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Graeme Wadlow

ABA Philosophy (HANDS in Autism Diamond) - 0 views

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    ABA Philosophy (HANDS in Autism Diamond) PB_ABA_based_strategies.swf (application/x-shockwave-flash Object)
Tero Toivanen

NeuroLogica Blog » Dr. Laureys Admits Facilitated Communication Failure - 1 views

  • This is where the story gets interesting, and where it became an international controversy. Enter Linda Wouters – a speech therapist who uses facilitated communication (FC). She claimed that after months of training she could communicate with Houbens by sensing the subtle movements of his right hand, which he could use to direct her across a computer screen keyboard.
  • FC, unfortunately, is pure pseudoscience. It was introduced in the late 1980s as a wonderful new method for communicating with children with cognitive disorders, on the assumption that they were more verbally than mentally impaired. Many therapists were convinced, and many parents were overjoyed as their previously non-communicative children starting writing poetry expressing their love for their parents. (And there was also a dark side as some children, through FC, started reporting physical and sexual abuse by parents and caretakers.)
  • When people got around to actually testing FC scientifically it turned out, rather unequivocally, that all the communication was being done subconsciously by the facilitator – a phenomenon called the ideomotor effect. They were not just supporting the hand of their client, they were directing it. Well-designed studies showed that the facilitator was always doing all the communication. FC then shrank to a fringe phenomenon – but its adherents would not give up, and FC continues to this day (even sometimes in courtroom testimony), hoodwinking the unawares and having to be debunked all over again and again.
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  • Regarding Rom Houben video showing Wouters performing FC with Houben clearly showed that he could not be doing the communication. In one video Houben was not even looking at the keyboard, and may not have even been awake. But in every video Wouters was moving his hand across the keyboard at unbelievable speeds – not even a neurologically intact person could direct another to keystrokes with such speed an accuracy by just moving one finger.
  • Laureys has now carried out those tests, and his results hold that it wasn’t Houben doing the writing after all. The tests determined that he doesn’t have enough strength and muscle control in his right arm to operate the keyboard. In her effort to help the patient express himself, it would seem that the speech therapist had unwittingly assumed control… In the more recent test, Houben was shown or told a series of 15 objects and words, without a speech therapist being present. Afterward, he was supposed to type the correct word — but he didn’t succeed a single time.
  • It is truly a scandal that FC is still around. Like homeopathy, therapeutic touch, and many similar medical pseudosciences – their persistence is not a failure of science, which has adequately shown them to be nothing but illusions, but rather of collective rationality.
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     It is truly a scandal that FC is still around. Like homeopathy, therapeutic touch, and many similar medical pseudosciences - their persistence is not a failure of science, which has adequately shown them to be nothing but illusions, but rather of collective rationality.
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

Why parents swear by ineffective treatments for autism. - By Sydney Spiesel - Slate Mag... - 0 views

  • Since most of the ways we diagnose autism are based on behavior, we can't rely on biological, structural, or chemical findings to determine if a treatment is working. We primarily measure success based on a patient's change, or lack thereof, in behavior.
  • The behavioral changes produced by the few effective treatments make life in social settings (including the home) possible, but we have no idea whether they have any effect on the underlying cause (or causes) of autism or whether they even make severely affected patients feel better.
  • One method intended to help, "facilitated communication," is based on the idea that a sensitive facilitator will hold the hand of a patient over a kind of Ouija board. She will then help the patient respond to questions by sensing his intention and helping guide his hand to spell out answers. Rigorous studies have shown that the spelled-out answers come from the unconscious (or, worse, the conscious) mind of the facilitator. Nonetheless, the practice is still in use, and I know parents who are utterly convinced that it is valid and useful. Frankly, something important did happen when facilitated communication was introduced to my patients: They improved, they brightened, they became more social and more interactive, and they seemed, somehow, happier, even though facilitated communication didn't actually translate their thoughts into words. I'll come back to "why" in a minute.
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  • The techniques of sensory integrative treatment include rubbing or brushing skin (using graded and tactile stimulation), balance exercises, exposure to soft music, and the use of weighted clothes, among other things. Does it work? Most of the research has been of very poor quality, but, in virtually all of the recent studies, sensory integration doesn't seem to be any more beneficial than any other treatment.
  • It looks as if environmental alteration, especially if coupled with increased attention and perhaps expectation, often leads to change in human behavior. It's called the "Hawthorne effect."
  • People respond—mostly favorably—to positive attention and interaction. The question we need to ask about all the treatments available for autism is whether they actively shape and change brain development and thus treat the underlying condition, as many proponents believe, or whether the benefits (if they are present at all) are simply another example of the Hawthorne effect.
  • Perhaps my patients who became more alive and more interactive after facilitated communication was introduced changed because their families and caretakers were taking them more seriously as people who might have an inner life—people worthy of attention and interaction.
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    People respond-mostly favorably-to positive attention and interaction. The question we need to ask about all the treatments available for autism is whether they actively shape and change brain development and thus treat the underlying condition, as many proponents believe, or whether the benefits (if they are present at all) are simply another example of the Hawthorne effect.
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

