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brightHello all,
This is just a formal notice that I am not continuing this blog, but have started a new one. Please look for me at:
http://thinkingautism.blogspot.com/
Thanks!
Susan
blueOh No!
I just found out that my favorite web site, TranslatingAutism.com, is ending. The March 31 blog was the last one going to be posted. This is a copy of the April 1, 2009 blog.
Dear Readers of Translating Autism,
I am sorry to announce that Translating Autism will be ending as a self-standing website. Yesterday's post was Translating Autism last official post. The decision to end this project was an extremely difficult one. I have been commenting on autism research for over a year, and during this time I have learned immensely from interacting with the wonderful autism community. I have been touched by your stories and I am grateful for the many notes of support I received. Yet, due to a number of professional and personal reasons, and after consulting with several colleagues, Translating Autism will be taken offline by the end of April.
However, I will continue to contribute to www.child-psych.org, and I will continue to review autism studies very often. In fact, as I mentioned on my last Translating Autism post, I will be dedicating this month to reviewing studies on low functioning autism, so you can expect weekly autism-related updates to child-psych.org. This new website will follow the same style and purpose of Translating Autism, but will also include a broad range of topics, from childhood depression to learning disabilities. In addition, all posts from Translating Autism have been imported into child-psych, and as of next week, these posts will only be available via child-psych.org.
Thank you all for your support during the past year and I hope that we continue to interact at child-psych.org.
Sincerely,
Nestor L Lopez-Duran PhD
So - log on to child-psych.org. The articles will not be focused only on autism, however, much to my dismay.
Thanks to Nestor for his work!
Susan
Hi all,
In my searching of the autism lit, I find odd articles that interest me. Recently, I found a controlled study on hyperbaric treatment for children with autism. Well, actually I found a summary of the article on TranslatingAutism.com. The summary was written by Nestor Lopez-Duran, Ph.D. In this study, he reports that the authors found that hyperbaric treatment resulted in significant improvements in overall functioning, receptive language, social interaction, and eye contact. The group of 62 children was divided into a treatment and a control group, and the evaluators were blind to which group a child was in.
However, the authors had potential concflicts of interest.They either worked in situations in whih they provided hyperbaric therapy, or were otherwise in the business. The study seems sound but given the conflicts of interest, it would be wise to take these results with a grain of salt. It is, however, interesting to note.
Citation: Rossignol, D., Rossignol, L., Smith, S., Schneider, C., Logerquist, S., Usman, A., Neubrander, J., Madren, E., Hintz, G., Grushkin, B., & Mumper, E. (2009). Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial BMC Pediatrics, 9 (1)
Susan
Frequently I check out various blogs, click on the links they contain, and find new blogs. A favorite autism blog of mine is:
http://autism.change.org/
Kristina Chew, Ph.D., is one of two bloggers for this site. She used to blog for AutismVox, but now is featured on the above site. The last post is a very deep one about the autism/MMR controversy, and I admit to reading several of her links and becoming very glassy-eyed at all the research debate. There's so much "he said" "she said" going on that I haven't followed in enough detail to really comment. That said, I believe that the MMR vaccine does not cause autism in a scientific manner, that is, statistically significant. However, I also do believe that some children, in some families, were injured by the vaccine. At this time, however, we don't have the science to predict which child will be more predisposed to injury. I do believe parents' experiences with their children, and I also believe that some children have likely predispositions.
However, I also believe the CDCs scientific studies that show, statistically, the MMR vaccine does not cause autism. Sound complicated? It's not, really; what is statistically significant does not mean that it would never happen to a few people.
And that's that for now!
The Article I Wish I Had Written
Prizant, Barry, Ph.D., CCC-SLP. (Spring, 2009). "Straight Talk about Autism: Treatment Options and Parent Choices: Is ABA the Only Way?" Autism Apectrum Quarterly.
After searching the literature for weeks now for articles on effectiveness of interventions for children with autism, reading the ABA intervention literature and the DIR/Floortime literature, I finally found a single article that is clearly written and wonderfully expressed. It is “Straight Talk About Autism: Treatment Options and Parent choice: Is ABA the only way?” by Barry Prizant, Ph.D., CCC-SLP.
