ASA's 36th National Conference on Autism Spectrum Disorders (July 13-16, 2005)

Embedded Skills Teaching: How to "sneak" in language and academic concepts throughout your child's day to promote learning and use of skills.

There is nothing "incidental" about incidental teaching: Parents and educators can use Embedded Skills Teaching throughout a child's day to promote the spontaneous use of academic and language skills while improving play and addressing generalization. Impaired play skills are a defining characteristic of children with autism. The limited appropriate use or interest in toys or activities greatly reduces a parents opportunity to interact (teach) with their child with autism. Embedded Skills Teaching (EST) examines three phases of play (cause and effect, cause and effect paired with interactive, and interactive paired with dramatic play) and how parents and educators can make play more attractive to children with autism. In addition, limited spontaneous use and generalization of academic concepts and language skills has been a long time criticism of Applied Behavior Analysis (ABA) programs. EST provides strategies to increase spontaneous language use (Environmental Arrangement, Responsive Interaction, Language Prompting), techniques for embedding the child's goals into everyday activities, and coordinating EST to practice the skills being taught in the child's therapies. These strategies will be demonstrated through discussion and video examples. Embedded Skills Teaching kits will be available at the end of the presentation.

When the resources don't fit: Designing treatments for your child

This presentation is a case study of a young child diagnosed with autism at the age of 2. The struggles of the family to find appropriate behavioral services and an educational environment led them to design and provide services on their own. Professional and para-professionals were initially resistant to an applied behavior analysis (ABA) format, but were subsequently impressed with behavioral improvements and cognitive strides. Intervention strategies included modification of Lovaas' discrete trial format, full implementation of the GF/CF diet, B6-Mag supplementation, a regularly implemented sensory diet, and standard early intervention services. The family soon became aware that the typical early intervention services were not sufficient to meet the needs of their child and immediately began researching the latest available data. In the interim, the GF/CF diet, B6-Mag supplements, DMG, and the Wilbarger brushing protocol, as well as other sensory exercises were begun in a staggered manner. The family also felt the ABA method appeared to be a much needed strategy for their child, but due to a remote geographic location and mounting financial constraints, were unable to obtain these services in the conventional manner. The family obtained the The ME Book, Lovaas (1981), and within 3 months and one week of diagnosis, set up a discrete trial program in their home with the mother as lead therapist and curriculum designer, and the father and three early intervention therapists as adjunctive therapists. The family was able to simultaneously obtain an amended IFSP which allowed for the child's speech/language, OT, and developmental intervention services to continue with an amendment to allow services to be delivered in the ABA format as prescribed by the family. All early intervention therapists were trained by the family and were to provide services within their scope of practice, only now delivering them through the discrete trial method. At diagnosis, the child was virtually non-verbal (in the 1 percentile), had little to no eye-contact, was highly aggressive, displayed signs of cognitive deficits, and was consumed with abnormal self-stimulatory behaviors. Today, after 2 years of parent-driven therapy, this same child now functions in a low-normal receptive and expressive language range, frequently displays age-appropriate social overtures, and engages in pretend and turn-taking play with typical peers. Eye contact now also falls in the low-normal range and aggressive behaviors are minimal and consistent with same-aged typically developing peers. Generalization of learned concepts has been good. The family has been diligent in redirecting the child's self-stimulatory behaviors into socially appropriate behaviors. The child has proven adept in art, music, dance, and academics. The family discovered the child to be hyperlexic and utilized this tool to expand the child's receptive vocabulary as well as develop verbalization through consistently applied association techniques. While Lovaas' techniques were the guiding framework for this program, the family has taken care to expand on their child's strengths and troubleshoot his weaknesses, as well as continually draw from all available resources in order to ensure a balance of activities that keep the child continually challenged and moving forward. The experiences of this family are evidence that a parent-designed and driven program can yield the best of outcomes when applied in a conscientious and reliable manner and should be viewed as yet another mode of therapeutic delivery for families who either find themselves in similar circumstances or simply choose to take the helm of their child's course of treatment.

Sleep problems and Autism: What can parents do?

The sleep patterns of individuals with autism have shown to be significantly different than that of typically developing peers. These differences may in turn be related to behavioral problems and cognition, making sleep a critical area of concern for individuals who have autism. Additionally, as any parent can tell you, when your child has a sleep problem, the entire family has a sleep problem. This talk will present a recent investigation of the sleep patterns for adults and children with autism in their home using a portable sleep recorder over multiple nights. Measures were taken on the individuals brain waves (EEG), eye movement (EOG), and muscle movement of the chin (EMG). Findings indicate a paucity of REM sleep (dream sleep), and increased propensity for sleep disturbance for individuals with autism. Although some sleep problems (e.g., REM sleep disorders) may be resistant to external interventions, best practices exist that may help parents improve children's sleep. This presentation will go over (a) why we think it important for future research to incorporate measures in the home environment, (b) why it is important to have multiple nights of data for each child and (c) present behavioral strategies designed to improve the sleep patterns of people who have autism.