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Friday, December 28, 2018

Reinforcement Resources

Z.Z. Reinforcer Survey - This survey includes a scoring rubric that breaks down potential reinforcers to Social / Privleges / Edibles / Activities and Tangibles.

Jackpot Reinforcer Survey Generator - allows to you create your own custom surveys.

Reinforcement Inventories for Children and Adults

Forced Choice Reinforcement Survey

Resources from the Kansas Technical Assistance System Network (TASN) 

This is a survey of questions to ask the student or child to find things you can use as reinforcers.

REINFORCER ATTRIBUTE LIST


This list helps you to narrow down reinforcers by using attributes of things your student likes. This is for students or children who will not choose items and you are struggling to find something to use as a reinforcer.

REINFORCEMENT IN THE CLASSROOM ARTICLE

This document explains how to use reinforcement in the classroom. This was taken from Autism Classroom Resources.

PREFERENCE ASSESSMENT FAQS

This document answers commonly asked questions about preference assessments.

PREFERENCE ASSESSMENT DECISION TREE

This document helps you determine what type of preference assessment to complete with your student or child. 

100 FREE REWARDS FOR CHILDREN

This document gives examples of items you can use as reinforceres with your student or child. 

INDIRECT PREFERENCE ASSESSMENT

This document goes over indirect preference assessments. It looks at what is it, why is it important, when to use, how to use it, and resources



Wednesday, December 26, 2018

Autism Quotes of the year

“I’m trying to quantify awkward.”
Ruth Grossman, Emerson College, summing up her research on social communication in children with autism.

“The notion that people with autism are just wrong about themselves all the time struck me as implausible.”
Matthew Lerner, Stony Brook University, on the importance of self-assessments in autism research.
“I scored this nose-to-butt sniffing for 10 years, but do I really understand [it]?”
Mu Yang, Columbia University, questioning whether researchers really know which mouse behaviors constitute a social act.


PECS and Speech Generating Devices: A Comparision Study

A pilot community‐based randomized controlled trial was conducted to compare the effects of the Picture Exchange Communication System (PECS) to a teaching sequence using a high‐tech Speech Generating Device (SGD) to teach social communication behaviors. The two approaches were compared to evaluate the effectiveness of the newer, more high‐tech intervention using technology to improve social and communicative behavior of children diagnosed with Autism Spectrum Disorder. A total of 35 school‐age children were randomized to either a high‐tech (SGD device) or low‐tech (PECS cards) form of Augmentative and Alternative Communication (AAC). Study participants received 4 months of communication training delivered in their classrooms, and the primary outcome measures of the trial were several functional communication skills emphasized in the PECS teaching sequence. Results indicated that both high‐tech and low‐tech AAC approaches resulted in significant improvements in communication, and that these improvements did not differ significantly between the two approaches. 

Helena schools implementing new programs to address rising autism rates

Helena's schools have recently seen a significant increase in conditions such as autism that can cause emotional disturbance and affect formal speech and language skills.
According to data collected by the school district's special education department, autism in particular has ballooned by 109 percent over the past five years. The number of diagnosed students district-wide grew from 69 in 2013 to 144 in 2018. 
One of the newest programs, Trailhead, is intended to serve as a first step for students with autism to receive behavioral and academic supports that will prepare them for a successful journey through school and in life.
Trailhead is one of two programs started with the resources the district already had available, Maharg said.
The program largely focuses on the communicative skills of students with autism. The program is semirelated to the district's Functional Life Skills program in that it also teaches the functional skill of communication. Trailhead's focus is on teaching kids the basics of how to function within a typical classroom by addressing adaptive, communication, social/emotional and cognitive needs. 
"How they struggle with environmental impulses. How they handle being put into an adaptive situation. How they adjust," Maharg said. "It's a skill we all take for granted."
The program’s overall goal is to get students to the point where they can re-enter a traditional classroom setting.

