Autism Department’s December 2012 Newsletter
Date: March 15, 2013
Poor vocabulary development is a hallmark of communication disabilities and language disorders. It is also a critical element of learning to read and a common core state standard in every subject area, in every grade level, in every state. Using both direct and indirect methods that are supported by evidence-based practice (EBP) and research, we can make lasting improvements in word learning and comprehension. Specific techniques in vocabulary therapy will be demonstrated for a wide range of students with mild to moderate language disorders, autism spectrum disorders, and intellectual disabilities.
Please visit: www.kidztherapy.com for registration and brochure
Kidz Therapy is proud to announce a new conference “Assessment and Treatment of Severe Problem Behavior” This is a two day conference January 10 and January 11 to be held at LIU Post. Please see our website for conference information and registration www.KidzTherapy.com
Physical Therapists and Occupational Therapists needed!
Kidz Therapy is hiring both full-time and fee-for-service Physical Therapists and Occupational Therapists for the Fall, 2012. We need therapists for early intervention, pre-school and school aged children. For more information about Kidz Therapy Services and Gayle E. Kligman Therapeutic Resources, please visit our website http://www.kidztherapy.com . You may send your resume to humanresources@kidztherapy.com.
SUMMER PROGRAMS 2012
Let’s Write Parent Training
Mon.& Wed. 8:30 – 9:00 Tues. 9:30 – 10:30,
Tues. & Thurs. 8:30 – 9:00 1:15 – 2:15, 2:00 – 3:00
Mon. & Wed. 5:00 – 5:30 4:00 – 5:00
Tues. & Thurs. 5:00 – 5:30 Wed. 9:30 – 10:30 &
2:30 – 3:30 & 4:00 – 5:00
Thurs. 1:30 – 2:30 &
Lunch Bunch 2:30 – 3:30
Mon. 12:00 – 1:00
Pragmatic Language Groups Twist and Shout
Mon. 2:00 – 3:00 Friday:10:30 -11:30
Tues. 9:30 – 10:30 Fri. 1:30 – 2:30
Wed. 9:30 – 10:30 & 2:00 – 3:00
Thurs. 9:30 – 10:30 Yoga For Kids
Fri. 9:30 – 10:30 Mon. 10:30 – 11:30
Feeding Groups Articulation Station
Wed. 1:00 – 2:00 Mon. 1:00 – 2:00
Fri. 9:00 – 10:00 Wed. 1:00 – 2:00
Social Skills Groups Language and Laughs
Mon. 10:30-11:30 & 4:00-5:00 Tues. 1:00 – 2:00
Tues. 9:30-10:30, 10:30–11:30, Thurs. 1:00 – 2:00
1:15-2:15, 2:30-3:30, &
4:00-5:00 Roots of Reading
Wed.9:30-10:30,11:00-12:00 Fri. 1:00-2:00
2:00-3:00, & 4:00 – 5:00
Thurs. 9:30-10:30, 11:00-12:00,
1:15-2:15, 2:30-3:30, &
4:00 – 5:00 Ready, Set, Kindergarten
Mon. 1:30 – 2:30
Prevalence of ASD is Now 1 in 88:
What Does This Mean?
On March 30th, the Centers for Disease Control (CDC) released an updated report on the prevalence of Autism Spectrum Disorders (ASD). The study, which is based on 2008 data, found the prevalence rate to be 1 in 88 children (1 in 54 for males). The CDC report highlights that this is a 78% increase from 2002. There are other findings from this study that are also interesting and noteworthy. When comparing the prevalence of ASD across race/ethnic groups, there were significant increases across all major groups (i.e., White non-Hispanic, Black non-Hispanic Hispanic). However, the greatest increase was among non-Hispanic black children (42%). The study also found that 38% of the children identified with ASD in this study also presented with an intellectual disability, meaning that they had an IQ score of 70 or below. While this percentage is lower as compared to other recent studies which found that approximately 55% of children with ASD also have an intellectual disability (Charman et al., 2011), this percentage is a 12% increase as compared to the previous 2002 prevalence study conducted by the CDC.
As mentioned in the CDC report, there is a possibility that the overall increase in the prevalence of autism is attributable to increased awareness and improved diagnostic procedures. Media outlets have also done a better job this time around (as compared to previous reported increases in prevalence) recognizing that the increase may very well be attributable to better diagnosis and increased awareness. Moreover, it will be very interesting to learn how the pending diagnostic criteria changes will impact future prevalence rates of ASD. Some have argued that the dramatic increase in autism prevalence is directly related to the changes in diagnostic criteria since the late 1990’s. However, that is what makes these latest findings rather interesting, as there have not been any major diagnostic criteria changes since 2002 to explain this most recent increase. The pending changes to be included in the next edition of the Diagnostic and Statistical Manual (DSM) will reportedly eliminate the Asperger’s diagnosis as well as the PDD-NOS (Pervasive Developmental Disorder — Not Otherwise Specified) diagnosis. There will reportedly be a new disorder called Social Communication Disorder (SCD) which is being loosely defined as autism without the repetitive and ritualistic behaviors.
