the history of autism

The History of Autism

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Over the last 10 years the word autism has become a very well-known term. With the rates of autism steadily on the rise, most people are now at least somewhat familiar with it. But many people probably don’t know when autism officially become a recognized disorder, and how it evolved into what we know today? Below is a time-line of the history of autism.

  • Early 1900’s – The term “autism” was first used by Swiss psychiatric Eugen Bleuler to describe athe history of autism certain a sub-set of patients with schizophrenia who were severely withdrawn.
  • 1940’s – Researchers in the United States began using the term autism to describe children with emotional and/or social issues.
    • Leo Kanner – A psychiatrist from Johns Hopkin’s University studied 11 children with normal to above average IQ’s who had challenges with social skills, adapting to changes in routine, sound sensitivities, echolalia, and had difficulties engaging in spontaneous activity.
    • Hans Asperger – Also studied a group of children who were similar to the children Kanner studied except the children did not present with any language problems.
  • 1950’s – Bruno Bettelheim, a child psychologist coined the term “refrigerator mothers.” These mothers were described as mothers who were cold and unloving to their children. He claimed children of cold and unloving mothers were more likely to develop autism. This has since been disproven as a cause of autism due the total lack of evidence supporting such a claim.
  • 1960’s – 1970’s – Researchers began to separate autism from schizophrenia and began focusing their attention more on understanding autism in children. Autism also started to be considered a biological disorder of brain development. During this time, treatments for autism included various medications, electric shock, and behavioral modifications, most of which focused on punishment procedures to reduce unwanted behaviors.
  • 1980’s – 1990’s – Early in the 80’s the DSM-III distinguishes autism as a disorder separating it from schizophrenia. During this time, behavioral modification became more popular as a treatment for autism. The way behavior modification was delivered began to rely more on reinforcement instead of punishment to increase desired behaviors. In 1994 the DSM-IV expands the definition of autism to include Asperger Syndrome.
  • 2000’s – present day – Rates of autism begin to rise and various campaigns have been launched to increase the awareness of autism. The prevalence of autism has increased from 1 in 150 in the year 2000, to 1 in 68 in 2014. Children are now able to be reliably diagnosed as young as 2 years of age. Due to years of research, the effectiveness of different intervention used to treat autism is better understood. Applied behavior analysis (ABA) is currently considered to be the “gold standard” treatment for individuals with autism.


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NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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Child being told to be quiet

Working With Parents Regarding Behaviors at Home

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One of the major stressors that parents have to deal with on a daily basis is negative behaviors.  Negative behaviors can take the form of  non-compliance, physical aggression, and/or verbal aggression.  Behavioral management focuses on increasing on-task behaviors (e.g. behaviors parents want the child to engage in) while extinguishing off-task behaviors (the negative behavior).   Below are some bullet points that are important for parents to realize about behavioral management.

  • Child being told to be quietNegative behaviors always increase in intensity when being modified or extinguished.
  • Focus should almost always be on positive reinforcement of appropriate behaviors
  • Punishment only utilized when behavior is dangerous to the child or others
  • Reasons for failure of reinforcement systems

o   Too confusing; if we as adults do not understand them, then the child of course will not

o   The wrong behavior is being addressed

  • Goals need to be attainable

o   Child and parent have to see that the system will work

o   Slowly increase demands

  • Never take away a reinforcement that a child earned
  • The reinforcer will constantly change

o   What is rewarding today for the child will likely be different in the near future

Behavior almost always can be modified.  It is important for parents and professionals that are working with the child to understand that, in order for a behavioral reinforcement system to work, there needs to be consistency with the approach.   The idea is to set realistic and measurable goals and constantly identify how much improvement is exhibited.

Child misbehaving in school

Behavior In The Classroom

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Many times children with behavioral concerns, attention issues, emotional concerns, or learning disorders will exhibit negative behaviors within the classroom setting.  Behaviors, by nature, are reasonable and driven by some factor.  The majority of the time, there is a purpose and a reason as to why a child engages in a negative behavior. What this indicates is that it is vital to figure out what the driving force of the behavior was as well as what the consequences of the behavior are.