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

NeuroLogica Blog » Facilitated Communication Persists Despite Scientific Crit... - 0 views

  • Facilitated Communication (FC) is a technique for allegedly aiding those with communication impairment, such as some people with autism, to communicate through typing or pointing at a letter board. The idea is that some children have greater cognitive ability than is apparent through their verbal skills, but they lack the motor skills to type or write. The facilitator in FC is trained to hold and support their client’s hand, to help stabilize it, so that they can type out their thoughts.
  • FC was enthusiastically embraced by the special education community in the late 1980s and early 1990s but problems quickly emerged, namely the question of authorship – who is doing the communicating, the client or the facilitator?
  • The scientific evidence came down clearly on one side of that debate – it is the facilitator who is the author of the communication, not the client.
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  • A 2001 review by Mostert came to the same conclusion – that the evidence supports the conclusion that the facilitators are the authors of communication in FC.
  • The strategy here is obvious – studies that directly and objectively confront the key question, who is authoring the writing in FC, gave an answer proponents did not like. They therefore shifted to indirect inference which is more amenable to judgement and qualitative analysis so that the desired results can be manufactured.
  • FC continues to exist on the fringe of legitimate science, but continues to fool journalists, patient advocates, and even physicians.
  • It is sad that FC continues to survive despite the overwhelming scientific evidence that it is not a legitimate method of communication, but rather an elaborate exercise in self-deception.  It is a useful example of how powerful and subtle self-deception can be, and also of the ways in which scientific evidence can be manipulated to generate a desired outcome.
Tero Toivanen

Facilitated communication: Facts, Discussion Forum, and Encyclopedia Article - 1 views

