Urine test to screen for Autism

Women have been doing it for over a decade: Pee on a stick in the privacy of your own home and moments later, find out if you are pregnant. Two lines or one, positive or negative, pregnant or not pregnant. It’s as simple as that. Could it now be this simple to diagnose Autism?

According to a research published a couple of years ago, children with autism have a different chemical fingerprint in their urine than non-autistic children. The researchers behind the study, from Imperial College London and the University of South Australia, suggest that their findings could ultimately lead to a simple urine test to determine whether or not a young child has autism.

According to the CDC, Autism affects an estimated one in every 100 people in the US. People with autism have a range of different symptoms, but they commonly experience problems with communication and social skills, such as understanding other people's emotions and making conversation and eye contact. Currently, diagnosing a child with Autism can be a very subjective process. Parents often notice something is not right about their child between the ages of 12-18 months. At present, the only way to assess a child for autism is through a lengthy process involving a range of tests that explore the child's social interaction, communication and imaginative skills. Many children don’t get diagnosed until even later, missing a critical window of opportunity for early intervention.

People with autism are also known to suffer from gastrointestinal disorders and they have a different makeup of bacteria in their guts from non-autistic people.

This research shows that it is possible to distinguish between autistic and non-autistic children by looking at the by-products of gut bacteria and the body's metabolic processes in the children's urine. The exact biological significance of gastrointestinal disorders in the development of autism is unknown.

The distinctive urinary metabolic fingerprint for autism identified in this new study could form the basis of a non-invasive test that might help diagnose autism earlier.

This would enable autistic children to begin treatment for autism, such as advanced behavioral therapy, earlier in their development than is currently possible.

Early intervention using the methods of Applied Behavior Analysis (ABA) can greatly improve the progress of children with autism. The earlier the better.

 

Daniel Adatto, BCBA
cadatto@tesidea.com

 

 

 

Twins and Autism Spectrum Disorders

For years, scientists, parents, and doctors have debated the causes of autism. According to certain studies, there is a higher rate of autism among identical twins and although not as high, fraternal twins. Twin studies may seemingly point to a genetic cause for the autism spectrum disorder; however, the increased risk amongst fraternal twins seems to indicate that environmental factors also play a role.

While there is still much to be studied on this topic, documentation of twins development where one twin suffers from autism and the other is typically developing can help researchers tremendously.

I came across a series of videos released by the National Autism Awareness Month, Rethink Autism a while ago which help to raise awareness of autism among parents. Through the powerful story of Trina McField, a mother who recognized early signs of autism in one of her twin boys, these videos educate viewers on how to spot the early signs of autism, highlighting the contrast in behavior between a child with autism and his typically developing twin brother. The videos also suggest evidenced-based treatment options available to parents and show the dramatic improvement in a two-year-old boy with autism after just five months of treatment at home. Behind the video footage is an incredible story of a mother who perseveres through doubt and uncertainty to bring hope to and create a future for her son with autism. The story inspires and empowers parents to start early intervention treatment using an Applied Behavior Analysis (ABA)-based curriculum. Recommended by the US Surgeon General and the American Academy of Pediatrics, ABA is the only treatment for autism that has been consistently validated by independent scientific research.

When in doubt consult with your pediatrician. And give us a call. We, who devoted our professional lives to this field, are here to help.  

 

Daniel Adatto, BCBA

cadatto@tesidea.com

Let’s teach our kids how to be happy

I recently overheard one teacher’s assistant say “They don’t know how to be happy”, after one of her students responded in a grumpy way for no clear reason. Interesting statement, I thought, why I don’t write a blog about it.

Happiness, being happy, is a subjective state. What is “happy” for one person might not be for another one. But for the sake of this discussion I think we can agree that when we are happy we feel good, we are more in control of our behaviors, and we enjoy ourselves. Most people know how to be happy for the most part because they know what makes them happy. An activity they enjoy doing, a favorite restaurant, time with loved ones, success at work, the satisfaction of fulfilling responsibilities, etc. In behavioral terms, most people know how to meet natural contingencies of reinforcement, or how to obtain rewards. 

