pictorial supports for students.
"Michelle's model of perspective-taking makes research into Theory of Mind practical for teaching these students and even students who may be considered "neurotypical." Specific lessons, and how to apply them in different settings, are explored. The Four Steps of Communication creates a framework for understanding the complexities of social thinking and for enhancing perspective-taking in students. Social Behavior Mapping and IEPs are examined. How to focus concepts for ages and skill levels are presented through practical handouts, activities and lesson ideas. This second edition of Thinking About YOU Thinking About ME contains much expanded content, including two new chapters and an updated philosophy. The assessment chapter now includes the Social Thinking Dynamic Assessment Protocol®, with more detailed assessment techniques." This book is useful for grades K-adulthood. I use it continually in my practice, and Michelle has numerous videos / DVD's to help support this material.
The book includes:
Michelle's perspective-taking model
How understanding the perspectives of others is the foundation of interpersonal relationships
How to address specific deficits in this area
The four steps of communication - enhancing perspective-taking
Specific, related treatment activities
Sample IEP goals and benchmarks
The ME Binder: teaching your students their IEP goals, why this helps
Social Behavior Mapping (another book Michelle has edited address this great technique in detail)
Visual ways to teach students the impact of behaviors on others and themselves
Sample maps and make your own!
The Social Thinking Dynamic Assessment Protocol
Why assessments fall short
Michelle's practical informal assessment strategy
25 pages of templates to use for the Social Thinking Dynamic Assessment Protocol
Additional concrete strategies and user-friendly templates to help your student(s) build their own more dynamic social thinking abilities and see the rewards of doing so.
This is where I often start with parents and teachers, and it is useful for years to come. Parents who have been struggling with finding an appropriate treatment / intervention focus are always pleased to find this book. Too often parents have been alone, working with "naturopaths," chiropractic doctors and other providers of alternative, unproven techniques and never hear about or read some simple, these well tried and scientifically supported interventions. So for those parents who ask "Where can I start?" this is my suggestion.
More information on Michelle's books and theory of mind can be found at my website www.socialcognitivetherapy.com
This is the best book I have found to start to understand how to help a child or student with Asperger's, high functioning autism, ADHD or a "NVLD. " This is where to start to learn more about social interaction and social awareness. It demonstrates how understanding the perspectives of others is key to all interpersonal relationships. It gives wonderful examples, and had easy to use charts, graphs, photo and pictorial supports for students.
"Michelle's model of perspective-taking makes research into Theory of Mind practical for teaching these students and even students who may be considered "neurotypical." Specific lessons, and how to apply them in different settings, are explored. The Four Steps of Communication creates a framework for understanding the complexities of social thinking and for enhancing perspective-taking in students. Social Behavior Mapping and IEPs are examined. How to focus concepts for ages and skill levels are presented through practical handouts, activities and lesson ideas. This second edition of Thinking About YOU Thinking About ME contains much expanded content, including two new chapters and an updated philosophy. The assessment chapter now includes the Social Thinking Dynamic Assessment Protocol®, with more detailed assessment techniques." This book is useful for grades K-adulthood. I use it continually in my practice, and Michelle has numerous videos / DVD's to help support this material.
The book includes:
Michelle's perspective-taking model
How understanding the perspectives of others is the foundation of interpersonal relationships
How to address specific deficits in this area
The four steps of communication - enhancing perspective-taking
Specific, related treatment activities
Sample IEP goals and benchmarks
The ME Binder: teaching your students their IEP goals, why this helps
Social Behavior Mapping (another book Michelle has edited address this great technique in detail)
Visual ways to teach students the impact of behaviors on others and themselves
Sample maps and make your own!
The Social Thinking Dynamic Assessment Protocol
Why assessments fall short
Michelle's practical informal assessment strategy
25 pages of templates to use for the Social Thinking Dynamic Assessment Protocol
Additional concrete strategies and user-friendly templates to help your student(s) build their own more dynamic social thinking abilities and see the rewards of doing so.
