Families Have Seen Great Success in Several Therapy Methods

A child participates in a therapy session based on Applied Behavior Analysis.
(photo: specialedpost.com)

With the recent discovery that a molecule in broccoli may alleviate several symptoms of autism, it is essential to look at all of the other developments that can truly help individuals struggling with the disorder. In particular, certain therapies are becoming increasingly more prevalent in the U.S. and internationally due to the positive responses that they have received.

For example, many parents have seen gr
eat benefits from having their children participate in animal therapy. Pet ownership has been known to improve social functioning skills, and furthermore, children with ASD who own a pet have been noted to develop comforting skills and a better ability to share. Children with ASD have also experienced improvements in behavior through assisted therapy programs such as horseback riding. Sara Gee, a riding instructor, states, “For autistic children, we find the benefits are many. The simple aim of the therapy is to teach children to sit quietly and enjoy the ride whilst taking part in exercises that encourage listening and following, color recognition, counting, and making choices.”

Another successful therapy method is CBT – Cognitive Behavioral Therapy. This therapy is a psychological intervention that is used to change how people think and behave. This therapy is based on the principle that how people think and feel has a direct relation to how they will behave. People with autism often get stuck in the same pattern of thinking or responding, so CBT uses various techniques to help them become more aware of how they think, therefore changing how they respond. Therapists have made this method more ASD-friendly by making certain exercises more repetitive, as well as more visual. For example, instead of asking a child how to rate their anxiety on a scale of 1 to 10, the therapist uses a visual image of a scale, where children can go to the image and illustrate their feelings.

Lastly, many parents have seen great success from Applied Behavior Analysis (ABA). This method of therapy breaks down actions into small steps that are easier for the child to understand. Each step is taught through repetition, with specialists providing intensive training of up to 35 hours per week. Families across the U.S. have reported incredible progress in their children, as they were noted to be significantly more expressive, as well as have a better ability to spontaneously engage in imaginative play, as well as have a better understanding of how to interpret the gestures of others.

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Chemical Present in Common Vegetables May Improve Several Symptoms of Autism

A recent study has discovered that a daily intake of vegetables such as broccoli, cauliflower, and cabbage can significantly improve several symptoms of autism spectrum disorders (ASD). Researchers at Johns Hopkins University School of Medicine, in conjunction with MassGeneral Hospital for Children, reported that daily treatment of sulforaphane, a molecule commonly found in certain vegetables, resulted in improved behavior and communication.

Although this is a pilot study and larger investigations need to take place, researchers are rather hopeful about sulforaphane’s therapeutic benefits. In their report, which is being published in PNAS Early Edition, participants who received a daily dose of sulforaphane showed significant improvement in both behavioral and communicative assessments in just four short weeks.

Dr. Andrew Zimmerman, co-corresponding author of the report, states, “Over the years, there have been several anecdotal reports that children with autism can have improvements in social interaction and sometimes language skills when they have a fever”. He continues, “We investigated what might be behind that on a cellular level and postulated that it results from fever’s activation of the cellular stress response, in which protective cellular mechanisms that are usually held in reserve are turned on through activation of gene transcription.” Dr. Paul Talalay, co-corresponding author, found that sulforaphane particularly supports key aspects of the cell stress response.

The current study focused on 44 males between the ages of 13 and 27, with each individual being in the range of moderate to severe on the autism spectrum. Each participant was either randomly assigned to a daily dose of sulforaphane, which was extracted from broccoli, or a placebo. Participants were assessed over the course of 18 weeks, using standardized measurements of behavior and social interaction.

Dr. Kanwaljit Singh, lead author of the study, states that the assessments were significantly better for the 26 individuals receiving sulforaphane than the 14 that received a placebo. In as little as four weeks, individuals showed improvement in factors such as irritability, repetitive movement, hyperactivity, and communication.

Dr. Zimmerman concludes, “It’s important to note that the improvements didn’t affect everyone – about one third had no improvement – and the study must be repeated in a larger group of adults and in children, something we’re hoping to organize soon.” He continues, “Ultimately we need to get at the biology underlying the effects we have seen and study it at a cellular level. I think that will be done, and I hope it will teach us a lot about this still poorly understood disorder.”