ASD Prevalence (Cont’d)
Hypothetically, a large portion of children who are now being identified with ASD could be identified with SCD once the changes in the DSM occur. Accordingly, one might expect a decrease in the prevalence rate of ASD in the future.
Regardless of the prevalence of ASD, one thing remains – we need to help these children learn and grow. This CDC finding simply confirms that there are many children and families in need of support. Exactly what represents the best way of providing support remains one of the most important public health concerns of this generation. Hopefully, over the next several years we can continue to enhance the services we are providing to these children and their families.
References
Charman, T., Pickles, A., Simonoff, E., Chandler, 5., Loucas, T., & Baird, G. (2011). IQ in children with autism spectrum disorders:
Data from the Special Needs and Autism Project (SNAP). Psychological Medicine, 41, 619-627.
U.S. Department of Health and Human Services – Centers for Disease Control and Prevention. (2012). Prevalence of Autism
Spectrum Disorders – Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008.
Morbidity and Mortality Weekly Report, 61, 1-19.
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UPCOMING PROFESSIONAL CONFERENCES
SUMMER 2012 – SPRING 2013
REGISTRATION CURRENTLY AVAILABLE FOR THE FOLLOWING:
- Ø LENNY CALTABIANO, PSY.D.
- A Contemporary View of Autism & Established Interventions
June 25 or August 13, 2012
- Applying the Principles of Behavior Analysis Across Domains
June 26 or August 14, 2012
- Beyond the Basics: Program Design and Implementation
June 27 or August 15, 2012
- Ø ZAUR ISAAKOV, PH.D., BCBA-D
- Establishing a Comprehensive Understanding of Data Collection & Graphing July 16-17, 2012
- Conducting a Functional Behavioral Assessment (FBA)
July 30, 2012
Visit our website to access brochures and to register: http://www.kidzconferences.comFor registration information – Marian Karcher 516 747-9030 ext. 161/
2012 Walk Now for Autism — Jones Beach
Let’s get started early this year. Become part of our Kidz Therapy Team and raise money for autism research and services through the annual Walk Now for Autism walk organized by Autism Speaks. Our team webpage is:
http://www.walknowforautismspeaks.org/longisland/kidztherapy
Simply click on this link and join!
JABA Research Review: Receptive Identification —
What is the Best Approach?
Reference:
Grow, L., Carr, J., Kodak, T., Jostad, C., & Kisamore, A. (2011). A comparison of methods teaching receptive labeling to children with autism spectrum disorders. Journal of Applied Behavior Analysis, 44, 475‑498.
Both the simple-conditional method and the conditional-only method use conditional discrimination. That is, they both present the student with an array of visuals, then the teacher presents the discriminative stimulus (56), the student engages in a response (or is prompted to do so), and the teacher provides differential consequences for correct and incorrect responses. The difference between the two methods is the way the visuals are presented. The simple-conditional method teaches the student in isolation first and gradually increases the array as the child achieves mastery. Here is an example of how the simple- conditional method is used: The student is given a visual (i.e. picture of a pencil) and is then presented with the 5b (i.e., “Point to [touch, show me] the pencil”), the student points to the picture and is provided with a reinforcer. You then repeat this step until mastery is achieved. Then you repeat this step with another picture in isolation (i.e. picture of a book). You repeat the steps for conditional discrimination; (“Point to book”, student responds; provide reinforcer). Once the child has mastered these pictures in isolation, you introduce one of these pictures as a distractor picture. You present both pictures to the student, present the 5°, the child points to a picture, and you differentially provide a consequence. Once the student has mastered each picture (i.e. pencil and book) with one distractor, you introduce a new picture in isolation (i.e. bed). You go through the steps previously stated, and the child receptively identifies “bed” in isolation, then with one distractor (pencil or book). Finally, you are ready to expose the child to all three pictures and present the child with the 5°. The child is now required to listen to the discriminative stimulus and select the picture you asked for in an array of three to receive reinforcement.
The conditional-only method is identical to the last step in the simple-conditional method. The conditional-only method teaches the student by introducing all three pictures from the beginning. The student must learn from the start to scan all three pictures and listen to the discriminative stimulus to receive reinforcement. Furthermore, the student is less likely to become position bias, as the target picture will alternate between one of three positions (e.g., left, center, or right).
