Thursday, October 30, 2008

Nova Scotia's Behavioral Therapy Program Works ... For Those Autistic Children Who Receive It

The Chronicle Herald reports that a Nova Scotia government early intensive behavioral intervention program works .... for those autistic children fortunate enough to receive it. The program was evaluated by Isabel Smith, a researcher based at the IWK Health Centre. She evaluated 27 children who completed a year of treatment as part of the early intensive behavioural intervention program:

She found all of them had significantly improved communication skills. They also had better problem-solving skills and reduced behavioural problems.

Unfortunately, not all autistic children receive treatment in Nova Scotia which uses an immoral lottery system to determine which children receive treatment. The Nova Scotia government has no plans to expand the program to include all autistic children who require treatment.




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Wednesday, October 29, 2008

Mr. Long, Lean and Lanky Visits the Pediatrician




























Conor visited the pediatrician today for a review. No pressing health issues; Conor just hadn't been to see him for awhile. While we waited for the doctor an assistant measured Conor's weight, 134 lbs, and height 5 feet 8 1/2 inches.

Conor's autism issues have been a challenge. But he has been blessed with excellent physical health and likes to keep moving. Over the last year he has had a major growth spurt. Mr. Long, Lean and Lanky is about 2 inches taller than Mom.




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Tuesday, October 28, 2008

CACI Presents Social Cognition and Aspergers Syndrome

The COMMUNITY AUTISM CENTRE INC.

Presents

Social Cognition and Aspergers Syndrome :
Teaching Social Skills From The Inside Out

(Based on the work of Michelle Garcia Winner and colleagues- /www.socialthinking.com )
Presenter- Sharon Kincade , B.A., M.A. Psyc

Sharon also has a Post Graduate Certificate in Counseling and is
currently working towards her Master's in Counseling. In addition, she
has a Diploma in University Teaching and is an Associate Member of The
College Of Psychologists. She has been involved with the Community
Autism Centre for 7 years .

A four Part Training Presentation

PART ONE: SOCIAL COGNITION- AN INSIDE OUT APPROACH
Friday, October 31,2008
10:00am - 3:00pm

Part Two: Social Thinking Across The Home And School (DVD Training
Michelle Garcia Winner)
Friday , November 28th,2008
9:00am - 3:00pm

Part Three : Growing Up Social- Exploring How Social Communication
Develops And Strategies To Help
(DVD Training- Michelle Garcia Winner)
Friday, January 30, 2009
10:00am - 3:00pm

Part Four : Social Behavior Mapping
(DVD Training- Michelle Garcia
Winner)
Friday, February 27th, 2009
10:00am - 3:00pm

REGISTRATION - $25.00
PLEASE CALL 642-1128 - Seating IS Limited (15 participants)



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Monday, October 27, 2008

Dr. Eric Larsson Reviews, Recommends UNB Autism Intervention Training Program

"The current AITP is a remarkable and thorough program that has been developed to an exceptional level of quality in the context of limited resources. The province-wide model is one that many other provinces should adopt, as it carries with it many cost-effective features. The curriculum content requires little modification".

- Dr. Eric Larsson, of the Lovaas Institute, External Review of the University of New Brunswick Autism Intervention Training Program

Dr. O. Ivar Lovaas is a world-renowned autism expert who has devoted his career to improving the lives of children with autism and their families. His Lovaas Model of Applied Behavior Analysis is based on 40 years of research and is backed by published studies showing half of children with autism who receive this intensive treatment become indistinguishable from other children on tests of cognitive and social skills by the time they completed first grade.

The one-on-one intensive behavioral treatment program is customized to meet the needs of each child and family served. The program is available nationwide at 12 Lovaas centers as well as through certified consultants across the country who are employed by the Lovaas Institute.

The Lovaas Model of Applied Behavior Analysis has undergone rigorous research at UCLA under the direction of Dr. Lovaas, proving its effectiveness in treating children with autism.