Home Videos May Speed Autism Diagnosis

For the study, a group of non-expert raters were asked to watch videos of 162 children, 116 of whom had autism and the remainder who had no diagnosis. All of the videos showed the child’s face and hands, the opportunity to use toys or other objects as well as the option for social engagement. The raters — who did not know about the children’s diagnostic histories — were asked to answer 30 questions with a simple “yes” or “no” about whether each child made eye contact, expressed emotion and other behaviors.

Information from the raters was then input into eight different algorithms. The most successful model relied on ratings for five behaviors and was able to accurately label 94.5 percent of children with autism and 77.4 percent of those without.
A subsequent test of the five-question model involving an additional 66 videos correctly flagged 87.8 percent of those with autism and 72.7 percent of the kids without.

After Other Options Fail, A Family Tries Medical Marijuana For Son With Autism

"The research basis for a lot of the hopes for using medical marijuana for autism - it's really minimal," says David G. Amaral, a psychologist and research director of the M.I.N.D. Institute at University of California, Davis. (M.I.N.D. stands for Medical Investigation of Neurodevelopmental Disorders.) "I mean there's very meager clinical evidence for effectiveness."
Meager evidence because there have been no large clinical trials to determine whether marijuana or its compounds are effective — or safe — in treating children with autism.
"Unless there's a clinical trial done in the right way and showing the safety, No. 1, of the drug," Amaral says, "and then the benefit of it ... it may be that families are wasting their time — and maybe exposing their family members to a potentially dangerous situation."
That's not to say that marijuana doesn't hold promise for autism treatment. In fact, the first large-scale clinical trial in the U.S. to test the idea is just getting underway at Montefiore Medical Center in New York.

Friday, December 21, 2018

Helping Anxious Students

20 Tips to Help De-escalate Interactions With Anxious and Defiant Students, by Katrina Schwartz https://www.kqed.org/mindshift/43049/20-tips-to-help-de-escalate-interactions-with-anxious-or-defiant-students

Helping Anxious Students Move Forward, by Jessica Minahan https://jessicaminahan.com/wp-content/uploads/Helping-Anxious-Students-Move-Forward-Red-Work-Avoidance-Minahan_EL_1218.pdf

Contingency Constracts


1.     Contingency Contract: this is also referred to as a behavioral contract; it is basically a document that specifies a contingent relationship between the completion of a specified behavior and access to or a delivery of a specified reward. The contract should be developed with the teacher and the student to modify academic performance/work completion. The recommended goal tracking apps or check-in, check-out sheets could be used to help set goals.  

a.      Ideas for contingency contract: working for increments of time to earn points or numbers off of work, turning in one assignment per day and then working up. Make sure you pick a goal that is obtainable and then work toward bigger goals as you see success. (Start with math like we discussed then add in other subjects as you see consistent success).

b.     Sample contracts and steps for implementation can be found at these websites:

                                                              i.      http://www.interventioncentral.org/behavioral-interventions/challenging-students/behavior-contracts ,

                                                           ii.      http://www.pbisworld.com/tier-2/behavior-contract/ ,

                                                         iii.      http://www.nea.org/tools/behavior-contracts-how-to-write-them.htm

(From OPI Behavior Consultant, Anna Donohoe)

Apps We Like

 Done: A simple Habit Tracker: (free on iPhone, iPad, iPod) helps you set goals for multiple skills/habits/routines (completing assignments, turning in work, staying on task, regulating outbursts, etc). You can set daily, weekly, or monthly goals and visually tracks progress.

SymTrend: (free on iPhone, iPad, iPod) helps individuals trach symptoms to help them understand patterns in behavior, triggers to their problems, how treatments are working. Logan could monitor energy/anxiety levels, mood fluctuations, activity level, skill level, social interactions, and frequency of outbursts. https://www.symtrend.com/tw/public/public_docviewer?ltrans_doc=2141&no_title=true

Tuesday, December 18, 2018

Autism Friendly Vacation Rentals in Orlando



See more here at Villakey.