This is where I often start with parents and teachers, and it is useful for years to come. Parents who have been struggling with finding an appropriate treatment / intervention focus are always pleased to find this book. Too often parents have been alone, working with "naturopaths," chiropractic doctors and other providers of alternative, unproven techniques and never hear about or read some simple, these well tried and scientifically supported interventions. So for those parents who ask "Where can I start?" this is my suggestion.
More information on Michelle's books and theory of mind can be found at my website www.socialcognitivetherapy.com
Sunday, June 13, 2010
Researchers Blast Another Link Between Autism and Vaccines
Researchers Blast Another Link Between Autism and Vaccines
"Some myths never go away; they just change form." that includes the debate about vaccines and childhood autism. One that never seems to go away. Here are the simple facts: there's no link between the disorder and thimerosal. So the anti-vacciners have simply changed the rules and now say that it's not the thimerosal, but vaccines still cause autism because children get too many vaccines too soon. "Their little bodies are overloaded." How they have determined this is hard to understand, and they have come up with alternative vaccine schedules, seemingly out of thin air.
The Los Angeles Times reports "an increasing number of parents are asking their pediatricians to space out vaccines and booster shots." But, "There's no need to do that, according to pediatric infectious disease specialists Drs. Michael J. Smith and Charles R. Woods of the University of Louisville School of Medicine." See the study here.
ULSM released a study in the medical journal Pediatrics, the leading journal in the field, that states unequivocally there is no relation between autism and the frequency of childhood vaccines. The authors, Smith and Woods, analyzed data on 1,047 children from a previous study investigating the thimerosal claim.
The children were born between 1993 and 1997, and had been vaccinated on a schedule of their parents' choosing. Later they were given a series of 42 neuropsychological tests between the ages of 7 and 10. Smith and Woods report roughly 47 percent of the children received their vaccines on a regular schedule. Another 23 percent received their vaccines, but not on schedule, and the remaining children received only some of their shots. From the results it is clear that the spacing of the vaccines had no effect on whether or not the children developed autism. The authors state "This study provides the strongest clinical outcomes evidence to date that on-time receipt of vaccines during infancy has no adverse effect on neurodevelopmental outcomes 7 to 10 years later....These results offer reassuring information that physicians and public health officials may use to communicate with parents who are concerned that children receive too many vaccines too soon." There simply were no differences, none.
Over and over again, with research study after research study, we see that vaccines have no relationship to autism, Asperger's Disorder or any neurological deficits.
What we should learn from these studies is that there is a group of individuals who for some philosophical or political reason seem to want to spread discontent among parents, who want to scare them, and for some reason return us to the medicine of 100 years ago. I fail to understand it. I just hope that the overwhelming evidence will sooner or later keep parents from wasting their time and money of treatments (like chelation, chiropractic and homeopathy) that are based upon the same woo science.
Dr. Jim Roche is a registered psychologist in Vancouver, British Columbia. He has offices in Burnaby (Coquitlam, Port Moody, Maple Ridge and New Westminster) and downtown Vancouver. His website can be seen at www.relatedminds.com and www.socialcognitivetherapy.com
"Some myths never go away; they just change form." that includes the debate about vaccines and childhood autism. One that never seems to go away. Here are the simple facts: there's no link between the disorder and thimerosal. So the anti-vacciners have simply changed the rules and now say that it's not the thimerosal, but vaccines still cause autism because children get too many vaccines too soon. "Their little bodies are overloaded." How they have determined this is hard to understand, and they have come up with alternative vaccine schedules, seemingly out of thin air.
The Los Angeles Times reports "an increasing number of parents are asking their pediatricians to space out vaccines and booster shots." But, "There's no need to do that, according to pediatric infectious disease specialists Drs. Michael J. Smith and Charles R. Woods of the University of Louisville School of Medicine." See the study here.
ULSM released a study in the medical journal Pediatrics, the leading journal in the field, that states unequivocally there is no relation between autism and the frequency of childhood vaccines. The authors, Smith and Woods, analyzed data on 1,047 children from a previous study investigating the thimerosal claim.