Eric V. Larsson, Ph.D., L.P., BCBA, Executive Director, Clinical Services, The Lovaas Institute for Early Intervention <http://www.lovaas.com/> , Midwest Headquarters where he implements a program of intensive early intervention services for families of children who suffer from severe behavior disorders. This intensive early intervention program is one of the most thorough and highly supervised behavior therapy programs in the field. Dr. Larsson is recognized as an expert in early intervention, inclusive communities, severe behavior disorders, multiple handicaps, autism, the rights of individuals with disabilities, nonaversive treatment, Applied Behavior Analysis, and self-injurious behavior. He has published papers on such topics as early intervention, functional communication, autism, social skills, parenting, and human rights. He has given over 70 presentations and 60 workshops on such topics as intensive early intervention, parenting, curriculum management, community leadership, behavior management, staff training, quality assurance, family violence, social skills, inclusive communities, autism, and consultation. He holds adjunct appointments at several major universities. H e is currently on the Autism Advisory Board of the Cambridge Center for Behavioral Studies.

Anne Higgins
Director Professional Development Division
College of Extended Learning
University of New Brunswick
506-453-4851
eah@unb.ca



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Straight Talk, Hard Facts: Governor Palin Slashed Autism and Special Needs Funding

hampsona, or Aram, from Southern Oregon has posted on ireport an article by Julie Pippert featuring two Alaska Government operating budget documents. Aram has a seven year old autistic daughter and is concerned by Ms Pippert's report showing that Governor Palin, in one year, actually slashed spending for the department that provides services for children with severe disabling conditions, including schooling, by 60%

The decreases in planned and actual spending are set out in two operating budget documents for 2007 and 2008:

1. State of Alaska FY2007 Governor's Operating Budget for the Department of Education and Early Development Special Schools Component Budget Summary

budget actuals are (FY = Fiscal Year):
FY 2005 6945.30
FY 2007 Management Plan 7949.30
FY 2007 Governors 8265.30

2. State of Alaska FY2008 Governor's Operating Budget for the Department of Education and Early Development Special Schools Component Budget Summary

FY 2006 7949.30
FY 2007 Management Plan 3173.70
FY 2008 Governor 3156.00

Some straight talk, "my friends"? Governor Palin's past record is not that of a friend of special needs children.



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Sunday, October 26, 2008

Autism, Parental Age and Birth Order

A study in the United States has found a link between higher parental age and the likelihood of first born children of older parents developing autism. The study, Advanced Parental Age and the Risk of Autism Spectrum Disorder, by Maureen S. Durkin, Matthew J. Maenner, Craig J. Newschaffer, Li-Ching Lee, Christopher M. Cunniff, Julie L. Daniels, Russell S. Kirby, Lewis Leavitt, Lisa Miller, Walter Zahorodny, and Laura A. Schieve is published in the advance access section of the online edition of the American Journal of Epidemiology, October 21, 2008.

The study defined "older" parents as mothers aged 35 or older and fathers aged 40 or older (maternal age ≥35, paternal age ≥40 years). The risk of developing ASD increased significantly with each 10-year increase in both maternal age and paternal age. Each 10-year increase in maternal age was associated with a 20% increase in ASD risk while each 10-year increase in paternal age was associated with a 30% increase in ASD risk.

The study also confirmed earlier studies showing greater risk of ASD development amongst first born children of older parents:

"The risk of ASD within each of 3 parental age categories (both parents "younger," 1 parent "older," and both parents "older") was highest among firstborn children and declined with increasing birth order" ....... The results of this study provide the most compelling evidence to date that ASD risk increases with both maternal and paternal age and decreases with birth order."

