Dr. Cheryl A. Young, BCABAAssistant Professor of Special Education

MSU-Billings, College of Education

Billings Community Autism Conference – August 3 & 4, 2009

Autism Speaks Video (PSA)

Rates of autism spectrum disorders are increasing because parents actively seek an autism diagnosis in order to increase access to services they want for their child.

FALSE: No parent really ‘wants’ the diagnosis of autism for their child – and most services are available for a wide range of conditions.

1 in 150 births (CDC, 2007)

1 to 1.5 million Americans (2000 US Census; CDC, 2001)

Fastest-growing developmental disability 10 - 17 % annual growth

(Autism Society of America, 2003; 2006)

Autism is caused by Thimerosal, a mercury-based additive that was used to preserve liquid vaccines (MMR, DTP, etc.)

FALSE: The US Institute of Medicine approved mercury-free vaccines beginning in 2003 through 2005. To date, no infant vaccines containing mercury. Autism prevalence rates continue to rise.

Children with high-functioning autism and Asperger’s syndrome aren’t really autistic.

FALSE: The autism spectrum covers five related developmental disabilities that affect

(a)communication(b)socialization(c)behavior

Autistic Disorder aka Classic Autism

Asperger’s Syndrome Childhood

Disintigrative Disorder Rhett’s

SyndromePDD-NOS

Pervasive Developmental Disorder –

Not otherwise specified

Schools and communities can handle the increase of children with autism because they have already established the infrastructure in their operations.

FALSE. Children with autism develop and learn in unique ways that are different from the established day-to-day operations of schools and community programs.

$90 billion annual cost (Jarbrink & Knapp, 2001)

90% of costs are in adult services Cost of lifelong care can be reduced by 2/3 with

early diagnosis and intervention In 10 years, the annual cost will be $200-400

billion4

(Autism Society of America, 2003; 2006)

Between 1994 and 2006, the number of 6 to 17-year-old children classified as having an ASD in public special education programs increased from 22,664 to 211,610

This represents a 933% increase.

If your taxes or association fees went up by this amount – would you do something about it?

The increasing number of children with autism in school programs is due to a reorganized categorization of disabilities

FALSE. Autism was added to IDEA in 1990 as a separate disability category. The number of cases follows national trends. MR has remained stable while autism continues to climb.

Number of Students with Autism

1844 58 53

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372

341

275

208

4155

7390 101

112127

165

206

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200

300

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Criteria 1: Student may not be identified as having autism if the student has… global cognitive defects in which the student exhibits "autistic-like" behavior.Criteria 2: Student may not be identified as having autism if the student has… "autistic-like" behavior such as...Asperger's disorder.Criteria 3: Student may not be identified as having autism if the student... has an emotional disturbance. (Students with "autistic-like behavior and Asperger's disorder can be identified as having autism.Students aged 3-5 identified as having autism. NOTE: 2001-2002 was the first year in which children aged 3-5 could be identified as having autism, rather than as developmentally delayed.

Montana – Prevalence of Autism in Schools

Data Source: Montana OPI

Male to Female: Prevalence is higher among boys than girls; 4.5 boys:1 girl Boys in New Jersey: 6 in 150.

Race: White (non-hispanic) ranged from 3.3 per 1,000 (AL) to 12.5 per 1,000 (NJ). Black (non-Hispanic) ranged from 3.4 per 1,000 (AL) to 7.7 per 1,000 (NJ) Hispanic ranged from 0.3 per 1,000 (WI) to 9.7 per 1,000 (NJ).

Onset: The median age of diagnosis ranged from four years, one month (UT) to five

years, six months (AL). However, for 51–91 percent of children with an ASD, developmental

concerns had been recorded before three years of age. 

World autism awareness day: Apri l 2◦ Autism does not discriminate based on nationality,

ethnicity, or social status In 2008, Autism Speaks predicted

autism wil l be the next global health crisis◦ United Nations World Focus on Autism, an

international global action - will address the world's autism crisis

China1,100,000

India200,000

U.S.1,500,000

U.K.650,000

Mexico150,000

Philippines500,000

Thailand180,000

In schools, we are guided by laws:◦ No child left behind (2001)◦ Individuals with Disabilities Education Act (2004)

In professions we are bound by ethics or oath:◦ Hippocratic Oath - "Above all, do no harm“◦ Be true to science

Parents?

The American Medical Association's AMA Physician Select FREE Service◦ Limited information on training and certification status ◦ More than 690,000 medical and osteopathic physicians ◦ It does not list disciplinary actions.

The American Board of Medical Specialties Certified Doctor Verification◦ Reports if a doctor is certified by one of the 24 recognized specialty boards ◦ All states can be searched simultaneously. ◦ Registration at the site is required, but this service is free of charge.

HealthGrades ◦ Searchable database of medical and osteopathic physicians◦ Reports cover education and training; specialties; board certification;

disciplinary actions◦ Fee charged to search physicians on this site.

Service providers who advertise treatments for children with autism use scientifically valid, evidence-based practice.

FALSE. There are many controversial and unsound therapies available to parents.

http://www.wishmission.com/

Guaranteed success.  I'll grant your wish or your money back - guaranteed!  My name is Chris Roller (email).  Make a wish, anything that ails you - backache, cancer, aids, bad knee, MS, autism, etc.  My technique is based from proven techniques like EFT, TFT and VT (why the mascarade?).  I have a patent pending on my technique based on the power of suggestion, which is also a prayer.  A wish is a prayer.  By repeating, "I don't have cancer", it is a prayer, a power of suggestion, and you can make it so, with my help.  I have been saying "I am very important to God" for 9 years now, and it became true (example).