The children were born between 1993 and 1997, and had been vaccinated on a schedule of their parents' choosing. Later they were given a series of 42 neuropsychological tests between the ages of 7 and 10. Smith and Woods report roughly 47 percent of the children received their vaccines on a regular schedule. Another 23 percent received their vaccines, but not on schedule, and the remaining children received only some of their shots. From the results it is clear that the spacing of the vaccines had no effect on whether or not the children developed autism. The authors state "This study provides the strongest clinical outcomes evidence to date that on-time receipt of vaccines during infancy has no adverse effect on neurodevelopmental outcomes 7 to 10 years later....These results offer reassuring information that physicians and public health officials may use to communicate with parents who are concerned that children receive too many vaccines too soon." There simply were no differences, none.
Over and over again, with research study after research study, we see that vaccines have no relationship to autism, Asperger's Disorder or any neurological deficits.
What we should learn from these studies is that there is a group of individuals who for some philosophical or political reason seem to want to spread discontent among parents, who want to scare them, and for some reason return us to the medicine of 100 years ago. I fail to understand it. I just hope that the overwhelming evidence will sooner or later keep parents from wasting their time and money of treatments (like chelation, chiropractic and homeopathy) that are based upon the same woo science.
Dr. Jim Roche is a registered psychologist in Vancouver, British Columbia. He has offices in Burnaby (Coquitlam, Port Moody, Maple Ridge and New Westminster) and downtown Vancouver. His website can be seen at www.relatedminds.com and www.socialcognitivetherapy.com
Monday, May 24, 2010
Autism Gluten-free Diet, Casein-free Diet Did Not Improve Behavior
Autism Gluten-free Diet, Casein-free Diet Did Not Improve Behavior
Posted using ShareThis
Again scientific research has dealt another blow to the idea that diets can curb the effects of autism.
Doing a web search for autism treatment here in British Columbia you will often find that the first, second and third search results on Google or Bing include treatments that have little scientific research to back them. These include chiropractics (even suggested for infants), homeopathy (one local homeopathic doctor provides homeopathic "inoculations" for childhood diseases!), and diets. Often the web pages you are directed to include testimonials of miracle cures. But successfully treating autism calls for hard work, time, and not so much for miracles. And one thing anyone in science knows, testimonials are notoriously misleading.
After viewing these pages patients often come to my office asking about gluten-free and casein-free diets. They tell me they have heard about "dramatic improvements" after the implementation of these diets plans. Research, I tell them, is pretty conclusive: diets have little impact, including on gastrointestinal problems!
Often times parents report changes when a diet is implemented, but fail to understand that along with the change in diet came changes in their expectations, changes in their behaviour, changes in their attitudes such as a reduction of anxiety and stress. And most importantly, a sudden easy to implement structured way to address and now explain the symptoms. Often they fail to see that the behaviour programming, language training and structured classrooms their children are often in may have had a far greater impact. Relying upon individual testimonials, rather than research designed to isolate the cause and effect of an intervention, is never a good way to make clinical choices.
In this study, which you can read more about through the above links, we have a randomized, double-blinded (meaning neither the participants nor the researches knew which treatment was being received), placebo controlled study, and we again find that the effects of these diets is null. (Numerous large scale studies show there is no support for these diets.)
In this study children were given snack foods with and without gluten and casein, both or neither. The researches evaluated the effects on attention, sleep, stool patterns and other characteristics of autistic behaviour. The study did not show any significant changes in any of these symptoms for any of the groups.
20 percent of parents in the Autism Treatment Network report using "alternative" treatments such as diet. 50% of these were diets. These diets has been promoted by celebrities such as Jenny McCarthy who details the diet she used with her son. However, what is not reported is that many parents report no success with these diets, or that it is far more likely that other treatments being administered at the same time have been the cause of behavioural changes. The above article reviews some of these cases.
What is important from this study is to note that, "There has not been any research to substantiate the GFCF diet for children with autism who do not (already) have celiac disease or wheat/milk allergies." In other words, yes, sometimes children have improved because they had allergies to milk, gluten, heat etc. Just as any child might. And that fact is unrelated to autism.
