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Tero Toivanen

Autism Therapy: pivotal response training | Healing Thresholds - 0 views

  • Future research may allow therapists to know in advance which type of applied behavior analysis (ABA therapy) is most likely to work for any given child with autism.
  • This study of six children was designed to see if it is possible to predict which type of ABA therapy will work for which child with autism.
  • The authors were able to predict which children would respond to pivotal response training, but not which ones would respond to discrete trial training. The authors note that all children were first exposed to pivotal response training and then to discrete trial training and this may have influenced the results. Children who liked toys were more likely to respond to pivotal response training than children who did not like toys.
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  • This study looked at whether or not a type of applied behavior analysis (pivotal response training) could be used to teach play skills to children with autism.
  • . Both children in the study improved their social skills during recess time.
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    Type of training in which certain behaviors are assumed to be crucial for other behaviors. These pivotal behaviors are then targeted so that the behaviors that depend upon them can change as well.
Tero Toivanen

Autism Therapies and Outcomes -- Outcomes and Autism - 0 views

  • The view of the behavior analyst should be that the subject is always right. If the child isn't learning, you need to know why. It's not that the child is defective, it's that the approach isn't working. The therapist needs to ask, "what do I need to do to teach this child?" ...Being autistic shouldn't stop children from learning. It has nothing to do with their ability to learn. They just don't learn typically. That's the problem we have. You can't use "autism" as way to explain behaviors: it is the behaviors. Why do the behaviors occur? We don't always know. But that doesn't mean we can't teach children with autism language and social interaction. They don't need us to have fun -- they can create their own reinforcers. The therapist has to find a reinforcer that's better than what the child can do on his own. That "better thing" should always have a social component.
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    It's important to remember that, when it comes to therapy for children with autism, failure to progress is never the fault of the child. If you hear from a therapist that your child doesn't progress because of his behaviors, attention span, intelligence level, or stubbornness, it's time to question the therapist's technique.
Tero Toivanen

News from the Associated Press - newsjournalonline.com - 0 views

  • Leo Lytel was diagnosed with autism as a toddler. But by age 9 he had overcome the disorder. His progress is part of a growing body of research that suggests at least 10 percent of children with autism can "recover" from it - most of them after undergoing years of intensive behavioral therapy.
  • She presented research this week at an autism conference in Chicago that included 20 children who, according to rigorous analysis, got a correct diagnosis but years later were no longer considered autistic.
  • Skeptics question the phenomenon, but University of Connecticut psychology professor Deborah Fein is among those convinced it's real.
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  • Previous studies have suggested between 3 percent and 25 percent of autistic kids recover. Fein says her studies have shown the range is 10 percent to 20 percent.
  • But even after lots of therapy - often carefully designed educational and social activities with rewards - most autistic children remain autistic. Recovery is "not a realistic expectation for the majority of kids," but parents should know it can happen, Fein said.
  • The children in Fein's study, which is still ongoing, were diagnosed by an autism specialist before age 5 but no longer meet diagnostic criteria for autism. The initial diagnoses were verified through early medical records.
  • The researchers are also doing imaging tests to see if the recovered kids' brains look more like those of autistic or nonautistic children.
  • Imaging scans also are being done to examine brain function in formerly autistic kids.
  • Results from those tests are still being analyzed.
  • Most of the formerly autistic kids got long-term behavior treatment soon after diagnosis, in some cases for 30 or 40 hours weekly.
  • Many also have above-average IQs and had been diagnosed with relatively mild cases of autism. At age 2, many were within the normal range for motor development, able to walk, climb and hold a pencil.
  • Significant improvement suggesting recovery was evident by around age 7 in most cases, Fein said.
  • None of the children has shown any sign of relapse. But nearly three-fourths of the formerly autistic kids have had other disorders, including attention-deficit problems, tics and phobias; eight still are affected.
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    Leo Lytel was diagnosed with autism as a toddler. But by age 9 he had overcome the disorder. His progress is part of a growing body of research that suggests at least 10 percent of children with autism can "recover" from it - most of them after undergoing years of intensive behavioral therapy.
Tero Toivanen

