I provide behaviour interventionist services in my Burnaby office for individuals with autism spectrum disorder (ASD and Asperger's disorder. I am a member of the ACT (Autism Community Training) RASP list and my services are covered under minsitry funding programs for children and teens.
Most of my services are focused on specific behavioural problems which parents and consultants are having a hard time dealing with. I provide parent training, consultation and some school based training and consltation. I have workd as the behaviour management specialist for several school districts and as a provincial autism consultant through the Provinical Outreach Program for Autism and Related Services (POPARD). I am deeply familiar with school based programs and have supervised and cnsulted with many professionals in local districts.
Two other things that I provide in my pracritce:
First, I provide autism diagnosist services. If you suspect your child has autism an appointment can usually be set up within 10 days to 2 weeks. I prioritize my cases with individuals with autism spectrum disorder because I am aware how few services there are here in BC. Please visit my website for more information on arranging an appointment for an autism diagnostic consultation. I require an initial 1 hour session to discuss current symptoms and history. The cost of this session is $175.00 and this is part of the overall costs if we decide to move forward with testing.
I also see children and teens in my office for individual therapy. This therapy usually is focused on issues of communications and follows the structure of interventions you will find in the work of Michelle Winner ( Social Thinking). Often these sessions include a period of play therapy, some didactic training and skills development, and then a period of feedback with parents so that they will understand the process and be able to impliment supportive skills trainng in the home.
In addition to diagnosising and providing therapy for autism spectrum disorder / Aspegers disorder, I also focus much of my practice on ADHD and executive dysfunction issues. These are often co-morbid with a diagnosis of ASD.
Finally, I not only provide autism spectrum disorder services to children and teens, but also to adults as well, and see patients from across the lifespan.
Please visit my website at www.relatedminds.com or http://www.relatedminds.com/autism and contact me if you have any questions I can help you with.
Showing posts with label New Westminster. Show all posts
Showing posts with label New Westminster. Show all posts
Monday, March 7, 2016
Tuesday, March 1, 2016
Adult Diagnosis of Autism Spectrum Disorder and Asperger's Disorder
The diagnosis of autism spectrum disorder (ASD), sometimes referred to as "Asperger's Disorder" can be very difficult for a family practitioner due to the amount of time and the instruments and tools used to complete a comprehensive examination.
While many people make a determination by filling out an on-line form, the diagnsis is actually far more complex. In British Columbia an "offical" diagnosis of autism spectrum disorder, especially high functioning autism which until recently was referred to as Asperger's Disorder - sometimes also diagnosed as "non-Verbal LEarning Disorder" requires several specific tests. For children under six a team is required, including a psychologist, physician and a speech pathologist. The reason a team is required is that autism can often look like other disorders, and other disorders can often look just like autism. Here the Ministry of Children and Families also requires specific tests be used. These include AT LEAST the ADOS- Autism Diagnossit Observation System, which is a procedural test that looks at current symptoms and behaviours, and the ADI-R, the Autism Diagnositic Interview Revised, which is a highly structured history. These are necessary for recognition of ASD by schools and the ministry.
When assessing/testing adult I use these same tests, as an autism diagnosis in BC can be used for obtaining tax credits, social services and most often accomodations at school, college, university and the workplace.
In addition to these specific tests and procedures I also administer a series of neuropsychological tests and personality assessments in order to rule out other possible causes of the symptoms. Additionally individuals with autism spectrum disorder/ adult Asperger's can also have co-morbid disorders, such as depression, anxiety, OCD and ADHD. This comprehensive look at your symptoms and hisotry helps guide treatment choices.
The cost of such an assessment is $1,200-1,600, depending upon the complexity. Regretfully, these costs are not covered by provincial MSP (medical Service Plan) but some costs may be covered by your extended health care plan.
My schedule allows me to see most individuals who are seeking an assessment for adult autism spectrum disorder within 3-4 weeks, as I try not to schedule out more than 4-6 weeks in advance, and prioritize adult autism spectrum disorder assessments as there are few professionals in the lower mainland with the ability or experience necessary to do these assessments.
For more information on adult autism spectrum disorder assessments please visit my web page and contact me by phone or by completing the form on the web page. I am a Registered Psychologist in British Columbia with over 25 years experience in the field of autism, including working as a special education teacher for students with autism spectrum disorder, as a school district behaviour management specialist and as a provincial autism consultant. I have also worked as a rehabilitation psychologist and neuropsychologist with adults returning to the workplace. This hands on experience with individuals across the spectrum of ages and development provides me with a unique set of skills and knowledge base.
