Category Archives: Treatment

Environmental Enrichment – At Home Sensory Stimulation Supplements Autism Therapies

Environmental enrichment is a simple, low-cost program that parents can implement at home to support sensory input therapies their children with Autism Spectrum Disorders (ASD). A recent clinical study led by Dr. Michael Leon, PhD of the University of California Irvine indicates a significant improvement of autism symptoms in children whose therapy was supplemented with environmental enrichment over those who stuck solely with their regular therapies.

The process is simple. Start by introducing a changing set of sensory exercises every morning and evening that engage at least two of the senses in any combination, like pairing a new fragrance with a gentle rub on the back or listening to classical music at bedtime while petting a soft blanket. Change the exercise every two weeks, making them increasingly more challenging, building to games like squeezing objects of different shapes, colors, and textures or pulling a specific toy out of a bag containing other items.

Sensory input therapies have been proven effective for children with ASD and have been increasingly incorporated into special education programs. Shema Kolainu – Hear Our Voices School and Center for Children with Autism in Brooklyn, NY features a Snoezelen Sensory room where children with autism can improve their auditory, visual, and motor skills by stimulating their senses while relaxing in a safe environment.

The clinical study indicated that 42% of the children receiving environmental enrichment in addition to their regular therapies saw a significant improvement after six months – more than 10 points on the Leitner International Performance Scale. However, like all ASD therepies, symptoms, and theories, results vary by individual. The good news is, environmental enrichment offers parents an opportunity to participate in their children’s growth, at little to no cost. There are no possible negative side effects, and it can be fun for both parent and child.



The Struggle for ABA Coverage

When 2-year-old Tony Burke was diagnosed with autism, his parents like many in their shoes, wanted to get him the best services they could that would serve their child’s needs. After doing some research they decided to start him with applied behavioral analysis therapy or ABA therapy, which is considered to be one of the most effective treatment methods for those on the spectrum. After some time, Tony’s grunting noises turned into words and then smaller sentences—the therapy was working. But then something happened that slowed down all his hard work—his family’s insurance started to deny claims.

In Pennsylvania, health insurance laws require ABA therapy to be covered, though in Tony’s case, his therapy was not covered in school, where he needed the most help. His family all of a sudden could not afford o pay therapy costs—adding up to $80,000 a year. These autism coverage acts were passed since 2010 in states like Pennsylvania and New Jersey, but coverage for ABA therapy still remains hard to obtain.

The prevalence of complaints can be hard to assess since the law also requires Medicaid to cover autismservices leaving providers who don’t get paid by private insurance with the option to just bill Medicaid. Some insurers also avoid covering therapies a child can get at school, including ABA, by dumping cost onto public schools or other agencies.

Another major problem is delayed payments. Kara Matunas from New Jersey had her claims for her 2 year old autistic daughter repeatedly denied. Her daughter Reagan, was receiving early intervention, speech, developmental, and occupational therapy. Two of the denials were reportedly “incorrectly generated due to a manual handling error.”

“They’re just purposely delaying coverage,” Mrs. Matunas explains. Even when the claims are eventually paid, the family is left paying $400-$500 a month which can be especially hard on even middle-class families. Autism laws apply only to fully insured plans where companies have a contract with insurance companies to pay claims. However, as more and more large firms are converting to self-funded plans where they have to pay for care more directly from their own wallets, coverage seems harder to come by.

Shema Kolainu – Hear Our Voices is a non-profit school and center for children with autism that offer a variety of services at no cost to families all over New York City. They not only offer center-based services, including ABA, speech, art, occupational, therapies to name a few, but also home based services that reach hundreds of families. Organizations like Shema Kolainu have had great success in helping children on the autism spectrum from early intervention to school-age children, and hope to offer services to families like the Burke’s and Matunas who need these services to help their children succeed.



Virtual Reality Programs as a Social Learning Tool for ASD

Does using technology to assist children with ASD further alienate them because social interaction is missing, or can it actually effect the opposite- by teaching them to socially interact? While some researchers say that    sitting at a computer screen reinforces isolation and brings out obsessive traits, another study done in Spain defends the use of special programs using virtual reality environments that are designed to stimulate awareness in children on the spectrum, while helping them feel safe.

