AUTISM SPECTRUM NEWS TM YOUR TRUSTED SOURCE OF SCIENCE-BASED AUTISM EDUCATION, WINTER 2014 INFORMATION, ADVOCACY, AND COMMUNITY RESOURCES VOL. 6 NO. 3 Using Technology to Enhance the Lives of Individuals on the Spectrum

The Pitfalls and Potential of Technology: A Guide for Parents and Professionals

Joshua John Diehl, PhD It is important to pay attention to the indi- W. J. Shaw Assistant Professor vidual. As a parent, educator, or therapist, University of Notre Dame you are looking for windows of engage- ment that provide an opportunity for social interaction. It is possible that a certain type apid advances in technology of technology might provide that window, over the past decade have led but only if the child shows an interest in to an overwhelming number of that particular app, game, or tool. If you products put on the market to are unsure about whether or not a partic- Rtreat Autism Spectrum Disorder (ASD). ular child might have an interest in a type The sheer number of products (from com- of technology, try to find opportunities to puter games to apps to robots!) can be in- “pilot” the technology before purchasing. timidating. Moreover, many product lines make enticing claims about what their Consider the Approach new technology can do. Technology pres- ents exciting possibilities, because many Before implementing an approach that individuals with ASD have an intrinsic uses technology with an individual with interest in or aptitude for technology. ASD, we must ask what the purpose of the Unfortunately, empirical studies of what technology will be. I often have seen the works, what doesn’t, and how new tech- purchase of a program/app/device precede nology should be implemented have not the development of a purpose for its use. kept pace with the technological advanc- To use an analogy, a 10 foot tall refrigera- es. What should we consider when deter- Find an Interest an individual has ASD that he or she will tor might look great in the store, but if you mining which technology is appropriate like a certain type of technology. The most can’t even fit it in your house, why would for our child, our client, or our student? I often hear “Individuals with ASD love consistent finding in research on the use of you purchase it? There are many potential Here I discuss three important factors, technology” or “Individuals with ASD technology with individuals with ASD is uses for technology, and some choices are discussed in order: 1) finding an interest, love robots.” As a researcher, I can say that there is considerable individual vari- simple. Is the purpose to provide an 2) considering the approach, and 3) se- that both of these statements are false. It ation, both in terms of interest in the tech- lecting the appropriate technology. is a mistake to assume that just because nology and in terms of response in therapy. see Guide on page 30

Scaling Inclusive Practices Through Technology

Jamie C. Pagliaro the years, at least in theory. Despite this districts are often limited in the amount ate support across the school day. Howev- Chief Learning Officer consistency, meeting the requirements of of follow-up they can provide after a pro- er, not all districts have implemented this Rethink LRE, creating a culture of inclusion, and fessional development session, due to the model as there may be challenges around ensuring staff and student success in this cost and availability of expert staff. philosophy (www.edutopia.org/blog/col- model of education continues to be a strug- laborative-team-teaching-challenges-re- hile the concept of “includ- gle for many school districts. Ensuring Ongoing Collaboration wards-marisa-kaplan) and other logistical ing” students with disabili- variables (e.g., not enough students with ties has only recently entered Disseminating Effective Practices Given the personalized nature of inclu- special needs in the same school building the collective consciousness sion, it would seem necessary to provide or grade level), and it is not necessarily ap- Wof educational reformers nationwide, it One of the most efficient ways for teachers with ample time to collaborate on propriate for all students with special needs is far from being a new fad or trend. The school districts to begin promoting in- individual student needs. Teachers often to spend their entire day in a general edu- Least Restrictive Environment (LRE) com- clusive practices is through profes- cite lack of planning time (www.forbes. cation classroom. Many students continue ponent of the Individuals with Disabilities sional development. Yet the traditional com/sites/erikkain/2011/03/08/high-teach- to be served primarily in self-contained Education Act (IDEA) has been a corner- stand-and-deliver nature of these sessions er-turnover-rates-are-a-big-problem-for- settings, or spend portions of their school stone of special education policy for nearly does not lend itself well to transforming americas-public-schools/) as a primary day in a resource room with specialized 40 years now. Mandating that, “to the max- teaching behavior. While didactic lecture challenge in education. Some districts support. In these models, it is less likely imum extent appropriate,” children with can be an effective way to improve staff have implemented collaborative team that teachers will have an opportunity to disabilities be educated alongside children knowledge of terminology and concepts, teaching models, which pair general and collaborate on identifying appropriate goals who are not disabled, while still receiving it does not typically impact staff perfor- special education teachers and students in or delivering interventions. In most cases, the supports and services they need to be mance in the classroom unless it is fol- the same classroom. This model offers an these duties fall to the special education successful, LRE has not, since it became lowed by activities such as performance exciting opportunity for teachers to mod- teacher, who may be operating independent law in 1975, been amended and is one of feedback, goal setting and self-monitor- ify traditional classroom routines, observe of the general education classroom. the few pieces of education policy that has ing (www.ncbi.nlm.nih.gov/pmc/articles/ student needs in a shared setting and cre-

remained relatively uncontroversial over PMC1986691/). Unfortunately, school atively problem-solve to provide appropri- see Inclusive on page 31

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Cindy Alterson, PhD, BCBA, Principal and Program Director Chairman Devereux Millwood Learning Center Dr. Peter D. Beitchman, DSW, LMSW, Chief Executive Officer Joel Bregman, MD, Medical Director and Director of Psychiatry The Bridge The Center for Autism Chairman-Elect Joseph D. Buxbaum, PhD, Director Jorge R. Petit, MD, President Seaver and New York Autism Center of Excellence Quality Healthcare Solutions Group Mount Sinai School of Medicine Vice-Chairman Susan M. Cortilet-Jones, MS, LMHC Barry B. Perlman, MD, Director, Department of Psychiatry Life Skills and College Coaching Specialist/Consultant Saint Joseph’s Medical Center Discovering Your World Secretary Stephen E. Freeman, Chief Executive Officer YAI Network Peg Moran, LMSW, Senior Vice President F●E●G●S Health and Human Services System Lynda Geller, PhD, Founder Spectrum Services, A Cooperative of Independent Treasurer Practices and Organizations, New York, NY Alan Trager, LCSW, Chief Executive Officer Westchester Jewish Community Services Ami Klin, PhD, Director Marcus Autism Center Members of the Board

Harold S. Koplewicz, MD, President Constance Y. Brown, MPA, Vice President, Community & Government Relations Child Mind Institute Institute for Community Living Carmen Collado, LCSW, Assistant Executive Director Cecelia M. McCarton, MD, Founder and Executive Director Jewish Board of Family & Children’s Services The McCarton Foundation The McCarton School (for Autism) Jonathan P. Edwards, LMSW, Training Specialist, Parachute NYC NYC Dept. of Health and Mental Hygiene Judith R. Omidvaran Parent Advocate, New York Alan Eskenazi, MA, CPHQ, CASAC, Vice President Quality Systems and Strategies ValueOptions, Inc. Theresa Pirraglia, Co-Founder and Board Member Donald M. Fitch, MS, Executive Director The Foundation for Educating Children with Autism The Center For Career Freedom John C. Pomeroy, MD, Founding Director Mary Hanrahan, LCSW, Government Relations Specialist Cody Center for Autism and Developmental Disabilities New York Presbyterian Hospital Stony Brook University Medical Center Joseph Krasnansky, LCSW, Vice President and Chief Program Officer Patricia Rowan, LMSW, Consultant and Advocate Lower Eastside Service Center Kid’s Connection Judith R. Omidvaran Parent Advocate, New York Pat Schissel, LMSW, Executive Director Asperger Syndrome and High Functioning Autism Association Debra Pantin, MSW, Associate Executive Director VIP Community Services Alison Singer, President Autism Science Foundation Theresa Pirraglia, Co-Founder and Board Member The Foundation for Educating Children with Autism Richard Swierat, Executive Director Janet Z. Segal, LCSW, Executive Vice President ARC of Westchester Four Winds Hospital Fred Volkmar, MD, Director Giselle Stolper, EdM, Executive Director Yale Child Study Center Mental Health Association of New York City

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Mental Health News Education, Inc. is not responsible for articles submitted to us without the final approval of the organization’s Executive Director, CEO, or Public Relations Department. All articles and Advertisements are subject to final approval by our Editorial Board. We reserve the right to edit any article sent to us. Letters to The Editor should only be sent to Autism Spectrum News and not to other publications. We do not publish open letters or third-party letters Letters for publication should be no longer than 150 words, must refer to an article that has appeared in our last issue, and must include the writer’s address and phone numbers. No attachments, please. We regret we cannot return or acknowledge unpublished letters. Writers of those letters selected for publication will be notified prior to press date. Letters may be shortened for space requirements. Send a letter to the editor by emailing: [email protected]. Copyright © 2014 Mental Health News Education, Inc. All rights reserved. Content contained in this publication may be reproduced for one-time personal use. However, anyone wishing to reproduce and distribute any content from within this publication for purposes other than personal use must request this intention in writing directly to the publisher. Failure to do so will be in violation of the copyright held by this publication. AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 3 Table of Contents