Web page: www.relatedminds.com
http://www.relatedminds.com/autism/
http://www.relatedminds.com/adult-autism-and-aspergers-disorder/
While many people make a determination by filling out an on-line form, the diagnsis is actually far more complex. In British Columbia an "offical" diagnosis of autism spectrum disorder, especially high functioning autism which until recently was referred to as Asperger's Disorder - sometimes also diagnosed as "non-Verbal LEarning Disorder" requires several specific tests. For children under six a team is required, including a psychologist, physician and a speech pathologist. The reason a team is required is that autism can often look like other disorders, and other disorders can often look just like autism. Here the Ministry of Children and Families also requires specific tests be used. These include AT LEAST the ADOS- Autism Diagnossit Observation System, which is a procedural test that looks at current symptoms and behaviours, and the ADI-R, the Autism Diagnositic Interview Revised, which is a highly structured history. These are necessary for recognition of ASD by schools and the ministry.
When assessing/testing adult I use these same tests, as an autism diagnosis in BC can be used for obtaining tax credits, social services and most often accomodations at school, college, university and the workplace.
In addition to these specific tests and procedures I also administer a series of neuropsychological tests and personality assessments in order to rule out other possible causes of the symptoms. Additionally individuals with autism spectrum disorder/ adult Asperger's can also have co-morbid disorders, such as depression, anxiety, OCD and ADHD. This comprehensive look at your symptoms and hisotry helps guide treatment choices.
The cost of such an assessment is $1,200-1,600, depending upon the complexity. Regretfully, these costs are not covered by provincial MSP (medical Service Plan) but some costs may be covered by your extended health care plan.
My schedule allows me to see most individuals who are seeking an assessment for adult autism spectrum disorder within 3-4 weeks, as I try not to schedule out more than 4-6 weeks in advance, and prioritize adult autism spectrum disorder assessments as there are few professionals in the lower mainland with the ability or experience necessary to do these assessments.
For more information on adult autism spectrum disorder assessments please visit my web page and contact me by phone or by completing the form on the web page. I am a Registered Psychologist in British Columbia with over 25 years experience in the field of autism, including working as a special education teacher for students with autism spectrum disorder, as a school district behaviour management specialist and as a provincial autism consultant. I have also worked as a rehabilitation psychologist and neuropsychologist with adults returning to the workplace. This hands on experience with individuals across the spectrum of ages and development provides me with a unique set of skills and knowledge base.
Web page: www.relatedminds.com
http://www.relatedminds.com/autism/
http://www.relatedminds.com/adult-autism-and-aspergers-disorder/
Saturday, December 4, 2010
MRI Test Shows Diagnostic Promise for Autism - in Pediatrics, Autism from MedPage Today
Medical News: MRI Test Shows Diagnostic Promise for Autism - in Pediatrics, Autism from MedPage Today\
Does this new research mean we can get a quick, easy and absolute diagnosis of Autism from a simple MRI scan? No, regretfully not, although that's how the mainstream press presents it. MRI scans of the brain in this research protocol focused on two specific regions in the temporal lobe was able to diagnose high-functioning autism with 94% sensitivity in a preliminary evaluation. There are, however some serious limitations with this study included the small sample size, lack of a comparator group with developmental disorders other than autism, and use of highly selected features for evaluation. These limitations mean that we don't know if this type of scan can or ever will (although ever is a long time) tell us if a child has autism, a language disability or other disorder. So far, and for the near future, the scan can't tell these different disorders apart, and that's why we use more complex tests for autism such as the ADOS (Autism Diagnostic Observation Scale) and the ADI-R (Autism Diagnostic Interview0-Revised). These remain, and most likely will remain, the standard for assessment here in British Columbia.
Autism, like many other social and learning disorders present on a scale, and it is necessary for the treating clinician to understand the unique way the disorder presents itself. Two children with identical brain scans may, I would expect, present very differently in terms of behaviours and immediate intervention needs because the disorder interacts with their temperament, other co-morbid issues (such as sensory sensitivities), environmental factors such as parenting skills/temperament/siblings and developmental experiences. Add on to this factors relating to the larger social environments such as schools. An MRI, blood or urine test may be helpful, and may very well become necessary for diagnosis or government funding in some locations, but a good clinical interview, observation in multiple settings, history taking and appropriate "hands-on" diagnostic assessment are still the foundation for building a good treatment and intervention plan.
.....................................................................................