As children with all forms of autism share a difficulty in attention, interpreting social cues as well as following directions, the goal of these Virtual Reality applications is to increase their understanding of body language, facial expressions, the use of imitation and environmental interactions, such as crossing the street. Avatars or characters have long been shown to help children to identify emotions, however, when they are in the protective computer generated environment, children can gain confidence by learning the rules and repeating the tasks. Verbal and gesture based interaction go hand in hand with these skills.

These applications are designed to be used not only on computers but also with more mobile technology such as phones and tablets. As a therapeutic accessory, they complement any other teaching method employed.  By helping the child build confidence through virtual reality learned interactions, we can help them adapt these skills into their every day lives.

Click Here for original study.

 



Autism & Success Stories

Mark Macluskie, around 12 months, about two years before his autism diagnosis; and at home last month before his 16th birthday.

Researchers are finding more cases where early, intensive behavioral therapy can improve language, cognition and social functioning in children on the autism spectrum. Deborah Fein, a clinical neuropsychologist at the University of Connecticut conducted a study of 34 young people who were all medically diagnosed with autism but now no longer meet the criteria for autism. She compared this group with 34 other typically developing peers and 44 young people who were considered “high-functioning” autistics. Another researcher, Catherine Lord, a leader in the field of autism diagnosis and evaluation and teaches at Weill Cornell Medical College, published a study that tracked the progress of 85 children from age 2, when the child was diagnosed, to about age 22, and found that nine percent of the cases no longer met the criteria for autism. They also found correlations with active parental involvement to play a role in the cases where the child was no longer autistic.

One such case was Mark Macluskie, who was diagnosed with medium to severe autism between the age of 2 and 3 years old. He didn’t seem to understand words, threw tantrums, engaged in self-harming behavior such as running his headfirst into the wall, and didn’t show any interest in the people around him. After being placed in a high functioning classroom Mark’s behavior actually got worse. Mark was then moved to the lowest functioning class where a neurologist told his mother to be prepared to someday put him in an institution.

Marks parents, Cynthia and Kevin, were desperate and so they made a lot of sacrifices to spend more time with Mark. Mrs. Macluskie quit her job and started doing all the research she could while also taking out a second mortgage on their house. They also had to empty all the furniture from their living room and instead made room for an inflatable trampoline with rubber walls so what Mark could get the sensory input he seemed to need by running into the wall, but without hurting himself.

She began to home school Mark, starting by watching episodes of “Leave It to Beaver” and “Little House On the Prairie” and then asking him what he thought the characters were thinking, feeling, or going to do next. Mark says, “I remember it being hard to answer my mom’s questions and being confused when I watched those shows. I knew she was doing all those things for a reason, I just didn’t know how it was going to help.” 

Later on Mark discovered a passion for robots after receiving a robot kit as a gift. His mother jumped on this development and formed a robot club where Mark was able to play with four typically developing children and build robots together. Soon, they were writing programming codes and entering into competitions. By this time, a specialist had concluded that Mark no longer met the criteria for autism.

Many parents are quick to read the cases and attempt to create their own plans for how to get rid of their child’s autism. Catherine Lord explains, “I see a lot of parents of 2-year-olds who have heard stories about kids growing out of autism and they tell us, ‘I want my kid to be one of those kids.’” She then serves to remind and counsel them that they should put their focus towards helping his/her child reach their highest potential, whatever that may beWhen you get too focused on ‘getting to perfect’ you can really hurt your childIt’s good to hope—but don’t concentrate so much on that hope that you don’t see the child in front of you.”

To read the full article, click HERE



Scientists Come Closer to Understanding Autism

(Source: http://scitechdaily.com/study-shows-oxytocin-improves-brain-function-children-autism/)

A recent study published in the Proceedings of the National Academy of Sciences has discovered that oxytocin levels in children actually have nothing to with the onset of autism. Oxytocin is the hormone responsible for our feelings of attachment and closeness that help us in bonding and socializing with others. A Stanford researcher, Karen Parker, who led the study, along with her team studied 200 children that included autistic children, their siblings, and non-autistic children. As many theories claimed, Parker’s hypothesis was also that “the kids with autism would have the lowest oxytocin levels, the siblings would be intermediate, and the neurotypical controls would be the highest. That clearly wasn’t the case.”