1 The Pitfalls and Potential of Technology 19 A Mom’s View: The Sex Talk vs. The You Have Autism Talk 1 Scaling Inclusive Practices Through Technology 20 ***Special Photo Spread*** 4 Two Studies Map Gene Expression Across Brain Development Over 100 Leaders Gather to Celebrate 4 Autism Science Foundation Announces Grant Recipients Autism Spectrum News’ First Annual Event! 6 NIH Study Finds Attention to Other’ Eyes Declines in Infants 22 Maximize Social Learning with Portable Tech & Video Modeling 6 Autism Speaks Awards iPads to 800 Individuals with Autism 23 B.F. Skinner’s iPhone: The Era of Technology-Enabled Clinicians 8 Augmentative Communication: Finding the Person “Trapped Inside” 24 The Importance of a Visual Schedule 9 The Ins and Outs of Technologically-Savvy Psychotherapy 25 Special Education and College Readiness 10 Providing Evidenced-Based Outcome Data to Make Better Decisions 26 Digital Storytelling Enhances Self-Expression 12 Developing Self-Reflection and Resilience in Adolescents 27 Robin’s Voice: Technology and Autism 13 Engaging Students with Autism Through Technology 28 Assistive Technology Need Not Be So Technical 14 Technology Opens Doors for College Students on the Spectrum 29 Building Skills in the Classroom with Smart Tablet Applications 16 “Twitter Speak” May Improve Communication with Your Teens 30 Letter to the Editor 18 Designing Databases to Drive Continuous Improvement for Clients 32 YAI Mourns the Loss of Thomas Dern

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Two Studies Map Gene Expression Across Brain Development

By Virginia Hughes heroic, in terms of the breadth and depth SFARI.org of what they’re going into,” says John Allman, professor of neurobiology at the California Institute of Technology, who ow that genetic studies have was not involved in either study. “They implicated several hundred represent just how incredibly difficult it is genes in autism, researchers are to address this stuff.” turning their attention to where andN when in the healthy young brain these Seed Genes genes are expressed. The first two studies to tackle these questions appeared on Novem- Geschwind’s team and others have pre- ber 21, 2013 in Cell. viously analyzed gene expression in post- One report, led by Matthew State at the mortem tissue from people with autism. University of California, San Francisco, A downside of that approach is that most analyzed nine genes that sequencing stud- of that tissue comes from adults, and none ies had strongly linked to the disorder1. from anyone younger than 2 years old. These genes tend to be expressed together In contrast, both new studies tapped into in certain layers of the cortex in the fetal BrainSpan, an online database of gene ex- brain, the study found. pression data from more than a dozen brain The second study, led by Daniel regions across the full span of human brain Geschwind at the University of Califor- development, from prenatal stages through nia, Los Angeles, took a broader approach, infancy, adolescence and adulthood. The looking at the expression patterns of hun- resource pulls from postmortem tissue dreds of autism-linked genes2. Some of opment, and for the function of neurons says. “The themes that are emerging from studies done by several nonprofit, govern- these genes tend to be expressed togeth- that produce the chemical messenger these analyses are very, very resonant with ment and academic groups. er in networks related to the workings of glutamate. These so-called ‘glutamater- each other. It’s a good thing when that hap- State’s team searched this resource for the synapse, or junction between neurons. gic neurons’ mediate excitatory signals pens in biology.” genes that had passed a high threshold of Other networks are involved in turning in the brain. Still, the research reveals a complex mix statistical confidence in whole-exome se- genes on or off. “It’s remarkable that, despite these huge of networks, time periods and cell types in- quencing studies — which sequence the Despite using different methods, both differences in how we approached the prob- volved in autism, underscoring the notori- protein-coding portions of the genome — studies found clusters of autism genes lem, we converged on the same time period ous heterogeneity of the disorder. that are important during mid-fetal devel- and on glutamatergic neurons,” Geschwind “Both of these studies are, in a sense, see Brain on page 31

Autism Science Foundation Announces 2013 Research Enhancement Grant Recipients

By The Autism Science Foundation funded by Dr. Kevin Pelphrey’s center. This ing children. It will also inform the design This study builds on a finding during Hi- funding will add an additional cohort of of future interventions with deaf and hard- gashimori’s Autism Science Foundation girls and will focus on the sex-based differ- of-hearing children with ASD. Post-Doctoral fellowship. n November 12, 2013, the Au- ences in neural response to treatment, which tism Science Foundation, a not- is not included in the current NIH funding. Cross-Modal Automated Assessment of Partners in Schools: A Program for Parents for-profit organization dedicat- Behavior during Social Interactions in and Teachers of Children with Autism ed to funding autism research, Use of Real Time Video Feedback to Children with Autism Spectrum Disorder Dr. Gazi Azad/University of Pennsylvania Oannounced the recipients of research en- Enhance Special Education Teacher Training Dr. Adam Naples/Yale University hancement mini grants. These grants are in- Dr. Jessica Suhrheinrich/University Funds will provide financial incentives tended to enable researchers to expand the of California at San Diego This grant supports implementation of for urban, public school parents and teach- scope or increase the efficiency of existing hardware to monitor a child’s facial ex- ers to participate in a study testing a new grants, or to take advantage of changes or Funds will be used to purchase iPads pression, gaze, speech, and posture during paradigm to improve parent-teacher com- findings that have occurred in or around for teachers to enable real-time feedback recording of neural activity in Dr. James munication about evidence-based inter- the project that warrant more funding. Six during a study implementing classroom McPartland’s lab. This technology will ventions. This project will result in a new projects were selected for funding. based Pivotal Response Training in pre- enable simulation of interpersonal inter- culturally sensitive tool for communication “Our goal with this funding mechanism is school through fifth grade special educa- actions based on a child’s verbal and non- improvement, which is the first step in fos- to speed up the pace of research and remove tion classes. This is significant because this verbal behavior. This study will investigate tering family-school partnerships for chil- research obstacles” said ASF president Ali- study will focus on teachers who were not the brain mechanisms of multimodal recip- dren with autism. son Singer. “We want researchers to be able previously able to master PRT. rocal social interaction for the first time. to move quickly when they’ve made the The Autism Science Foundation is a kind of breakthrough that just needs a bit The Effects of Autism on the Sign Role of Astrocytic Glutamate Transporter 501(c)(3) public charity. Its mission is more funding to exploit rapidly”. Language Development of Deaf Children GLT1 in Fragile X Syndrome to support autism research by providing The following projects were selected for Dr. Aaron Shield/Boston University Dr. Haruki Higashimori/Tufts University funding to scientists and organizations enhancement grant funding: conducting autism research. ASF also pro- This grant will expand the control group This grant will allow for promising new vides information about autism to the gen- Sex Differences in the Neural of typically developing deaf children to discoveries in mice with Fragile X Syn- eral public and serves to increase aware- Mechanisms of Treatment Response compare to deaf children with ASD. Find- drome to be tested on human brain tissue ness of autism spectrum disorders and the Dr. Pam Ventola/Yale University ings from this study will inform the even- samples. This is significant because it will needs of individuals and families affected tual adaptation of the Autism Diagnostic bridge their findings from rodent models by autism. To learn more about the Autism This grant will support a 16-week Pivotal Observation Schedule and other instru- to humans and help further validate a new Science Foundation or to make a donation Response Treatment trial to expand work ments for use with deaf and hard-of-hear- therapeutic target for Fragile X and autism. visit www.autismsciencefoundation.org. AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 5 PAGE 6 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014 AUTISM SPECTRUM NEWS DESK

NIH Study Finds Attention to Others’ Eyes Declines in 2 to 6-Month-Old Infants Later Diagnosed with Autism

By The National Institute er sibling already diagnosed with autism; of Mental Health (NIMH) those in the low risk group did not. Jones and Klin used eye-tracking equip- ment to measure each child’s eye move- ye contact during early infancy ments as they watched video scenes of a may be a key to early identifi- caregiver. The researchers calculated the cation of autism, according to a percentage of time each child fixated on study funded by the National In- the caregiver’s eyes, mouth, and body, as Estitute of Mental Health (NIMH), part of well as the non-human spaces in the im- the National Institutes of Health. Published ages. Children were tested at 10 different this week in the journal Nature, the study times between 2 and 24 months of age. reveals the earliest sign of developing au- By age 3, some of the children—nearly tism ever observed—a steady decline in at- all from the high risk group—had received tention to others’ eyes within the first two a clinical diagnosis of an autism spectrum to six months of life. disorder. The researchers then reviewed “Autism isn’t usually diagnosed until the eye-tracking data to determine what after age 2, when delays in a child’s so- factors differed between those children cial behavior and language skills become who received an autism diagnosis and apparent. This study shows that children those who did not. exhibit clear signs of autism at a much “In infants later diagnosed with autism, younger age,” said Thomas R. Insel, M.D., we see a steady decline in how much they director of NIMH. “The sooner we are able look at mom’s eyes,” said Jones. This drop to identify early markers for autism, the in eye-looking began between two and six more effective our treatment interventions however, do not exhibit this sort of inter- of the Marcus Autism Center, Children’s months and continued throughout the course can be.” est in eye-looking. In fact, a lack of eye Healthcare of Atlanta, and Emory Univer- of the study. By 24 months, the children lat- Typically developing children begin to contact is one of the diagnostic features of sity School of Medicine followed infants er diagnosed with autism focused on the focus on human faces within the first few the disorder. from birth to age 3. The infants were divid- caregiver’s eyes only about half as long as hours of life, and they learn to pick up To find out how this deficit in eye-look- ed into two groups, based on their risk for did their typically developing counterparts. social cues by paying special attention to ing emerges in children with autism, War- developing an autism spectrum disorder. other people’s eyes. Children with autism, ren Jones, Ph.D., and Ami Klin, Ph.D., Those in the high risk group had an old- see Eyes on page 30