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 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
Does this new research mean we can get a quick, easy and absolute diagnosis of Autism from a simple MRI scan? No, regretfully not, although that's how the mainstream press presents it. MRI scans of the brain in this research protocol focused on two specific regions in the temporal lobe was able to diagnose high-functioning autism with 94% sensitivity in a preliminary evaluation. There are, however some serious limitations with this study included the small sample size, lack of a comparator group with developmental disorders other than autism, and use of highly selected features for evaluation. These limitations mean that we don't know if this type of scan can or ever will (although ever is a long time) tell us if a child has autism, a language disability or other disorder. So far, and for the near future, the scan can't tell these different disorders apart, and that's why we use more complex tests for autism such as the ADOS (Autism Diagnostic Observation Scale) and the ADI-R (Autism Diagnostic Interview0-Revised). These remain, and most likely will remain, the standard for assessment here in British Columbia.
Autism, like many other social and learning disorders present on a scale, and it is necessary for the treating clinician to understand the unique way the disorder presents itself. Two children with identical brain scans may, I would expect, present very differently in terms of behaviours and immediate intervention needs because the disorder interacts with their temperament, other co-morbid issues (such as sensory sensitivities), environmental factors such as parenting skills/temperament/siblings and developmental experiences. Add on to this factors relating to the larger social environments such as schools. An MRI, blood or urine test may be helpful, and may very well become necessary for diagnosis or government funding in some locations, but a good clinical interview, observation in multiple settings, history taking and appropriate "hands-on" diagnostic assessment are still the foundation for building a good treatment and intervention plan.
.....................................................................................
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 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
Tuesday, November 30, 2010
Mitochondrial Dysfunction Seen in Some Kids with Autism
Medical News: Mitochondrial Dysfunction Seen in Some Autistic Kids - in Pediatrics, Autism from MedPage Today
In medical news: A small exploratory study has found that children with autism seem more likely to have problems with their mitochondria than children with typical neurodevelopment. Children recruited from an ongoing case-controlled study found those with autism appeared to have lower oxidative phosphorylation capacity, as well mitochondrial DNA abnormalities, Cecilia Giulivi, PhD, of the University of California Davis, and colleagues reported in the Dec. 1 issue of the Journal of the American Medical Association. Although this small study suggests that mitochondrial defects in children with autism may be more common than in controls, it is a cross-sectional study and causality cannot be determined. That seems to be something missed in the mainstream press, which tout this report as proof of causation. Findings from this preliminary cross-sectional study, which included only 10 cases and 10 controls, cannot establish a causal relationship between mitochondrial dysfunction and autism.
"Whether the mitochondrial dysfunction in children with autism is primary or secondary to an as-yet unknown event remains the subject of future work," the authors wrote. But, they further note that "mitochondrial dysfunction could greatly amplify and propagate brain dysfunction, such as that found in autism, given that the highest levels of mitochondrial DNA abnormalities are observed in postmitotic tissues with high energy demands (e.g., brain)." Giulivi and her colleagues analyzed a subset of children ages 2 to 5 participating in the ongoing Childhood Autism Risk from Genes and Environment (CHARGE) study in California. The researchers looked for mitochondrial problems in the peripheral blood lymphocytes of the 20 children included in the analysis.
"The team identified several factors indicative of defective or abnormal mitochondria in children with autism. Additionally, although there were no between-group differences in glycemia or lactate levels, there was a significantly higher mean plasma pyruvate level in the children with autism (P=0.02) -- consistent with the lower pyruvate dehydrogenase activity seen among the cases. Defects in pyruvate dehydrogenase activity result in insufficient energy production, according to the researchers." The authors acknowledged some limitations of the study, including the relatively small sample size, the possibility of type I errors, and the fact that the children with autism in this substudy were higher functioning than those from the original study.
If a correlation eventually leads to us accepting a causation, what does this mean? mitochondria are called the "powerhouses" of cells, they create energy for cellular metabolism and when they are dysfunctional, cells do not operate efficiently. Essentially they are the key to concerting what we eat into energy within the cell. Poor performance of the mitochondria is disruptive for cells, and we would assume especially for brain cells which have high very energy demands. A lack of energy in brain cells during early development could explain why the brains of children with autism spectrum disorder don't function properly. Mitochondria have already been shown to accompany other neurological conditions, including Parkinson's disease, Alzheimer's disease, schizophrenia and bipolar disorder. What does this mean for treatment? Nothing right now. i'm sure within a week every supplement out there will be mentioning how they help address this issue with this pill or that diet, but the truth is, as you can see, this research is in its very basic stage. While many want to make giant leaps to specific supplements they either sell or advertise, we do not yet understand this relationship clearly enough,m nor do we know what to do about the dysfunction of the mitochondria. What I am sure of is that fish oil pills are not an easy answer.