This oxytocin deficit theory was popular because of the socialization difficulties many children with autism face. There have also been a few studies where giving people with autism a boost in oxytocin could help their social functioning. Oxytocin is produced in the hypothalamus and affects not only the brain, but also the body.

Parker’s study found that there was actually a high genetic influence on a child’s oxytocin levels. So if their parents had low levels of oxytocin then their children also appeared to have low levels as well. These different levels of hormone affected the social functioning of kids with autism and without autism the same way, “As your oxytocin levels got higher, your social functioning was more enhanced,” Parker explains.

However, there are still many parts of the story left to discover when it comes to oxytocin role and its potential benefits for those on the spectrum. Despite the fact that it is not actually a cause for autism, it can provide answers to questions such as why some autistic children have responded to oxytocin treatments and others do not. Regardless, there is promising research ahead for researchers studying this influential hormone. 

​Dr. Eric Hollander, Clinical Professor of Psychiatry and Behavioral Sciences and Director of the Autism & Obsessive Compulsive Spectrum Program at Albert Einstein College of Medicine and Montefiore Medical Center, Director of the Spectrum Neuroscience and Treatment Institute and also Chairman of the ICare4Autism Advisory Council, dedicates part of his research to studying the ways that oxytocin can benefit children on the spectrum ​and the role this hormone plays in social attachment and repetitive behaviors. So far, Dr. Hollander and his team have had positive results in manipulating oxytocin levels for the benefit of people on the spectrum and are still conducting research in order to create treatments and best practices. Dr. Hollander recently gave a presentation on Oxytocin at this past ICare4Autism Conference, click HERE to read more.


Autism & Severe Problem Behavior: What Do We Do?

Some children on the spectrum experience very severe problem behavior, that includes causing themselves great physical harm or causing others harm, which poses a real challenge to parents, doctors, and educators alike when it comes to treatment.  Earlier this month a California couple was accused of keeping their 11-year-old autistic son in a cage, which elicited a lot of criticism and debate over how to best take care of those children who unfortunately engage in this behavior. Amy Lutz, the author of Each Day I Like It Better: Autism, ECT, and the Treatment of Our Most Impaired Children, and a mother of a severely autistic son, talks about how people are quick to judge when it comes to taking care of your child. Her son’s aggressive behaviors were so dangerous that he has to spend ten months at the Kennedy Krieger Institute at just nine years old. Without knowing the details and context for these parents accused of caging their own child, we can’t really say whether this was a form of abuse or maybe a short-term solution to a very difficult challenge.

Dr. Gregory Hanley, Professor of Psychology at the Western New England University and adjunct Professor of Psychiatry at the University of Massachusetts Medical School, gave a dynamic and informative workshop about how to assess and treat severe problem behavior for children with ASD at ICare4Autism’s International Autism Conference. He talked a lot about using effective and safe methods as a behavioral analyst to not only help children on the spectrum, but also making sure to treat them as an individual with dignity and respect. Much of the problem behavior that he used as examples throughout the workshop included children who would throw tantrums, or engage in self-harming behaviors, and even trying to physically harm others.

The method he described to work through these behaviors is called functional assessment. He then provided a few qualifications and adjustments to the way behavioral analysts used to and still do functional assessments. Many behavioral analysts can be afraid for their safety or the child’s especially if the case is one of producing physical injury. Dr. Hanley argues that with the right method and approach, the analyst can provide a safe environment that allows them to learn essentially what it is that causes the problem behavior. Functional assessments like the ones that Dr. Hanley described are just ways in which behavior can be treated, however, there are other cases where the problem behavior is in fact a mental issue that requires medical treatment. The medicine available today includes anti-depressants, anti-seizure drugs, or in extreme cases electroconvulsive therapy. 

We hope that as this field of research continues to grow, we can come to a better understanding about the individual and how to help them lead more successful lives. To see Dr. Hanley’s presentation slides used during his workshop, click HERE.