Webinar - Resolving Common Problems for Individuals with IDD in Learning to Cook


Date: February 7, 2019
Time: 4:00 p.m. - 5:00 p.m. EST


Each person with IDD has unique challenges and abilities; consequently, there is no single path to development of authentic and generalizable cooking skills for this population. At the same time, there are common difficulties that are manifested across this cohort and which can be anticipated – and addressed -- when designing appropriate activities. 

These include: 
Difficulties in opening food packaging: A range of options will be offered for opening common products as well as traditional and pull-top cans. 
Difficulties in mixing ingredients: Though a simple action, many individuals with motor challenges will need special methods to grasp the needed motion and the presentation will offer several. 
Challenges in learning how to safely chop and cut ingredients: The presentation will briefly overview some of the most effective means for teaching prep skills with minimal risk. 

Over-reliance on others to complete tasks: Independence is often hindered for those with IDD by well-meaning staff and caregivers. Several methods for overcoming this barrier are addressed. 

It should also be noted that traditional text-based recipes are a significant obstacle for many in learning to cook given minimal literacy skills, difficulty in multi-step processing, and issues with 
cognitive functioning. The presentation will briefly explain how Active Engagement bypasses this problem through use of a pictorial cueing system in lieu of conventional recipes.
Register here. 

Monday, December 17, 2018

Good Study Design Does Not Equate Useful Results

A toungue-in-cheek example of why it's important to look closely at how a study is designed and not just the results. From the British Medical Journal.

Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial



Friday, December 14, 2018

Why autism at 2.5% isn’t surprising.

Let’s get one thing out right away–autism prevalence studies undercount. Not all autistics are diagnosed. That’s just a fact. Consider the recent CDC study. They look at school and medical records. In many cases, they find children are autistic based on their records–but the schools and doctors hadn’t diagnosed those children.
Combining data from all 11 sites, 81% of boys had a previous ASD classification on record, compared with 75% of girls (OR = 1.4; p<0.01). 
Yeah, more than 20% of the kids counted in their prevalence had no diagnosis. They and their families didn’t know.
And, if there isn’t enough in the records to show a kid is autistic? That kid gets uncounted altogether. 
So, when people look at the CDC prevalence estimates from over the years and cry “epidemic”, well, there’s a reason why those people usually have some causation theory that they believe in. The irony is that they are usually wrong that their theory needs an epidemic to support it. But, heavily biased people are not usually the best sources of reliable analyses.
What would be a better method of counting how many autistics are in a population? Sounds obvious–test all the kids in a given population. Equally obvious–this is a much more expensive and difficult task. One such study was published in 2011. Yes, 7 years ago. In Prevalence of autism spectrum disorders in a total population sample, the autism prevalence in Korea was found to be 2.63%.  A study performed in South Carolina and reported at IMFAR last year found a prevalence of 3.62%.
This all said, we had another autism prevalence come out this week–The Prevalence of Parent-Reported Autism Spectrum Disorder Among US Children. This study found a prevalence of 2.5%.
Now here’s a nice thing about this recent study–OK, two nice things. First, they don’t just look at kids of one age. Second, you can obtain the data. Which I did. Let’s look at the autism prevalence broken down by birth year.

1985 paper on the theory of mind



Read the full article at Spectrum. 

Autistic children, parents may shape each other’s language

Parents speak to their autistic children using fewer words and less complex sentences than do parents of typical children, which in turn shapes the children’s language skills, a new study suggests1.
The findings contradict the recommendations of some autism therapies, which ask parents to speak in simple sentences, says lead researcher Riccardo Fusaroli, associate professor of cognitive science at Aarhus University in the Netherlands.
Fusaroli and his colleagues tracked language learning from about age 2 to 5 in autistic and typical children. The two groups started out with similar language abilities.
As they got older, however, the autistic children became less talkative and used simpler sentences than the controls did. Their parents also began to use less complex language; over time, the parents’ language at one visit predicted that of their children at the next, and vice versa.

