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Therapy & Treatments : The Right Fit
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Posted by sylvia on Saturday, March 25, 2006 (08:02:44)
TBO News
By Donna Koehn
In the story of the elves and the shoemaker, the little sprites work all night long to produce neat rows of perfect shoes.
Laura Crawford works her magic under the bright fluorescent lights of a Target department store.
Beaded purple high heels, the right discarded a giant's step from the left, are whipped into place in the proper box, proper size, proper shelf. As fast as customers manage to mangle her work, she's a blur of efficiency that fixes the mess without pause.
Until a co-worker approaches.
"Laura, you let me know when those brown boots go on sale; I've just got to have me those boots," the seasoned employee says, smiling down at the slender redhead kneeling by shoe boxes.
Laura freezes, her face empty of expression. She doesn't look up.
"How am I supposed to know? I don't put the price on them."
The co-worker drifts away, and it's time for job coach Mike Chapman to step in.
"She was just asking you, being friendly, like a friend would ask," he says quietly.
"Oh."
And she's back to her charges, those errant shoes the gosh-darn customers keep messing up.
Laura Crawford, 22, has autism. As she strives to navigate a tricky world of social cues and nuances she cannot decipher, job coaches from the TEACCH program encourage the world to give a little back to her.
It's part of the philosophy of the renowned research, education and job training center that began at the University of North Carolina, Chapel Hill, 33 years ago.
TEACCH was born when parents united to fight institutionalization of their autistic children in the early 1970s. But those children grew up, and the Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH) grew with them.
Now, with nine sites throughout the state of North Carolina, it has helped place hundreds of adults into a variety of jobs -- both menial and cerebral -- that capitalize on their wide range of skills. They drive trucks, work in banks, repair computers and conduct lab research.
Accepting 'Culture Of Autism'
One guiding principle from the beginning has been acceptance of what director Gary Mesibov refers to as "the culture of autism."
"We use this to mean that people with autism are a group distinctive in and of itself," says Mesibov, who joined TEACCH in 1974. "They have common characteristics that are different, but not necessarily inferior, to the rest of us. Some of them have a higher IQ than I do."
Chapman, who left studies in physics to become first a job coach, then director of supported employment for TEACCH, spends 40 to 60 hours assessing each person. He looks for strengths and weaknesses to find the right fit, both on the job and off. The program tries to help clients socialize and have a little fun.
"This doesn't necessarily mean taking our values and putting those on them, but respecting their own," he says.
In Laura's case, it meant convincing management at Target to allow her to concentrate on the shoe department rather than mastering all areas of the store -- what's expected of most other employees. Like those size-9 purple pumps in the size-9 box, Laura needed to find her spot.
"She just can't ignore messes," says Gabe Byars, who studied the evolution of clams at Duke University before shucking that three years ago to become a TEACCH job coach.
"Laura got the job at Target herself. One day, she was shopping there with a friend and just had to start folding the clothes," he says. "A manager came up to her and offered her a job."
Laura's work ethic is never questioned; one day she told her manager she wanted to go ahead and work another six hours so she could have every shoe perfectly placed. A tangle of red rubber flip-flops last summer nearly drove her to distraction.
So, in addition to trying to help her learn how to smile and greet customers -- a tough part of the job for her -- much of Laura's coaching has centered on how to settle for less than perfection.
Compared to the fly-by-night teens who often staff retail, Laura is a manager's dream. The Target store at which she works in Durham has asked TEACCH for more workers. Another already on the payroll does office work.
"They are our most reliable team members," says Laura Smrecek, executive team leader for human resources. "They want to come to work and do their jobs."
Dedication is one of TEACCH's selling points to employers; tax incentives grease the wheels. Sick days go mostly unclaimed. Job coaches for mentally disabled clients learn the jobs along with them and stay at their sides all day, if need be, at no charge to the employer.
But in return, employers have to give a little. Usually, it isn't much.
Problem On The Dish Line
SAS, a business analytics software company in Cary, hired a team of TEACCH clients to wash and sort dishes in its spacious company cafeteria. The dish washers mingle with employees at company picnics, swim alongside them in the SAS pool and work out with busy executives in the weight room.
But team member Ronnie Peterson, 35, had a problem.
From time to time, the TEACCH client would run screaming from the dish room, dashing across the cafeteria, crashing business lunches and startling working parents as they shared a meal with their children from the company day care center.
Instead of issuing a pink slip, Ronnie's boss allowed his job coach to analyze the problem. The first solution was to teach him how to better manage stress and give him a place where he could go when he became overwhelmed -- a basement that contained his bellows. The second solution was even easier -- slowing down the dirty dish conveyer belt by just a couple of seconds to ease his frustration.