  • The procedure is controversial, since a majority of peer reviewPeer reviewPeer review is the process of subjecting an author's scholarly work, research, or ideas to the scrutiny of others who are experts in the same field. Peer review requires a community of experts in a given field, who are qualified and able to perform impartial review...ed scientific studies conclude that the typed language output attributed to the clients is directed or systematically determined by the therapists who provide facilitated assistance. Some peer-reviewed scientific studies have indicated instances of valid FC, and some FC users have reportedly gone on to type independently.
  • Harvard UniversityHarvard UniversityHarvard University is a private university located in Cambridge, Massachusetts and a member of the Ivy League. Founded in 1636 by the colonial Massachusetts legislature, Harvard is the oldest institution of higher learning in the United States and currently comprises ten separate academic units... psychologist Daniel WegnerDaniel WegnerDaniel M. Wegner is an American social psychologist. He is a professor of psychology at Harvard University and a fellow of the American Association for the Advancement of Science. He is known for his work on mental control and conscious will, and for originating the study of transactive memory and... has argued that facilitated communication is a striking example of the ideomotor effectIdeomotor effectThe ideomotor effect is a psychological phenomenon wherein a subject makes motions unconsciously. As in reflexive responses to pain, the body sometimes reacts reflexively to ideas alone without the person consciously deciding to take action..., the well-known phenomenon whereby individuals' expectations exert unconscious influence over their motor actions. Even FC users and proponents do acknowledge the possibility of facilitators at times "guiding" users, consciously or unconsciously. Other theorists (Donnellan and Leary, 1995) argue that autism is in significant part characterized by dyspraxia (a movement disorder), and that there exists a synchronistic "dance" to communication in all mammalian social interaction which accounts for the mixed results in validation studies.
  • Stephen von Tetzchner, the author of another leading textbook on Augmentative and Alternative CommunicationAugmentative and alternative communicationAugmentative and alternative communication is communication for those with impairments or restrictions on the production or comprehension of spoken or written language.-Definition :... has done theoretical research about facilitated communication. In his opinion "The existing evidence clearly demonstrates that facilitating techniques usually led to automatic writingAutomatic writingAutomatic writing is the process or production of writing material that does not come from the conscious thoughts of the writer. Practitioners say that the writer's hand forms the message, with the person being unaware of what will be written...., displaying the thoughts and the attitudes of the facilitators."
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  • Mark Mostert (2001) says: "Previous reviews of Facilitated Communication (FC) studies have clearly established that proponents' claims are largely unsubstantiated and that using FC as an intervention for communicatively impaired or noncommunicative individuals is not recommended." In March 2007, Scott Lilienfeld included facilitated communication on a list of treatments that have the potential to cause harm in clients, published in the APSAssociation for Psychological ScienceThe Association for Psychological Science , previously the American Psychological Society, is a non-profit organization whose mission is to promote, protect, and advance the interests of scientifically oriented psychology in research, application, teaching, and the improvement of human welfare... journal Perspectives on Psychological Science.
  • The phrase "independent typing" is defined by supporters of FC as "typing without physical support", i.e., without being touched by another person. Skeptics of FC do not agree that this definition of independence suffices because of the possibility of influence by the facilitator. For example, Sue RubinSue RubinSue Rubin is a functionally non-verbal published autistic author who was the subject of the Oscar-nominated documentary Autism Is A World in which she communicated via the controversial communication technique of facilitated communication...., an FC user featured in the autobiographical documentary Autism Is A World, reportedly types without anyone touching her; however, she reports that she requires a facilitator to hold the keyboard and offer other assistance.
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    The procedure is controversial, since a majority of peer reviewed scientific studies conclude that the typed language output attributed to the clients is directed or systematically determined by the therapists who provide facilitated assistance. Some peer-reviewed scientific studies have indicated instances of valid FC, and some FC users have reportedly gone on to type independently.
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