Autism Speaks Awards iPads to 800 Individuals with Autism Pilot Study Showed Their Effectiveness on the Communication Skills of Individuals with ASD

By Ali Waters improve the communication and language Content Manager skills of the recipients and expand oppor- Autism Speaks tunities for them at school and in the com- munity as a result.”

n December 9, 2013, Autism Testimonials Speaks donated iPad 2’s to 800 financially disadvantaged indi- In 2012, Autism Speaks donated 830 iP- viduals with autism, as well as ads bringing the total to date to 1,630. Tes- Oteachers and social workers who work in the timonials from last year’s recipients and autism community with individuals in need. their parents reflected the profound impact After the iPad grant application was an- the devices had on their loved one’s com- nounced in November, Autism Speaks re- munication skills and behavior. ceived more than 16,000 applications for “This is only my son’s second week of iPads. Thanks to generous donations from school using it, and already the difference Sevenly.org, Wyndham Worldwide, the has been amazing,” said the mother of a Geier Foundation, the James Walter Pickle nine-year-old recipient. “Using the fun, ed- Charitable Foundation, the Boston Bruins ucational apps, he has been able to demon- Foundation, the Agarwal Foundation and strate to his teachers that he knows his al- Jonathan Izak, the organization mailed 800 phabet, numbers, shapes, colors, and many iPad 2s to individuals in 46 states between other concepts. What a difference! Before, the ages of four and 60-years-old. Each A brother and sister proudly hold their iPad from Autism Speaks he would get frustrated, upset, refuse to iPad came with a unique Autism Speaks even attempt, and sometimes have melt- Kraken A.M.S. case from Trident Case, downs when faced with the dreaded paper as well as a free download code for Brain status, his or her age and verbal ability, and individuals with autism have had with worksheet. Now, not only is he completing Parade’s popular app See.Touch.Learn Pro, most importantly, the applicant’s response iPads,” said Lisa Goring, Autism Speaks more work - he’s having fun doing it! The which usually costs $39.99. to how the person would use the iPad and vice president of Family Services. “We possibilities for learning are endless, and Review committees thoroughly re- how it would change his or her life. were thrilled to be able to provide 800 iP- best of all - he’s loving it!” viewed each applicant’s unique situation in “The 16,000 applications we received ads to financially disadvantaged individu- terms of the individual’s family’s financial are a real testament to the success that als. It is our hope that these devices will see iPads on page 34 AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 7 PAGE 8 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

Augmentative Communication: Finding the Real Person “Trapped Inside”

By Maegan Meneses, MA, CCC-SLP Queens, N.Y. “He pointed to his mouth, as Speech Language Pathologist we tried to figure out what he was trying to YAI Center for Specialty Therapy say,” Bouvin said. “‘Are you hungry?’ Af- ter 20 minutes, we finally figured out that he had to go to the dentist. Jerry was so ex- erry, a young man with autism, ap- cited that we understood. He is extremely proached two women in the waiting motivated to communicate.” area. He pressed a button on his aug- When I first met Jerry, he would often mentative communication device and write a word down to convey if he wanted Jsaid, “Good morning. It’s nice to meet you.” something or attempt to produce 1-2 word Thanks to a Nova Chat 7 communica- utterances, but that was clearly not a func- tion device, Jerry, 22 (note: he turns 23 on tional means of communication for him. 1/22/14), has a voice for the first time and He frequently perseverated on different he’s proud that people can easily under- topics. But we didn’t know the full extent stand what he has to say now. of his literacy and his understanding of As a Speech-Language Pathologist, I more complex language. work with children, adolescents and adults Jerry’s world, as well as ours at YAI’s with a variety of communication deficits AAC Center, all changed about a year ago and who typically struggle to interact so- during a speech and language evaluation in cially. I was initially inspired to pursue Kew Gardens. speech-language pathology by observing a During the evaluation, I asked him his family member with autism and the prog- favorite TV show. He just stared blankly at ress he made throughout his childhood. My me. I wasn’t sure if he didn’t understand mother, a nurse practitioner, also suggest- the question or simply couldn’t communi- ed that I enter this field while I was in my Maegan Meneses works with Jerry on his Nova Chat 7 at cate his answer. He saw my iPad on a near- early years of college, as she works with by table and he opened it up and typed in many speech therapists in the hospital and YAI’s Augmentative & Alternative Communication Center “Laverne and Shirley Show.” I knew at that understands my desire to work with and moment that Jerry was capable of so much help people. of these individuals as possible with the My colleague Rachel Bouvin, Super- more than we had imagined, and I knew at More than 3.5 million Americans cannot means to communicate so they can interact visor of Rehabilitation Services at YAI’s that moment that he needed an augmenta- rely on their natural speech to meet their with peers, family members, and staff. This Center for Specialty Therapy, clearly re- tive communication system. daily communication needs (Beukleman & also enables them to more fully participate calls the day when Jerry was trying to Jerry is one of many individuals who has Mirenda, 2005). Our goal here at the YAI in school, at home, and work, while helping make himself understood. been evaluated at the program, which began Augmentative and Alternative Communi- them establish and maintain social relation- He guided her to the supervisor’s of- cation (AAC) Center is to provide as many ships, and meet their own personal needs. fice at our Kew Gardens Day program in see Real Person on page 33

We don’t raise grades. We raise expectations.

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The Ins and Outs of Technologically-Savvy Psychotherapy

By Alyson H. Sheehan, PhD and providers alike have been drawn to the and Shana Nichols, PhD possibility that electronic communication ASPIRE Center for may be a forum for facilitating therapeutic Learning and Development growth without leaving home. At the same time, the gains obtained in psychotherapy have a long-standing link to the interactions hen the parents of a bright, 7 between client and therapist. Can the goals year-old girl were informed of therapy possibly be reached through a that their daughter’s de- computer screen? Moreover, how can regu- lays in social and emotion- latory organizations and insurance compa- Wal development were likely indicative of nies keep pace with these alternative tech- Autism Spectrum Disorder (ASD), they nological approaches to therapy? responded in a manner similar to many Continually expanding research and prac- other parents who have received such tice in teletherapy has directly sought to news. They began seeking medical and answer these questions. Interventions and developmental specialists to obtain com- studies are primarily aimed at clarifying the prehensive information and appropriate, means by which technology can enhance individualized treatment to address their participation in psychotherapy without ne- daughter’s unique needs. Her meltdowns gating its fundamental tenets (Bischoff et and anxiety about change were beginning al., 2004; Hill et al., 2001; Oliver & Demiris, to interfere greatly with her ability to par- 2010). The American Psychological Associ- ticipate at school. Unfortunately, these ation recently released guidelines for tele- parents quickly learned that the provid- Alyson H. Sheehan, PhD Shana Nichols, PhD therapy practice, and some state licensing ers available around the small city where boards have begun to publicize their expec- their family resided had little, if any, ex- Technology’s rapid advancement has culties to interpersonal relationships. How- tations for licensed providers (APA, 2013). perience in working with such difficulties. vastly impacted the process of planning, ever, the movement towards computeriza- A brief review of informational materi- Their frustration intensified as a series of seeking, and participating in services that tion across mental health services has led als illustrates the varied terminology used phone calls and internet searches revealed foster optimal everyday functioning, such to a controversial, yet inevitable, shift. to describe computer-based therapy. Al- that ideal services for their daughter did as the concerns presented in the scenario The past decade has been characterized though we use “teletherapy” for the pur- indeed exist – just not in a location that above. Among the range of diverse sup- by a push to make therapeutic services in- poses of this article, interchangeable or was plausibly accessible to their family. ports that individuals on the autism spec- creasingly accessible, universally afford- related approaches may be referred to as How could they possibly secure efficient trum and their families may seek, psycho- able, and, especially for individuals with telepsychology, tele-mental health, remote and effective treatment for their daugh- therapy is a valuable tool for addressing ASD and social learning difficulties, less treatment, videoconferencing, online ter without disrupting the entire family’s short- and long-term concerns ranging characterized by stigma and general dis- functioning? from school struggles to emotional diffi- comfort. Consequently, therapy seekers see Psychotherapy on page 33 PAGE 10 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