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Autism Disorders in Children May Be Linked to Iron Deficiency in Mothers

According to a recent study, autism disorders in children may be linked to the iron intake of their mother during pregnancy. Mothers of children with autism were noted to have taken less iron supplements before and during their pregnancy than those with typically developing children.

The Childhood Autism Risks from Genetics and the Environment (CHARGE) study incorporated over 350 pairs of mothers and children, which included both children with autism, and children developing typically. Among the participants, it was found that mothers with a low iron intake were five times more likely to have a child on the autism spectrum if they were older than 35 at the time of the child’s birth, or if they suffered from metabolic conditions such as diabetes.

Dr. Rebecca J. Schmidt, assistant professor with the Department of Public Health Sciences and researcher with the MIND Institute states, “The risk associated with low maternal iron intake was much greater when the mother was also older and had metabolic conditions during her pregnancy”. She continues, “The association between lower maternal iron intake and increased ASD risk was strongest during breastfeeding, after adjustment for folic acid intake”.

Researchers precisely analyzed the supplements the mothers’ took during pregnancy, including vitamins, as well as the nutritional content of their breakfast cereals. Researchers examined the frequency and dosages of the supplements consumed in order to accurately study iron intake through supplementation.

Dr. Schmidt states, “Iron is crucial to early brain development, contributing to neurotransmitter production and immune function. These pathways have been associated with autism”. She adds, “Iron deficiency is pretty common, and even more common among women with metabolic conditions. However, we want to be cautious and wait until this study has been replicated. In the meantime, the takeaway message for women is to do what your doctor recommends. Take the recommended daily dosage [of vitamins throughout pregnancy].”

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Individuals with ASD May Have Impaired Predictive Ability

Researchers at the Massachusetts Institute of Technology (MIT) have recently created a hypothesis stating that individuals with autism may lack the ability to predict what may happen next, which therefore creates difficulty in understanding the events occurring around them.

Richard Held, along with his colleagues at MIT, have discussed the fact that individuals on the spectrum may have difficulty in predicting future events, with an impaired predictive ability explaining many symptoms of autism. This new study is currently appearing in Proceedings of the National Academy of Sciences.

Although traits of autism are incredibly diverse, Held and his colleagues wanted to see if any of these traits had a common cause. By analyzing their previous research and looking at first-hand accounts, they were able to determine that certain traits associated with autism disorders may be manifestations of an impaired ability to predict or understand the events that are about to occur. For instance, although the world is ever-changing, many individuals on the autism spectrum find it difficult to adapt to change, and therefore engage in repetitive behaviors, and are most comfortable sticking to a strict schedule, in order to create a feeling of “sameness”.

According to the researchers at MIT, another indicator of impaired predictive ability is the extreme hypersensitivity to stimuli that individuals on the spectrum often possess. Held and his team believe that people with autism never familiarize themselves to stimuli. Therefore, it is difficult to be able to predict a certain stimulus that one does not familiarize themselves with.

Furthermore, impaired predictive ability may also explain why some individuals on the spectrum have difficulty with dynamic objects. For example, children on the spectrum may be overwhelmed in places like the playground, where there are children running around, throwing balls, and a lot of movement is taking place. An inability to process where an object in motion is headed can result in confusion or fear. Held’s study states that in order to interact successfully with a moving object, you need to be able to have a sense of where it is headed, and to plan your motor movements accordingly. Held and his team will be conducting further research to better understand the capabilities and deficits of those on the spectrum in processing what is about to occur.

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First-Responders Learn to Properly Approach and Aid those with ASD

First-responders are receiving trainings that are critical in helping those on the autism spectrum during an emergency.
(photo: bigstory.ap.org)

With the autism diagnosis rate rapidly increasing, an emerging issue is having safety officials develop a better understanding of how to properly aid those on the spectrum. Approaching those with autism when they are in danger takes great precaution.