Now, Ronnie and his co-workers sing and dance to rap music as they spray food from dishes and sort forks and spoons. His "screaming place" has been relabeled the "relaxation place."
"Sometimes it's so simple," says Glenna Osborne, TEACCH program consultant. "Sometimes it seems too simple."
Success may mean recognizing and capitalizing on the autistic clients' unique strengths.
Meredith Daniels, 27, has a flat affect and eyes that hold the gaze just a little too long. A stranger might sense something is wrong but might not guess autism.
A whiz at organization, she types well and enjoys creating graphic designs on the computer. She's also obsessed with rainbows.
Now in her fourth year working at the TEACCH Greensboro office, Meredith combined those into a color-coordinated filing system that is a marvel.
"And she did the whole system unasked," Osborne says.
Thinking Disney Thoughts
Sometimes job coaches use the object of an obsession to provide rewards.
Sara Redmon, 21, works as a janitor at a client day center. The "structured teaching" approach at TEACCH means her daily instructions are explicit, right down to the number of squirts of Windex to use on each mirror. But also spelled out on her clipboard: five minutes to "Take a break and think of DISNEY!"
"Well, I wasn't going to say anything, but yes, I love 'DuckTales' and 'Darkwing Duck' " cartoons, says Sara, as her eyes light up. "If I think of them, I can get through the day."
She also is addicted to anything featuring actors Tim Curry or Patrick Stewart (Capt. Jean-Luc Picard of "Star Trek").
"And, of course, Vincent Price."
Redmon's mother, Barbara, calls her doe-eyed redhead "the light of my life."
"When we lived in Tennessee, it was all about trying to change her," she says. "But that's like trying to put a round peg in a square hole. All they had when she was growing up was behavior modification. When she would blow, she would be punished, but that's what was stressing her to the point of overload."
Sara pipes in: "It's like asking a computer to change its programming."
Debate continues about the best way to reach people with autism, Mesibov says. TEACCH was the result of one man's resistance to common thinking of the day.
Eric Schopler, retired founder, studied with Bruno Bettelheim, the psychologist who theorized decades ago that autism was caused by cold, distant mothers who rejected their children. Treatment required the children to climb on cold, unyielding statues of women so they could better understand what their mothers were really like.
"Eric kind of figured anything would be better than that," Mesibov says.
Schopler instead stressed the need for parents to have an important role in the care of their children. As the parents interacted and their sense of advocacy grew, they brought their children to a breakfast for state legislators, who agreed to fund the program, established under the umbrella of UNC's psychiatry department.
"Folklore is that we brought a kid to the breakfast who liked to dip neckties in grits," Mesibov says.
It's Free To State Residents
TEACCH receives about $5 million from the state and matches that through private donations, grants and training activities. Professionals from throughout the world come to North Carolina to learn about it. The program is free to North Carolinians, and many families have moved to the state for it. That isn't encouraged, as TEACCH clients already face a five-year wait for services.
Although TEACCH also is a hotbed of research into autism, including studies on brain imaging and the search for the specific genetics involved, Mesibov says it sometimes gets a bum rap as "giving up."
He readily admits that no one there is trying to erase autism or hold out hope for a simple answer.
He feels sorry for parents who go broke trying to find the right diet or therapy to rescue their children from the mysterious brain disorder. Although there is no shortage of anecdotal tales of children who have been cured, the empirical data so far are lacking.
"One of the biggest drags on the field of adult autism is that there's 'the' cure," Mesibov says. "So people tend to block the idea from their minds that these kids are going to grow up."
Barbara Redmon sees obvious differences in Sara, who now speaks with animation, hand gestures and a vitality that belies her autism.
"This program has helped me socially, to be more expressive and more open to change," Sara says. "I was very upset, very stressed before."
As all parents do, Barbara once dreamed big for Sara.
"Now, I think of a successful life as one that brings her happiness," she says.
"Sara has never felt understood -- until now. Just to have her understood is so wonderful."
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Therapy & Treatments : Special Kids Video Modeling Therapy Programs
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Posted by sylvia on Friday, May 27, 2005 (14:43:57)
Genetic Engineering News
Helping Toddlers, Children and Teens with Autism, Down Syndrome, Mental Retardation and Developmental Disabilities Learn to Speak, Read, Write, Socialize, Self-Help And Play
Pioneered by a father of a boy with autism, Special Kids(C) Video Modeling Therapy Programs this week celebrates distribution in a record 30 countries, helping children the world over with a variety of developmental, cognitive and learning disabilities acquire speech, reading, writing, early academics, personal hygiene, self-help, social and play skills.