Using Technology to Provide Evidenced-Based Outcome Data to Make Better Decisions

By Barry Katz found them insufficient. Traditional • Providing a consistent, simple and CEO electronic solutions required staff to powerful tool across disciplines Operant Systems, Inc. report behaviors through PC interfac- es—which meant that much reporting Increase Volume of Reliable Data - had to wait hours or more, until staff Because staff can now record data chools, provider agencies and had the opportunity to transcribe data more quickly, easily, and promptly, parents are concerned with from their binders. Analysis, too, was they’re recording more of it. The vol- looming cuts in special educa- often confined to client-server systems ume of recorded behaviors immediate- tion services. Schools, provid- that limited the flexibility with which ly available for analysis has increased Ser agencies and parents are looking to clinicians could use them. by 60 percent, fueling faster and bet- become more efficient and effective In contrast, TeachMe Skills brings ter analyses, and better refinements in with their programs. The Devereux together mobile technologies that ad- treatment plans. School of NY has meet the challenge dress the shortcomings of traditional by partnering with Operant Systems’ solutions. Devereux New York staff Gains Consistent Reporting, Analysis TeachMe Skills ,a mobile and web record behaviors as they happen, using from Across the Enterprise - The chil- technology, that aids them in the plan- any mobile devices that they carry with dren in our school programs may be ning, observing, recording, analyzing them. A set of various behaviors make campus residents, day-program clients, and modifying a student’s progress. it easvisualy, even intuitive for staff to ICF participants, or any combination. The process began with John O’Keefe, learn and use the TeachMe Skills App. For the first time, Devereux New York the Executive Director of the Devere- Staff professionals—including speech assembles comprehensive reports and ux School of NY asking some funda- and language teachers, physical and analyses that cover a child’s experi- mental ‘How’ questions about their Barry Katz occupational therapists, the special-ed- ence across these environments. program. As a consummate leader he ucation staff—also use the app to doc- asked his staff, how can we; Business Needs ument their provision of services. Successfully Treats “More Intense, Behavioral data is hosted “in the More Problematic” Children - The • Provide evidenced-based outcome There are too many children who will cloud” by Operant. Clinicians analyze school now successfully treats children data that demonstrates the effec- never realize their parents’ hopes for the data using a TeachMe Skills mobile with issues that are “more intense, more tiveness and the efficiencies of our them, due to debilitating combinations and web interfaces with graphs and problematic,” than previously, accord- educational and clinical services? of developmental delays, and psychiat- charts that show the severity and fre- ing to O’Keefe. That success is based ric and behavioral disorders. Yet other quency of monitored behaviors. They in part on the more in-depth analyses • Increase productivity in adminis- children, similarly afflicted, will go on conduct these analyses from anywhere, and closer tracking of client progress trative services? to lead fulfilling and rewarding lives. at any time, either with an Internet con- that clinicians gain with TeachMe. It’s But for Devereux New York, increas- nection. also based on the greater time that staff • Reduce the preparation time to ing challenges threaten another type of Clinicians use their analyses to help spends with clients, time previously collect all students’ data before an disablement. The number of children decide whether each child’s treatment consumed in administrative chores. audit? diagnosed with autism, for example, plan is proving effective, and to make has doubled in a decade, creating un- changes to those plans—for example, Makes Better, Fuller Use of Remote • Obtain staff buy-in to effortlessly precedented demand for limited ser- changing behaviors to be monitored or Care Settings - Devereux New York collect and manage educational vices. Meanwhile, those services have skills to be learned. Those changes are opened four ICFs in the past year, a and clinical data? become more expensive to provide, at immediately sent over the web to the major expansion for the school, in part a time when funding for them has be- Windows Phones of the relevant staff because it is better able to identify chil- • Reduce negative behaviors and in- come increasingly scarce. members. dren from its residential and other pro- crease students’ positive behaviors? That’s the context in which Devere- grams who are likely to thrive in the ux New York uses applied behavioral Benefits small-scale, community-based setting, • Track progress towards assessment analysis to treat its clients, especially and because it can better monitor and goals? those with autism. The technique dis- John O’Keefe declares the solution assess their progress. courages specific negative behaviors, a success for his staff, his school, and, • Use existing technology as well as rewards specific positive ones, and most importantly, the children under Monitors, Evaluates Staff More Effec- mobile technology? continually refines the treatment pro- their care by: tively - Administrators use TeachMe gram based on each child’s progress. to assess how thoroughly staff mem- • Reduce audit risks? Applied behavioral analysis depends • Recording timely data bers track behaviors and implement upon a massive, virtually continuous the treatment plan for each child under • Reduce staff turnover and increase collection of behavioral data for clini- • Enabling staff to record data at the their supervision—giving administra- staff satisfaction? cians to analyze. That data comes from right time and the right place tors a new and highly useful tool with staff who both work with the children which to evaluate staff performance. • Gain parent support and accolades? and lug around binders and clipboards • Increasing a student’s positive be- to record their behaviors. Behaviors haviors while decreasing negative The Devereux School and its staff Devereux of New York, who serves could go unreported, or reported inac- behaviors are prepared for the challenges of de- special-needs children with autism, curately, inconsistently, and tardily. livering there services in a more cost severe disabilities, and disorders has • Reducing risk of litigation by pro- effective and efficient manner using teamed up with Operant Systems mo- Solution viding reliable data the proven track record of Operant bile/web technology TeachMe Skills Systems’ TeachMe Skills. to serve more children more effective- John O’Keefe, Executive Director • Reducing administrative work for ly than it could before. With more ex- of Devereux New York, discovered staff For more information about Operant tensive, timely, and accurate clinical TeachMe Skills from Operant Systems. Systems’ TeachMe Skills, visit www. data, Devereux can now better ana- While electronic systems for the col- • Enabling clinicians, psychiatrists operantsystems.com, email support@ lyze client progress and modify treat- lection and analysis of behavioral data and teachers to make more effec- operantsystems.com, or call 305-771- ment plans. had long existed, O’Keefe had long tive decisions. 3124. AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 11

Plan goals based on standard assessment tools e.g. ABLLS, VB_MAPP, Pearson Vineland, Brigance, Goldman-Fristoe Test of Articulation, CELF-4 Language Evaluations, etc.

Observe the progress towards a child’s or adult’s goals

Record skills acquisition and behavior intervention data

Analyze session and progress reports/graphs with your educational, clinical and administrative team

Modify educational and clinical goals in a timely and reliable manner using a mobile device

www.operantsystems.com

TeachMe records data both in a one-on-one & group settings and generates billing information. Patent 8,182,267. -Version 1.0.48 PAGE 12 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

Developing Self-Reflection and Resilience in Adolescents with Asperger’s Syndrome and High Functioning Autism

By Dorothy Lucci, MEd, CAGS into our instructional methods. Our ado- triggers and relaxation techniques among Program Director lescent programs use a curriculum we de- others. After designated periods and multi- Aspire/Massachusetts General Hospital veloped called the Science of Me (Lucci, ple times during the day, participants rated D., Levine, M., McLeod D.S., and Chal- themselves in these areas as did staff. Both len-Wittmer, K., 2013). In this curriculum sets of data were uploaded to the web, syn- ome key ingredients to success we incorporate two pieces of technology chronized and then printed and reviewed as an adult in college or in work as an integral part of instruction: a web during social groups. A visual graph/chart are: self-awareness, self-reflection, and mobile based software system, Sym- was printed that included a comparison stress-management, social com- trend™ and a stress-management tool de- of staff/teen plotted together on the same Spetence, and resilience. This is true for veloped by HeartMath called emWave™ page. This allowed for discussions of per- everyone with and without disability. It along with HeartMath’s curriculum The sonal data and reflection by each partici- would be fabulous if we could eliminate Inside Story. pant about themselves as an individual and stress from all our lives; however stress is Symtrend’s™ web-based and mo- as a member of a group. Many teens with a part of life, a part of everyone’s life so bile-based technology system can be used and without an ASD diagnosis may be ret- developing stress management and resil- for a variety of purposes: behavior analy- icent to participating in these discussions. iency is a critical life skill. At Aspire/MGH sis, outcome measurement, data manage- Our participants did not view the feed- we believe the earlier in a person’s life we ment, self management, team communi- back, even if “negative,” as emotionally begin this training the better prepared our cation, and coaching/direct instruction triggering. Our hypothesis is they were in- participants will be for adult life. Our three (Levine, M., 2013). In our work we used trigued by “seeing” their data “concretized core areas of focus: self-awareness, social it primarily as a data collection tool and and objectified.” It allowed more honest competency and stress-management are an instructional tool for self-reflection, discussions and we found that by using addressed in all programs and they serve self-awareness, social competency and Symtrend™, teens’ self-awareness of their as the backbone of all of our instruction stress management. Symtrend™ has the feeling states, cognitive flexibility, stress and consultation. We serve individuals capacity for individualization which al- awareness and management improved as from the age of five to thirty in a variety of lowed us to author our own screen content did their social behavior as it related to oth- programs including social groups, summer Dorothy Lucci, MEd, CAGS which mapped onto our Science of Me ers. Our data also suggested that teens used camp, summer teen explorations, intern- curriculum and the Inside Story. the visual graphs to describe their internal ships, college mentoring and consultation High Functioning Autism (HFA) well. Each participant and staff person utilized states and broaden the neurotypical per- and professional development. Focusing Given that many individuals with AS an Apple iPod Touch with Symtrend™ son’s perspective of individuals with ASD. on these three competencies and utilizing and HFA are visual learners, enjoy technol- uploaded onto each device. Our screen During a discussion, a staff member rated a a strengths based approach as well as a ogy and are generally concrete, sequential content included: feeling states, attitude, teen as “not part of the group” and the science based approach serves our partic- learners we made the deliberate decision cognitive flexibility, group participation, ipants with Asperger’s Syndrome (AS) and to incorporate these learning preferences social thinking, anxiety, stress level, stress see Developing on page 34 AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 13