In this article, Dr. Prizant clarifies that ABA is not the only specific, definitive treatment or approach for children. He describes the differences between Traditional ABA and Contemporary ABA. Traditional ABA uses primarily adult-child (one to one) teaching situations to the exclusion of social instruction in various social settings, and typically does not focus on the core social-communicative and relationship challenges faced by children with autism. Contemporary ABA is more flexible, includes naturalistic teaching in natural routines and activities that focus on social initiation and spontaneity. Recently, many of the most respected ABA/ASD researchers have been openly critical of traditional ABA and have abandoned such practices in favor of more naturalistic approaches that have a strong developmental and child-centered basis.
The claim that children with ASD must receive 25, 30 or 40 hours of ABA in order to develop is not supported. The National Research Council (a committee appointed by the National Academy of Sciences, NRC, 2001) conducted the most comprehensive review of educational research to date, and concluded that given the current state of research in ASD, there is no evidence that any one approach is better than any other approach for children 0-8 years of age. “Studies have reported substantial changes in large numbers of children receiving a variety of intervention approaches, ranging from behavioral to developmental.” (NRC, 2001). The National Research Council recommended that children with autism receive a minimum of 25 hours/week of active engagement in interventions. The most important areas of focus must be:
a) Functional, spontaneous communication
b) Social Instruction in various settings
c) Teaching of play skills focusing on appropriate use of toys and play with peers
d) Instruction leading to generalization and maintenance of cognitive goals in natural contexts
e) Positive approaches to address problem behaviors
f) Functional academic skills where appropriate.
Another myth Dr. Prizant counters is that there are hundreds of studies that demonstrate that ABA works, and few or no studies that demonstrate that other approaches work. He states that this is not supported by the literature. The ABA studies demonstrate the effectiveness of specific elements of practice and these studies are cited by proponents of ABA. There are very few studies that have looked comprehensively at intervention programs, that is, those that simultaneously address a variety of domains of learning and skill development for a child and family over time. In an open-access article published in November, 2008, researchers from Canada completed a clinical systematic review (Ospina, M.B., Seida, J.K., Clark, B., Karkhaneh, M., Hartling, L., Tjosvold, L., Vandermeer, B. & Smith, V., 2008) of behavioral and developmental interventions for children with autism. Their findings support the statement that there is no one single method for improving skills of children with autism. There is evidence that the Lovaas method (Traditional ABA) improves some core symptoms of ASD compared to special education, but these findings are based on methodologically weak studies with few participants and relatively short-term follow-up. Since no definitive behavioral or developmental intervention improves all symptoms of children with autism, these authors recommend that clinical management be guided by individual needs and availability of resources.
It has come to me in my work that the core issue is engagement; children with autism need to be thoroughly engaged in activities that nurture their social, emotional, language, cognitive and relationship skills. These interventions need to be systematic, data-based to ensure progress, and fun. Children learn by having fun; we do not have any data that indicates that children with ASD are any different. In fact, the developmental intervention literature is full of citations that support the notion that children with autism are relational, in their own unique ways.
Too much of the application of ABA is just mechanistic; it’s a procedure, not a teaching technique. I’ve seen too many teachers/aides simply “Run the programs”, not investing in any relationship or engagement with the children. “Running the programs” is not teaching; it’s a substitute for teaching, which involves engaging with children.
I believe that ABA is a terrific tool and the basis for a lot of high-quality instruction of children on the spectrum, but that by itself, it is insufficient. Relationships matter. Engaging with children with ASD, using whatever interventions work, is what makes the difference.
not sureHello all,
I know I have seriously neglected this blog, but I haven't been neglecting children with autism. I am still working as an independent behavior therapist and taking courses/practicum in Floortime. I am still reading the newest articles and keeping up with the field. I am still consulting in autism, inclusion, behavior, ABA. I have been reading the ABA literature and the Floortime literature. Even though they may seem incompatible, I believe they are not. I am doing Floortime with a 15 year old under supervision and am excited by its possibilities. I've been reading Stanley Greenspan's and Serena Weider's "Engaging Autism", the neuroscience behind DIR/Floortime, and trying to comapre the two fields of research. More on that later.