For instance, 14-year-old Nick from Vancouver had a fall when he was at summer camp, and although he had a serious leg injury, it was difficult to express this to first responders. Medics were unable to diagnose him, as Nick, who is autistic and has difficulty communicating, could not properly express what was wrong. Nick’s mother, Kari, felt that the medics should have had a better approach to understanding what the injury was, and it was clear they did not know how to work with someone on the autism spectrum. It was soon revealed that the medics did not have any training on how to address those with autism or other developmental disabilities.

Nick, who ended up having a broken hip and needed to undergo surgery, inspired workshops in his area to address ways to deal with emergencies when the individual has autism. With autism rates rising, more emergency services are configuring how to address those on the spectrum, and tend to the specific needs and concerns of parents.

Workshops are discussing some of the primary safety concerns for those with autism, including the fact that nearly half of all children with autism tend to wander. Furthermore, children with autism tend to be drawn to water. Therefore, it is essential to call police when a child with autism goes missing, and to check all sources of water. It is critical to think of places where a child likes to go, and the places and things that they might be drawn to.

Communicating with those on the spectrum can be difficult in times of crisis, as some individuals on the spectrum are nonverbal. Several police departments are implementing databases that aid children and adults who have trouble communicating due to a disability. For example, the Pensacola Police Department maintains a database, called the Take Me Home Program, consisting of a photo, physical description, emergency contacts, and information about the individual’s disability. If they are found alone, officers can pull up all the information that will further assist them in helping the individual.

In addition, many police departments within the U.S. and Canada are leading trainings to assist those with ASD, as part of crisis intervention training sessions. For many, it is the first time that training specifically focuses on those with autism. These trainings are increasingly more critical, as first responders should have a better understanding of how to approach and aid the increasing autistic population.

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Parental-Focused Interventions May Lead to Many Benefits in Children with ASD

According to a clinical trial, parental coaching interventions can lead to incredible improvements in young children with autism spectrum disorders (ASD). The Play and Language for Autistic Youngsters (PLAY) Project resulted in improved interactions between parent and child, along with other benefits for the children.

Richard Solomon, MD, who led the study at the Center for Developmental and Behavioral Pediatrics in
Ann Arbor, Michigan, states, “PLAY offers communities a relatively inexpensive, effective intervention for children with ASD and their parents”. The initial trial consisted of nearly 130 families, each with a child with ASD that is between the ages of 3 to 6 years old. The families were randomly assigned to one of two groups: they either received standard community services, or they received those services in addition to the PLAY Project.

Families from the PLAY project received three-hour home visits per month from trained and certified consultants. These consultants taught approaches to improve parent-child interactions, as well as social skill development in each child, through various methods of coaching, modeling, and the use of videotape followed by written feedback.

The PLAY Project promotes functional development in children on the spectrum, as well as enhance their playing skills, by enhancing parents’ interactional abilities. Through the trial, parents reported that they were able to engage their child in play sessions for up to two hours a day. Furthermore, coaching led to significant improvements in the child’s ability to initiate interactions with their parent.

Approximately half of the children that received consultation from the PLAY Project improved significantly in at least one category, compared to only a third of children who received standard services.  Dr. Solomon states, “We’re excited about these findings that offer a less costly and highly effective option, especially for children who are presently on waiting lists for high-cost services”. Furthermore, in recent years, similar studies have shown that parent-meditated programs, similar to PLAY, have shown quite promising results, by enhancing a child’s communication, attention, and ability to connect with others through social activities.

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Supporting the Learning Process for Children with ASD through Technology

Developments in technology have given children on the autism spectrum incredible opportunities to express themselves and grow. TalkingTiles is a new app that is being used to help develop a range of skill-sets for children on the spectrum, such as learning to read, learning about colors, and how to recognize safety signs.

The app is currently being used in the Mississippi Adolescent Center, part of the state’s Department of Mental Health. With many of the patients being autistic and nonverbal, the app has been an essential tool in helping children communicate their wants and needs without using words. Donna Horton, Director of Client Services at the center, states, “The kids fell in love with [the app].” With so many opportunities available for the child through the app, Horton continues, “[the app] is only limited by the imagination of the educator.”

“The cool thing about TalkingTiles [is that] we’ve seen a decrease in maladaptive behaviors”, Horton added. Through the app, kids are better able to express what they need, therefore reducing tantrums or poor behavior.