One School’s Experience Engaging Students with Autism Through Technology

By Amanda Coons, MS, BCBA, data, record conversational samples, moti- Rebecca Stanmyer, BS, CCC-SLP vate students, and improve receptive, ex- and Kathleen Marshall, BA, MA, SAS pressive and pragmatic language skills in Anderson Center for Autism addition to being used as an augmentative assistive communication device. At ACA, iPads are used by speech lan- ducators, clinicians, therapists guage pathologists within therapy ses- and other professionals contin- sions on a daily basis. They are used in ue to look for new ways of using a direct-teaching approach as well as in technology to benefit students naturalistic settings to motivate students, Ewith autism. Video modeling to teach so- and promote independence in language cial or self-regulation skills, individual- learning and communication. Using iPads, ized computer-assisted instruction, and therapists are able to play videos and mu- augmentative communication devices are sic, allow students to play popular games widely utilized interventions. School pro- and search topics of interest without mov- grams can be overwhelmed when consid- ing from the instructional site (desk/table), ering technology options for students on minimizing interruptions and providing the spectrum. Cost, accessibility, identi- immediate reinforcement. As time pro- fying and measuring student outcomes, gressed, numerous applications for lan- teacher/therapist training, and adult and guage development and topics were incor- student “buy-in” are just a few of the areas porated including cause and effect, literacy, to be considered. written language, social stories and prag- Located in Staatsburg, New York, An- Amanda Coons, MS, BCBA, Rebecca Stanmyer, BS, CCC-SLP, matic language skill building. Children are derson Center for Autism’s residential taught prerequisite skills for communica- school serves students on the autism spec- and Kathleen Marshall, BA, MA, SAS tion (matching, motor imitation and verbal trum. As in any school setting, Anderson imitation) as well as turn-taking, appropri- Center for Autism (ACA) administrators with autism while others have chosen to erful tool for autism treatment and the ate play and social attention to partners, all and staff are continually looking for ways utilize computer-assisted instruction for all broader speech pathology and special ed- using different applications geared toward to motivate students and positively impact or parts of the instructional day. ACA iden- ucation fields. “Advances in technology students with autism. Therapists love the learning outcomes. In recent years, a myr- tified three areas important to our student afford new opportunities for both facilitat- new tool and the students seem to thrive iad of technology options have become population where various technology op- ing language learning and exploring addi- with the use of this technology. available and their use with students on the tions could have positive outcomes. These tional dimensions of instruction” (Romski However, the most talked about features spectrum has received a great deal of atten- areas included: communication training, & Sevcik 1997). Many educational appli- of an iPad for a person with autism continue tion. Some schools quickly transitioned to group instruction and play skills. cations can easily be incorporated into the using tablets such as iPads for all students IPads were identified quickly as a pow- therapy setting and can be used to collect see Engaging on page 38 PAGE 14 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

Technology Opens Doors for College Students on the Spectrum

By Dana R. Reinecke, PhD, BCBA-D ful for students who have difficulty work with peers in a variety of ways – real Assistant Professor and Chair getting started writing, but can talk time, asynchronous, and at-a-distance – Center for Applied Behavior Analysis about the subject more easily. This and often serve as a bridge to more sponta- The Sage Colleges application allows students to speak neous, face-to-face interactions. into a microphone and converts their Finally, students with autism are often speech to text that they can then edit more successful when their learning envi- ndividuals with autism spectrum dis- into a written product. ronment is simplified. This includes being orders are entering college in increas- consistent, limiting changes or surprises, ing numbers (USDOE, 2011). These • Offer more frequent, lower-stakes clearly broadcasting all expectations (in students may benefit from the many tests to alleviate test anxiety. Offering both audio and text formats), and using Iopportunities enjoyed by non-disabled col- a weekly five-question quiz is much stable patterns. For example, having work lege students, but they may also find college less stressful for most students than always due on the same day of the week; much more challenging. Disability services one 50-question exam at the end of a providing reminders; and using consistent mandated by ADA such as preferential 10-week semester. visual supports (such as notes on yellow seating, notes provided, tape-recorded lec- paper and assignments on green) are sim- tures, alternate setting, and extended time • Explore alternative formats for quiz- ple ways to support students with autism. for exams may be helpful (Andreon & Du- zes such as SurveyMonkey links and Once again, technology provides helpful rocher, 2007). These accommodations may smart phone polling apps such as Poll methods for adopting these strategies. not provide enough support for students on Everywhere, which may also be less the spectrum, however, as these individuals stressful for students. • Word processing and presentation pro- can be challenged in many areas. grams allow teachers to reuse templates Autism is associated with difficulties in Dana R. Reinecke, PhD, BCBA-D Another important way to support col- throughout a course for consistency. sensory processing and executive function- lege students with autism is to apply the ing, as well as learning differences and lan- tism spectrum are resistant to being treated principles of shaping, or the process of • Students with autism can be encour- guage and social skills deficits (Andreon & “differently.” And alternative assessments gradually shifting expectations to maintain aged to use technology to provide Durocher, 2007). Each individual with au- need to be equivalent, fair, and meaningful. a consistent level of success, ultimately automatic prompts and reminders for tism presents with a variety of challenges Technology can help overcome the chal- resulting in the establishment of new skill themselves, by setting calendar alerts across these areas, and has a unique pattern lenges of incorporating choice strategies sets. Instructors can apply shaping at the on their smart phones, and teachers of strengths and weaknesses. This means into classes. Alternative forms of content college level by providing frequent assess- can use programs like Remind 101 to that to the greatest extent possible, support delivery do not need to be fancy, they just ment, clear and specific feedback, oppor- send out text messages to the class to must be customized to individual needs to need to be made available to students who tunities to revise work based on feedback, keep everyone on track. best help college students on the spectrum. need them. and assignments that build in complexity. The ongoing proliferation of technologi- These strategies can be time-consuming • Clip art and photographs available on- cal advancements makes such individual- • Choose textbooks available in both au- for teachers and are often based on written line can be used as icons and symbols ization increasingly possible. See Mull & dio and text formats. If a book doesn’t feedback, which can be difficult or confus- as additional visual supports. Sitlington, 2003 for a review of literature have an audio format but can be read ing for students. Once again, technology on the use of technology to support post- on an e-reader, there may be the option provides solutions. While there are challenges for students secondary students with disabilities – and to convert to audio. with autism spectrum disorders who enter remember that technology has come a long • Offer frequent online quizzes that can college, there are also many solutions that way in the past 10 years. • Encourage students to create their own be automatically graded. Most col- can easily be implemented by instructors One key support is to provide choices in audio content for later listening by al- leges have a learning management using available technology. The strategies content delivery. If students are presented lowing them to record lectures and system, or LMS, in which instructors described in this article are all used in The with a variety of learning experiences, they class activities with smart phones. (even of face-to-face courses) can set Sage Colleges’ Achieve Degree program, can choose their most effective strategies. up question banks and offer quizzes which is a true bachelor’s degree designed Traditional college teaching strategies of- • Record classes and make them avail- that provide immediate feedback with- specifically for students on the autism ten involve assigning readings and then able to students for repeat listening out instructor intervention. Though spectrum. The Achieve Degree is a fully lecturing on selected aspects of the read- and viewing by posting them to You- time-intensive to set up, this proves online program, but these suggestions are ings – or on entirely different material. Tube, on public or private channels. extremely efficient in the long run. equally applicable in traditional face-to- Students with autism who are limited in face or hybrid settings. Students with au- their abilities to process different types of • Make lecture notes and PowerPoints • Set up gradebooks in the LMS to pro- tism in any college program can be more information could miss out on a lot with available for students who rely on vide students with continuous feed- successful given the proper support, and this strategy. Even simple information like written formats for most of their learn- back on their progress. In the absence technology solutions have made those sup- instructions for assignments and teacher ing. Cloud services such as Dropbox of a LMS, share spreadsheets through ports more easily available. and peer introductions may be difficult to and Google Drive provide multiple ac- Google Drive or Dropbox to keep process. Often, this information is only cess points so students can customize students updated on their grades and To learn more about the Achieve Degree shared verbally, so students who struggle their experience. progress. online bachelor’s program at Sage, visit with auditory processing are at a disadvan- www.sage.edu/achieve, e-mail achieve@ tage. Providing written as well as verbal Choices of assessment can be offered • Utilize screencasting and record- sage.edu or call (855) 509-6607. instructions may be the best solution for by providing flexibility in the format of ing programs such as Audioboo and these students. deliverables. Screencast-O-Matic to deliver audio References Choice of assessments can also be help- feedback for students who are stronger ful to students with autism. Some express • Allow students to demonstrate their listeners than readers. Adreon, D., & Durocher, J. S. (2007). their knowledge and demonstrate mastery of understanding of content verbally. Evaluating the college transition needs of material verbally, while others do better in Services such as Audioboo allow for Students with autism benefit from flex- individuals with high-functioning autism writing. Some students with autism can be free recording and sharing so that stu- ibility, especially when confronting social spectrum disorders. Intervention in School extremely anxious about tests, or lack cer- dents can submit audio essays to fulfill challenges. Instructors can change the way and Clinic, 42(5), 271-279. tain test-taking abilities like staying on task certain assignments. group and partner work is handled, but or managing their time, making testing an eliminating collaborative experiences for Mull, C. A., & Sitlington, P. L. (2003). The ineffective way to truly assess their learning. • Give students who struggle with long students with autism is not a good solution role of technology in the transition to post- Offering choices can involve a tre- writing assignments the option of long-term. Instead, instructors can take secondary education of students with learn- mendous amount of extra work for the producing a PowerPoint or Prezi that advantage of the plethora of technological ing disabilities: A review of the literature. The instructor to prepare and update content highlights and describes the important options now available for social network- Journal of Special Education, 37(1), 26-32. and assessments in different formats and information in an outline format. ing. Skype, Facebook, Twitter, and e-mail modalities. Choices should be offered are just a few ways in which students with USDOE. (2011). http://www2.ed.gov/about/ carefully, because some students on the au- • Software such as Dragon can be help- autism can more comfortably interact and offices/list/ocr/transition.html AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 15 PAGE 16 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