If a parent or teacher has significant concerns about a child’s behavior, it is truly important to figure out what is going on.  Many times in these situations a Functional Behavioral Analysis (FBA) is required.  An FBAis when some behavioral specialist with the school will go and observe the child over several days and several times during the days.  The individual will first identify the percentage of time the child is off task in comparison to a few peers.  It is always important to have the percentage of off task behavior with several other children in the classroom.  This way there is anecdotal data indicating that child ‘X’ was off task xx% while the other children on average were off task only xx% which could indicate that the child in question actually is off task more than peers.

Child misbehaving in schoolOnce off-task time is established the focus is then on identifying the antecedents and consequences of the behaviors at hand.  There almost always is a driving force (the antecedent) which causes the behavior.  In addition, there usually is a reaction, either positive or negative (consequence), which results in increasing the likelihood of the behavior in the future.

Once the FBA has concluded and information has been disseminated to the team, the next step is to create an action plan to decrease negative behaviors while increasing positive, on-task behaviors.  This is when a functional intervention plan is created.  This plan utilizes the data created by the FBA to set up reinforcement of on-task behaviors, identify triggers and situations that might increase the negative behavior, and set up manageable goals.  A goal must be manageable and attainable.  For example, if a child is off task on average 80% of the day, a goal of being off task 10% of the day would be unrealistic.  What might be established is that with reinforcement and behavioral management, the goal for the first few weeks would be that the child is off task only 70% of the day, then slowly decrease it until the goal is consistent with the amount of time that the rest of the class is off task.

The take home message about behavior in school is that in order to change behavior we have to first identify what the behavior we want to change is, how often it occurs, and why it occurs (what triggers it and what does the child get out of it).

Boy having a temper tantrum

1-2-3 Magic Behavioral Principles: Harder Than We Think?

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The popular discipline program, 1-2-3 Magic, is based on the basic behavioral principles of reinforcing positive behavior and reducing negative.  Simple, right?  Not necessarily, especially if you are parenting a child with a difficult temperament or developmental delays.  The difficulty lies not in the conceptual understanding of the program, but in the execution.  With practice and guidance it can be done and is well worth the effort.

The two most common pitfalls are 1) inconsistency in counting and following through with time-out and 2) unintentional reinforcement during time-out (e.g., talking and expressing emotion).  Every parent will fall victim to one or the other at the beginning.  The goal is to be aware of these traps, catch yourself when you are committing them, and work to avoid them next time.

Here is how to get started:

Step 1: Getting noncompliance and other negative behaviors under control.  The idea is to consistently send the message to your child that these behaviors are not ok.  How do we do that?  We consistently set limits on what is not acceptable by using a counting system.  This gives your child up to two opportunities to change their behavior before a consequence is handed down.  When your child does not comply after number 2, immediately go to number 3 and that’s it.  They will soon catch on that you are serious.  There is a learning curve, and not without its emotional meltdowns along the way, but children learn very well if consistency is in place.

Step 2: Get more of the good behaviors.  This is the fun part.  Spend time with your child one-on-one, have fun with them, listen, and be a model for appropriate ways to cope with situations.

With practice, it becomes easier.  Feel confident in your ability to create change in your home and enjoy the rewards!

 

Phelan, Thomas. (2010). 1-2-3 Magic: Effective discipline for children 2-12. Glen Ellyn, IL: ParentMagic, Inc.




What is Co-Treating?

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You may have heard your therapist say, “I think a co-treat would be a great option for your child!” But what does that really entail? Will your child still be getting a full treatment session? Will his current and most important goals be worked on? Will he benefit as much as a one-on-one session? When a co-treatment session is appropriate, the answer to all of those questions is…YES!

What is a co-treatment session?

Co-treatment sessions are when two therapists from different disciplines (Speech Therapy (SLP), Occupational Therapy (OT), Physical Therapy (PT), etc.) work together with your child to maximize therapeutic goals and progress.

When is a co-treatment session appropriate?

When the two disciplines share complimentary or similar goals.