What I find curious is the greater risk of autism development amongst firstborn children given that the parental age will always be greater amongst the subsequently born children than amongst first born. The authors of the study offer no conclusion on this point but provide several existing hypotheses as possible explanations:

The observation in this and at least 2 previous studies (2, 4) that the risk of developing ASD was highest for firstborn children and declined with increasing birth order is a pattern also observed for other childhood disorders, including type I diabetes and atopy, and is cited as support for the "hygiene hypothesis." According to this hypothesis, firstborn children are exposed to fewer infections from other children early in childhood and, because of delayed immunologic challenge, may be more likely to develop autoimmune responses including those that may adversely affect neurodevelopment (29). Another possible factor that could lead to the observed birth-order effect is exposure to potentially neurotoxic, fat-soluble chemicals accumulated in maternal tissue that have been passed to offspring transplacentally or through breast milk (30). Because of accumulation over a lifetime, the load of such neurotoxins transmitted might be expected to be highest for firstborn children, particularly when combined with advanced maternal age. Another possible explanation for the observed birth order effect is "stoppage" or a tendency for parents of 1 child with ASD not to have subsequent children because of the demands of parenting a child with a disability or concerns about genetic susceptibility (31), thus increasing the likelihood in the cohort as a whole that a child with ASD will have a low birth order. Information available for the present study did not allow examination of these hypotheses.

I was 42 when my younger son Conor, subsequently diagnosed with Autistic Disorder, was born. As an older father within the definition of this study I hope that this line of study continues to be explored objectively and professionally and is not derailed or distorted by the anger, from all "sides", that afflicts much public discussion of autism causes and treatments.

Anyone interested in following this issue in the "blogosphere" should check out the blog AUTISM PREVENTION FATHER BABIES 25-33 PATERNAL AGE IS A KEY IN NON-FAMILIAL AUTISMVaccines by concernedheart which is listed on my Autism Blog List in the right side bar of this blog. Concernedheart has been following this area for awhile and updates regularly.

Saturday, October 25, 2008

Canada's Autism Wastelands - Saskatchewan, Ontario, Nova Scotia

On September 02, 2007 I described Saskatchewan as Canada's Autism Wasteland. In fact Canada has at least three autism wastelands although Saskatchewan still ranks as the worst province in Canada for provision, or more accurately, non-provision, of autism services.

1. Saskatchewan

As stated in Canada's Autism Wasteland To Take First Step Forward on September 02 2007, Saskatchewan, at that time, was the only province in Canada without a program for provision of autism services. 14 months later nothing has changed according to Theresa Savaria, the executive director of Regina's Autism Resource Centre. In Man running to raise awareness about autism spectrum disorder , Leader Post, October `17, 2008, Savaria states:

"Parents can go on the Internet and see that everyone is recommending intensive intervention, but Saskatchewan is the only province that doesn't have that"


2. Ontario

Ontario is notorious for its lengthy waiting lists for provision of autism services. As reported on April 29, 2008 in the Toronto Star:

The wait list of autistic children who are eligible to receive intensive behavioural intervention therapy, or IBI, reached 1,148 on March 31, up from 985 last year.

More than 1,400 children were receiving IBI services as of March 31, according to newly released government figures.

But the long waits have forced many parents to drain their savings and go into debt to pay for the therapy the province has promised to provide, said NDP critic Andrea Horwath.

3. Nova Scotia

Nova Scotia does provide some autism treatment services but not for everyone. In Nova Scotia a lottery system is used to determine which autistic children receive autism treatment. Nova Scotia lost two medical professionals, a husband and wife, who moved to Manitoba to seek ABA treatment for their autistic child.

In Helping kids with autism shouldn't be a lottery Bobby-Lynn Hall reported that:

In Nova Scotia, there are children receiving Early Intensive Behaviour Intervention, a treatment proven to improve vocabulary and social skills and reduce behaviour issues in most children with ASD, but it's based on a lottery system.

We all talk about how great it would be to win the lottery and what we'd spend the money on. But what if your child's future was dependent on winning a lottery and what if you didn't win? Would you be thinking maybe if you had picked a different number, or maybe if you had bought your ticket last week instead of this week, that maybe things would have been different and maybe your child would be the one receiving the treatments that could help him experience things that otherwise may not have been possible?

