The Autism Blog

This month’s Autism 200 series class is Autism 208: Crisis Supports : A Panel Discussion

Facilitator: Eric Boelter, PhD, BCBA-D

Panelists include: Elizabeth Landry, NW Justice Project, Gary Stobbe, UW Adult Autism Clinic, Beth Leonard, Developmental Disabilities Ombuds, Stacy Dym, Arc of King County, Gail Krieger, Medicaid/Healthcare Authority, Beth Krehbiel, Developmental Disabilities Administration, Arzu Forough, Washington Autism Advocacy and David O’Neal, Sound, Health Community Network Program

When faced with a crisis, where do individuals with severe autism and Intellectual impairment turn for support, treatment, services and stabilization? Those with complex mental health or significant behavioral challenges are not being served by current crisis services. Lack of appropriate services, held in hospitals, and inappropriate inpatient psychiatric placement are just a few of the alarming concerns. This panel session will take a closer look at what is available, challenges, gaps, barriers, and what should be done to prevent and intervene for people experiencing crisis, challenging behaviors and/or mental health emergency. This panel will address the needs of those enrolled in the Developmental Disability Administration (DDA) system. A future Autism 200 will address the needs of those not enrolled in DDA system.

Class Schedule: This class will be held Thursday, September 19, 2019 at Seattle Children’s Hospital in Wright Auditorium from 7:00 to 8:30 p.m. Please join us in person or watch on Facebook live. For more information see the  Autism 200 Series webpage.

Here is a link to the class flier: Autism 208 Crisis Supports FLIER Sept 19, 2019

Welcome to our series on Research. We continue with information about the WONDER study. Read about more research opportunities in our next research blog.

Who? Families with an infant under the age of 6 months with an older biological sibling (whole or half) with Autism Spectrum Disorder, and who use English as a primary language.

What? Seattle Children’s researchers want to better understand social brain development in infants during the first 3 years of life. Over the course of 3 years, there will be 5 in-person study visits at our research lab in Seattle. During the visits, researchers will: record brain activity and eye movement while showing your child pictures and videos, engage your child in play-based activities to monitor child development. Feedback about your child’s performance on developmental assessments will be provided. One caregiver will be asked to complete questionnaires around the same time as the study visits, and 4 phone interviews over the course of the study. Study visits will vary in length from 1- 2 ½ hours. Phone interviews and questionnaires will last approximately 1-2 hours. Appointments will be scheduled at a time that works well for your family. Families may receive up to $410-$425 by the end of the study for completing all the study activities. Children will receive a small toy at each visit. Parking validation is provided.

When? This study is currently enrolling participants. Contact the study team . Drs. Fred Shic and Sara Webb, Center for Child Health, Behavior & Development, are the co investigators of this study.

Please join us for Autism 207, the second of a 2 part series: “Transition to Adulthood”. People with developmental disorders are at an increased risk of abuse and neglect. This population also appears to be at an increased risk of exposure to intimate partner violence in childhood, which can produce lasting effects. At the same time, post-traumatic stress can be very difficult to detect and treat among developmentally delayed adults. This presentation will outline primary risks, as well as recommendations for assessment and treatment of trauma and neglect in adults with autism and developmental disorders.

Rachel L. Loftin, PhD, is a clinical and school psychologist who specializes in autism spectrum disorder (ASD). She has extensive experience in diagnosis, assessment, and intervention to help promote positive outcomes for people with ASD. In addition to her clinical work, Dr. Loftin has been involved in cases involving special education, family, criminal, and civil law. She has particular expertise working with people with autism, intellectual disability, and other conditions that can increase social vulnerability and complicate interactions with law enforcement. Dr. Loftin’s clinical-research interests include interventions to increase independent function in young adults, strategies for increasing self-monitoring, transition to adulthood, and sexuality education and sexual identity in people with ASD.
Dr. Loftin is adjunct faculty in the Psychiatry & Behavioral Sciences Department at Northwestern University’s Feinberg School of Medicine and in the Psychiatry Department of the Yale School of Medicine

Class Schedule: This class will be held Thursday, August 15, 2019, at Seattle Children’s Hospital in Wright Auditorium from 7:00 to 8:30 p.m. Please join us in person or watch on Facebook live. For more information see the  Autism 200 Series webpage.