Furthermore, caregivers using the app can better express to the child what they plan to do with their day, giving the children a better idea of what their schedule is, offering them a sense of structure and security. Caregivers can explain where they are going (with a picture of a school, doctor’s office, etc.), and what activities they may participate in. TalkingTiles utilizes videos, pictures, and words that the children can use to help them communicate.

The essence of TalkingTiles is to help engage children in the various learning and therapy processes. Furthermore, the app is individually designed to help cater to the different needs of each child. The progress of each child is tracked, so that the caregivers can determine what the next step would be to enhance the child’s development.

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Are you an Autistic or a Person With Autism?

There is an on-going heated debate in the autism community, mainly between self-advocates and parental advocates on whether to identify as “autistics,” “autistic people,” or “people with autism.” This is not an argument about semantics by people who are excessively sensitive to political correctness, but rather an important discussion about how autistic people and their advocates want to identify themselves and be identified by others. The tricky part of this argument is that ultimately, both sides are on the same side, they just have a fundamental disagreement about the most empowering and respectful terms of identification.

Words and language are incredibly powerful, not just in the ways they allow us to express ideas and share information, but in the way subtle semantic nuances and social connotations can dramatically change the tone and attitudes implicit in communication and influence the ways they are received. All cultures have preferred terms for self-identifying, and it can be very confusing for people outside that culture who want to use the most respectful, appropriate, or politically correct terminology for identifying people as being of that culture.

Many self-advocates in the autism community and their allies prefer identifiers such as “Autistic,” “Autistic person,” or “Autistic individual” because they view autism as an inherent component of their identity as an individual, just as people choose to be referred to as “Muslims,” African-Americans,” or “Jewish.”

On the other hand, many parents of autistic children and autism professionals prefer the use of “person-first” identifiers; “person with autism” rather than “autistic person.” They want their children to be identified as children first or people, to emphasize their humanity and that they are, in fact, people first. Many parents are also very sensitive to judgment on their children’s behalf, and believe that for many people the word “autistic” carries negative connotations.

This movement for person-first language aims to emphasize the value of the person over the importance of the condition or disability.  This only seems to be an issue, however, with modifiers that are seen to be negative. For example, there is no hotbed debate (for now, at least) over whether it is inappropriate to refer to someone as a “diabetic” or “diabetic person,” and so you will rarely see or hear the phrase “person with diabetes” as a descriptor. So this attempt to neutralize a negative societal connotation through semantics, can actually serve to reinforce it.

Self-advocates also oppose person-first terminology because it seems to imply that they can be separated from their autism. They can’t be separated from their autism any more than they can be parted from their ethnic background. Nor should they be made feel that they should want to.  Self-advocates argue that it is impossible to affirm the value and worth of an autistic person without recognizing that they are autistic.

Both sides of the fence agree that using phrases like “suffers from autism” or “autism sufferer” are not acceptable terms and are harmful in the shaping of societal attitudes towards autism. To many self-advocates, however there is an implied “suffers from” in the person-first terminology. They don’t want to imply that there is anything unfortunate about their autism or that they would be better people if they were neurotypical people. Self-advocates want to be feel empowered by their self-identification, not apologetic.

Where the semantics and grammar collide, lies a fundamental question hidden deep between the lines: is autism something you have or something you are? From a non-linguistic perspective, it is both. Autism is expressed as an individualized set of neurological, physical, social, and/or psychological characteristics that mean it is something you have, in the same way I have red hair and pale skin. It is also fundamental to the formation of the identity of autistic people in the same way that I am Irish. Is it possible that the context, then that should determine the most appropriate identifying terms?

In writing this blog, we have always employed both person-first and descriptive-first terminology interchangeably to appeal to the most people and in response to subtle differences in context. In researching this posting, however, the arguments from the self-advocates are most persuasive, in good part because our society respectfully agrees to identify a people with the terms they prefer. That is why it is vitally important for the autism community to continue this debate so we can inform the rest of the world what is the preferred, appropriate way to identify autistic people with autism spectrum disorders. Please respond to this post with your opinion, but remember to be respectful. At the heart of this debate is the shared goal of creating a societal standard that is the most respectful to autistic people and conveys the empowering connotations that they deserve.