Using single-subject methodology, this study included three students who were evaluated three times and were given a 3-week follow-up to see if mastered skills had been maintained, comparing the simple-conditional and conditional only approaches. The results of this study show that the conditional-only method required an average of 62% fewer sessions to meet mastery. Additionally, the simple-conditional method was associated with error patterns that required additional training components. Error patterns did occur during the initial training of the conditional-only method, but the students did not require any additional training components to acquire the skills. These findings are consistent with previous studies and, therefore, teaching skills in isolation first may be unnecessary and may lead to error patterns and less efficient acquisition
Attention Problems May Be Sleep-Related
By KATE MURPHY
| April 16, 2012, 6:15 pm 34
Diagnoses of attention hyperactivity disorder among children have increased dramatically in recent years, rising 22 percent from 2003 to 2007, according to the Centers for Disease Control and Prevention. But many experts believe that this may not be the epidemic it appears to be.
Many children are given a diagnosis of A.D.H.D., researchers say, when in fact they have another problem: a sleep disorder, like sleep apnea. The confusion may account for a significant number of A.D.H.D. cases in children, and the drugs used to treat them may only be exacerbating the problem.
“No one is saying A.D.H.D. does not exist, but there’s a strong feeling now that we need to rule out sleep issues first,” said Dr. Merrill Wise, a pediatric neurologist and sleep medicine specialist at the Methodist Healthcare Sleep Disorders Center in Memphis.
The symptoms of sleep deprivation in children resemble those of A.D.H.D. While adults experience sleep deprivation as drowsiness and sluggishness, sleepless children often become wired, moody and obstinate; they may have trouble focusing, sitting still and getting along with peers.
The latest study suggesting a link between inadequate sleep and A.D.H.D. symptoms appeared last month in the journal Pediatrics. Researchers followed 11,000 British children for six years, starting when they were 6 months old. The children whose sleep was affected by breathing problems like snoring, mouth breathing or apnea were 40 percent to 100 percent more likely than normal breathers to develop behavioral problems resembling A.D.H.D.
Children at highest risk of developing A.D.H.D.-like behaviors had sleep-disordered breathing that persisted throughout the study but was most severe at age 2 1/2.
“Lack of sleep is an insult to a child’s developing body and mind that can have a huge impact,” said Karen Bonuck, the study’s lead author and a professor of family and social medicine at Albert Einstein College of Medicine in New York. “It’s incredible that we don’t screen for sleep problems the way we screen for vision and hearing problems.”
Her research builds on earlier, smaller studies showing that children with nighttime breathing problems did better with cognitive and attention-directed tasks and had fewer behavioral issues after their adenoids and tonsils were removed. The children were significantly less likely than untreated children with sleep-disordered breathing to be given an A.D.H.D. diagnosis in the ensuing months and years.
Most important, perhaps, those already found to have A.D.H.D. before surgery subsequently behaved so much better in many cases that they no longer fit the criteria. The National Institutes of Health has begun a study, called the Childhood Adenotonsillectomy Study, to understand the effect of surgically removing adenoids and tonsils on the health and behavior of 400 children. Results are expected this year.
“We’re getting closer and closer to a causal claim” between breathing problems during sleep and A.D.H.D. symptoms in children, said Dr. Ronald Chervin, a neurologist and director of University of Michigan Sleep Disorders Center in Ann Arbor.
In his view, behavioral problems linked to nighttime breathing difficulties are more likely a result of inadequate sleep than possible oxygen deprivation. “We see the same types of behavioral symptoms in children with other kinds of sleep disruptions,” he said.
Indeed, sleep experts note that children who lose as little as half an hour of needed sleep per night — whether because of a sleep disorder or just staying up too late texting or playing video games — can exhibit behaviors typical of A.D.H.D.
Not only is a misdiagnosis stigmatizing, but treatment of A.D.H.D. can exacerbate sleeplessness, the real problem. The drugs used to treat A.D.H.D., like Ritalin, Adderall or Concerta, can cause insomnia.
“It can become a vicious, compounding cycle,” said Dr. David Gozal, chairman of the department of pediatrics at the University of Chicago Pritzker School of Medicine, whose clinical practice focuses on children with sleep disorders.
Sleep deprivation is difficult to spot in children. Of the 10,000 members of the American Academy of Sleep Medicine, only 500 have specialty training in pediatric sleep issues. And pediatricians may not even know to make a referral, because they often depend on parents to bring up their children’s sleep problems during checkups.
But parents themselves often are uninformed about healthy sleep habits. A study conducted last year by researchers at Penn State University-Harrisburg and published in The Journal of Sleep Research showed that of 170 participating parents, fewer than 10 percent could correctly answer basic questions like the number of hours of sleep a child needs.