How to Improve Emotional Self-Regulation Among Children with Autism and Attention Disorders

Before beginning the lesson, it’s important to note that the child should already be capable of identifying and labeling emotions. The activities should be initiated when a child is in a good mood. This lesson is also meant to be taken in stages with the child moving to the next step after they have successfully developed a mastery of the preceding step.

1. Create an emotional levels chart.

Create a visual aid that depicts the different levels of emotions that a child may feel, allowing the child to create their own labels for each level. For example, levels can be labeled “feeling good,” “a little upset,” “upset” and “very upset.” The chart should have two columns with the emotional levels in one column. Title the other column, “I feel this way when…” and leave the rows blank for the child to fill in.

Read more here from OnlinePsychology@Pepperdine, the online Masters in Applied Behavioral Analysis program from Pepperdine University.

YETI Groups Spring and Summer 2019


Thursday, December 13, 2018

Sex differences in brain hint at roots of ‘camouflaging’ in autism

Autistic women’s activity in a ‘social’ brain region tracks with the extent to which they mask their autism, according to a new study1.
Their activity in this and another social brain region when they reflect on themselves or others resembles that of their typical peers. Men with autism, by contrast, show less activity in these regions than typical men do.
The new findings reinforce the idea that autism manifests differently in women than it does in men.
“Maybe the idea of a hypoactivated social brain doesn’t apply universally to everyone on the spectrum,” says co-lead investigator Meng-Chuan Lai, assistant professor of psychiatry at the University of Toronto in Canada.
The findings represent the first attempt to pinpoint brain areas that may be involved when autistic women ‘camouflage,’ or mask their autism traits.

Support Through Education & Planning Topic: Behavior at Home - Missoula

YETI STEP
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Support Through  
Education & Planning
Topic:  Behavior at Home
Audience:  Parents

Dates: 2/19, 2/16, 3/5, 3/12, 3/19

Time:   Tuesdays 6:00-7:30

Location:   Curry Health Center, 634 Eddy, U of M
Remote Computer Access Available

Childcare: Available with Registration

Format:   Parents will engage in group education for the first half of the session.  The second half will target individualized programming for behavior strategies in the home.  The program will be enriched by support from a Social Work Graduate Student and follow-through with Graduate Student Clinicians in Speech, Language, and Hearing Sciences

Registration  $20 Fee to hold your spot. For more information, or to register for YETI STEP, call the Clinic Manager, Meghann Schroeder, at 243-6105.  Six families are welcome to join this semester

Follow-up study: Microbiota Transfer Therapy’s behavior, GI benefits still evident after two years

This artilce also appeared in the 2018, Volume 32, No. 3 issue of ARI's Autism Research Review International newsletter. 
A new study reports that the positive behavioral and gastrointestinal (GI) changes seen in children with autism spectrum disorders (ASD) following fecal transplants appear to be lasting.
Fecal transplants are currently used as a treatment for C. difficile infection and inflammatory bowel disease. A research team headed by James Adams at Arizona State University has been investigating the potential of this approach for treating children with ASD, who have a high rate of diarrhea, constipation, and other bowel problems that may be connected to their behavioral issues.
In their initial study (see ARRI 31/1, 2017), led by Dae-Wook Kang, 18 participants with ASD and GI problems underwent Microbiota Transfer Therapy, or MTT. Participants first received two weeks of antibiotic treatment and a bowel cleanse to prepare the GI tract. Next, they received one high dose of microbiota administered either orally or rectally, followed by a lower oral daily maintenance dose for 7 to 8 weeks. The researchers used a standardized product containing more than 99% bacteria obtained from healthy individuals and tested to ensure safety. The children also took an acid pump inhibitor to reduce stomach acidity and increase the survival rate of the microbes.
In the new study, led by Rosa Krajmalnik Brown, the researchers followed up with all 18 participants two years after treatment stopped. “Notably,” they say, “gastrointestinal symptoms were significantly reduced compared with the beginning of the original trial, and autism-related symptoms improved significantly after the end of treatment.” In addition, they say, “DNA-sequencing analyses revealed that changes in gut microbiota at the end of treatment still remained at follow-up, including significant increases in bacterial diversity and relative abundances of Bifidobacteria, Prevotella, and Desulfovibrio.”