"With more than 12 years of countless success stories behind us -- as well as numerous clinical studies that all support video modeling as an effective teaching tool for toddlers, children, teens and others with developmental disabilities -- we're thrilled to see our Video Learning Programs now in 30 countries around the world," says John Sprecher, founder of Special Kids and father of Jeff, a young man with autism. "We encourage anyone who has a child or teen with a developmental, cognitive or learning disability to consider the positive impacts that video modeling -- essentially a highly visual therapy -- can have on their son or daughter, as it has countless other boys and girls."
Special Kids is a company founded almost by accident. In 1989, John Sprecher noted how his son Jeff, then two and newly diagnosed with autism, responded to certain television shows. Sensing an opportunity to teach, Sprecher developed an "alphabet" and "numbers" home video program -- and the previously non-verbal Jeff learned to identify, and speak, the alphabet and numbers within three months. Numerous parents borrowed this program with similar success, then encouraged Sprecher to author an article in the Autism Society of America's magazine.
Sprecher did so - and the demand for programs was overwhelming, with more than 300 letters received from parents and teachers around the world, encouraging Sprecher to mass produce his programs. Within four years, a library of Special Kids Video Modeling Therapy Programs was introduced for sale.
Today, clinical studies show that Video Modeling Therapy Programs are highly effective in teaching children with autism, Down Syndrome, mental retardation and other developmental disabilities. A total of 11 Special Kids programs are now available, as well as a variety of supplementary products.
"Special Kids truly is a case of necessity being the mother of invention," Sprecher says. "Today, one boy's autism has now helped children, parents and teachers in 30 countries -- and more than 500 United States school systems -- acquire communications, social and play skills they might not otherwise have. That makes their lives better, as well as the lives of their parents and caregivers. There's nothing more rewarding than that."
For a complete listing of all Special Kids Video Modeling Therapy Programs, as well as ancillary teaching products, visit http://www.special-kids.com or call 800.KIDS.153. Testimonials, testimonial interviews with parents, product samples, product samples for review and other support materials are all available FREE upon request to milissa@special-kids.com
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Therapy & Treatments : Relationship Development Intervention(tm) Program
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Posted by Sylvia on Wednesday, May 18, 2005 (13:58:33)
Medical News Today 20/04/05
Preliminary research indicates that the Relationship Development Intervention (RDI(tm)) program may help children with Autism Spectrum Disorder (ASD) achieve improvements on the Autism Diagnostic Observation Schedule (ADOS), a standardized protocol for observation of social and communicative behavior associated with autism.
The research, published in this month's Autism Spectrum Quarterly, indicates that 12 of the 17 children in the study group improved in at least one category on the ADOS.
The RDI program is a parent-based clinical treatment that addresses the core problems faced by all individuals with ASD, such as learning friendship, empathy and a love of sharing their world with others. The RDI program is based on extensive research in typical development and translates research findings into a systematic clinical approach. Dr. Steven Gutstein, author of the study, called the findings encouraging.
"It is clear that individuals with ASD can benefit from our completely new way of thinking about and treating their deficits," said Gutstein. "We are challenging families and professionals to think beyond achieving mere functionality as a successful outcome for individuals with ASD; our reference point for success in the RDI program is quality of life." However, Gutstein was careful to point out that the small sample size needs to be taken into account when considering the implications of the research. Additional research is underway.
The study observed 31 children - all between the ages of two and nine and all with ASD - during a 16-month period. The families of 17 children participated in the RDI program while a control group of 14 children of similar diagnoses, ages, cognitive and language functioning participated in other treatments. After 16 months, 70 percent of the children in the RDI program had improved in at least one diagnostic category on the ADOS and 13 of the 17 RDI children were attending regular education settings without significant support.
In contrast, not a single child in the non-RDI group had improved in any diagnostic category of the ADOS and none had moved from a special to a regular education setting during the same 16 months.
About Connections Center
Established in 1995, the Connections Center for Family and Personal Development, based in Houston, is a multi-disciplinary program to develop innovative evaluation and intervention programs for people with relationship disorders. Led by Drs. Steve Gutstein and Rachelle K. Sheely, the Connections Center staff provides a full range of evaluation and treatment services, including RDI. They provide education and training to families and professionals worldwide. More information is available at www.rdiconnect.com
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Therapy & Treatments : Low-Cost Therapy Shows Promise for Autism
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Posted by Sylvia on Wednesday, May 18, 2005 (13:44:16)
Reuters 19/04/05
A form of therapy that focuses on parents' interactions with their children could help treat autism at a far lower cost than other strategies for the disorder, according to researchers.
Their study found that a therapy called responsive teaching, given over one year, led to gains in language and behavioral development among young children with autism or other pervasive developmental disorders -- a group of disorders marked by problems in the development of communication and social skills.
Children with autism have, to varying degrees, difficulty in using and interpreting verbal language and body language, and in interacting with other people, including their parents. Responsive teaching works on strengthening this interaction, encouraging parents to "follow their child's lead" and respond to their actions.