With so many different interventions being used in the treatment of ASD, it can be incredibly challenging to understand what they all mean, which ones are effective, what the research tells us about different models, and which one is best for an individual child. Terms like Applied Behavior Analysis, Pivotal Response Treatment, Early Start Denver Model, Project DATA and Incidental Teaching become a blur, especially when parents and caregivers are trying to make sense of what is best for their child. Although developing a new term may seem like it just adds to the confusion, the term Naturalistic Developmental Behavioral Intervention (NDBI) was coined by Laura Schreibman and colleagues in 2015 in an attempt to unify the field around interventions that have a shared set of characteristics. Let’s take a look at what this new term means and why it is helpful.

Many years of research has shown us that interventions based on Applied Behavior Analysis (ABA) are effective for teaching skills to individuals with ASD and reducing challenging behaviors (e.g., tantrums, aggression, rigid behavior patterns). ABA interventions can be delivered in many different ways. Many researchers and clinicians have moved toward developmentally-focused models where ABA interventions are delivered within natural activities (e.g., play) and routines (e.g., family routines). As these interventions have evolved, they have increasingly begun to blend developmental theories and interventions with ABA, and thus, the NDBI approaches were born.

Some of the hallmark features of NDBI include teaching functional skills for increasing quality of life; a focus on enhancing motivation and engagement in treatment; embedding active opportunities for teaching in the natural environment; and following the child’s lead and interests when selecting teaching materials and activities. In a nutshell, NDBI combine effective teaching methods based on the science of ABA with the developmental methods known to enhance motivation, engagement and learning. This blend is then used to embed learning into activities that are appropriate and fun for individuals and families regardless of age or developmental level. While some have referred to it as a “modern ABA”, we just refer to it as good teaching!

Many existing treatment models fall into the NDBI category, including Early Start Denver Model (ESDM); Pivotal Response Treatment (PRT); Classroom Pivotal Response Treatment (cPRT); Enhanced Milieu Teaching (EMT); Incidental Teaching (IT); Project ImPACT (Improving Parents as Communication Partners); Project DATA (Developmentally Appropriate Treatment for Autism in Toddlers); Social ABC’s; and Joint Attention, Symbolic Play, Engagement and Regulation (JASPER). While some of these models are primarily available in university-based research settings (e.g., EMT, JASPER), others are more readily available in the community depending on where you live (e.g., ESDM, PRT, Project DATA).

Since making sense of these interventions and gaining access to them can be very difficult for clinicians and families, a small group has recently collaborated to improve access to this information. A new book, titled, Naturalistic Developmental Behavioral Interventions for Autism Spectrum Disorder (Bruinsma, Minjarez, Stahmer and Schreibman) is due out this fall. Further, an NDBI conference has just been announced for October in Irvine, CA! The book and conference will focus on outlining the core components that are shared among these interventions in an attempt to increase access to the “active ingredients” of treatment regardless of which model you choose. This effort is focused on moving away from rigid adherence to any one model and promoting widespread use of a core set of intervention strategies that are known to be effective in improving the lives of individuals with ASD. The conference will feature speakers who have developed these models (e.g., Laura Schreibman, Sally Rogers), which will be an exciting opportunity to learn about ASD intervention straight from the source! Hope to see you there!

Conference information and registration.

Welcome to the July edition of Ask Dr. Emily!

We often receive questions that we want to share with all our readers. To help with this, Dr. Emily Neuhaus, a clinical psychologist at Seattle Children’s Autism Center, will share insights in a question and answer format.

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