STD cure $250 Autism $1,000 Baptism Free

Hyperbaric Chamber

Chelation TherapySwim with Dolphins

Pet Therapy

Equine Therapy

Electric Shock Therapy

Special education services must be based on “peer-reviewed research.”

IEP must include “a statement of the special education and related services and supplementary aids and services, based on peer-reviewed research to the extent practicable, to be provided to the child.”

IDEA, 20 U.S.C. § 1414 (d)(1)(A)(i)(IV)

Use interventions that have support in research literature (“everyone’s doing it” is not good enough)

Teachers must be able to explain the research behind their intervention.

Teachers must keep informed (read!) Must keep RECORDS of interventions Provide FAPE, meaningful instruction

Effective educational practices for students with Autism at this age group:

Access to typically developing peers Extended learning opportunities Systematic instruction Functional approach to problem behavior

National Research Council (2001)National Research Council (2001)

Appropriate curricular content across domains Systematic instruction and data-based decision making Individualized supports and services Comprehensible and/or structured environments Functional approach to problem behaviors Family involvement, including education

Applied Behavior Analysis (ABA) Discrete Trial Teaching (DTT) Pivotal Response Training (PRT) Learning Experiences: Alternative Program (LEAP)

Source: Simpson, R. L. (2005). Evidence-based practices and students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities. 20(3), 140-149.

Play-Oriented Strategies Picture Exchange Communication System (PECS) Incidental Teaching Structured Teaching (TEACCH) Augmentative/Alternative Communication Assistive Technology Joint Action Routines Cognitive Behavior Modification Social Stories and Social Decision Making Strategies Sensory IntegrationSource: Simpson, R. L. (2005). Evidence-based practices and students with

autism spectrum disorders. Focus on Autism and Other Developmental Disabilities. 20(3), 140-149.

Gentle Teaching, Floor Time – DIR Pet/Animal Therapy Relationship Development Intervention (RDI) Van Dijk Curricular Approach, Fast ForWord Cognitive Scripts, Cartooning, & Power Cards Irlen Lenses, Auditory Integration Training Megavitamin Therapy, Bariatric Chamber Feingold Diet, Herb, Mineral and other

supplements to Diet Music Therapy and Art Therapy

Source: Simpson, R. L. (2005). Evidence-based practices and students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities. 20(3), 140-149.

Facilitated Communication Holding Therapy

Source: Simpson, R. L. (2005). Evidence-based practices and students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities. 20(3), 140-149.

National Autism Center Report: The National Standards Project goals

1. Provide straightforward info to parents, educators and service providers that help to make treatment decisions

2. Create an evidence-based practice guideline for ASD that addresses some gaps in previous reports

3. Identify critical areas in which additional research is needed

4. Promote evidence-based practices in treating ASD

Behavioral Strategies are based on prompting, reinforcement, task analysis, & time delay.

Positive behavior supports are based on FBA, FCT, Stimulus Control, Response Interruption/ redirection, Extinction, Differential Reinforcement

Computer Aided Instr. Discrete Trial Training Naturalistic Interventions Parent-Implemented Peer-Mediated PECS Pivotal Response Tr.

Self-Management Social narratives Social Skills Training Structured work systems Video Modeling Visual Supports VOCA/Speech Generating

Antecedents (choices, prompting, etc.) Behavioral (function based treatment) Comprehensive Behavioral (ABA Lovaas, intensive

treatment – 25 hrs/wk, 9 mo/year) Interventions for young children (inclusive,

developmental preschool, etc.) Joint Attention Intervention

Modeling, imitation Naturalistic teaching Peer training Pivotal response treatment Schedules (visual, written) Self-Management (checklists, self-reinforcing) Story-Based Interventions

What are the problems, where can we find the solutions?

Once students with autism are successfully included in general education classes and can earn good grades, their problems are over.

FALSE. Employability and socialization continues to be a problem well into adulthood.

Students with autismStudents with autismPost-Secondary Activit iesPost-Secondary Activit ies

IDEA requirements are loosely implemented It is misunderstood that individuals with ASD are easily

employed Coordination is lacking between educational,

behavioral, mental health, vocational rehab., and MR/DD systems

Pervasive and inaccurate belief that ABA treatment ends with early adolescence or is no longer applicable to adults

“Appropriate, measurable post-secondary goals based on age-appropriate transition assessments related to training, education, employment, and, where appropriate, independent living skills.”

Begin no later than age 16 (age 14 ‘97) Student attends/participates in IEP

“Students with disabilities such as autism must be supported with training in communication, social skills, and employability skills through their transition years and beyond.”

Activity schedules and task analysis Provide visual supports Environmental modifications and/or provide

instruction in the appropriate use of idle time Provide clear and accurate directions Use prompting, shaping, and reinforcement

1. Prevalence rates for autism continue to climb2. Thimerosal did not cause autism, and a cause/cure has yet

to be discovered3. The autism spectrum covers five related disabilities that

affect (a) communication, (b) socialization, and (c) behavior4. Schools and communities will have to work collaboratively

to educate children with autism5. Recategorization of special education has not changed the

prevalence rate of children with autism6. Beware of advertised, controversial therapies7. With collaborative effort, adults with autism can be

successfully employed in the workforce.

cyoung@msubillings.edu(406) 657-2195