I agree with Ms Hall. To me Nova Scotia's lottery system is an immoral attempt to avoid the responsibility for providing autism treatment to all those who need it without accepting responsibility for excluding those unfortunate enough to draw the lottery number. It is both immoral and cowardly.

Canada's Autism Wastelands are evidence of the need for a National Autism Strategy in Canada, a real National Autism Strategy, not the phony PR efforts of the Harper government and its alleged Health Minister Tony Clement.

Wednesday, October 22, 2008

Senator Obama Not Governor Palin Has Plan For Autism


In commenting on autism issues in the context of American politics I can only do so as an outsider, a Canadian with no vote, but keenly aware that American events can have a dramatic impact on Canada. I have followed American presidential elections closely since my grade 3 teacher put pictures of President John F. Kennedy on our classroom bulletin board and I remember hearing the horrific news of his assassination one year later. I am heavily biased toward the Democrats, and admire many of them - Ted Kennedy, Bill Clinton, Hillary Clinton, Joe Biden, Bill Richardson, Al Gore and Barack Obama. I still can not believe that Al Gore did not win in 2000.

With that declaration of bias again out in front though I am curious about Governor Palin's announcement yesterday that autism is an issue near and dear to her heart. Governor Palin has a nephew with autism. And that certainly identifies a personal connection to autism for the Governor but notwithstanding that personal connection what does she actually have in mind for autism programs? What plan, if any, does she have for autism? The answer, apparently, is none. The Governor spoke with KRNV News4's Shelby Sheehan:

"There are a lot of wasteful expenditures in the federal (government)," Palin said. "Let's get rid of those and put them into strengthening NIH (National Institutes of Health) and these other areas where we can help our kids with autism."

....

"Here's the difference between John McCain and our ticket and Barack Obama and Joe Biden," she said. "We don't just talk the talk, we walk the walk. And that's why in not just that first speech, but in every speech I give, I talk about being an advocate and a friend in the White House for our families who have members who have these special needs."

The WKNV online reports that Governor Palin did not indicate what expenditures would be cut and what autism programs would be funded in a McCain-Palin administration. Stating over and over that you are an advocate for autistic persons appears to be a clear example of talking the talk but does not demonstrate that Governor Palin is prepared to walk the walk as she claims. As the report indicates Governor Palin has no actual plan for how to help autistic persons and their families.

WKNV reports that Senator Obama has specified what action he would take when, sorry IF, he becomes President (my bias again) :) The Obama plan can be found in full at Obama 08 BARACK OBAMA: SUPPORTING AMERICANS WITH AUTISM SPECTRUM
DISORDERS
. The elements of the Obama plan include:

1. Appoint Federal ASD Coordinator to Oversee All Federal ASD Efforts.
2. Fully Fund the Combating Autism Act and Federal Autism Research Initiatives.
3. Support Special Needs Education for Children with ASD.
4. Support Universal Screening.
5. Work Together.

Senator Obama, not Governor Palin, appears ready to walk the walk to help autistic persons and their families. Here in Canada it is not clear if Stephen Harper has even uttered the word "autism". The sweater PM has made it clear that a Harper government will do nothing to address Canada's autism crisis. Hopefully, if Senator Obama's historic presidency does come to be, he will have some positive influence on our Canadian Prime Minister with respect to autism issues.

On autism issues Canada is still looking for The Change We Need.

Tuesday, October 21, 2008

Some Autistic Students Do Well In The Mainstream Classroom and Some Do Not

KESQ.com in Palm Springs, California reports that an increasing amount of autistic students are leaving special education classes and integrating into mainstream classrooms. Educators in the area provide the support necessary and they recognize that the mainstream classroom does not work for ALL students with autism. They look at what works best for each student:

"In the past we had children undiagnosed in general education, coping or diagnosed incorrectly without the support needed," says Palm Springs Unified Schools District's Autism Specialist Sally Talala.

