The Importance of Choosing Evidence-Based Treatments for Children with Autism

Your child just received an autism diagnosis and you want to get them started in some type of therapy, but how do you chose from the vast number treatments that claim to help children with autism?  In addition to the seemingly endless list of treatments you can find on the internet, there is also many fad intervention that occasionally pop up, which claim to “cure” autism.  These fads do not have evidence supporting their claims, and can be potentially dangerous. So how exactly do you sort out the good treatments from the bad? The answer is to remember these three words: Evidence-Based Practice.

Evidence-Based Treatments for Autismevidence based treatments for autism

What is evidence-based practice? Evidenced-based practice means that the intervention is based on scientifically valid and reliable research. The best example of an evidence-based intervention for individuals with autism is applied behavior analysis (ABA). ABA has over 40 years of research supporting the use behavior analytic interventions to improve the lives of individuals with autism.

 Non-Research-Based Treatments for Autism

There are currently many popular treatments for autism which have little to no scientific evidence supporting their effectiveness, but are still widely used. These treatments include the following:

  • Special diets (Gluten-free and casein-free)
  • Biomedical interventions
  • Vitamin supplements
  • Therapeutic horseback riding
  • Music therapy
  • Facilitated communication

Dangers of Using Non-Evidence-Based Interventions for the Treatment of Autism

  • Wasting valuable time – I have heard many families say they are just going to “try” out a specific intervention to see if it works. While this may seem harmless, it can in fact waste very valuable time for the child. Any time spent on an ineffective treatment is taking away time where the child could be developing functional skills.
  • Wasting money: Most autism treatments are expensive, even those which are evidenced-based. Insurance companies are now beginning to cover more evidenced-based interventions such as applied behavior analysis. They do not however, cover those interventions which are not scientifically valid. Families have been known to shell out thousands of dollars for treatments which will have no lasting effect on their child.
  • Causing harm to the individual with autism: There many are current treatments that claim to “cure” autism by doing a number of potentially dangerous acts. A few of these interventions include: Chelation therapy, Bleach enemas, Chemical castration, and Miracle mineral solution (MMS). These treatments can all cause serious, life-long health issues, or worse yet death.

If you find yourself feeling overwhelmed or are having trouble sorting out non-evidenced-based treatments, contact an autism professional to help you with this important decision. Always be weary of treatments which claim to “cure” autism, and remember if a treatment seems too good to be true, it probably is.

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NSPT offers ABA Therapy services in BucktownEvanstonHighland ParkLincolnwoodGlenview 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!

More information about autism treatment can be found at:

http://www.asatonline.org/for-parents/learn-more-about-specific-treatments/

References:

fecal smearing

How to Help Reduce Fecal Smearing in Children with Autism

Co-written by Jessica Wein MSW, LSW

In order to change or eliminate a behavior, such as fecal smearing, it is important to first understand the function of the behavior. There is a reason your child is engaging in this behavior, so understanding the motivation behind it will best inform the type of intervention/s to employ. One way to ascertain the necessary information, is to find out the “ABCs” of the behavior:

A- Antecedent; what occurs directly before and/or leading up to the behavior (fecal smearing)?
B- Behavior; the behavior itself
C- Consequence; what occurs after the behavior including reactions of caretakers?

Motivations to engage in smearing fecal matter can range from attention seeking purposes to serving a sensory input need. In some cases, there can be several motivations for the child to engage in this behavior.

Once you know the “ABCs” of the behavior, you can then manipulate certain aspects of the environment (i.e. the antecedent and/or consequence) as means to change or eliminate the behavior altogether.

For children on the autism spectrum, it is important to utilize a behavioral approach, using few (if any) words. It is also important for the caregiver to remain emotionally neutral when the child is engaging in fecal smearing. Specifically, not showing a positive or negative reaction. It can also be helpful for the caregiver to reward and provide consistent, positive praise when the child engages in more ideal behaviors. By giving attention to positive behaviors, the child will learn which behaviors earn positive attention and/or desired rewards.

What to Expect When You Suspect Autism Download our free, 17-Page eBook

Some helpful tips to reduce fecal smearing:

  • Social stories which reinforce the routine of appropriate bowel care
  • Clothing which can inhibit access: for example back zip footed pajamas
  • Messy play

Children may seek different types of input from poop smearing such as scent, texture or the temperature. To accommodate these sensory experiences try:

  • Scent: smell sharp smelling cheese or play doh that is scented
  • Touch: play-doh; slime
  • Visual: finger painting; shaving cream

Resources:

  • http://www.thespeciallife.com/poop-fecal-smearing-and-the-autism.html
  • http://autism360.org/ask-autism360/fecal-smearing
  • http://www.netmums.com/children/guide-to-bedwetting/faecal-smearing

AAC: Speech Devices for Autism

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.