EXAMPLE: Maintaining attention to task, executive functioning, pragmatics, etc. Playing a game where the child needs to interact with and attend to multiple people while sitting on a stability ball for balance. [all disciplines]
*When children have difficulty sustaining attention and arousal needed to participate in back-to-back therapy sessions.
EXAMPLE: Working on endurance/strength/coordination while simultaneously addressing language skills. Obstacle courses through the gym while working on verbal sequencing and following directions. [SLP + PT or OT]
*When activities within the co-treatment session can address goals of both disciplines.
EXAMPLE: Art projects can address fine motor functioning as well as language tasks like sequencing, verbal reasoning, and categorizing.
*When a child needs motivations or distractions. [OT + SLP]
EXAMPLE: Research has shown that physical activity increases expressive output. Playing catch while naming items in category or earning “tickets” for the swing by practicing speech sounds.  [PT or OT + SLP]
EXAMPLE: PT’s need distraction for some of their little clients who are working on standing or walking and working on language through play during these activities works well. [PT + SLP]

Why co-treat?

  • Allows therapists to create cohesive treatment plans that work towards both discipline’s goal in a shorter amount of time.
  • Allows for therapists to use similar strategies to encourage participation and good behavior in their one-on-one sessions with the child.
  • Allows for therapists to collaborate and discuss the child’s goals, treatment, and progress throughout the therapy process. Together, they can consistently update and generate plans and goals as the child succeeds.
  • Aids in generalization of skills to different environments, contexts, and communication partners.
  • Allows for problem-solving to take place in the moment. For example, an extra set of hands to teach or demonstrate a skill or utilizing a strategy to address a negative behavior.

Co-treatments sessions can be extremely beneficial for a child. There are endless ways therapists can work together to promote progress and success towards a child’s therapeutic goals.. However, co-treatments may not always be appropriate and are only done when the decision to do so is made collaboratively with the therapists and the parents.

Contact us for more information on the benefits of co-treating in therapy sessions.

AAC: Speech Devices for Autism

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For a child with autism, communication can be a challenging and difficult hurdle to manage. For some children, verbal communication may simply be an impossible or ineffective means of communicating. For these circumstances, an augmentative/alternative communication device (AAC) may be an answer.

What is AAC?

AAC is an acronym for Augmentative Alternative Communication and describes a communication tool that is substituted for traditional expressive speech to allow a child to communicate. These tools can be low-tech like PECs or an eye gaze board or they can be high-tech speech generating devices. Many insurance companies will cover AAC devices with the proper paperwork.

Use of AAC with Autism

AAC devices can be used at any age and across many settings. Research has been shown to support growth in attention, communicative initiation, expressive and receptive language and pragmatic skill development through use of an AAC.

Many children with autism acquire language early in life and regress quite suddenly. Other children with autism simply develop very few words, if any. With proper intervention, children with autism can explore a variety of options and find better ways to gain speech and language skills. Some research suggest that, when used in intervention, speech devices have resulted in faster progress in therapy.

Use of AAC with the Verbal Child

AAC devices can be used for children with verbal skills as well. One characteristic of autism is echolalia, or the repetition of heard speech. For children who script or repeat in conversation, an AAC device can assist is helping them to formulate novel utterances and to participate in more meaningful conversational turns. More importantly, use of an AAC device will not prevent your child from using and increasing their verbal skills.

Is AAC Right for My Child?

A speech-language pathologist with a concentration in AAC devices can assist you and your child in determining the appropriate device based on individual needs and skills.

To read about common misconceptions about augmentative and alternative communications, click here.

For more information and resources of AAC devices for autism, check out The Center for AAC and Autism’s website.

8 Great Apps for Kids with Autism

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Parents often ask me if I have suggestions for applications to download on their iPads, iPhones or other devices for their children.  I do!  I have TONS of apps that I use in my work with children with Autism daily.