The Technique of “Twitter Speak” May Create More Effective Communication with Your Teens

By Beth Yurman, PsyD or avoiding the conversation altogether. begin to justify reasons as to why none of Licensed Psychologist Twitter is a social network that was cre- your concerns should be concerns, and dis- ated to allow its users to “tweet” or speak miss the conversation. Once this becomes in very short, succinct phrases that convey a pattern, your child may begin to avoid all witter Speak.” What is it and the user’s thoughts/feelings/emotions. The conversation. A question such as, “what “ how will it help communication idea behind Twitter is that viewers receive did you do at school today?” might yield with your teenager progress more the most pertinent information, without the reply, “nothing” from your child on a smoothly? If you are a parent who any added detail. “Twitter Speak” is the daily basis. Thas ever been confronted by your child real life application of the term “tweet.” Just as public school curriculum is often responding with short, disinterested com- “Twitter Speak” can be a very useful tool “chunked” in special education classes so ments when you attempt having what you to use when conveying important informa- that material is broken down and becomes believe to be a “regular” conversation, the tion to youngsters because it focuses on the simpler for struggling students, it is imper- information to follow might be key. most crucial points and eliminates any ad- ative for parents to also subscribe to this Being a teenager can be a confusing time ditional details. The additional details that “chunking” technique when speaking with for many youngsters who are trying to find you might provide are exactly what be- their children. Just as bulleted points are themselves and figure out where they fit in come white noise and dismissed altogether written down as a professor gives a long in the world. The teenage years are when by the teenager who is looking for immedi- lecture, these points are crucial for children developing children form an identity for ate gratification and answers. For example, to receive as well. When too many details themselves, and begin to understand the when parents are making a point about the that support the main ideas are added into world around them and function more inde- importance about being home at night for a conversation, the main ideas become lost pendently. To enhance this independence, Beth Yurman, PsyD certain curfew, instead of delving into the and muddled in the teenager’s mind, and teenagers wish to receive information that detail that causes your own mind to loop the conversation can go south quickly. pinpoints their curiosities instantaneously (increased risk of being in danger, less As parents it is our duty to provide our and provides immediate answers. Many tain points across to their teenagers. While sleep at night, car accidents on the road, children with information to help them times, avoidant behavior or disrespectful parents care for their children and wish to traffic, less visibility, etc.), it is important navigate through the world and develop in- dismissal towards parents during a normal include as much information as possible to establish the most important point(s) and dependent skills. However, when too much conversation can become commonplace. when discussing important topics, often state clearly to your child something along information is provided children can go Often interpreted as frustrating and trou- what is heard by the child is the first few the lines of: “I want you to get sufficient into “information overload” and our good blesome by parents, this does not have to sentences of speech while the rest becomes sleep so I need you to be home by 11 pm intentions become washed away. “Twitter be routine. “Twitter Speak” (credit is giv- white noise and is tuned out. Once the on weekends.” When lengthy explanation Speak” is a simple way to enhance commu- en to Ms. Patricia Schissel for coining this white noise “switch” is turned on, the re- and details are incorporated into an ex- nication with your teenager and improve term) is a term that I have found to be very sponse from your child might be one-word- plicit rule that you are trying to establish, helpful when parents are trying to get cer- ed, brief, or result in him/her walking away your teenage will hear something punitive, see Twitter on page 32

C Spectrum Services

A Cooperative Private Practice Offering an Array of Specialized Services

Spectrum Services provides child and adult diagnosis, family and couples therapy, pragmatic language and social groups, specialized individual skill-building therapy, cognitive behavior therapy (CBT), trauma focused therapy and EMDR, dialectical behavior therapy approaches,mindfulness work, college coaching and transition support, psychoeducational, neuropsychological, and speech & language testing, vocational support, family support, and educational consulting for individuals and families affected by Autism Spectrum Disorders and related conditions.

Lynda Geller, PhD, Founder and Psychologist The Asperger Syndrome Training & Employment Partnership (ASTEP) Rahimeh Andalibian, PsyD, Psychologist focuses on employer education and training, and advises employers on how to recruit Ronni Aronow, MA, MS, College Transition Consultant and manage employees with Asperger Syndrome. www.asperger-employment.org Jaime Black, PsyD, Psychologist Karen Chin, PhD, Psychologist Asperger Syndrome and High Functioning Autism Association (AHA) Katherine Cody, PsyD, Individual and Family Therapy provides support programs, conferences, activities, a hotline and reliable, up-to- David A. Cooperman, MD, Psychiatrist date information for individuals and families. www.ahany.org Peter DellaBella, MD, Psychiatrist Valerie Gaus, PhD, Psychologist Career and Employment Options, Inc. (CEO) provides transition supports for Debora Harris-Thivierge, BCaBA students in special education and job placement services for students and adults Rhea L. Hooper, MA, CCC-SLP, Speech and Language Pathologist with Asperger Syndrome and other disabilities. www.ceoincworks.com Carole Kornsweig, MA, CCC-SLP, Speech and Language Pathologist Stephen Migden, PhD, ABPP, Independent Educational Consultant Mitchell Nagler, MA, LMHC, Mental Health Counselor The Elija Foundation provides advocacy support, educational outreach and Michele Robins, PhD, Neuropsychologist comprehensive workshops in Applied Behavior Analysis for educators and family Shuli Sandler, PsyD, Psychologist members. www.theelijahfoundation.org Patricia Schissel, LMSW, Social Worker Leslie Sickels, LMSW, Social Worker Contact us through www.spectrumservicesnyc.com for clinical services. Ilene Solomon, PhD, Neuropsychologist Nancy Waring Weiss, MS, CCC-SLP, Speech and Language Pathologist Please visit www.aspergercenter.com for articles of interest for families and Beth Yurman, PsyD, Psychologist adults with Asperger Syndrome.

www.spectrumservicesnyc.com • 303 Fifth Avenue, Suite 1003, New York, NY 10016 AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 17

Do you need support for a child, teen or adult on the autism spectrum?