There are treatments that work, that have been scientifically proven to improve behaviour, communication and social interaction. Regretfully these are intensive, slow and prolonged. But they are your best bet. Here in British Columbia there are many services available to help you with behavioural issues, including trained behaviour specialists paid for through your autism funding, speech pathologists, paid for through your autism funding and in our school districts training for teachers, teacher aides and others through the Provincial Outreach Program for Autism and Related Disorders. There is hope, there are treatment, but there are few miracles. Another valuable source for behavioural experts is ACT. Whatever you do, look to treatments that have been rigorously tested, that make sense, and don't imply a simple answer you could only call "miraculous".
If you would like further information about assessment or treatment for autism, Aspergers, ADHD and other childhood disorders you can find further information on my professional web page at www.socialcognitivetherapy.com or www.relatedminds.com
I can also be contacted at drjimroche@gmail.com
Dr. Jim Roche
Registered Psychologist
778.998-7975
Posted using ShareThis
Again scientific research has dealt another blow to the idea that diets can curb the effects of autism.
Doing a web search for autism treatment here in British Columbia you will often find that the first, second and third search results on Google or Bing include treatments that have little scientific research to back them. These include chiropractics (even suggested for infants), homeopathy (one local homeopathic doctor provides homeopathic "inoculations" for childhood diseases!), and diets. Often the web pages you are directed to include testimonials of miracle cures. But successfully treating autism calls for hard work, time, and not so much for miracles. And one thing anyone in science knows, testimonials are notoriously misleading.
After viewing these pages patients often come to my office asking about gluten-free and casein-free diets. They tell me they have heard about "dramatic improvements" after the implementation of these diets plans. Research, I tell them, is pretty conclusive: diets have little impact, including on gastrointestinal problems!
Often times parents report changes when a diet is implemented, but fail to understand that along with the change in diet came changes in their expectations, changes in their behaviour, changes in their attitudes such as a reduction of anxiety and stress. And most importantly, a sudden easy to implement structured way to address and now explain the symptoms. Often they fail to see that the behaviour programming, language training and structured classrooms their children are often in may have had a far greater impact. Relying upon individual testimonials, rather than research designed to isolate the cause and effect of an intervention, is never a good way to make clinical choices.
In this study, which you can read more about through the above links, we have a randomized, double-blinded (meaning neither the participants nor the researches knew which treatment was being received), placebo controlled study, and we again find that the effects of these diets is null. (Numerous large scale studies show there is no support for these diets.)
In this study children were given snack foods with and without gluten and casein, both or neither. The researches evaluated the effects on attention, sleep, stool patterns and other characteristics of autistic behaviour. The study did not show any significant changes in any of these symptoms for any of the groups.
20 percent of parents in the Autism Treatment Network report using "alternative" treatments such as diet. 50% of these were diets. These diets has been promoted by celebrities such as Jenny McCarthy who details the diet she used with her son. However, what is not reported is that many parents report no success with these diets, or that it is far more likely that other treatments being administered at the same time have been the cause of behavioural changes. The above article reviews some of these cases.
What is important from this study is to note that, "There has not been any research to substantiate the GFCF diet for children with autism who do not (already) have celiac disease or wheat/milk allergies." In other words, yes, sometimes children have improved because they had allergies to milk, gluten, heat etc. Just as any child might. And that fact is unrelated to autism.
There are treatments that work, that have been scientifically proven to improve behaviour, communication and social interaction. Regretfully these are intensive, slow and prolonged. But they are your best bet. Here in British Columbia there are many services available to help you with behavioural issues, including trained behaviour specialists paid for through your autism funding, speech pathologists, paid for through your autism funding and in our school districts training for teachers, teacher aides and others through the Provincial Outreach Program for Autism and Related Disorders. There is hope, there are treatment, but there are few miracles. Another valuable source for behavioural experts is ACT. Whatever you do, look to treatments that have been rigorously tested, that make sense, and don't imply a simple answer you could only call "miraculous".
If you would like further information about assessment or treatment for autism, Aspergers, ADHD and other childhood disorders you can find further information on my professional web page at www.socialcognitivetherapy.com or www.relatedminds.com
I can also be contacted at drjimroche@gmail.com
Dr. Jim Roche
Registered Psychologist
778.998-7975
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