For kids with special needs this doesn’t come naturally. They often live in a state of confusion and anxiety.  Not only is it difficult for them to understand what’s going on around, they don’t know how to meet natural contingencies of reinforcement. In plain English, they don’t know how to achieve positive experiences. The chaotic organization of their behaviors can make them feel in a constant state of discontent.  This can cause frustration, anger, disappointment to the people around them who then react with aversive methods of discipline. Which then feeds the cycle.

Therefore, it is our job as teachers and parents to rescue them. We need to teach them how to be happy. In the process, we can also manage their behaviors.
How do we do this?

As explained in my blog post titled “What’s your talent?” we do so by exposing them to experiences where they can feel a sense of success and achievement:

1.      Contrived rewards and praise have to be built into their daily schedule of activities, at home and at school. Instead of waiting for them to fail to reprimand them, let’s create the environment and provide them with the necessary support to succeed.

2.      Catch them being good. Even during challenging situations make an effort to praise them for something. Do not focus exclusively on the “bad.”

3.      As we discussed in a previous blog (See “Fun can change behaviors”), something as simple as fun is the easiest way to change people’s behavior for the better. For example, if a child is resisting brushing teeth, going into the bathroom together and singing a funny song may be motivation enough. If getting dressed is a struggle, initiate a game of tickle, act silly and turn getting dressed into something fun.  Instead of demanding that a child clean up the toys, turn on some music, dance around and turn it into a game.  Make it fun and you will make it easier.

4.      Another way to help them be happy is to teach the child a more effective and appropriate way to get her needs met. If your child is having a hard time doing homework, for example, teach her to ask for breaks, or help.

Disciplining our kids is part of our job description as a parents and teachers. I know I’m doing my job right when I make them laugh/smile. I do that best when I’m enjoying my time with them. You need to have “fun” in your toolbox because fun is one of the most powerful tools of discipline.

 

Daniel Adatto, BCBA

cadatto@tesidea.com

Family involvement

We always say that when parents and other caregivers get involved in the interventions, their children show the most gains and progress. Parents become the therapist and thus, the intervention is in place 24-7.

The question is what it means to be involved. Here are my recommendations regarding the necessary steps of family involvement:

Phase 1: Look, listen, and learn

·       This is the introductory phase where the parent observes the behaviorist working one to one with the child. The parent will observe different segments in a variety of domains including independent living skills, functional communication, play, and behavior. Verbal instruction as well as modeling will be used throughout this phase to familiarize the family with common strategies and techniques.  

·       20 - 25% of the session will be devoted to observation. 

Phase 2: Working together

·       The parent has now observed all of the segments and is given a choice of what segment they would like to work on. During this step the parent and provider are both actively involved in the segment. The parent begins to give instructions, redirect inappropriate behavior, and use reinforcement contingencies.

·       The behaviorist is collecting data on the consumer’s interactions with the parent as well as with herself/himself.

·       20 – 25% of the session the parent and behaviorist will work together on achieving the consumer’s goals.

Phase 3: Parent lead

·       The parent is now leading the segment with the support of the provider. Instructions, redirections, and opportunities are all directed by the parent.

·       The behaviorist is taking data on the interaction and is only stepping in when necessary to give feedback to the parent.

·       25 – 30% of the session will be parent lead.

Phase 4: Independence

·       In the fourth and final step the parent is working with the consumer one to one and the provider has been completely faded. The parent is responsible for handling difficult behaviors, following through with demands, and employing environmental modifications.

·       The parent and behaviorist are both taking data that will be compared during the debriefing session to check for reliability.

·       25 – 30% of the session will include parent participation.

 

All this take and investment in terms of work and commitment. But it is worth it because you are investing in your family quality of life.

 

 

Daniel Adatto, BCBA

cadatto@tesidea.com

The First 3 Months of Early Intervention

Numerous research studies show that the earlier the better when it comes to early intervention using applied behavior analysis in the treatment of autism.  What is not so often written about, is how exactly to begin an early intervention program and what are the critical first steps to take when a Behavior Analyst begins working with a child with autism.