Asperger Syndrome and High Functioning Autism Association

• Monthly support meetings for families, teens, adults and spouse/partners • Bi-annual conferences for professionals, family members and individuals on the spectrum • Email listserv and member news publication, On The Spectrum • Referral to resources and professionals through our phone and email support • Recreational activities for families

www.ahany.org 888-918-9198 [email protected] AHA Association, a Not-for-Profit Corporation PAGE 18 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

Designing Databases That Drive Continuous Improvement for Clients and Organizations

By Andrew Shlesinger, MSW database is basically a central repository and Frank Bird, MEd, BCBA into which all forms of data from around Melmark the organization can be collected, orga- nized, reported, graphed, charted, com- pared and otherwise analyzed. Databases oday’s classrooms are often filled can be programmed directly to include with technology, some not even automation of workflow, reporting and imagined just a decade ago. Tablet more, or it may collect data from a sepa- computers loaded with education- rate “front-end” program or web applica- Tal or communication software, PC stations, tion the organization has developed. iPods, Augmentative and Alternative Com- Designing a database and program that munication (AAC) devices, and Wi-Fi in- is right for your school requires both ternet service are all commonplace. They a bird’s eye view of the organization and serve various uses including data collec- a detailed understanding of the day-to-day tion, communicating, skill acquisition, or tasks each member of your staff encoun- reinforcement. ters. Melmark, for example, designed and This article will focus on the technol- programmed their proprietary academ- ogies that help collect and analyze data ic and clinical database over seven years across students, classes, programs and ago from the ground up. This program au- schools. These solutions offer teachers tomates the academic and clinical data the tools to deliver individualized treat- collection as well as all the graphing and ment to their student in a timely and ef- reporting requirements. Implementing fective manner while providing the or- this program freed each direct staff mem- ganization with the information it needs Andrew Shlesinger, MSW Frank Bird, MEd, BCBA ber from approximately two hours of data to continuously improve on key areas of and report preparation per week, equating quality and effectiveness. and analysis. Technology can assist the delivery and shifts thousands of hours of to thousands of hours per year shifted from teaching process dramatically by provid- teacher time from data-entry work to work- paperwork to working with the students. Individual Treatment Solutions ing real-time data collection, calculations ing with the students. Additional databases at Melmark serving of results, automation of the workflow Due to the data-intensive nature of ev- the individual include weight and BMI Delivering evidence-based teaching processes, graphing and reporting, assess- idence-based teaching methodologies like trackers, bowel movement and menses strategies competently and effectively of- ment data, analysis tools and automation Applied Behavior Analysis, much of the trackers, sleep charts and proprietary ten requires a tremendous amount of mea- of agency and governmental requirements. focus of custom technology solutions re- surements, data-collection, calculation Such technology improves the speed of volves in some part around a database. A see Improvement on page 37 AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 19

The Sex Talk vs. I nodded nonchalantly, my eyes trained here and there that make him different, on the road. There didn’t seem to be much things like speech therapy and a parapro- The You Have Autism Talk more to say. fessional and stimming. I figured we’d sit Jack down at some But instead of a spark igniting, I pictured point soon and have a similar discussion, this discovery more like a balloon full and o, we’ve got this guy in middle about him and autism. And I’ve been buoyant with air. Each new finding— school now. And he is all sorts of dreading this talk, the You Have Autism each new why do I have an aide and Rose cool. Savvy. Phrases like let’s play talk, much more than the Sex Talk. doesn’t—is like the tiniest leak, until the have been replaced by let’s hang Because sex—although an awkward and brightly colored circle drifts to the floor, Sout. He makes scrambled egg sandwich- uncomfortable subject—ultimately leads to empty and weightless. es for himself in the morning and wants family and children. And if you have one Last spring I had all the kids in the car to walk home from the bus stop alone in too many French Martinis on date night it and we were headed to the playground so the afternoon. There is swagger in his ne- can even lead to a fifth baby who weighs ten they could run around while Joey played on-sneakered step. pounds. That happened to a friend of mine. baseball. Charlie suggested he could watch Last spring all the parents of incoming Discovering sex is like a flame gather- the kids if I needed to take Henry to the fifth graders were invited to the middle ing speed along a long fuse, eventually bathroom, but Rose interrupted, “Why school cafeteria so we could preview exploding in a brilliant spark of color and doesn’t Jack watch us? He’s older.” The Movie. You know, The Movie that enlightenment. “Because,” Charlie answered. “He has shows ten-year old kids how their bodies But discovering you have autism? That’s autism. He can’t.” change and mature, what they can expect like saying, listen, I know we’ve been pre- Hearing this, Jack promised, “I won’t as they enter puberty and discover the tending all along that you’re just like the rest have my autism at the park. I will leave it opposite sex. Let me just say I learned a of us, that it’s perfectly normal to ask people in the car.” few things. when they will die and to remember what (It took everything I had not to look back I imagined we would sit Joey down when year Hershey started making chocolate. and ask, oh, we can LEAVE IT BEHIND? the time came and have the Sex Talk. But Joey But it’s not. You’re not. You are differ- All these years we’ve been lugging your about six months ago I realized he knows ent, diagnosed, identified. autism around to all sorts of inconvenient way more than we think; juicy details and He and I were alone in the car one after- You have something called Autism places like the grocery store and church tidbits gleaned from the back of the school noon, talking about kids and families, and I Spectrum Disorder. and doctors’ offices and the library, where bus and movies and music. Every once in asked him how many kids he’d like to have. For the most part, the You Have Autism it screams and shouts and asks people a while he’ll ask something like, “So you “Oh, I don’t know,” he answered casu- Talk seemed to be following the same about death? Huh.) and Dad had sex five times?” And I will ally. “I guess it depends on how much I path as the Sex Talk. In the past year or say, yes, just five. enjoy having sex.” so, Jack started picking up on little details see The Talk on page 32 PAGE 20 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

Leaders Gather to Celebrate Autism Spectrum News’ First Annual Event

Staff Writer educators, and other stakeholders in au- tism Spectrum News publication speaks to Autism Spectrum News tism. The event raised $20,000 to enhance the autism community’s increasing demand community autism education and aware- for a trusted resource of science-based au- ness by expanding the free distribution of tism education, information and communi- n November 6, 2013, Autism Autism Spectrum News and by providing ty resources.” Spectrum News held its first unlimited free access to our website (www. According to Ira Minot, LMSW, Found- annual Leadership Awards Re- mhnews-autism.org) that provides vital au- er and Executive Director of MHNE, “My ception at the Crowne Plaza tism information and education to the en- son David and I owe the success of Autism Oin White Plains, NY, to celebrate leaders tire autism community. Spectrum News to the countless individu- who are making a difference in the autism Honored sponsors of the event included als and organizations that are working tire- community. the YAI Network, The Daniel Jordan Fid- lessly to improve the lives for individuals The Beacon of Hope Award was present- dle Foundation, the ARC of Westchester, with autism and their families. The finan- ed to honor two outstanding members of the Autism Science Foundation, Optum, cial success of this event will allow Autism the autism community for their extraordi- NY Collaborates for Autism, Susan Cor- Spectrum News to touch the lives of many nary dedication and devotion to individuals tilet-Jones, Alan Eskenazi, Donald Fitch, more families and communities in New with autism and their families. Charles N. Judith Omidvaran, Jorge Petit, Terry Pir- York and across the country that are in need Cartwright, MD, Director of the YAI Au- raglia, Patricia Rowan, and Mary Zingaro. of vital autism information and education.” tism Center was presented with the Beacon “I couldn’t be happier with the success of A big change is coming to the Autism of Hope Award in Research and Clinical our first annual event. The work that Linda Spectrum News website, according to Da- Outreach and Linda Walder Fiddle, Esq., and Charles have done for individuals with vid Minot: “In the coming year, we are re- Founder and President of The Daniel Jor- autism is truly inspiring. They are also two designing the entire website to enable our dan Fiddle Foundation was presented with of the nicest and most genuine individuals content to reach more people in a whole the Beacon of Hope Award in Advocacy you will ever meet, and the autism commu- new way. This is a big project for us, and and Philanthropy. Both Charles and Linda nity is very fortunate to have them advo- once completed it will serve as a new way gave truly inspirational acceptance speech- Event Honorees cating on their behalf,” said David Minot, of communicating with the autism commu- es. Each highlighted their lifelong journeys Charles N. Cartwright, MD Publisher of Autism Spectrum News. nity by providing a more interactive and which led them to devote their lives to cre- According to Dr. Peter D. Beitchman, immersive experience. This will be big!” ating vital programs to improve the lives and Linda Walder Fiddle, Esq. DSW, LMSW, Chairman of the Board of Autism Spectrum News would like to of children and adults with autism, and to Mental Health News Education (MHNE), thank all of our generous sponsors, donors, unlocking the mysteries of autism through Inc. Board Members, Autism Spectrum the organization that publishes Autism honorees, guests and volunteers for mak- groundbreaking scientific exploration. News Editorial Board Members, service Spectrum News, and CEO of The Bridge ing the Autism Spectrum News First An- Over 100 guests were in attendance, providers, individuals on the spectrum, in NYC, “The success of this first annual nual Leadership Reception a tremendous including Mental Health News Education, parents and family members, advocates, event and the continued growth of the Au- success!