...............................................................................
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 ADHD and many other learning disabilities. These posts, however, are not meant to provide medical advice. NEVER use internet blogs as your key to making medical decisions. Print out things you find and wonder about and take them to your medical doctor and ask the expert.
Please feel free to visit my website at www.socialcognitivetherapy.com, or one of my other sites at: Psychology Today, AAMFT, PSYRIS or my professional site or www.adhdhelp.ca.
Autism and ADHD 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
In medical news: A small exploratory study has found that children with autism seem more likely to have problems with their mitochondria than children with typical neurodevelopment. Children recruited from an ongoing case-controlled study found those with autism appeared to have lower oxidative phosphorylation capacity, as well mitochondrial DNA abnormalities, Cecilia Giulivi, PhD, of the University of California Davis, and colleagues reported in the Dec. 1 issue of the Journal of the American Medical Association. Although this small study suggests that mitochondrial defects in children with autism may be more common than in controls, it is a cross-sectional study and causality cannot be determined. That seems to be something missed in the mainstream press, which tout this report as proof of causation. Findings from this preliminary cross-sectional study, which included only 10 cases and 10 controls, cannot establish a causal relationship between mitochondrial dysfunction and autism.
"Whether the mitochondrial dysfunction in children with autism is primary or secondary to an as-yet unknown event remains the subject of future work," the authors wrote. But, they further note that "mitochondrial dysfunction could greatly amplify and propagate brain dysfunction, such as that found in autism, given that the highest levels of mitochondrial DNA abnormalities are observed in postmitotic tissues with high energy demands (e.g., brain)." Giulivi and her colleagues analyzed a subset of children ages 2 to 5 participating in the ongoing Childhood Autism Risk from Genes and Environment (CHARGE) study in California. The researchers looked for mitochondrial problems in the peripheral blood lymphocytes of the 20 children included in the analysis.
"The team identified several factors indicative of defective or abnormal mitochondria in children with autism. Additionally, although there were no between-group differences in glycemia or lactate levels, there was a significantly higher mean plasma pyruvate level in the children with autism (P=0.02) -- consistent with the lower pyruvate dehydrogenase activity seen among the cases. Defects in pyruvate dehydrogenase activity result in insufficient energy production, according to the researchers." The authors acknowledged some limitations of the study, including the relatively small sample size, the possibility of type I errors, and the fact that the children with autism in this substudy were higher functioning than those from the original study.
If a correlation eventually leads to us accepting a causation, what does this mean? mitochondria are called the "powerhouses" of cells, they create energy for cellular metabolism and when they are dysfunctional, cells do not operate efficiently. Essentially they are the key to concerting what we eat into energy within the cell. Poor performance of the mitochondria is disruptive for cells, and we would assume especially for brain cells which have high very energy demands. A lack of energy in brain cells during early development could explain why the brains of children with autism spectrum disorder don't function properly. Mitochondria have already been shown to accompany other neurological conditions, including Parkinson's disease, Alzheimer's disease, schizophrenia and bipolar disorder. What does this mean for treatment? Nothing right now. i'm sure within a week every supplement out there will be mentioning how they help address this issue with this pill or that diet, but the truth is, as you can see, this research is in its very basic stage. While many want to make giant leaps to specific supplements they either sell or advertise, we do not yet understand this relationship clearly enough,m nor do we know what to do about the dysfunction of the mitochondria. What I am sure of is that fish oil pills are not an easy answer.
...............................................................................
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 ADHD and many other learning disabilities. These posts, however, are not meant to provide medical advice. NEVER use internet blogs as your key to making medical decisions. Print out things you find and wonder about and take them to your medical doctor and ask the expert.
Please feel free to visit my website at www.socialcognitivetherapy.com, or one of my other sites at: Psychology Today, AAMFT, PSYRIS or my professional site or www.adhdhelp.ca.
Autism and ADHD 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
Saturday, November 20, 2010
Autism Caught On Tape - Technology To Help Children With Autism
Click here for the link and video. (http://www.sciencedaily.com/videos/2007/1103-autism_caught_on_tape.htm)
ScienceDaily () -- Computer scientists have devised two tools to help people interact with autistic children. Videotaping interactions allows teachers or parents to replay situations and evaluate the cause of particularly good or bad behavior. Cataloging actual data, rather relying on memory or interpretation, proves to be a more accurate measure of a situation. These tools are demonstrated in a simple but startling video. You need to watch this video and ask yourself, "How close to this can I get my child's school?"