Insurance Mandates and Out-of-Pocket Spending for Children With Autism Spectrum Disorder

Abstract

BACKGROUND: The health care costs associated with treating autism spectrum disorder (ASD) in children can be substantial. State-level mandates that require insurers to cover ASD-specific services may lessen the financial burden families face by shifting health care spending to insurers.
METHODS: We estimated the effects of ASD mandates on out-of-pocket spending, insurer spending, and the share of total spending paid out of pocket for ASD-specific services. We used administrative claims data from 2008 to 2012 from 3 commercial insurers, and took a difference-in-differences approach in which children who were subject to mandates were compared with children who were not. Because mandates have heterogeneous effects based on the extent of children’s service use, we performed subsample analyses by calculating quintiles based on average monthly total spending on ASD-specific services. The sample included 106 977 children with ASD across 50 states.
RESULTS: Mandates increased out-of-pocket spending but decreased the share of spending paid out of pocket for ASD-specific services on average. The effects were driven largely by children in the highest-spending quintile, who experienced an average increase of $35 per month in out-of-pocket spending (P < .001) and a 4 percentage point decline in the share of spending paid out of pocket (P < .001).
CONCLUSIONS: ASD mandates shifted health care spending for ASD-specific services from families to insurers. However, families in the highest-spending quintile still spent an average of >$200 per month out of pocket on these services. 

Tuesday, December 11, 2018

Missoula - Parent Information and Training Session




ADOS II Booster Training - Missoula

Missoula - April 19, 2019
Broadway Inn and Convention Center

8:30 a.m. to 3:30 p.m.
This is a one day review of the ADOS 2 training complete with scoring practice and practical question review. Participants are required to bring their ADOS manuals for reference in scoring practice.

YOU MUST HAVE COMPLETED A PRIOR ADOS II TRAINING TO ATTEND THIS WORKSHOP.
This workshop is presented by Dr. Lauren Swineford.

Register here.

Thursday, December 6, 2018

LAMP Trainings - Billings (FULL), Bozeman, Missoula (FULL)

LAMP is an augmentative alternative communication (AAC) approach designed to give users a method of independently and spontaneously expressing themselves through a speech generating device. The LAMP training is focused on students who use a device for speech, and not only symbolic communication (e.g., PECS.) “LAMP focuses on giving the individual independent access to vocabulary on voice output AAC devices that use consistent motor plans for accessing vocabulary.”

This course will cover the components of LAMP: readiness to learn, engaging the learner through joint engagement, and learning language through a unique and consistent motor plan paired with an auditory signal and a natural consequence. 

Discussion will include how this approach addresses the core language deficits of autism, device features that are beneficial to teaching language, and how to use those features to implement LAMP components.
Billings     February 4, 2019  FULL - Registration closed.
Bozeman    February 5, 2019
Missoula    February 7, 2019  FULL - Registration closed.


Wednesday, December 5, 2018

Would you like to be a CDC "Learn the Signs. Act Early." Ambassador?

 The Centers for Disease Control and Prevention’s (CDC) National Center on Birth Defects and Developmental Disabilities and the Association of University Centers on Disabilities (AUCD) with support from the Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB), announce a funding opportunity for Act Early Ambassadors to work with CDC’s “Learn the Signs. Act Early.” 
 
 RFA for CDC's "Learn the Signs. Act Early." 2019-2020 Ambassador Program (.PDF).
 