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How to Work With Autistic Peers

ICare4Autism is dedicated to building awareness and opportunities for people with autism spectrum disorders (ASD) in the workplace. Our Global Autism Workforce Initiative is developing programs throughout the US and abroad to connect autistic adults across the spectrum with training and employment opportunities appropriate for each individual’s unique interests, skill sets, and functionality. We aim to guide employers in the development of a more inclusive workforce, and are inspired by organizations such as Walgreens who actively seek to employ and provide appropriate training for people with cognitive and physical disabilities.

The upside of increased diagnosis of ASD is a broader awareness and understanding of autism beyond the autism community. Through fictional television characters, popular culture has provided glimpses into the unique character traits that can signify some form of autism and the many ways ASD can be beneficial in the workplace, although usually in over-dramatized roles as crime solvers, brilliantly quirky scientists, or crime solving scientists.  People are becoming more patient and accepting of the social difficulties many autistic people experience, and are increasingly more willing to learn how to relate and work with their autistic peers, because as we all know, autistic people have a lot to offer.

An article was published yesterday in the online version of Forbes Magazine called, “What You Need to Know About Working With Colleagues on the Autism Spectrum.” It is very encouraging in its message to be patient, reserve judgement, and employ their recommended tips to help build a work environment where everyone can perform to their best abilities. What is most encouraging, though, is the underlying subtext that it is very common to have autistic colleagues and that it is important for everyone to learn how to work with each other.

The article, co-authored by Forbes staffer Dorie Clark and Dr. Brent Betit, provides a comprehensive outline of tips and strategies for building effective professional relationships with autistic co-workers, and we invite you to add to this list or challenge any recommendations with which you disagree.

1)   Avoid eye contact if your autistic colleague does.

2)   Take their affect in stride – a flat tone of voice is a trait that can’t be controlled anymore than eye color or height.

3)   Listen carefully – many people with ASD lack understanding of the unwritten rules of communication and social interactions in the workplace. You may expect that you listen to their impressive knowledge of baseball statistics that they will feign the same interest in your cat’s cute antics. Listen with an ear to learn, not as an opening to share.  (BTW- your non-autistic colleagues probably don’t want to hear about your cat either)

4)   Minimize “social clutter” – if your colleague has a hard time fitting in and tends to be distracting in meetings, try holding video meetings. This can help everyone focus and stay on message.

5)   Embrace project management solutions – Adopt structural and workflow changes that help keep everyone organized and on track. Autistic people tend to work best within a structured environment.

6)   Embrace universal design – design a process that works for everyone, including professionals with ASD. Accommodating differences in the workplace can give you edge with recruitment and retaining the most talented workforce to build your business and your bottom line.

Let’s keep the conversation going. What do you want people with limited knowledge of autism to know about how to foster good working relationships with professionals on the autism spectrum? Please share your tips and insights by posting a comment below.

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New Federal Committee Will Boost Employment For Autistics

The U.S. Department of Labor announced that they are assembling a new advisory committee that will guide government officials on how to improve employment prospects for people with disabilities, including autism spectrum disorders (ASD). They are currently soliciting nominations for individuals to serve on the National Advisory Committee on Increasing Competitive Integrated Employment for Individuals with Disabilities.

This follows the Workforce Innovation and Opportunity Act, which was passed in July. The committee will examine ways to develop competitive, integrated employment opportunities for people with significant intellectual or developmental disabilities, and make recommendations to the Secretary of Labor Thomas Perez.

The panel will also be consulted on improving an existing program that allows some employers to pay disabled workers less than the minimum wage through oversight and better implementation.

The new law also limits eligibility to work for less than the federal minimum wage of $7.25 per hour, which will significantly impact people transitioning from school to employment.

Nominations for members of the advisory committee are being accepted until October 14, 2014 and are open to members of the general public as well as elected government officials. For more information, you can visit the Federal Register website.

ICare4Autism is excited about this new advisory committee and hope that it will help us to facilitate our own Global Autism Workforce Initiative. ICare4Autism is currently developing programs that will make vocational training and employment referral services more accessible to people with autism and similar disabilities.

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