For a couple years, as a provincial consultant with POPARD, my job was to drive or get on a plane and arrive at a school where there were severe behaviour problems going on. The tool I used to figure out the problem was simple: I watched. That's what this video system does for the teacher, it watches. And more important, it avoids the many pitfalls of relying upon memory of what happened. When teachers try to remember what happened before and after a behaviour of concern they are often unaware of the environment (watch the video!) or they may already have preconceived notions of what is causing the behaviour, and look for that "thing" to happen. Coming in as an outside observer I am often able to avoid both these problems. But this video system...well, I've been replace!
Some simple variations on this tracking system would be to just video times of the day when you know there will be a problem. But you need to collect data to understand the issues.
What the tape skips is the reason we are doing this. Watching you'll see a young boy starts hitting himself. Why? Often times we will hear 1) To get attention , or 2)for self stimulation. Neither of these were the reason in this case, and usually are not. Self abuse and violence with young children with autism is often for communication. Data, information, helps us understand the FUNCTION of a behaviour. Once we understand the function we can do two things: 1) Change the environment so the child doesn't need to engage in the behaviour, and 2) Teach a new skill to meet the function. In the video the child want's something, and can't communicate quickly and easily enough to get what he wants. Yes, he needed to get someone's attention to get it, but attention is not the goal. By watching the situation carefully we can understand the function of the behaviour and teach a new skill to meet that function. MAybe in this case the child needs some visual supports to help communicate (a communication book or pad?). Maybe he needs to practice and be successful at using a sign? I don't have enough details about this child's level of communication skills, but what is important is that we always need to specify how we are going to gather data, gat information, to answer our questions. Video is one possible means. And if your child is having a severe problem at school, I'd have the school watch this video and figure out how they intend to collect that data they need to complete a reliable Functional Behaviour Analysis (FBA).
This blog is not offered as medical advice or as a means of diagnosing or treating autism, Asperger's disorder or any other disorder. Don't go on-line and take an "autism test." The diagnosis is complex, and it involves not just looking for symptoms of autism, but also ruling out other disorders that might look just like autism, Aspergers and other disorders related to ASD. So avoid these on-line "tests" which are nothing more than a collection of symptoms. You need to see a licensed or registered professional for that. Medical doctors can diagnose autism, but the diagnosis is complex and often they will make a referral to a Registered Psychologist. You can obtain a referral from the British Columbia Psychological Association for a psychologist near you. The Ministry of Family Services can also advise you on obtaining many diagnostic services for free in your community.
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 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
ScienceDaily () -- Computer scientists have devised two tools to help people interact with autistic children. Videotaping interactions allows teachers or parents to replay situations and evaluate the cause of particularly good or bad behavior. Cataloging actual data, rather relying on memory or interpretation, proves to be a more accurate measure of a situation. These tools are demonstrated in a simple but startling video. You need to watch this video and ask yourself, "How close to this can I get my child's school?"
For a couple years, as a provincial consultant with POPARD, my job was to drive or get on a plane and arrive at a school where there were severe behaviour problems going on. The tool I used to figure out the problem was simple: I watched. That's what this video system does for the teacher, it watches. And more important, it avoids the many pitfalls of relying upon memory of what happened. When teachers try to remember what happened before and after a behaviour of concern they are often unaware of the environment (watch the video!) or they may already have preconceived notions of what is causing the behaviour, and look for that "thing" to happen. Coming in as an outside observer I am often able to avoid both these problems. But this video system...well, I've been replace!
Some simple variations on this tracking system would be to just video times of the day when you know there will be a problem. But you need to collect data to understand the issues.
What the tape skips is the reason we are doing this. Watching you'll see a young boy starts hitting himself. Why? Often times we will hear 1) To get attention , or 2)for self stimulation. Neither of these were the reason in this case, and usually are not. Self abuse and violence with young children with autism is often for communication. Data, information, helps us understand the FUNCTION of a behaviour. Once we understand the function we can do two things: 1) Change the environment so the child doesn't need to engage in the behaviour, and 2) Teach a new skill to meet the function. In the video the child want's something, and can't communicate quickly and easily enough to get what he wants. Yes, he needed to get someone's attention to get it, but attention is not the goal. By watching the situation carefully we can understand the function of the behaviour and teach a new skill to meet that function. MAybe in this case the child needs some visual supports to help communicate (a communication book or pad?). Maybe he needs to practice and be successful at using a sign? I don't have enough details about this child's level of communication skills, but what is important is that we always need to specify how we are going to gather data, gat information, to answer our questions. Video is one possible means. And if your child is having a severe problem at school, I'd have the school watch this video and figure out how they intend to collect that data they need to complete a reliable Functional Behaviour Analysis (FBA).