Using Technology as a Tool for Skill Development

Dr. Dana Reinecke Presenting at 2014 ICare4Autism Conference

Dr. Dana Reinecke gave a presentation at the 2014 International Autism Conference titled, “Technology Opens Doors for Students of All Ages on the Spectrum” where she discussed the best ways to use different aspects of technology to help those on the spectrum. She also discussed the reasons and situations where technology might not be so helpful and even so far as detrimental to a child’s development. For example, if the technology you are using does not actually meet a particular need that you may trying to address, if it becomes more of a distraction than it is helpful, and if it is too expensive and time consuming, then using technology may not be the best choice in your situation.
Another important point she was about using technology as a replacement for social interaction or as a babysitter for your child. Using technology too much and to the extent where it is being used in place of any other types of exercises can be counteractive towards the progress you are trying to make with your child or student.
​Young adults need to have social skills in today’s world to be able to ​maintain a job make personal decisions that are helpful and beneficial for their lives. Individuals need to be able to negotiate with others in order to have their needs met, which can be an especially difficult thing for people on the spectrum as many of them process the environment differently than we do.
​She also stressed the increase of autism diagnoses and rising need for different kinds of treatment and therapies to help people on the spectrum lead productive and fulfilling lives. Dealing with the stresses of daily life, the working life, the young adulthood life can be overwhelming for people who are not on the spectrum, and for people who are these could be disabling for them as they need certain skills in order to thrive in today’s social and tech savvy society. ​
Teachers, parents, and therapists all listened in to learn ways in which they could use technology to further their goals in teaching students on the spectrum different skills. She made sure to provide examples of sources as well as her own program design that people can create themselves to focus on specific needs. Overall, Dr. Reinecke was able to convey alot of useful tools for the audience.


Creating New Understanding around Autism Spectrum Disorder​

Dr. Stephen Shore presenting at 2014 ICare4Autism International Autism Conference

On Day 3 of the 2014 ICare4Autism International Autism Conference, Dr. Stephen Shore, assistant professor in the Special Education Dept. at Adelphi University and ICare4Autism Advisory Council member, gave a presentation of Autism and the Arts: Movement, Music, and the Sensory System. In his presentation he engaged audience by having them participate in an activity that would help them better understand what it means when autistic people experience sensory overload.

In groups of five, audience members chose one person to “have autism”, while the other people in the group were told to read loudly, tap the person’s head, scratch their necks, etc. The person designated to have autism’s goal then was to listen carefully to a passage being read to them by one of their group members in order to answer questions about it after. At the end of the activity, the audience shared their experience and feelings.  Many of the responses included feeling overwhelmed and annoyed, feeling the need to lash out or run away, and just an overall sense of loss as to how to appropriately complete their task and focus. 

The first step to helping an autistic person really is to understand the hows and whys of their feelings and actions. Behavioral therapists do a good job of this as they assess why children react or act out in certain ways and in turn, develop ways to help translate these behaviors into something productive. Dr. Shore’s demonstration let the audience have a glimpse into an autistic person’s mind who is suffering from sensory overload.  With that understanding comes the ability of the parent, teacher, therapist, or other professional, to better deal with and help the individual on the spectrum. 

Dr. Shore focuses on music therapy as an important creative outlet for students on the spectrum.  He has developed his own ways of teaching music that is tailored to the meet the needs of autistic individuals for example by having his students engage in a more visual and creative learning process. ​Another main point of his presentation focused on the way movements and your ability to understand the environment is an imperative part of helping people on the spectrum gain control of their bodies and minds. Research has shown that o​nce you have control over your body and understand your environment, you are able to function and communicate more effectively .

Overall, Dr. Stephen Shore left the audience with a renewed sense of creativity and some important lessons in learning how to address the needs of people on the spectrum so that they are able to succeed in mainstream society.



Making Global Connections at Shema Kolainu

Dilara Mitu discussing how to help poverty stricken children with disabilities in Bangladesh with Dr. Joshua Weinstein, CEO & Founder of Shema Kolainu & ICare4Autism

Today Dilara Mitu, Managing Trustee and Director of the SEID Trust took the time to visit Shema Kolainu in the hopes of starting a collaborative relationship and learn some best practices used at the center. The SEID Trust is an NGO in Bangladesh that is a voluntary development organization working towards promoting the rights of underprivileged children with disabilities, especially those with ASD. It specifically serves poverty stricken children within the community who need the resources the most; they do this through their own fundraising efforts, as they are not publicly funded.

