BYU’s annual autism workshop, Best Practices in Autism: What’s New in Autism Intervention Research, focused on everyday ways to help patients, students, and children be more successful, as shown through the latest evidence-based interventions. Nearly 300 people attended and watched the event on livestream on January 29, 2016.
Sponsors of the event included BYU, BYU’s David O. McKay School of Education, Timpanogos Regional Hospital, and BYU Continuing Education.
The conference featured an introduction to evidence-based interventions by each of the presenters and was followed by three smaller, in-depth sessions.
“ABA in School Settings” Blake Hansen, PhD, Brigham Young University
By focusing on increasing student abilities to self-evaluate and monitor their own behavior, self-management interventions are very effective. Blake Hansen, a member of the McKay School Counseling Psychology and Special Education Department, discussed why it helps to combine rewards with social and academic skill instructions.
There are different methods that can be implemented, such as a ticket system or self-monitoring procedures. By having a function-based self-management intervention, students were producing better results than when they were using self-monitoring with consequences alone.
One such way to keep success rates up is through the Class-Wide Function-Related Intervention Teams, otherwise known as the CW-FIT program. Its main components are lessons given by the teachers. They group the class into teams and use a goals-and-points system with incentives and consequences. There is a daily point goal set with points being awarded to teams exhibiting positive behavior when a timer sounds. Reward and praise is given to the groups who meet the goal.
“The teachers make sure that the rules they gave are followed and reinforced,” Hansen said. “The instructions given for the students include getting their teacher’s attention, following directions told the first time, and ignoring inappropriate behaviors from their peers.”
Teachers found that their students were better behaved and less time was spent attending to behavioral problems in the classroom. CW-FIT had an overall high satisfaction rating from both teachers and students.
“What’s the Big Deal about Early Start Denver Model?” Terisa Gabrielsen, PhD, Brigham Young University
The Early Start Denver Model (ESDM) is an evidence-based intervention package for young children with autism spectrum disorder. Terisa Gabrielsen shared information for understanding ESDM techniques by showing the audience examples of exercises in writing goals and objectives, planning joint activity routines, and collecting data related to goals.
Gabrielsen explained that some of the obstacles to learning are impaired imitation, emotional sharing, communication skills, and joint attention, which affect one’s developmental course. The Early Start Denver Model works on reinforcing skills and introduces a set of teaching procedures within a developmental curriculum.
“When we address these limitations, we can redirect and help our students acquire the necessary skills,” Gabrielsen said. “There is a social communication focus that emphasizes imitation and a partnership with parents. If you are not doing it in partnership with the parents, then you are not doing it.”
ESDM is an intervention for children ages 12 to 60 months, which can be delivered in any setting either by a therapy group or by the parents in an individual or group program.
“Mindfulness and Emotion Training for Anxiety” Mikle South, PhD, Brigham Young University
There are some possible differences in anxiety in individuals with autism spectrum disorder. Mikle South focused his presentation on interventions for anxiety in ASD, reviewing the general and unique features of anxiety. He mentioned the different types such as safe vs. threat, fear vs. anxiety, and ramping up then ramping down.
South explained how there are cognitive and emotional threats that are both external and internal. An example of this would be failing a class or experiencing issues with self-worth. Anxiety can start to impair function and everyday life obstacles can be considered very stressful.
“They won’t try something unless they know they will one hundred percent succeed,” South said. “If they know what to do, they will feel less anxious.”
Treatment ideas include reducing sensory exposure, increasing certainty, and facilitating physiological and emotional awareness. By wearing earphones, having alternate clothing without tags, and creating quiet, safe places, one reduces environmental exposure and provides relief. An increased structure means an increased certainty. South said that schedules at home and at school simplify expectations that provide relief.
“Break things into smaller, simpler components . . . helps children have more structure,” South explained. When discussing teaching emotional awareness for others and self, he stated, “Do emotional skills first and social skills second. We want to help people facilitate awareness of their bodies.”