Entering into a traditional classroom isn't for every child with autism. Specialists say it takes a team approach to find out what is best for each individual.

The assistance team is growing. Parents, schools and specialists work together to place each child in the right class for their specific needs. They take a look at social skills, communication and behavior, integrating those with more mild cases.


Here in New Brunswick, in recent years, much has been done to further the education and well being of autistic students. Teacher assistants and resource teachers have been receiving autism specific training through the University of New Brunswick College of Extended Learning Autism Intervention Training Program. The autism specific training has helped provide many autistic students receive a real education. Some autistic students can receive their education in the classroom for all or part of the day.

Some of our schools have also begun to accommodate the needs of those autistic children, like my son Conor, for whom education in the general classroom for most of the day is an overwhelming, counterproductive and even harmful experience. They are taught in smaller, quieter, less busy areas where they can receive one on one instruction, by autism appropriate learning methods and with a curriculum suitable to their development level. They are also brought into the mainstream classroom for brief periods for activities within their individual ability ranges.

Despite this progress there are those in New Brunswick who insist that the mainstream classroom is the right place for all students. Their intentions are noble but their understanding of autistic children is lacking. Their beliefs are part of a philosophy of total classroom inclusion for all students that has dominated the New Brunswick education system for the past thirty years. The recent efforts to accommodate the needs of autistic students has been met with determined resistance by the total inclusion advocates who include the current Chair of the New Brunswick Human Rights Commission who was instrumental in promoting New Brunswick's total inclusion philosophy, the Executive Director and other representatives of the New Brunswick Association for Community Living, and some senior Education Department officials.

Despite the efforts of these very influential, well connected advocates of total mainstream inclusion progress has been made. There are people in government, in the Department of Education, school districts and schools who have made decisions in the best interests of autistic children notwithstanding pressure from the total inclusion advocates.

Hopefully those autistic children who can learn in the mainstream classroom will continue to be educated there while those autistic children for whom the mainstream classroom is not appropriate will continue to be accommodated in learning environments suitable for them in light of their autistic conditions.

Hopefully the best interests of autistic children will continue to prevail over the rigid philosophical beliefs of the total mainstream classroom inclusion advocates.

Monday, October 20, 2008

New York Times' Slanted Article On DIR/Floortime and Autism

The New York Times has published in its print and online editions a lengthy piece by Melissa Fay Greene promoting DIR/Floortime. The article acknowledges to some extent the value of ABA as an autism intervention but implies that ABA is outdated and that DIR/Floortime is a new modern improved form of autism intervention. The usual cliches about ABA being rote learning are trotted out along with the positive buzzwords used to promote DIR/Floortime "relationship", "respectful of the child". The article indicates that experts do not endorse any one method.

What the article does not do is mention the fact that there is no empirical evidence to support the effectiveness of DIR/Floortime as an autism intervention. The MADSEC Autism Task Force Report (2000 rev. ed.) described DIR Flootime as without scientific evaluation of any kind.

MADSEC Autism Task Force Report, page 6:

• Without scientific evaluation of any kind:
Greenspan’s DIR/”Floor Time,” Son-Rise.


MADSEC Autism Task Force Report, page 43:

Discussion

There have been no peer-reviewed, published studies of Greenspan’s DIR/Floor Time’s
effectiveness for children with autism.

Conclusions

There have been no peer-reviewed, published studies of Greenspan’s DIR/Floor Time’s
effectiveness for children with autism. Researchers should consider investigation using research protocols. Professionals considering Greenspan’s Floor Time should portray the method as without peer-reviewed scientific evaluation, and should disclose this status to key decision makers influencing the child’s intervention.