How Can a Neuropsychological Evaluation Help My Child?

A neuropsychological evaluation can help a child in multiple ways.  The focus of the evaluation is to provide information for parents about why a child is struggling with regards to his or her academic achievement, social engagement, and/or emotional regulation.  Parents will bring their children in for a neuropsychological evaluation when they have concerns about their performance in any of the above domains.

What is the goal of a neuropsychological evaluation?

The goal of the evaluation is to provide diagnostic clarification based upon a set of symptoms that the child exhibits.  This information is attained through the following ways:

  • Parental interview
  • Parental and teacher report
  • Behavioral observation Read more

Make the Most of Pediatric Therapy Sessions

Parents often ask how they can help their child make optimal progress while in therapy.  Attending therapy once or multiple times a week is a large commitment, both financially and time-wise.  Therefore, it’s important to make the most of your child’s time in therapy and to ensure you optimize your resources to help your child progress as much as possible.

5 Things parents can do to make the most of pediatric therapy sessions:

  1. Communicate with your child’s therapist.  If you don’t know what your child is working on in therapy, then there is a problem.  Your therapist should continually inform you what specific goals your child is working on and why.  Your therapist should also give you specific ways to address these goals at home.  If you feel unsatisfied with the communication between you and your therapist, talk to him or her about it.  Troubleshoot ideas to open the lines of communication, whether it’s talking at the end of treatment sessions, planning periodic phone meetings, or receiving e-mail updates.
  2. Check-in about the big picture.  In addition to weekly communication with your child’s therapist, schedule time every so often for a more thorough “check-in” meeting about your child’s progress and to collaborate on a plan moving forward.  This might be a face-to-face meeting or a phone conference.  These are best done without the distraction of your child or other siblings present.  Discuss your child’s progress, ask your questions, and get an idea of where things are going from here.  Is your child making progress?  If not, why?  Should therapy be increased to twice a week?  Will your child benefit from additional support from another therapeutic discipline? Read more

What is Pairing? Advice for Pediatric Therapists

Pairing is a very important part of starting a therapy program with a child.  It helps you, as a therapist, build rapport with the child and establish a pairingrelationship.  When working with a child, one of the main things you want to do is pair yourself with fun and reinforcing items.  You want the child to find you, and the environment, exciting and pleasing.  If the child is having fun and likes being with you, then he will be more motivated to come to therapy to work and play.

6 tips to help with pairing:

  1. Play!  When you first meet a child show him the different toys, games, and activities that are available.  Allow him to play with the different items to familiarize himself. Read more

How to Handle Fireworks and Your Child’s Sensitivity to Noise

By the time the 4th of July rolls around, summer is in full swing!  Kids spend their days at camp; families spend more timefireworks relaxing, and everyone enjoys spending time outside in the sun. The 4th of July is a fun time to gather friends and family and celebrate with food, games and (of course) fireworks!

While these July 4th traditions bring excitement for many children, there are kids with hypersensitivities who do not look forward to the noisy day. Below are 5 strategies that can help your sensitive child enjoy the day as well.

5 Ways to Help Your Child with Hypersensitivities Enjoy the 4th of July:

  1. Prepare your child for the day by providing them with explanations of where you are going, what you will do there, and what they will hear. This will help them to understand what to expect from the day without being fearful. You can also prepare them for the noise by having a family music night where everyone bangs on pots and pans around the house!
  2. Watch a video, either online or on television, that has fireworks in it.
  3. Bring cotton balls or ear plugs to the fireworks event to help decrease the intensity of the sound.
  4. Ask friends who lives near a local fireworks show if you can watch from their home. Being indoors will also decrease the intensity of the sound.
  5. If your child still won’t have an enjoyable time during fireworks with the above strategies, consider having a babysitter stay home with your kids. She can plan fun holiday games and crafts to celebrate at home.

Have a safe and wonderful 4th of July!

For more ideas on helping your child, click here to read about activities to address your child’s tactile hypersensitivities.
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DSM-5 Changes in Autism

With publication of the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013, DSM-V Changeschanges to diagnostic labels, symptom criteria, and specifiers of Autism have been put into action.  Perhaps the most obvious change is the exclusion of Asperger’s Disorder in the latest manual.  Not to say the syndrome no longer exists, rather the nosology has been altered.  Asperger’s is now subsumed under the broad diagnosis of Autism Spectrum Disorder.  Apparently, the “spectrum” is now greater than ever, but thanks to a variety of specifiers, the child’s strengths and weaknesses can be easily communicated.