At a recent ABAI conference an expert from Poland held a session on why the first 3 months of an early intervention ABA program are so critical. The presentation focused on quality of services and building a strong foundation, reminding us not to jump ahead too quickly, not to target all deficits but to prioritize deficits and skills to ensure quality. The presenter emphasized how important it was to develop a positive relationship with the client in the first month in order to obtain optimum results. This information probably seems intuitive to most Behavior Analysts yet so many of us go about our first treatment sessions the wrong way.

When a typical ABA program begins, a Behavior Analyst will gather information on problematic behavior and details surround that behavior - the frequency, where it occurs, when it occurs, etc. The Behavior Analyst will meet with important people in your child's life, such as friends, babysitters, teachers, and relatives to get an understanding of how they behave within a variety of relationships. Also, they will schedule a time to observe your child to personally witness the problematic behavior. Once they have gathered enough information, the Behavior Analyst will complete an entire behavioral assessment on your child's behavior and then begin to implement the plan in your child’s natural setting such as the home or classroom. A Behavior Therapist will typically show up with a bag of tricks (toys, games, motivators) and get to work. This is where, according to the presenter, some of us may be going wrong.

What she recommended was to use the first month to build motivation in the child by establishing a playful rapport. Do whatever it takes to win him over – jump on the couch, do fun activities or just be silly.  If a child knows that every time his therapist comes he/she will need to work, then a feeling of dread comes over the child when the therapist arrives. But if the first month is used to establish a positive foundation, the child will look forward to the arrival of his therapist and be more motivated to work.

Another recommendation was to take a step back in the beginning to identify the motivating factors that are already in the child’s home. If all the therapist uses to motivate the child are his special toys in the bag of tricks, it will be very difficult for the parents to replicate once the therapist leaves. If there are things in the household that motivate the child – special  DVD’s, one-on-one attention, preferred games – use these motivators rather than the toys that come and go with the therapist.      

And as we always say, consistency in the implementation of the treatment plan across people and time is paramount in the success of the intervention.

We at Total Education Solutions are committed to being at the forefront of the behavioral health services industry. We strive to keep up to date with all the latest research and trends in the industry. It is always our pleasure to pass along to our readers and clients the valuable information we learn.

Daniel Adatto

cadatto@tesidea.com

Unsuccessful Behavior Management: Common Causes

We often see behavior management programs fail. Even when implemented by professionals. So let’s take a look at possible causes:

 

- Not looking at the “big picture”:

Many interventions focus on extinguishing the viewed behavior without thoroughly evaluating their cause. Identifying the cause is critically important to be able to find a solution. Even though causes are not immediately observable, they relate significantly to the immediate behavior.

 

- Failure to determine the true cause of the problem:

In children with developmental disabilities, there are usually three interwoven factors into a large percentage of behavior difficulties: the inability to understand effectively, expressive communication problems, and sensory issues. To be successful, an assessment of behavior problems has to consider what need the behavior is trying to meet. 

 

- Trying to deal with too many things at once:

When children have lots of problems in lots of areas, it can be overwhelming. When the parents try to correct too many things simultaneously, both adults and kids become frustrated.

 

- Focusing on extinguishing behaviors rather than teaching skills:

Telling the children what not to do is sometimes helpful, but it is even more important to teach them what they should do instead. One of the most effective ways of reducing/eliminating inappropriate behavior is to teach the child a more effective and appropriate way to get his needs met.

 

- Presuming the child understands:

A child’s difficulty in understanding is frequently a significant source of behavior problems. Presuming the child understands directions and rules can be misleading.

 

- Failing to teach functional communication skills:

For most behavior difficulties, communication emerges as part of the problem and is an essential part of the solution. If the behavior problem is related to the child’s communication needs, then teaching more effective communication skills needs to be a major part of the solution.

 

- Bombarding the child with too much verbal & sensory input:

When children are having difficulty, it is tempting for the adults to do more...talk more, get closer, or any other reaction that only intensifies the situation. Taking a break and backing off is often times the way to go.