New Theory Of Autism Suggests Symptoms Or Disorder May Be Reversible - 0 views

  • the brains of people with autism are structurally normal but dysregulated, meaning symptoms of the disorder might be reversible.
  • autism is a developmental disorder caused by impaired regulation of the locus coeruleus, a bundle of neurons in the brain stem that processes sensory signals from all areas of the body.
  • The new theory stems from decades of anecdotal observations that some autistic children seem to improve when they have a fever, only to regress when the fever ebbs.
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  • This study documented that autistic children experience behavior changes during fever.
  • Einstein researchers contend that scientific evidence directly points to the locus coeruleus–noradrenergic (LC-NA) system as being involved in autism. "The LC-NA system is the only brain system involved both in producing fever and controlling behavior," says co-author Dominick P. Purpura, M.D., dean emeritus and distinguished professor of neuroscience at Einstein.
  • The locus coeruleus has widespread connections to brain regions that process sensory information. It secretes most of the brain's noradrenaline, a neurotransmitter that plays a key role in arousal mechanisms, such as the "fight or flight" response. It is also involved in a variety of complex behaviors, such as attentional focusing (the ability to concentrate attention on environmental cues relevant to the task in hand, or to switch attention from one task to another). Poor attentional focusing is a defining characteristic of autism.
  • "What is unique about the locus coeruleus is that it activates almost all higher-order brain centers that are involved in complex cognitive tasks," says Dr. Mehler.
  • autism, the LC-NA system is dysregulated by the interplay of environment, genetic, and epigenetic factors
  • They believe that stress plays a central role in dysregulation of the LC-NA system, especially in the latter stages of prenatal development when the fetal brain is particularly vulnerable.
  • a higher incidence of autism among children whose mothers had been exposed to hurricanes and tropical storms during pregnancy.
  • autistic children, fever stimulates the LC-NA system, temporarily restoring its normal regulatory function. "This could not happen if autism was caused by a lesion or some structural abnormality of the brain," says Dr. Purpura.
  • future of autism treatment probably lies in drugs that selectively target certain types of noradrenergic brain receptors or, more likely, in epigenetic therapies targeting genes of the LC-NA system.
  • If the locus coeruleus is impaired in autism, it is probably because tens or hundreds, maybe even thousands, of genes are dysregulated in subtle and complex ways," says Dr. Mehler. "The only way you can reverse this process is with epigenetic therapies, which, we are beginning to learn, have the ability to coordinate very large integrated gene networks."
  • "You can't take a complex neuropsychiatric disease that has escaped our understanding for 50 years and in one fell swoop have a therapy that is going to reverse it — that's folly. On the other hand, we now have clues to the neurobiology, the genetics, and the epigenetics of autism. To move forward, we need to invest more money in basic science to look at the genome and the epigenome in a more focused way."
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    the brains of people with autism are structurally normal but dysregulated, meaning symptoms of the disorder might be reversible.
Tero Toivanen

Applied Behavioral Analysis - Understanding ABA Therapy - 1 views

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    Applied Behavior Analysis (ABA) techniques have been proven in many studies as the leading proven treatment and method of choice on treating individuals with autism spectrum disorder at any level. ABA approaches such as discrete trial training (DTT), Pivotal Response Training (PRT), Picture Exchange Communication System (PECS)
Tero Toivanen

Autism disorders might be reversible. | - I Teach Autism.com - - 0 views

  • Scientists at Albert Einstein College of Medicine of Yeshiva University have proposed a sweeping new theory of autism that suggests that the brains of people with autism are structurally normal but dysregulated, meaning symptoms of the disorder might be reversible.
  • The central tenet of the theory, published in the March issue of Brain Research Reviews, is that autism is a developmental disorder caused by impaired regulation of the locus coeruleus, a bundle of neurons in the brain stem that processes sensory signals from all areas of the body.
  • The new theory stems from decades of anecdotal observations that some autistic children seem to improve when they have a fever, only to regress when the fever ebbs.
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  • Einstein researchers contend that scientific evidence directly points to the locus coeruleus–noradrenergic (LC-NA) system as being involved in autism. “The LC-NA system is the only brain system involved both in producing fever and controlling behavior,” says co-author Dominick P. Purpura, M.D., dean emeritus and distinguished professor of neuroscience at Einstein.
  • The locus coeruleus has widespread connections to brain regions that process sensory information.
  • It is also involved in a variety of complex behaviors, such as attentional focusing (the ability to concentrate attention on environmental cues relevant to the task in hand, or to switch attention from one task to another).
  • “What is unique about the locus coeruleus is that it activates almost all higher-order brain centers that are involved in complex cognitive tasks,” says Dr. Mehler.
  • Drs. Purpura and Mehler hypothesize that in autism, the LC-NA system is dysregulated by the interplay of environment, genetic, and epigenetic factors (chemical substances both within as well as outside the genome that regulate the expression of genes). They believe that stress plays a central role in dysregulation of the LC-NA system, especially in the latter stages of prenatal development when the fetal brain is particularly vulnerable.
  • Drs. Purpura and Mehler believe that, in autistic children, fever stimulates the LC-NA system, temporarily restoring its normal regulatory function.
  • the future of autism treatment probably lies in drugs that selectively target certain types of noradrenergic brain receptors or, more likely, in epigenetic therapies targeting genes of the LC-NA system.
  • “You can’t take a complex neuropsychiatric disease that has escaped our understanding for 50 years and in one fell swoop have a therapy that is going to reverse it — that’s folly. On the other hand, we now have clues to the neurobiology, the genetics, and the epigenetics of autism. To move forward, we need to invest more money in basic science to look at the genome and the epigenome in a more focused way.”
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    Scientists at Albert Einstein College of Medicine of Yeshiva University have proposed a sweeping new theory of autism that suggests that the brains of people with autism are structurally normal but dysregulated, meaning symptoms of the disorder might be reversible.
Tero Toivanen