This blog is not offered as medical advice or as a means of diagnosing or treating autism, Asperger's disorder or any other disorder. Don't go on-line and take an "autism test." The diagnosis is complex, and it involves not just looking for symptoms of autism, but also ruling out other disorders that might look just like autism, Aspergers and other disorders related to ASD. So avoid these on-line "tests" which are nothing more than a collection of symptoms. You need to see a licensed or registered professional for that. Medical doctors can diagnose autism, but the diagnosis is complex and often they will make a referral to a Registered Psychologist. You can obtain a referral from the British Columbia Psychological Association for a psychologist near you. The Ministry of Family Services can also advise you on obtaining many diagnostic services for free in your community.
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 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
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, July 19, 2010
Does it make sense to use Time Out with children with Asperger's?
Another parent comes by with tales of woe from attempting to use "Time-Out" to change behaviour. Well, this doesn't surprise me at all. Time Out is a very difficult procedure, and it really isn't designed to do what most people expect: get a new behaviour started. It is especially difficult to use with children with ADHD, autism, Asperger's and other disorders that have a high percentage of problems with executive function.
Time Out is designed to reduce the frequency of a behaviour by reducing the reinforcement it gets. If a behaviour isn't reinforced, eventually it will fade away. The problem with this is that often times we don't do Time Out well, and because we argue, occasionally give in, and sometimes the child simply wins or gets other reinforcement (like attention) Time Out is very hard to do. This is especially true with children with attention deficit hyperactivity disorder, autism or those kids we think of having paediatric bipolar disorder. Even if we do it wrong one time out of five, we are providing what we call "intermittent reinforcement" and the child will become even more difficult to change. Intermittent reinforcement is what keeps people going back to gamble, in spite of the fact they only win occasionally. Face it, if you've watched "Super Nanny" you know she uses Time Out a lot, calling it the "naughty circle." And in every episode she needs to return and retrain the parents.
But eventually things do improve, and that's often because other behaviour techniques are being used that work better for ADHD, autism and bipolar disorder. These include setting up a family visual schedule, which helps reduce anxiety and depersonalizes the parent-child interactions, and there is always a positive reinforcement system (sometimes a token system) being used.
Whatever the inappropriate and unwanted behaviour is, somehow it works for the child. Somehow it is reinforcing. It may not have been at first, but sooner or later something about the behaviour and the response to it is reinforcing. Otherwise the behaviour would have stopped. It's our job to find out what is reinforcing the behaviour, what its "function" is, and teach our children new, more appropriate and functional "replacement behaviours." Behaviours that serve the same function as the original one, but are appropriate. We call this behaviour the FERB or Functionally Equivalent Replacement Behaviour. Every behaviour plan worth it's salt has a FERB. The replacement behaviour is taught, reinforced, and at the same time the inappropriate behaviour is ignored (as much as humanly possible ....we aren't all Super Nanny!). In this way we are teaching a new skill, and ignoring something we want to go away. We also make environmental changes to decrease the need to engage in the inappropriate behaviour (that's the purpose of that visual family schedule).
Notice, we are ignoring, and teaching, but what are we not doing? We aren't punishing. It isn't really a "naughty circle." It's a Time Out space where what your doing doesn't get reinforcement. Punishment is seldom an important component of successful parenting!
A really good book to learn interaction techniques to deal with children who have frequent and excessive temper tantrums is Dr. Ross Green's "The Explosive Child." It teaches you the skill and philosophy behind providing positive behaviour support to your child rather than trying to use punishment, which, you may have noticed, might stop a particular behaviour, but fails in one big way: It doesn't teach new skills!
For more information about child and adolescent parenting you can visit my web page at www.relatedminds.com, or www.adhdhelp.ca or my Psychology Today Website. You can also call my office at 778.998-7975 to make an appointment for a consultation.
Time Out is designed to reduce the frequency of a behaviour by reducing the reinforcement it gets. If a behaviour isn't reinforced, eventually it will fade away. The problem with this is that often times we don't do Time Out well, and because we argue, occasionally give in, and sometimes the child simply wins or gets other reinforcement (like attention) Time Out is very hard to do. This is especially true with children with attention deficit hyperactivity disorder, autism or those kids we think of having paediatric bipolar disorder. Even if we do it wrong one time out of five, we are providing what we call "intermittent reinforcement" and the child will become even more difficult to change. Intermittent reinforcement is what keeps people going back to gamble, in spite of the fact they only win occasionally. Face it, if you've watched "Super Nanny" you know she uses Time Out a lot, calling it the "naughty circle." And in every episode she needs to return and retrain the parents.