“Parents didn’t know what was normal sleep behavior,” said Kimberly Anne Schreck, a psychologist and behavioral analyst at Penn State who was the study’s lead author. “Many thought snoring was cute and meant their child was sleeping deeply and soundly.”
Lenny Caltabiano, Psy.D.
Director of Autism & Behavioral Services
On March 30th, the Centers for Disease Control (CDC) released an updated report on the prevalence of Autism Spectrum Disorders (ASD). The study, which is based on 2008 data, found the prevalence rate to be 1 in 88 children (1 in 54 for males). The CDC report highlights that this is a 78% increase from 2002. There are other findings from this study that are also interesting and noteworthy. When comparing the prevalence of ASD across race/ethnic groups, there were significant increases across all major groups (i.e., White non-Hispanic, Black non-Hispanic, Hispanic). However, the greatest increase was among non-Hispanic black children (42%). The study also found that 38% of the children identified with ASD in this study also presented with an intellectual disability, meaning that they had an IQ score of 70 or below. While this percentage is lower as compared to other recent studies which found that approximately 55% of children with ASD also have an intellectual disability (Charman et al., 2011), this percentage is a 12% increase as compared to the previous 2002 prevalence study conducted by the CDC.
As mentioned in the CDC report, there is a possibility that the overall increase in the prevalence of autism is attributable to increased awareness and improved diagnostic procedures. Media outlets have also done a better job this time around (as compared to previous reported increases in prevalence) recognizing that the increase may very well be attributable to better diagnosis and increased awareness. Moreover, it will be very interesting to learn how the pending diagnostic criteria changes will impact future prevalence rates of ASD. Some have argued that the dramatic increase in autism prevalence is directly related to the changes in diagnostic criteria since the late 1990’s. However, that is what makes these latest findings rather interesting, as there have not been any major diagnostic criteria changes since 2002 to explain this most recent increase. The pending changes to be included in the next edition of the Diagnostic and Statistical Manual (DSM) will reportedly eliminate the Asperger’s diagnosis as well as the PDD-NOS (Pervasive Developmental Disorder – Not Otherwise Specified) diagnosis. There will reportedly be a new disorder called Social Communication Disorder (SCD) which is being loosely defined as autism without the repetitive and ritualistic behaviors. Hypothetically, a large portion of children who are now being identified with ASD could be identified with SCD once the changes in the DSM occur. Accordingly, one might expect a decrease in the prevalence rate of ASD in the future.
Regardless of the prevalence of ASD, one thing remains – we need to help these children learn and grow. This CDC finding simply confirms that there are many children and families in need of support. Exactly what represents the best way of providing support remains one of the most important public health concerns of this generation. Hopefully, over the next several years we can continue to enhance the services we are providing to these children and their families.
References
Charman, T., Pickles, A., Simonoff, E., Chandler, S., Loucas, T., & Baird, G. (2011). IQ in children with autism spectrum disorders: Data from the Special Needs and Autism Project (SNAP). Psychological Medicine, 41, 619-627.
U.S.Department of Health and Human Services – Centers for Disease Control and Prevention. (2012). Prevalence of Autism Spectrum Disorders – Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report, 61, 1-19.
KIDZ THERAPY SUMMER PROGRAM JULY 9 TO AUGST 17 2012
(Click Below)
Dear Parents, Professionals, and Friends of Early Intervention:
Click Here for ONE-STEP to STOP the Insurance Industry Take-Over of Early Intervention!
Governor Cuomo has proposed changes for Early Intervention which will greatly impede our ability to provide services, drastically limit parental-choice, and dramatically drive up the administrative costs of Early intervention.
In short, the Governor proposes turning over much of the Early Intervention Program to insurance companies, who would:
(1) be in charge of setting rates,
(2) impact service utilization, and
(3) limit a parent’s ability to be served by the provider or evaluator of their choice.
The Governor’s proposal originates from the desire of local Counties to be relieved of their role and responsibility in providing quality and accessible E.I. programs. There is also talk of allowing new co-pays to be levied and insurance policy deductibles to be met. Additionally, if a particular provider is not on the panel of a child’s insurance company, that provider would not be allowed to evaluate or deliver therapy for that child, in spite of being a licensed professional with credentials and experience providing E.I. services!
These proposals will destroy the very fabric of the necessary and successful Early Intervention Program that has been built in New York State. We URGE you to voice your opposition to this insurance scheme IMMEDIATELY while the Legislature is still in a position to reject it in the State budget. The Early Intervention Program’s children and their families need your help and support….
Click Here for ONE-STEP to STOP the Insurance Industry Take-Over of Early Intervention!
kidztherapy 
Written
on May 21, 2012