The American Academy of Pediatrics reviewed autism interventions in Management of Children with Autism Spectrum Disorders(2007) and stated, at page 5, with respect to RID that:

Relationship-focused early intervention models include Greenspan and Wieder’s developmental, individual-difference, relationship-based (DIR) model,55 Gutstein and Sheely’s relationship-development intervention (RDI),56 and the responsive-teaching (RT) curriculum developed by Mahoney et al.57,58 The DIR approach focuses on (1) “floor-time” play sessions and other strategies that are purported to enhance relationships and emotional and social interactions to facilitate emotional and cognitive growth and development and (2) therapies to remediate “biologically based processing capacities,” such as auditory processing and language, motor planning and sequencing, sensory modulation, and visual-spatial processing. Published evidence of the efficacy of the DIR model is limited to an unblinded review of case records (with significant methodologic flaws, including inadequate documentation of the intervention, comparison to a suboptimal control group, and lack of documentation of treatment integrity and how outcomes were assessed by informal procedures55) and a descriptive follow-up study of a small subset (8%) of the original group of patients.59

The article also fails to indicate the value of ABA as an autism intervention and the large body of evidence supporting its effectiveness:

MADSEC (2000)

Conclusions

There is a wealth of validated and peer-reviewed studies supporting the efficacy of ABA
methods to improve and sustain socially significant behaviors in every domain, in individuals
with autism. Importantly, results reported include “meaningful” outcomes such as increased
social skills, communication skills academic performance, and overall cognitive functioning.
These reflect clinically-significant quality of life improvements. While studies varied as to the
magnitude of gains, all have demonstrated long term retention of gains made.

Other major contributions of ABA to the education and treatment of individuals with autism
include:

• a large number of empirically-based systematic instruction methods that lead to the
acquisition of skills, and to the decrease/elimination of aberrant behaviors;
• a technology for systematically evaluating the efficacy of interventions intended to affect
individual learning and behavior; and
• substantial cost/benefit.

Over 30 years of rigorous research and peer review of applied behavior analysis’ effectiveness
for individuals with autism demonstrate ABA has been objectively substantiated as effective
based upon the scope and quality of science. Professionals considering applied behavior
analysis should portray the method as objectively substantiated as effective. Methods of applied behavior analysis should be considered to evaluate the effectiveness of any intervention used to help individuals with autism. Researchers should continue to vigorously investigate behavioral intervention as the most promising area of research and treatment benefitting individuals with autism known today. Early interventionists should leverage early autism diagnosis with the proven efficacy of intensive ABA for optimal outcome and long-term cost benefit.


American Academy of Pediatrics (2007)


The effectiveness of ABA-based intervention in ASDs has been well documented through 5 decades of research by using single-subject methodology21,25,27,28 and in controlled studies of comprehensive early intensive behavioral intervention programs in university and community settings.29–40 Children who receive early intensive behavioral treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behavior as well as some measures of social behavior, and their outcomes have been significantly better than those of children in control groups.31–40

The New York Times is still a news source of great influence. When it is using that influence in promoting interventions for children with autism, a neurological disorder, it should do its homework and present an accurate and credible review of the professional literature. Simply offering a guest column to a promoter of an intervention lacking in empirical verification of its effectiveness does a disservice to autistic children whose decision makers, family or public, could be misled by the NYT and its weighty reputation.

Saturday, October 18, 2008

Autism Society New Brunswick AGM

Another Autism Society New Brunswick AGM has come and gone. Turnout was low this year. But those who attended were very interested in autism in New Brunswick, asked good questions and offered valuable insights. The afternoon sped by quickly.

Some scenes from the day:



ASNB VP Lana Thomson (L) and President Tamara Downey (R)
greeting people at the entrance. Tamara is also a nurse who
was ready to report to duty at the Chalmers Hospital
near the end of the meeing.




ASNB veterans Albert & Dawn Bowie enjoy the day.



Harold Doherty - showing off my new tie and
offering my two cents worth.



ASNB VP Lana Thomson and NB NDP Leader Roger Duguay
who honored us with a visit and showed real interest in
autism issues in New Brunswick.