But eventually things do improve, and that's often because other behaviour techniques are being used that work better for ADHD, autism and bipolar disorder. These include setting up a family visual schedule, which helps reduce anxiety and depersonalizes the parent-child interactions, and there is always a positive reinforcement system (sometimes a token system) being used.
Whatever the inappropriate and unwanted behaviour is, somehow it works for the child. Somehow it is reinforcing. It may not have been at first, but sooner or later something about the behaviour and the response to it is reinforcing. Otherwise the behaviour would have stopped. It's our job to find out what is reinforcing the behaviour, what its "function" is, and teach our children new, more appropriate and functional "replacement behaviours." Behaviours that serve the same function as the original one, but are appropriate. We call this behaviour the FERB or Functionally Equivalent Replacement Behaviour. Every behaviour plan worth it's salt has a FERB. The replacement behaviour is taught, reinforced, and at the same time the inappropriate behaviour is ignored (as much as humanly possible ....we aren't all Super Nanny!). In this way we are teaching a new skill, and ignoring something we want to go away. We also make environmental changes to decrease the need to engage in the inappropriate behaviour (that's the purpose of that visual family schedule).
Notice, we are ignoring, and teaching, but what are we not doing? We aren't punishing. It isn't really a "naughty circle." It's a Time Out space where what your doing doesn't get reinforcement. Punishment is seldom an important component of successful parenting!
A really good book to learn interaction techniques to deal with children who have frequent and excessive temper tantrums is Dr. Ross Green's "The Explosive Child." It teaches you the skill and philosophy behind providing positive behaviour support to your child rather than trying to use punishment, which, you may have noticed, might stop a particular behaviour, but fails in one big way: It doesn't teach new skills!
For more information about child and adolescent parenting you can visit my web page at www.relatedminds.com, or www.adhdhelp.ca or my Psychology Today Website. You can also call my office at 778.998-7975 to make an appointment for a consultation.
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
Saturday, May 8, 2010
Floor Time
Stanley Greenspan, the developer of the autism intervention "Floor Time" died this week at 68.
Dr. Greenspan was a psychiatrist who developed this influential approach to teaching children with autism and other developmental disabilities. He died of a stroke. He leaves his wife and co-author Nancy Thorndike Greenspan, who helped author several of his more than 30 books on education and children.
"Floor Time," as it is called, is used in many special education classrooms and therapeutic settings. It is one of the major early interventions for autism. Often times "Floor Time" is seen as an approach that is in opposition to other interventions such as behavioural interventions like ABA (Applied Behavioural Analysis) and clients are often surprised when I recommend both more traditional behavioural interventions as well as this more child centred intervention.
Dr. Greenspan encouraged parents, teachers and behavioural interventionists to get down on the floor with their child, even very young children, and engage with them with words, gestures and modelling in order to encourage the development of one-to-one interpersonal relationships and to expand their world of ideas, concepts, words and communications skills.
In 2000 Dr. Greenspan and Dr. Barry Brazelton co-authored an important book, "The Irreducible Needs of Children." In it he differentiates behavioural approaches from "Floor Time" in which the child leads. Dr. Greenspan found that babies who failed to connect with parents, for whatever reason, are deprived of emotional tools that he feels are necessary for learning and growth. These cannot happen without these ability to use these basic emotional ties. He writes, "Our emotions serve as the orchestra leader for getting the whole mind and brain working together."
While for a child with little communication ABA and behavioural training is a necessary component to teaching basic associations and skills, the emotional component of communication also needs to be focused on. In the best programs I have observed teachers work on ABA goals during several structured periods of the day and then spend several other periods engaged in "Floor Time" skills with children, letting the child lead.
Often schools and agencies want to limit the number of different interventions they use. But emotional contact, and teaching the child to lead, are critical to teaching the child to communicate in a human way. "Floor Time" may really be more about teaching the parent, teacher or interventionist how to follow than it is about direct intervention with the child. ( Another book I often recommend for parents of high functioning children is by Dr. John Gottman, Raising an Emotionally Healthy Child.)
Floor Time is hard to describe, but there is a wonderful video on Dr. Greenspan's web page showing him engaging in play with a child and his mother. Click here to get to the web page. you can also see him working on various videos on YouTube.
Our thoughts go out to Dr. Greenspan's family and co-workers.