Ms. Mitu met with Dr. Weinstein, CEO & Founder of Shema Kolainu and ICare4Autism, to discuss ways in which she could help the children and the larger community that she serves. After attending the 2014 International ICare4Autism Conference this past June 30th thru July 2nd, she says that she was able to learn a lot. When she heard about the conference there was no doubt in her mind that it would be worthwhile. She says the expenses that she paid to make the trip was nothing compared to the insights and knowledge that she gained from the 3 days. She especially enjoyed the presentations by Anat Baniel and Martha Herbert who gave her different perspectives in which to learn about ASD and best practices.

Ms. Mitu has a strong belief in simply having faith in children and promoting their abilities so that they can be productive members of society similar to Shema Kolainu and ICare4Autism’s goals. Dr. Weinstein was enthusiastic to learn about her organization’s commitment to giving autistic children a voice of their own and also listened to many of the challenges they faced in doing so.

After having an constructive discussion, she was then given a tour of the center so that she could see for herself the practices they had discussed. Overall we are excited to have another organization reach out and are more than happy to share resources. ICare4Autism is dedicated to its mission of collaborating on an international level so that people on the spectrum are able to live more fruitful and happy lives. We thank Ms. Mitu for her visit and will be keeping in touch!



Can Solitary Mammals Help Us Learn About Autism?

There is still so much that we do not know about autism spectrum disorder—from why it has increased in prevalence in the past decade to how to treat those who are affected.  Autism is defined as, “a neural disorder characterized by poor social interaction, problems in verbal and non-verbal communication, and restrictive, repetitive behavior.” Using these common characteristics seen in people on the spectrum, researchers are now looking into studying solitary mammals as a means to better understand the disorder. 

A recently published article in the Journal of Comparative Psychology argues that certain mammals exhibit similar behavior to that typically seen from people with autism. Some of these mammals include polar bears, opossums, skunks, tigers, cougars, and orangutans. Though many of them do have some social behavior they tend to function more independently. According to researcher Jared Edward Reser, both people on the spectrum and solitary mammals have a smaller need for attachment and bonding behaviors, lower stress from separation, and less expressiveness. Biologically the two groups are also similar in that they both produce lower level of oxytocin and vasopressin, which are two hormones that play a large role in social bonding and feelings of attachment. For example, oxytocin is released into the body during positive social interaction, which is responsible for the feelings of closeness we experience with others.

A previous study that used oxytocin injections on adults with autism had results that showed an increase in eye contact, prosocial behavior, and reduced fear/anxiety in social situations. Although much more research is still needed to determine whether oxytocin has a place in treating autism, it does have potentially promising results especially for treatment of more severe cases.

Using this comparative research can be controversial, though researchers acknowledge that only a certain autistic behaviors can be studied and explained by using these comparisons. Autism involves a variety of symptoms and no single animal model could possibly be enough to understand autistic individuals, but it can provide new insight and points for research. Reser points out that it may give us new perspectives on how we look at autistic behavior. “Are the different behaviors we label as being autistic necessarily pathological or are there advantages involved, especially in modern society?” Many scientists as well as autism advocacy groups realize that autistic people can be very successful, especially in fields such as computer programming, mathematics, and physics, therefore continuing to treat them as mentally ill can be counterproductive to our society.

Helping children with autism by providing them with therapy and specific attention to their needs has been a successful and alternative form of “treatment”. So by studying these solitary animals, perhaps we can gain insight into the biology of social interaction, “we can also recognize the need to accept that humans vary widely in terms of how they deal with others.” Dr Eric Hollander,chairman of ICare4Autism Advisory Council, professor of psychiatry and behavioral sciences at Albert Einstein and Director of the ASD Program at Montefiore Medical Center does similar research especially with studying social attachment and the biology behind social interaction as it relates to ASD. He is committed to finding best practices that will help advance the lives of children and adults who are on the spectrum. In an interview with Medscape he says, “Studying autism is really a great opportunity because if you understand what goes wrong in autism, you understand a little bit more about what makes people human. It gives you insight into issues around being able to see things from other people’s perspectives and issues around social attachment, which are really what makes us human.”

Dr. Hollander has been listed in NY Magazine and Castle Connolly’s as one of the “Best Doctors in America” and has done several interviews for the New York Times, the Today Show, and Dateline NBC. He will be giving the opening remarks at our upcoming International Autism Conference as well as presenting on Day 2, which focuses on biomedical research and new developments in autism treatments. For the opportunity to hear him speak, get more information and register for the conference HERE! 

For original article, click here