 
 
To be considered, applicants must:
• Reside or physically work in the state/territory they wish to represent as an Ambassador;
  • • be connected to or familiar with state/territory/tribal programs that serve young children and their families, such as child care, WIC, Early Head Start, home visiting, or others;
  • • be involved in or familiar with any cross-systems efforts to improve developmental monitoring/screening and early identification of developmental delay and disability in their state/territory; and
  • • have knowledge and expertise in child development and/or systems that support families with young children, and/or early identification and referral for developmental delay/disability;
  • • have good presentation and communication skills;

    • • have a strong interest in working collaboratively to further the goals of the "Learn the Signs. Act Early." program in their state or territory.
    Act Early Ambassadors are required to:
    • • work with CDC’s LTSAE program, AUCD, fellow Ambassadors, and their state’s Act Early state team or other related collaborative initiatives to support national, state/territorial, and local activities to improve early identification of developmental delay and disability
    • • focus efforts on increasing developmental monitoring through the promotion and sustained integration of LTSAE materials into statewide systems and other programs that serve families with young children;
    • • collaborate with programs that serve young children and their parents, such as Head Start and Early Head Start, WIC, home visiting, IDEA Part C/Child Find and others, as well as health care and child care professionals to introduce and sustainably integrate LTSAE developmental monitoring tools and trainings into the work of those programs with parents and professionals
    • • make a 2-year commitment to this program (March 1, 2019—Feb 28, 2021);
    • • attend a 2-day Ambassador training at CDC in Atlanta each year (scheduled for April 30 and May 1, 2019; 2020 date TBA);
    • • develop, maintain and implement a work plan that includes at least 2 Ambassador goals; at least 1 of your goals must advance the adoption and sustained integration of developmental monitoring using LTSAE in one statewide system/program such as WIC, home visiting, IDEA Part C/Child Find, early care and education (including early Head Start), child welfare, or similar.
    • • participate in 90-minute Ambassador calls with AUCD and CDC every other month;
    • • prepare an annual report of Ambassador activities; and
    • • complete pre- and post-Ambassadorship surveys.
     
    Additionally, Act Early Ambassadors are encouraged (but not required) to:

    • collaborate with state agencies and others to improve policy and programs related to early identification;
    • • post updates and share resources among the network of Ambassadors (through the Ambassador email listserv and other mechanisms);
    • • participate in 1-hour "learning circle" webinars every other month;
    • • participate in 1-hour evaluation workshops every month;
    • • participate in 1-hour, topic-specific "Act Early" webinars on a quarterly basis; and
    • • present Ambassador achievements and lessons learned at state and national conferences and other appropriate forums.
    Act Early Ambassador responsibilities typically require about 6-10 hours per month.

     
    To support Ambassadors, AUCD will provide:
      • • $4,000 annual stipend plus travel expenses to Atlanta, GA, for annual Ambassador training. o Stipend can be used to support a variety of activities related to the implementation of the Ambassador work plan (e.g., local travel, meeting costs, printing, etc.). Please note, if you cannot accept a stipend for Ambassador efforts related to work you’re already carrying out, you can use the stipend for convening meetings, printing materials, etc.
      • • Scheduled and as-needed technical assistance provided by email, phone and webinar.
      • • Structured peer support, and a forum to network, share ideas and problem-solve with colleagues working on similar issues nationwide. o Note: participation in in-person meetings, webinars, and the Ambassador group email list helps keep Ambassadors connected with one another; this connection to other Ambassadors is among the most valued aspects of the Ambassador experience.
      • • Technical expertise and consultation, and information from leading national experts in the fields of child development, developmental disability, and health promotion.
     
    Informational Call: December 17, 2018 at 2:30pm ET - Dial-in: 1-866-794-4983
     
     
    If you are interested in pursuing this please contact Doug Doty (ddoty@mt.gov) for additional information.