I mentioned in my last post that I was going to post about an article I found called, "Can Children with Autism Recover? If So, How?" It's in the December 2008 Neuropsychology Review and the authors review published articles about so-called recoveries. The bulk of their review is based on behavioral articles, and the authors begin by establishing a definition of "recovery". They conclude that betwen 3% and 25% of children on the spectrum "recover", mostly by intensive behavioral intervention. (Note: They do not review the Greenspan research). The favorable predictors for recovery are relatively high intelligence, receptive language, verbal and motor imitation, motor development, but not overall symptom severity. Earlier age of diagnosis and treatment and a diagnosis of PDD-NOS are also favorable. Seizure, mental retardation, and genetic syndromes are not favorable to recovery. Head growth does not predict outcome.
Even in recovery, however, there are residual traits, such as those affecting higher-order communication and attention. There are also situations in which tics, depression and phobias exist after recovery.
They hypothesize that the mechanisms of recovery include: normalizing input by forcing attention outward or enriching the environment, promoting the reinforcing value of social stimuli, preventing interfering behaviors, mass trials of weak skills, reducing stress and stablizing arousal. Improving nutrition and sleep quality are not specifically benefiecial to recovery.
Their conlusions coincide with my beliefs after reading much of the research and my years of experiences. It doesn't mean that other children can't improve dramatically; certainly they can. But this article goes a long way toward explaining the mechanics of the so-called "recovery" movement.
There still is a lot of hope out there!
Hi,
I've been trying to keep up with the online autism research and am stymied by the complexity of how to actually read, purchase or obtain the latest research articles. I thought I just purchased an online (electronic) version of a new article caled "Can Children with Autism Recover?", was billed, but it didn't download on my laptop despite clicking on the PDF version. It cost me $32.00 and I can't find it! I sent an email to the company but since I just sent it, I haven't heard.
The cost is a factor also; if I spent $32.00 for every article I wanted to read, it would be quite expensive. $32.00 seems a bit steep for one article. However, the information is good and I try to pick and choose which ones I want. The issue of recovery is quite complicated and this is a well-written research article so I am very curious about it, and looking forward to reading it. I will let you know when I do!
irritatedHi all,
I just received an email from CafA Autism which contained the link to Denis Leary's published chapter about autism. It's here:
http://www.autismunited.org/
I, too, am extremely disappointed to read his attacks on autism; he talks about parents' wanting an excuse for their child's pathetic behavior, not wanting to take responsibility for their own actions, wanting an autism diagnosis to coddle their children...it's not funny, it's not edgy humor, it's pathetic. He had recently published a statement saying the leaked sections of his book "needed to be read in the context of the chapter/book", but in reading the entire chapter, there's no "context" that's acceptable. He still calls the increase in autism fake and an response to parents wanting to coddle their kids. He also states that he knows a few children with autism and they all have "special talents" in music or math or dates...the old prodigy theory...
He's a smart, funny and talented actor and I am extremely disappointed at his ignorance of this matter. We all should boycott this book, and Denis Learly in particular.
Click on the link and read this chapter. There's no merit to it at all. Don't buy the book to read it.
Susan
cool
Hi all,
Today I checked my Google Alerts for autism and came across what I thought would be a wild and wacky story, but it turns out to have some meat to it. It's a letter published by Dr. Bernard Rimland in Autism Research Review International, citing some parents' anecdotal evidence of the effectiveness of marijuana in handling the behaviors of their children. Dr. Rimland describes himself as not a pro-drug guy, but is interested in safe and effective methods for helping persons with autism. In this letter, he cites the risks of behavior-altering legal drugs for people with autism, and concludes that there are always risks and possible side effects. He is interested in hearing more from parents who have used or are considering using marijuana with their children. You can read the article/letter yourself at:
http://www.autismwebsite.com/ari/newsletter/marijuana.htm
Interesting, to say the least.
Susan
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