Other Changes to the DSM-5:

  • The creation of a single category for communication and social interaction symptoms.  The focus is less on the actual language impairment, per se, but more on the qualitative social aspect of impairment.
  • Diagnosis now requires at least two restricted and repetitive behaviors, with the old manual requiring only one.
  • Criteria have been clarified to reflect the variations in behaviors, interests, and sensory experiences.

What this means for rates of diagnosis of Autism Spectrum Disorder in the future remains to be seen.  Criticism has abounded, with some predicting inflation in diagnosis while others fear the many costs associated with potential under-diagnosis.  Nonetheless, it is important to realize that with the changing in terminology, treatment of Autism has remained stable and continues to be evidence-driven.

For more on Autism read When to Screen Children for Autism and Other Pervasive Developmental Disorders and Potty Training and Autism: The Complete Guide.  To learn more about the Chicago Autism Clinic, click below or call us at 877-486-4140.


Develop Executive Functioning Skills This Summer

Does your pre-teen have difficulty staying on task? Does he become overwhelmed when presented with a long-term project? Does he have a hard time controlling his emotions and behaviors? Is it a constant struggle for him to clean up his room? If so, your child may have difficulty with executive functioning. Executive functioning skills are the executive functionsfundamental brain-based skills required to execute tasks: getting organized, planning, initiating work, staying on task, controlling impulses, and regulating emotions.  These skills provide the foundation that all children need to negotiate the academic, home, and social demands of childhood.

Summertime is a great break from busy schedules overrun by homework, projects, and extracurricular activities, but the decreased structure can cause a child with executive functioning difficulties to lose the skills they have gained during the school year. Research has shown that practice is crucial in the development of executive functioning skills; kids who practice executive skills are not only learning self-management, but also developing the connections in the brain that will support the development of executive skills in later adolescence and adulthood!  Read on for ways to keep your child’s executive functioning skills sharp over summer break.

Tips for developing executive functioning skills all summer:

  • Praise: If you know your child is particularly good at a certain skill (e.g. task initiation), communicate that to your child and encourage him to use it to complete summer tasks.  For example say, “I really like how you got started on your chores before lunch.” This will encourage the maintenance of the particular skill your child has mastered.
  • Calendars: Summer schedules can be vastly different from the rest of the year, so to prevent difficulties with handling the change in schedule, use a calendar.   Calendars are a great visual tool to help a child with time management, planning and prioritizing. It allows him to plan ahead and know what is expected and when.
  • Accountability: Whether your child is participating in sports, dance, or going to camp, have your child be responsible (or partially responsible, depending on age and capability) for his equipment or supplies.  This can help him to maintain his organizational and working memory skills.
  • Summer Cleaning: If your child has difficulty with task initiation and organization in his room, take the time over the summer to organize a different space together (garage, spare closet) so you can problem solve together how to start, what to do, and how to be efficient. This allows your child to practice this daunting task with some guidance from you.   He can then carry this skill over to improve his personal space. You may even find old bins or containers your child can use for his room!
  • Summertime Incentives: Rewards make the effort of learning a skill and the effort of performing a task worthwhile. In the summer, there are a lot of fun activities and more time to do them! Take advantage of this and use these fun activities (extra time on the computer, extra time at the pool, going to a friend’s house) as rewards for the tasks you want your child to complete.

Instead of allowing your child to forget the gains he made in executive functioning skills at school, use the summer to make gains and have fun!  For more help with executive functioning, click below to download your free executive functioning checklist.

 

Summer Training for Fall Gaining

As summer begins, summer plans take shape.  Hopefully these plans involve lots of fun and sunshine.  Summer should be an enjoyable and exciting time for all children and their families, but it is important to remember to also focus on children’s growth and development.  Sometimes during the break from school, skills gained in an educational or summer therapytherapeutic setting can be lost.  It is important to remember that summer is a great time to keep working on skill development, therapeutic goals, and preparing each child for the challenges of the upcoming school year.

Research continues to show that consistent and high intensity therapy (two or three times per week) results in faster and better functional outcomes for daily skills.  With a more relaxed schedule, summer is a perfect time to increase therapy intensity and have fun building the skills children will need for the new school year.

Specific areas of focus in the summer to prepare for school:

North Shore Pediatric Therapy wants to help your child gain the confidence and independence to conquer all age appropriate tasks! Summer spots are limited. Call us at 877-486-4140 and let us know how we can best support you and your child!