Again, for more information on assessments for autism, Aspergers and learning disabilities you can visit my website at www.socialcognitivetherapy.com or www.drjimroche.com
I have offices located in Burnaby and Vancouver which are convenient to the entire lower mainland.
Dr. Greenspan was a psychiatrist who developed this influential approach to teaching children with autism and other developmental disabilities. He died of a stroke. He leaves his wife and co-author Nancy Thorndike Greenspan, who helped author several of his more than 30 books on education and children.
"Floor Time," as it is called, is used in many special education classrooms and therapeutic settings. It is one of the major early interventions for autism. Often times "Floor Time" is seen as an approach that is in opposition to other interventions such as behavioural interventions like ABA (Applied Behavioural Analysis) and clients are often surprised when I recommend both more traditional behavioural interventions as well as this more child centred intervention.
Dr. Greenspan encouraged parents, teachers and behavioural interventionists to get down on the floor with their child, even very young children, and engage with them with words, gestures and modelling in order to encourage the development of one-to-one interpersonal relationships and to expand their world of ideas, concepts, words and communications skills.
In 2000 Dr. Greenspan and Dr. Barry Brazelton co-authored an important book, "The Irreducible Needs of Children." In it he differentiates behavioural approaches from "Floor Time" in which the child leads. Dr. Greenspan found that babies who failed to connect with parents, for whatever reason, are deprived of emotional tools that he feels are necessary for learning and growth. These cannot happen without these ability to use these basic emotional ties. He writes, "Our emotions serve as the orchestra leader for getting the whole mind and brain working together."
While for a child with little communication ABA and behavioural training is a necessary component to teaching basic associations and skills, the emotional component of communication also needs to be focused on. In the best programs I have observed teachers work on ABA goals during several structured periods of the day and then spend several other periods engaged in "Floor Time" skills with children, letting the child lead.
Often schools and agencies want to limit the number of different interventions they use. But emotional contact, and teaching the child to lead, are critical to teaching the child to communicate in a human way. "Floor Time" may really be more about teaching the parent, teacher or interventionist how to follow than it is about direct intervention with the child. ( Another book I often recommend for parents of high functioning children is by Dr. John Gottman, Raising an Emotionally Healthy Child.)
Floor Time is hard to describe, but there is a wonderful video on Dr. Greenspan's web page showing him engaging in play with a child and his mother. Click here to get to the web page. you can also see him working on various videos on YouTube.
Our thoughts go out to Dr. Greenspan's family and co-workers.
Again, for more information on assessments for autism, Aspergers and learning disabilities you can visit my website at www.socialcognitivetherapy.com or www.drjimroche.com
I have offices located in Burnaby and Vancouver which are convenient to the entire lower mainland.
Friday, February 5, 2010
Autism Society of America: Free iPhone App for Children with Autism, Asperger's Syndrome and Developmental Delays
Autism Society of America: Free iPhone App for Children with Autism, Asperger's Syndrome and Developmental Delays
New visual teaching tool from Model Me Kids
Model Me Kids® recently introduced a new visual teaching tool for helping children learn to navigate challenging locations in the community: Model Me Going Places™, an application for the iPhone and iPod Touch. The app contains photo slideshows of children modeling appropriate behavior in various community locations, such as the:
hairdresser
mall
doctor
playground
grocery store
restaurant
The app is based on locations included in the Model Me Going Places DVD, the latest addition to the Model Me Kids social skills training series for children with autism and Asperger Syndrome (expected release date for the DVD is March 2010).
Users can touch the forward and back buttons to move through the photos one by one, or simply press a slideshow button to advance photos automatically. A home button brings users back to the navigation menu where they can choose their next destination. The app also includes audio narration (English) and descriptive text for each photo.
Download the free app at the Apple store or to learn more, visit http://www.modelmekids.com.
New visual teaching tool from Model Me Kids
Model Me Kids® recently introduced a new visual teaching tool for helping children learn to navigate challenging locations in the community: Model Me Going Places™, an application for the iPhone and iPod Touch. The app contains photo slideshows of children modeling appropriate behavior in various community locations, such as the:
hairdresser
mall
doctor
playground
grocery store
restaurant
The app is based on locations included in the Model Me Going Places DVD, the latest addition to the Model Me Kids social skills training series for children with autism and Asperger Syndrome (expected release date for the DVD is March 2010).
Users can touch the forward and back buttons to move through the photos one by one, or simply press a slideshow button to advance photos automatically. A home button brings users back to the navigation menu where they can choose their next destination. The app also includes audio narration (English) and descriptive text for each photo.
Download the free app at the Apple store or to learn more, visit http://www.modelmekids.com.
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