The approach is "child-centered," Dr. Gerald Mahoney, a co-author on the new study, told Reuters Health, and it stands in contrast to the widely held belief that education for autistic children must be highly structured and "direct" them in learning particular skills.
"We don't really focus on structured lessons," explained Mahoney, who co-directs the Center on Intervention for Children and Families at Case Western Reserve University in Cleveland.
Instead, he said, responsive teaching offers parents strategies they can use to "enhance their daily, routine interactions with their children."
Another way the tactic differs from other forms of autism therapy is in cost. Contact with therapists is limited to about once a week, and the yearly price tag for the program is about $5000 -- a fraction of the cost of many other therapies, which, Mahoney said, can run up to $50,000 a year.
Though more research is needed on the effects of responsive teaching, Mahoney noted that the more manageable cost is a potentially "huge advantage" of the approach.
For the current study, reported in the Journal of Developmental and Behavioral Pediatrics, Mahoney and colleague Frida Perales followed 50 children whose parents began responsive teaching when the children were around the age of 2. Some of the children had a pervasive developmental disorder, or PDD -- most commonly autism -- and some had other forms of developmental disabilities.
The idea behind responsive teaching is that by enhancing parents' interactions with their children, the children will "acquire and use pivotal developmental behaviors," which in turn will improve children's language skills and social and emotional development.
For instance, if stronger parent-child interactions improve the pivotal behavior of cooperation, the result could be fewer behavioral problems. Similarly, improving the pivotal behavior of "joint attention" between a parent and child could aid in the child's learning of language.
Mahoney and Perales found that while parents and children in their study met with therapists only about 32 times during the year, the parents said that they used responsive teaching strategies -- such as imitating their children, or following their lead -- about 15 hours per week, on average.
After a year, the researchers found, the children showed large gains in their cognitive development, especially when it came to communication skills. Their rate of development in terms of expressive language increased by an average of 167 percent, while their ability to understand language improved by nearly as much, according to the report.
Between 70 and 80 percent of the children showed such improvements.
Children with PDDs also showed improvements in the social and emotional problems they had at the study's outset, according to Mahoney and Perales.
Responsive teaching is one form of "relationship-focused" education for children with developmental disorders -- a theoretical approach that also includes the more widely known "Floor Time" program developed by Dr. Stanley Greenspan. Though he has reported success with that program based on a chart review of 200 children, Mahoney and Perales note in their report, the lack of rigorous research into relationship-focused education makes it too soon to recommend the approach for PDDs.
The new findings, they conclude, "provide support for the notion that relationship-focused intervention can be an effective procedure for enhancing the development of children with PDD."
However, they add, more research -- including studies that use comparison groups of children not treated with a relationship-focused approach -- is needed to "gain greater confidence" in the therapy's potential benefits.
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Therapy & Treatments : Sensory integration helps children with autism learn
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Posted by sylvia on Thursday, March 03, 2005 (19:05:53)
ABC local.go.com 30/01/2005
By Karen Meyer
Creative indoor play areas help keep children busy and active. Autistic children need a play environment that keeps them calm. Children with autism have different sensory integration issues. Adapting homes for these children requires recommendations from therapists.
Michael and Wendy Rosen's 7-year-old son Jack was diagnosed with autism when he was two years old.
"It affects his ability to communicate as well as have social interaction with people," said Wendy.
In order to help Jack at home, they needed to create special areas that would be beneficial to Jack. The Rosen were referred to Deborah Michael, president of North Shore Pediatric Therapy.
"In the home what we can do is try to provide equipment for them that they can feed their nervous systems that arousal that they're looking for," said Deborah.
"A lot of them are under aroused and they seek out stimulation to arouse themselves," said Deborah.
"We've been able to modify our house by having a swing, a bazillion balls all over the house," said Wendy. "A bag of beans or a box of beans gives him the sensory input that he needs in order to help him learn. Therapy balls help him get the impact that he needs. He'll bounce on those."
Adaptations were also made in Jack's bedroom.
"We have a tent that hangs from his ceiling and the tent gives him the feeling of being enclosed," said Wendy.
Jack can bounce on a trampoline in his bedroom.
"He also has a weighted blanket on his bed that he sleeps with and that gives him the pressure," said Wendy.
Deborah says you can find many of these items in catalogs or you can make them.
"We have a therapist who's made a lot of things. They've made body bags for kids to get in and play in and they'll just hug their body," said Deborah.
Since the Rosen's have made changes in the house, Jack's occupational skills have improved.
"His speech too has improved, even though that's going to be a continual struggle he has made improvements there," said Michael.
"Sensory integration has definitely starting to shine now. People know what it is because if the media and because of research and papers coming out and it works. It really works," said Deborah.
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