 

- Making the whole process too complicated:

 Too many directions, lecturing, bringing the past, complaining, usually makes things too complicated, thus worsening the problem. Be simple and matter-of-fact. Stating the problem (“your room is messy,” “is time to go to sleep,” etc.) is much more effective than lecturing (“I told you one million times”, “you have to be responsible and clean your room”, “I’m not your servant”, “every day the same thing”, etc.). Offering choices rather than giving directions is often times a good idea (i.e. “Do you want to do your homework before or after dinner?” rather than “Do your homework.”)    

 

- Reacting to difficult behaviors inconsistently:

Children get confused easily. The more inconsistent the adults are in managing behavior situations, the longer it will take to observe positive changes in the child’s behavior.

- Not getting the right amount of help:
Dealing with behavior problems can be an overwhelming and exhausting task. Evaluating yourself as part of the situation is difficult. Different people will evaluate situations from different points of view. Teaming together with others will help the whole situation is perspective.

- Not defining success:
Taking into consideration their disability, are we trying to make kids perfect or are we trying to make them behave appropriately? Success is not perfection. Think of success as appropriate participation and interaction with others.

- Forgetting that kids are kids:

Just by their nature, children are going to have their ups and downs. Everything a child does is not a major problem. Take time to sort out the things that children do just because they are kids from the behaviors that are the real problem.

 - Forgetting to have fun:  

Dealing with behavior problems is serious business. It is easy to focus exclusively on behavior problems instead of the good times. Don’t forget to enjoy your child when things are going well.

Remember, learn how to behave so your kids will too.

 

Daniel Adatto, BCBA
cadatto@tesidea.com 

Happiness starts at the top

After attending an IEP two days ago I received this email from the student’s dad yesterday:

“Hello Daniel,

I want to thank you for your advice yesterday with Sam's (not real name) IEP. The main reason I think he does not like German class is the way he is treated by the teacher. At the beginning of the year she was dealing with Sam in a rude and dismissive manner, and I think that her behavior and treatment of my son is the reason for his problematic behavior in her class. I thought that it was insightful when you pointed out that Sam, like most children, responds better when treated with respect rather than in a dismissive manner. Thank you”

When I said that I thought it was common sense rather that especially “insightful,” as this father points out. 

And today, what a coincidence, I came across this article from Aubrey Daniels International (http://www.talentmgt.com/blogs/5/post/7090-happiness-starts-at-the-top?utm):

 Keeping employees happy and engaged can be a challenge for many organizations. Our latest newsfeed offers resources and tips for how to reinforce employees and create a happier

Happiness Starts At The To

In today’s workplace a lot of emphasis is put on making employees happy, but many companies mistakenly do so through added perks. Dr. Aubrey Daniels explains that being happy at work is less about what employees are given and more about how they are treated. This blog explains why companies should focus on recognizing employee contributions and achievements in order to b"In reading The Pursuit of Happiness, a recent article in Talent Management magazine about the job of “chief happiness officer,” my first reaction is that a company that appoints one needs one. Increasing perks, and even income, won’t cause people to be happy. If it did, how would you explain why many who are rich are also seemingly unhappy?

Happiness comes from how employees are treated as they work, not as something you give them to make them happy. An important factor to keep in mind is that because happiness is perishable, recognition of accomplishments, contribution and progress needs to be very frequent.  Measures of happiness can only be made by looking at accomplishments. Attendance, effort, productivity, quality and safety are all lagging measures. It is difficult to be happy when the company is not performing well. If you are not treated well, it is also difficult to be happy, regardless of the economic health of the organization. In other words, happiness starts at the top and is reflected not in what the CEO says but in how those words are reflected in policy, processes and management behaviors. If the CHO can bring about those changes, there is a viable and important job. If not, there will be little happiness and lots of wasted time and money.”

How true this is when it comes to parenting and teaching, especially kids with special needs that present behavior challenges! If the approach is “rude and dismissive,” as Sam’s dad pointed out in his email, how can we expect the kids to behave nicely and respectfully? Why we demand the children to behave when the adults that deal with them don’t?

Yes, kids, like most of us, respond better when treated with respect and dignity, regardless of their special needs, challenges and deficits. Something to think about.

Daniel Adatto, BCBA

cadatto@tesidea.com