Interview with Robert Koegel | Pivotal Response Treatments for Autism Author on ABC's S... - 1 views

  • The NLP became synonymous with motivation and motivation is pivotal in teaching children with autism to respond to multiple questions.
  • 1988 was the first time the word pivotal was used to describe this method. It was referred to previously as the NLP. It is considered a behavior intervention with similarities to the Lovaas method/ABA. 
  • Why would you say PRT is more effective than other therapies
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  • First and foremost, children think of it as fun and learn skills by doing what they enjoy.
  • PRT is effective in all of the child’s environments and versatile enough to use at home, in clinical settings, in an inclusive classroom, and in the community, and parents can easily start folding PRT strategies into the child's established routine right away.
  • How does PRT decrease stress for parents?
  • Children often hate having to perform drill practices involved with other autism treatments, they feel like they are being forced to do something they don't enjoy and they react to this by causing a scene to get out of treatment.
  • What exactly are "pivotal responses?"
  • "areas that are central to wide areas of functioning such that improvements occur across a large number of behaviors." 
    • Tero Toivanen
       
      Pivotal responses määrittely!!!
  • Once they understand the connection between using their own words and getting something they want, they will start to use words spontaneously to communicate their needs. Mastering this one pivotal behavior, motivating the child to understand the connection between their own efforts to communicate with the outcomes of their efforts, will have an enormous ripple effect on other skills.
    • Tero Toivanen
       
      In practice.
  • It works because there is a motivator that makes the child want to work to accomplish the task at hand, the reward for accomplishing the task has a direct connection to it.
  • PRT was named by the National Research Council of the National Academy of Sciences in 2001 as one of the top 10 state-of-the-art treatments for autism in the United States.
  • A child who is highly motivated to communicate and is having fun doing it will learn much more rapidly than a child who is not motivated and not enjoying what they are learning.
Tero Toivanen

Research Unearths New Treatments for Autism - 2 views

  • The Utah researchers found that children receiving a combination of the two treatments (Lovaas-type training at school and TEACCH methods at home) showed three to four times greater progress on all outcome tests than did children who received only the school-based treatment. That study was reported in the Journal of Autism and Developmental Disorders (Vol. 28, No. 1, p. 2532).
  • Researchers in Washington, D.C., are comparing a discrete trial training approach with a "developmental, individual-difference, relationship based" (DIR) approach, says child psychiatrist Stanley Greenspan, MD, professor of psychiatry at George Washington University Medical School.
  • Psychologist Robert Koegel, PhD, at the University of California, Santa Barbara, and his colleagues are attempting to tailor a standard treatment to the specific needs of an autistic child and family. The standard treatment is called pivotal response training
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  • An initial retrospective study is comparing two groups of 20 children initially diagnosed with autism who were functioning well after two or more years of treatment, either with a discrete trial training approach or the DIR approach. The study aims to determine if treatment differences lead to subtle differences in outcome, for example, in terms of flexibility, emotional range, creativity and richness of the child's inner life. Investigators are planning to follow this research with a prospective, randomized, more rigorous study of the two approaches.
  • "In our previous studies we found out that it looks like you can't just deliver a standard treatment to autistic kids, that there's so much variability among the children that what works for one child doesn't work for another child," he says. "Our hypothesis is that...unless you individualize treatment, you're not going to get the best effect."
  • Researchers at the University of Maryland are testing an intervention to trigger children's "social engagement system," which includes behaviors such as listening, looking, facial expressions and vocalizations that support social interaction, says psychologist Stephen Porges, PhD. The treatment is designed to improve autistic children's ability to interact with others, thereby making them more receptive to traditional therapies.
  • The intervention is based on the theory that tensing the middle ear muscles enables people to pick out the human voice from lower frequency sounds in the environment, Porges says. Treatment involves exercising middle ear muscles by playing music that has been altered to include only frequencies associated with the human voice, which improves one's ability to listen to human voices. This, in turn, stimulates the entire social engagement system, Porges says. About 80 percent of 50 children with autism or other behavioral problems receiving this treatment via five 45-minute sessions in a double blind, randomized controlled study showed marked improvements in listening, language and other communication skills.
  • In a report last year in the Journal of Autism and Developmental Disorders (Vol. 28, No. 1, p. 15-23) evaluating an intensive home-based discrete trial training intervention, Stephen Sheinkopf, PhD, of the University of Miami and Bryna Siegel, PhD, of the University of California, San Francisco, noted that children receiving an average of only 21 hours per week of treatment showed gains in IQ comparable to those achieved by children receiving 32 hours per week. The intensity question remains an issue of importance for the autism community. "If we need 40 hours a week, fine," says psychologist Geraldine Dawson, PhD, of the University of Washington. "But if you only need 25, you have to realize that 40 hours is a tremendous burden not only financially, but on families and on the child."
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    Several treatments, and combinations of treatments, are under intense study.
Tero Toivanen