Autistic Aphorisms: Intelligence, Genius, and Autism - 0 views

  • Professor James Flynn has incorporated an interesting sidebar into his book What is Intelligence? In it he lists his seven choices for Western civilization’s greatest minds: Pythagoras, Plato, Aristotle, Archimedes, Newton, Gauss, and Einstein.
  • Hundreds of research teams, maybe even thousands by now, have so convinced themselves that intelligence must originate from inside our skulls, have so convinced themselves that only within networks of cranial neurons can be found the secrets to humanity’s growing mental capacity, that all have managed to overlook completely the far more plausible alternative—the one existing right before our very eyes.
  • It is time to reconsider that conventional wisdom, time to regard genius with a different set of eyes; for genius is not a function of greater intelligence, genius is the description of how intelligence grows.
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  • Look at the content of any intelligence test—language, arithmetic, patterns, designs. What we measure with the aid of those I.Q. booklets are not the abilities we inherited from out our animal past, but instead their exact counterpart; we measure only those skills the species has been adding throughout all its history since. In some sense, an intelligence test measures the modernness of an individual; an intelligence test measures an individual’s ability to appropriate for himself the same set of skills the species has been appropriating as a whole—skills that do not find their origin in our biological nature, but instead owe their existence to the strange, brewing mixture of non-biological pattern, structure and form that has been rapidly taking shape all around us.
  • The unusual characteristics of humanity’s transformational individuals are not the result of their genius, they are genius’s prerequisite
  • But counter to prevailing wisdom, there are many autistic individuals—most likely a majority—who do make substantial progress by means of an alternative perceptual course, a course that allows them not only to navigate meaningfully their surrounding world, but also to assimilate, if somewhat awkwardly and belatedly, to the human species itself (and thereby explaining how autism, estimated to be present in nearly one percent of the human population, could go entirely unrecognized until as recently as sixty-five years ago).
  • all autistic individuals must crystallize their existence by means of this alternative perceptual course—it becomes, in essence, autism’s most salient feature.
  • The unusual behaviors and interests of autistic children—lining up toys, staring at ceiling fans, twirling, flapping hands repeatedly, fascination with knobs, buttons, switches, letters, shapes and digits, watching the same video again and again, singing the same song over and over—these activities betray a form of perception completely unlike that of most other children, a perception noticeably absent in social and biological focus, but also noticeably drawn to symmetry, repetition and pattern.
  • The unusual routines of autistic children are the natural, indeed the expected, mode of expression for a form of perception engaged primarily by the structural aspects of the non-social, non-biological world.
  • Autistic individuals would have been the first to notice the inherent structure contained in the natural world—the geometry of plants, the isomorphisms of natural objects, the logic of the celestial seasons—only they would have had motivation to embrace such form, only they would have had the need to perceive nature’s symmetry, repetition and pattern in order to form their cognitive grounding.
  • We know only bits and pieces about the four Greeks on Professor Flynn’s list, but filling in with the traits from the list’s more modern members, we can reasonably summarize all the unifying characteristics: late- or strange-talking, socially awkward, irascible, obsessed with structure, compelled by form, unusually—not necessarily greatly—intelligent.
  • The continuing medicalization of autism, the insistent demonization of autism’s spontaneous effect—these carry the danger of an unforeseen consequence. For the cure of autism will not be the end of a tragic brain disorder; autism’s eradication will not see the passing of a troubling mental disease. The removal of autism from the entire human species will produce only an ironic solution to the mystery of our expanding human intelligence, it will produce the ignoble end to the Flynn effect.
  • When confronted by data that runs counter to our accustomed way of seeing things, we as humans have but two choices: we can try to explain the results away, or we can adjust our perception of the experienced world. The former choice paves the all-too-common road of modern academic science; the latter, as described above, walks the more promising path of genius.
  • Autism is not a mental illness, not a brain disorder, it is instead the source of humanity’s changing perception of its experienced world; it is, with care and understanding, genius’s fertile soil.
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    Autism is not a mental illness, not a brain disorder, it is instead the source of humanity's changing perception of its experienced world; it is, with care and understanding, genius's fertile soil.
Tero Toivanen

A Controversial Autism Therapy Unravels a Family - TIME Healthland - 0 views

  • "With a facilitator guiding her arm, the child who had never been taught to read was suddenly writing poetry and English essays, taking history exams and doing algebra. The middle-schooler who couldn't put on her coat without help was typing about her plans to become a college professor,"
  • But the technique, in which the aide's hand is supposedly guided by the child to type what she wants to say, has been proved ineffective. It has been shown to rely on the aide's projections rather than to reflect the child's thoughts. Although some autistic children can learn to communicate genuinely via a keyboard with only initial guidance, facilitated communication, in which an aide always does the typing has repeatedly failed to demonstrate that the words are written or thought by the child. For example, when the facilitator is not allowed to hear the questions being asked of the child, the resulting answers are wrong or nonsensical.
  • When the Wendrow's daughter's aide typed allegations of sexual abuse against the girl's father and brother — and claimed that the child's mother had been ignoring her complaints — a prosecution of the family was set into motion that became nearly unstoppable. The aide refused to believe she was not typing her own ideas, even though the child was clearly not capable of the complex language being attributed to her. Once prosecutors and the aide became convinced of the truth of the allegations, even overwhelming evidence of their falsehood was ignored.
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    Facilitated Communication (FC) is dangerous!
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