“This is key”: that’s what Temple Grandin—one of the first people to document their experience on the autism spectrum—said repeatedly during the commentary of her namesake HBO drama. It is this focus on “key” interventions and approaches to autism that inspired the theme for the 2020 Autism Translational Research Workshop: “Active Ingredients—Little Things That Make a Big Difference.”
The Autism Translational Research Workshop is a collaborative effort made possible by the McKay School of Education, Timpanogos Regional Hospital, and BYU Continuing Education. The annual conference is geared toward educators, healthcare workers, psychologists, social workers, and beyond, with many parents and students who also attend. Attendees can meet with autism professionals and learn the latest methods and ideas in the field. Here are some of the takeaways from each session!
The workshop began with a panel of four mothers and one sister to someone with autism spectrum disorder (ASD). Among the five panelists, they care for eight individuals with autism diagnoses. Several of the panelists have also pursued careers or activism to help individuals on the spectrum. For many of these women, empathy is key in their journeys with ASD.
“I have found the biggest one key thing is just really respecting what they say they're experiencing,” said Karen Fairchild, LCSW and mother of three adult children with autism. Fairchild said that even if she couldn’t fully understand everything her children were going through, learning to respect and validate that experience was a huge breakthrough for her entire family.
Kari Bushman, who works at a nonprofit school for young adults with autism and whose brother was diagnosed at 40, said that “tough empathy” and clear communication is especially important for young adults, who often lack awareness about how the “real world” works. “A lot of our students are stunned to find out that their electricity and water and Internet cost money; or that people expect them to live on their own; or that people expect them to get a job,” said Bushman. "It’s essential that these expectations are communicated very specifically.” It’s because we love them, said Bushman, that we provide that information.
Emily Flinders, whose oldest son has autism, emphasized the importance of communication and collaboration between parents and educators. “It's really hard as the parent to continually be asked by teachers and administrators to be the expert on your child when you are baffled by so much about your child,” said Flinders. “So it's really helpful if there's a dialogue between the teacher and the parent, where the teacher is also sharing [with the parents] what's working well and what maybe isn't working well . . . because that information is helpful in both directions.”
The panelists also talked about the importance of clarifying intent, helping young adults gain work experience, and overcoming perfectionism. They also recommended a few books that have helped them on their journeys with autism, two of which were The Loving Push: How Parents and Professionals Can Help Spectrum Kids Become Successful Adults and Designing Your Life: How to Build a Well-lived, Joyful Life.
Michele Villalobos: Adjusting Teaching Styles
Michele Villalobos, PhD, is a professor of psychiatry at University of North Carolina School of Medicine and former clinical director of a TEACCH Autism Center, which provides community-based services, training programs, and more to enhance the lives of those with ASD.
In her presentation, Villalobos said that difficulty with social communication is at the heart of autism. And it is through that lens that educators should view challenging behaviors. From there she outlined several obstacles that individuals face in the classroom and how teachers can adjust their teaching to meet the needs of students on the spectrum.
For example, many with ASD struggle with implicit learning or thinking in generalizations. Teachers can help by using specific language and visual strategies to explain concepts more clearly. Students with ASD also struggle with auditory processing; in such circumstances, using gestures and visual strategies will help the student. In fact, in almost every obstacle Villalobos identified, teachers can help by interacting with the student using visual aids and gestures. Seeing isn’t believing—seeing is learning.
Katrina Hahn: Gender Differences
Katrina Hahn is a certified speech-language pathologist in the Department of Pediatrics at the University of Utah, and the focus of her presentation was gender differences in autism. Given that more boys than girls are diagnosed with autism (4:1, according to one study), much of researchers’ understanding of autism comes from observing it in boys; however, autism can be a lot harder to spot in girls.
The key to diagnosing girls with autism is understanding that girls are much better at hiding the symptoms. Hahn pulled several characteristics of autism from the DSM-5, such as deficits in social-emotional reciprocity, deficits in nonverbal communication, and highly restricted, fixated interests that are abnormal in intensity or focus.
While girls on the spectrum struggle with reciprocity, they are better able to “camouflage” their social behavior than their male counterparts. Whereas boys with ASD may avoid eye contact, girls might overcompensate with too much eye contact. And while girls still exhibit intense, fixated interests, the things they fixate on aren’t far from what girls their age are also interested in (animals, reading, pop stars). Hahn’s presentation was a testament to how autism manifests itself differently not only between genders but between individuals. As autism advocate Stephen Shore said, “If you’ve met one person with autism, you’ve met one person with autism.”
Heather Davis: Positive Behavior Supports
Heather Davis, PhD, BCBA, is the clinical and educational director at the Carmen B. Pingree Autism Center of Learning in Salt Lake City. Davis’ presentation focused on keys to success in education and learning. For children with autism, the key is positive behavior supports (PBS).
When dealing with problematic behavior in the classroom, many teachers’ first instinct is to punish bad behavior (i.e., negative reinforcement). PBS, on the other hand, assumes that behavior can be both learned and unlearned and that punishment does not teach new behavior. With that, Davis encourages teachers to use positive reinforcement (using specific, targeted praise) and differential reinforcement (give attention to good behavior, ignore unwanted behavior). The burden of changing behavior is often placed on the student, but PBS’s final assumption flips the script: for student behavior to change, teachers must first change their own behavior.
Karen Fairchild: Effective Therapy
Fairchild is an LCSW at Utah Valley Psychology in Orem, where she works with clients (from children to adults) affected by autism, both those diagnosed with ASD and their families. In her presentation, Fairchild highlighted a number of therapeutic models she has used with her patients—cognitive behavioral therapy, dialectical behavioral therapy (e.g., mindfulness, emotion regulation), and internal family systems therapy—but she’s really just a proponent of whatever works. “One of my favorite words right now is effective; I’m really looking for what’s actually effective,” she said.
Whatever approach therapists take with their clients on the spectrum, Fairchild believes the key is to establish a relationship with the client; if she has not established a good relationship, it doesn’t matter how many great ideas she has. Fairchild also stressed that psychotherapy “especially within autism, is never going to be a quick fix.” Her role, she said, “is to encourage growth and to encourage better and better strategies. But that’s going to be their process, and I’m there just to help facilitate that.”
Finally, the workshop also gives community clinicians opportunities to hone their skills and calibrate with colleagues who do autism diagnosis in diagnostic reliability sessions led by Terisa Gabrielsen, PhD. These sessions can also be followed up with online mentoring to keep the regional autism community connected in continuing improvement of clinical practice.
Writer: Anessa Pennington
Contact: Cynthia Glad 801-422-1922