Sensory Friendly Classrooms with Dr. Roya Ostovar - The SPD Blogger Network - 3 views

  • Having sensory friendly settings is common sense and it benefits everyone, all students and learners as well as teachers and staff. Changing the classroom also teaches all students how to find practical and adaptive ways of making their setting work for them to allow for optimal learning and functioning, a skill that is beneficial to everyone. It also makes more sense to change the environment to fit the child’s needs and not the other way around. Changing the classroom helps the child with SPD blend in with other students, and it is not isolating, or stigmatizing.
  • A sensory friendly classroom improves attention, concentration, ability to focus for longer periods of time, learning, social functioning, and it also reduces the overall level of stress
  • For more specific and multiple examples of the accommodations that can be made, a book I authored titled “The Ultimate Guide to Sensory Processing Disorder” offers a comprehensive guide.
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  • Vision: Reduce/ eliminate clutter and visual distractions; modify assignments to be shorter; use a highlighter
  • Auditory: Reduce/eliminate distracting noise; play Mozart or calming music in the background when possible
  • Tactile: Allow students to use chalk on the board because it is more tactile rich
  • Olfactory: Use scented markers to wake kids up; have lavender lotion or soap; and avoid noxious odors in the classroom
  • Vestibular: Allow movement and breaks; offer therapy balls to sit on; Movin-Sit cushions benefit the whole classroom; stretch breaks, start class with movement activities
  • Properioception: Movement, Movin-Sit cushions, Brain Gym, Yoga, Chair push ups (i.e. sitting on hands and pushing up); chairs and tables at right height and positioned correctly
  • A sensory friendly classroom gets the kids with SPD and ASD ready to learn; improves the overall functioning of the child including learning, attention, concentration, social functioning, and behavioral presentation; and lowers their stress and anxiety levels
  • Two quick suggestions: 1) Simplify the classroom: Less is more. Take a minimalistic approach to setting up the room and; 2) Support all learning styles: Some kids learn through auditory channels, some visual, and some through kinesthetic and hands on activities. By the same token, incorporate activities that support the sensory channel and each child’s sensory profile
Tero Toivanen

Early intervention for toddlers with autism highly effective, study finds - 1 views

  • The study, published online today in the journal Pediatrics, examined an intervention called the Early Start Denver Model, which combines applied behavioral analysis (ABA) teaching methods with developmental 'relationship-based' approaches.
  • The five-year study took place at the University of Washington (UW) in Seattle and was led by Dawson, then a professor of psychology and director of the university's Autism Center, in partnership with Rogers. It involved therapy for 48 diverse, 18- to 30-month-old children with autism and no other health problems.
  • At the conclusion of the study, the IQs of the children in the intervention group had improved by an average of approximately 18 points, compared to a little more than four points in the comparison group. The intervention group also had a nearly 18-point improvement in receptive language (listening and understanding) compared to approximately 10 points in the comparison group. Seven of the children in the intervention group had enough improvement in overall skills to warrant a change in diagnosis from autism to the milder condition known as 'pervasive developmental disorder not otherwise specified,' or PDD-NOS. Only one child in the community-based intervention group had an improved diagnosis.
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  • In this study, the intervention was provided in a toddler's natural environment (their home) and delivered by trained therapists and parents who received instruction and training as part of the model.
  • Parents are taught strategies for capturing their children's attention and promoting communication. By using these strategies throughout the day, the children were offered many opportunities to learn to interact with others.
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    A novel early intervention program for very young children with autism - some as young as 18 months - is effective for improving IQ, language ability, and social interaction, a comprehensive new study has found.
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