The presentation finished with South offering techniques for children to help develop mindfulness and gain some control over their internal world without suppressing it.
“Occupational Therapy—Evidence Based Interventions” Heidi Woolley, OTD, OTR/L, University of Utah
Occupational therapy (OT) helps people achieve independence in all aspects of their lives, including their psychological, social, and environmental needs. Heidi Woolley presented information on evidence-based interventions and occupational therapists’ role with ASD.
Woolley said that occupational therapists are widely seen as experts for sensory and motor concerns. The interventions include relationship-based, developmental skill-based, social-cognitive, behavioral, sensory integration, and parent-directed techniques. Occupational therapists focus on sensory processing and social-behavioral performance with children and work on transition and independence with adolescents and adults.
OT interventions are designed to improve the person’s social and developmental performance as well as reinforce consistency. Research has shown that integrating more clinical-based interventions in a more traditional setting has been successful.
There is really strong evidence that there are primary differences in how children with autism react compared to normal kids,” states Woolley. “People with autism need repetition.”
“A Spoonful of Remedies for Pediatric Feeding Problems in Children and Adolescents with Autism Spectrum Disorder” Aaron Fischer, PhD, University of Utah
Aaron Fischer presented on the functions of behavior with the cause and implication of Pediatric Feeding Problems. People with autism often have food selectivity and food refusal. There are medical and environmental factors that can cause this problem. Fischer mentioned that it could be a lack of exposure to food textures, behavioral management problems, or a medical condition.
Research found that up to eighty percent of children with ASD have pediatric feeding disorders. This leads to weight loss, malnutrition, growth problems, and impaired cognitive, social, and emotional growth.
Fischer gave suggestions and behavioral treatments for pediatric feeding problems such as sitting at a table as a family to eat, preparing one meal for the family, and not having access to electronic devices during the meal. He also discussed the Autism MEAL Plan, a problem behavioral program, which is for parents of children with ASD. The plan not only helps parents to structure meals and monitor progress, but it also increases appropriate behavior and helps with many other skills.
“Communication and Language Interventions for Minimally Verbal Children with Autism Spectrum Disorder” Stacy Shumway Manwaring, PhD, University of Utah; Teresa Cardon, PhD, Utah Valley University
Stacy Shumway Manwaring and Teresa Cardon discussed how early behavioral interventions offer major benefits to children with ASD.
Spoken language levels include nonverbal, verbal, minimally verbal, low verbal, and preverbal (toddlers) Language difficulties range from a delay in language to not speaking currently and not developing language throughout the lifespan. Minimally verbal toddlers use some spoken language, but it may be language that appears noncommunicative.
Manwaring and Cardon explained that there is no single reason that can show why some of the children in the minimally verbal category fail to acquire language, but research has found a decrease in these cases, thanks to a greater access to effective early interventions and earlier diagnoses. Three interventions discussed were the JASPER + Enhanced Milieu Teaching + Speech Generating Device, the Reciprocal Imitation Training, and Pivotal Response Treatment. Each of these interventions has different stages and techniques to help improve communication and language skills in children with ASD who are minimally verbal.
“Social Play Interventions” Thomas Higbee, PhD, Utah State University
It is highly important to teach young children with autism how to play. Thomas Higbee offered some evidence-based strategies for teaching play and social skills to young children with autism. Children with autism often maker fewer social initiations compared to their typical peers, and so their play is solitary.
“Play is a young child’s work,” Higbee said. “It serves as an important function in development to help children learn social rules and norms.”
One set of techniques that help promote social interactions is social scripting. Scripts are phrases or sentences that help young children with autism to start or continue conversations. The scripts are meant to be introduced and then faded, leading to flexible, spontaneous unscripted language. Parents and siblings can help promote play-based verbal initiations by using script fading. Research has shown these to be effective methods to increase interactions during play.
Resources from the conference are available through the McKay School’s Autism Connect website.
March 17, 2016
Writer: Joann Distler
Contact: Cynthia Glad (801)422-1922