My 8 favorite apps to use with kids diagnosed with Autism for iPhone/iPad users are the following:

  1. 123 Token Me– This app is a visual token board that can be used for one child (free version) or unlimited children and unlimited behaviors ($9.99).  This app gives you the versatility to choose background color, various token choices, and graphs and visually displays data for you. This is the most motivating token board I have used with my kids because it is interactive.  Also, one of the token options shows a picture of the child, which they all love!
  2. First Then Visual Schedule HD– This app is 2 applications put into one; it is both a visual schedule and a choice board.  It allows you to show the child “first ___, then ____.” with the ability to make choices from a visual field.  It also allows you to make more complex, multiple-step, visual schedules.  It is a bit on the pricey side at $14.99 but totally worth it if your child struggles to make choices verbally or would benefit from a visual schedule.  It is much easier to carry around than a paper schedule or choice board, because you can update it on the fly using the camera function or Google images.
  3. Duck Duck Moose, Inc.- (includes Wheels on the Bus, The Itsy Bitsy Spider, Old MacDonald and many more).  All of the Duck Duck Moose apps are a big hit with all the kiddos I work with as they are interactive, the characters move, jump and dance, and they all play familiar kid’s songs.  The apps range in price from free versions up to $3.99 each. Read more

How to Teach Your Child about Bullying

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The beginning of the school year is a great time for parents and guardians to talk with kids about bullying.  Bullying is a problem which affects millions of children and teenagers.  It takes place in many forms: physical, verbal, psychological/social and through means of social media.  Read on for several tips for talking to kids of any age about bullying.

Tips for talking to kids about bullying:

  1. Teach assertiveness.  Model and teach your child peaceful ways to solve problems.
  2. Teach empathy.  Talk to your child about helping others and taking action if she observes someone being hurt or hurting themselves. This is only if the situation is safe to do so.  Help build empathy in your child by talking about examples from television, movies and books.  Ask your child how she thinks others must feel in the various scenarios.
  3. Hold children accountable.  Teach your child that if she is watching someone being bullied, then she has a responsibility to tell someone; otherwise this hurts the victim also.
  4. Get to know your child’s friends.  Encourage your child to invite her friends over.
  5. Be a good role model.  Model these skills whenever appropriate.

For more bullying resources, click here to watch our Bullying Webinar or click here to read about including bullying in your child’s IEP.

Reference: http://www.ncpc.org/topics/bullying/teaching-kids-about-bullying/what-to-teach-kids-about-bullying

What to Do When All You Hear is “No” from your Toddler

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It happens all too often.  We spend every minute teaching toddlers to talk and once they do, we can’t get them to stop! Around age one, first words will appear, just in time for toddlers to learn to express their opinions. The word “no” is often one of the first to be acquired and used by this age group.

If you are hearing “no” from your toddler more than you would like, keep this in mind.  First, as difficult as it may be to always hear “no” from someone so small, toddlers should be able to say no in acceptable ways. This is a critical step to learning independence and working collaboratively with others. Secondly, try to see things from your toddler’s perspective; assess WHY he is saying no. It could be he is tired, hungry or not feeling well.  Maybe he is just crabby (it happens to adults, right?). On the other hand, your toddler may be saying “no” because he is nervous or uncomfortable.  Or your toddler may be exerting independence and refusing simply because he can. To hear “no” from your toddler less frequently, try to address the situation first (i.e., give a snack, introduce the stranger, or allow time to adjust to new changes).   Read on for more ways to hear fewer “nos” from your little one. Read more

What to Do When Your Child has a Potty Accident

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Potty training can be difficult.  Throughout the process there can be slip-ups and accidents.  If you have a child who is already potty training, or if you have a child who exhibits signs that he or she is ready to start potty training, then keep these helpful strategies in mind for when an unavoidable accident occurs.

Strategies for dealing with a potty accident:

Potty

  1. Environment:  Create a friendly and inviting bathroom environment.  Provide different books that your child can read while she sits on the toilet.  You can even offer to play different songs while your child sits on the toilet and tries to go potty.
  2. Schedule:  Make sure that you, along with everyone who is with your child throughout the day, is on the same potty schedule.  Using this potty schedule, select a certain amount of time that you want your child to practice going on the potty.  You can start with having your child go to the potty every 30 minutes.  Set a timer. When it goes off, have your child stop what she is doing and try to go to the potty.  After she tries, reset the timer and wait for the next 30 minute potty try.  If your child is still having accidents on a 30-minute schedule, switch to 15 minutes intervals to catch the accident before it happens. Read more