Marco Damiani, MA, Executive Vice Jorge R. Petit, MD, President, Quality Dr. Peter D. Beitchman, DSW, LMSW, David Minot, Publisher, Autism President, Innovation and Services, Healthcare Solutions Group and CEO, The Bridge and Chairman, Spectrum News, Linda Walder Fiddle, YAI, Charles N. Cartwright, MD, President-Elect, Board of Directors, MHNE Board of Directors, Mental Health Esq, Founder and President of The Director, YAI Autism Center with Constance Y. Brown, MPA, Vice News Education, Inc. (MHNE) with Daniel Jordan Fiddle Foundation (DJF) with his Beacon of Hope Award President, Community and Government Donald M. Fitch, MHNE Board with her Beacon of Hope Award, and and David Minot, Publisher, Relations, Institute for Community Member and Anne G. Katz, Vicki Ofmani, MEd, LDT-C, Founding Autism Spectrum News Living and MHNE Board Member Former Board Member, MHNE Board of Trustees Member, DJF

Judith Omidvaran, Parent Advocate, Autism advocates Mary Zingaro, ASN Editorial Board Members Cindy Stuart M. Flaum, Special Needs ASN Editorial Board Member and Bonnie Kaplan and Ellen Weinstein Alterson, PhD, BCBA, Principal/Program Financial Planning with David Kuhn, MHNE Board Member, Charles N. Director, Devereux Millwood Learning PhD, BCBA-D, Clinical Director, Cartwright, MD, Director, YAI Autism Center and Theresa Pirraglia, Co-Founder Center for Autism and the Developing Center, and Marna Solarsh and Board Member, The Foundation for Brain at NY Presbyterian Hospital Educating Children with Autism AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 21

Leaders Gather to Celebrate Autism Spectrum News’ First Annual Event

Top Row: Antoinette Gentempo, Vicki Ofmani, Board of Trustees, The Daniel Jordan A proud family in support of Charles, including: Sam Cartwright, Fiddle Foundation (DJF), Pamela Ball, Director of Community Affairs, DJF, Steven Taube Berger, Shirley Berger, Terry Kaye, Mark Walters, A. Ball, Strategic Planning Chair, DJF, Jessica Walder, Assistant Director, Special Needs Charles N. Cartwright, MD, Director of the Program, Metrowest JCC, Jeff Walder, and Linda Delaney, The Gillen Brewer School YAI Autism Center, and Harold Berger Bottom Row: Sherie Reiter, Linda Walder Fiddle, Founder and President of The Daniel Jordan Fiddle Foundation, Amy Gravino, A.S.C.O.T Coaching, LLC, and Michael Gravino

Dr. Peter D. Beitchman, DSW, LMSW, CEO, The Bridge and Chairman, Board Marco Damiani, MA, Executive Vice President, Innovation and Services, YAI, of Directors, Mental Health News Education, Inc. (MHNE) Jorge R. Petit, MD, Charles N. Cartwright, MD, Director, YAI Autism Center, Nicole Rizzitiello, President, Quality Healthcare Solutions Group and President-Elect of the MHNE Practice Administrator, NY Presbyterian Center for Autism and the Developing Board of Directors, Peg Moran, LMSW, Senior Vice President, F●E●G●S Health and Brain, Jill Krata, PhD, Manager of Clinical Services, YAI Autism Center, Human Services System and Secretary of the MHNE Board of Directors, and and Tracy L. Kernan, Mental Health Clinician, YAI LINK and YAI Autism Center Michael Friedman, LMSW, Former Board Member, MHNE

Richard Swierat, Executive Director, Sam Cartwright was very proud of Marty McGreevy, Academic Coordinator, David H. Minot, BA, Publisher of Autism ARC of Westchester and ASN Editorial his father Charles Cartwright, MD New Frontiers In Learning with Dianne Spectrum News and Associate Director Board Member with Tibisay Guzman, for receiving the Beacon of Hope Zager, PhD, Michael C. Koffler Professor of MHNE with his father Ira H. Minot, Assistant Executive Director, Day and Award in Research and in Autism, Pace University and ASN LMSW, Founder & Executive Director, Community Services, ARC of Westchester Clinical Outreach Editorial Board Member Mental Health News Education, Inc. PAGE 22 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

Maximize Social Learning by Combining Portable Technologies and Proven Video Modeling Techniques

By Laurie Jacobs, MA, CCC-SLP ing, they can begin to create customized in their real-world environments as seen in Co-Founder videos targeting specific skills for individ- the study by D’Ateno, et al., 2003. Social Skill Builder, Inc. ual children. As the video scenarios unfold, the user Why Social Skills Training? steps inside familiar social situations to f you are looking for a way to bridge make choices, predict outcomes and prob- A 1992 Duke/Emory University study the social language gap to help kids lem-solve. With the visual attraction of vid- showed that nearly 93 percent of commu- with ASD, Asperger’s and other learn- eo and interactive of the questions, learning nication is nonverbal, requiring acknowl- ing disabilities achieve success in so- social skills becomes fun and entertaining. edgment of gestures, body language and Icial situations; interactive video modeling Lasting improvement can be achieved by facial expressions. Unlike their neurotypi- tops my list. This method has research-val- using teaching strategies that capitalize on cal peers, children who struggle with prag- idated results, and I have seen my own cli- the visual learning strengths of children on matic language do not acquire basic social ents grow by leaps and bounds by watch- the spectrum and allow for repeated evalu- skills through general experience and ob- ing real-life, same-age peers modeling ation of targeted social behaviors. servation, usually because of the complex- social scenarios, dissecting and discussing Students with video modeling training ity of the interaction and all of the “un- the videos with them, and then building so- have exhibited increased confidence and written” and situational-dependent rules. cial understanding and incorporating those acceptance of transitions in different so- Social skills training uses problem-solving skills into their daily lives. cial scenarios; and increased expressive techniques to actively teach children the Interactive video modeling programs, language skills and decreased anxiety and skills they need to be successful and to such as Social Skill Builder social skills negative behaviors have been noted in sit- cope with challenging situations in their software curriculum and other video ap- uations that once caused problems (Chen social environment. Research has demon- plications available online or in the por- SH, Bernard-Opitz V 1993). In real life sit- strated that video social skill training using table applications (app) market can kick uations, social learning opportunities often real peer subjects (as opposed to drawings start your video modeling program. These occur so quickly that teachable moments or cartoons) is one of the most effective can be readily found by a simple internet Laurie Jacobs, MA, CCC-SLP such as body language or a glance are gone treatments for helping children with ASDs search for social language videos or apps, before they can be identified; but with vid- and other learning disabilities succeed in and my website www.socialskillbuilder. eo modeling each scene can be paused, their interpersonal and social awareness. com provides an updated list of apps that highlight that video modeling “can be a with the opportunity to replay scenarios Additionally, research has established I recommend. Remember, you are looking useful medium for learners who cannot and study the different layers of social cues that many students with pragmatic learning for short videos using real pictures (think take advantage of print material or com- for greater understanding. Such practice disabilities, particularly those with ASDs, Snapchat, Vine or Instagram) and succinct plex language repertoires.” Once the par- provides children with more intuitive in- are drawn to visual stimulation and are often narration to detail the skill you are focus- ent or instructor is comfortable with the sight into social interactions and increases ing on. Nikopoulous and Keenan (2006) structure and concepts of the peer model- their confidence as they try out new skills see Social on page 36

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B.F. Skinner’s iPhone: The Era of Technology-Enabled Clinicians

By Michael J. Cameron, PhD, BCBA-D, Autism Spectrum Disorder and their fami- Melissa Cline, MSEd, BCBA, lies. More specifically, we have examined and Rebecca Hise, MS, BCBA the practicality of both web-based and mo- Pacific Child and Family Associates bile phone interventions. Our fieldwork shows that both of these technological platforms result in highly favorable clini- .F. Skinner was an American hu- cal outcomes. manist, philosopher, behavioral scientist, author, and inventor. In Web-Based Intervention: A Case Study his latter capacity, Skinner had a Bkeen interest in the education of children. The goal of one of our clinicians was to In fact, in a notable quote that captures his support a young boy (we will use the pseud- personal philosophy he suggested that: “It onym Ammon to refer to him) to engage has always been the task of formal educa- in the observances, rituals, and routines tion to set up behavior which would prove of his family. More specifically, Ammon useful or enjoyable later in a student’s life.” was expected to: (a) attend to his personal In consequence, in 1953, in an effort to hygiene (e.g., brush his teeth, shower, put make education both effective and enjoy- on deodorant, and change his clothing on able, Skinner built the first teaching ma- a daily basis); (b) take responsibility for chine. The efficiency and effectiveness of household chores such as putting his cloth- the teaching machine can be attributed to ing in a laundry basket at the end of the the automaticity of feedback, the delivery day; and (c) participate in family-strength- of educational reinforcement, the inherent ening routines (e.g., listening to family joys individualized pacing system, a logical in- vancement of our culture. Therefore, in an Technologies (CBITS) (http://cbits.north- during the evening meal). However, during structional sequence, and active student en- effort to celebrate B.F. Skinner’s legacy, we western.edu), “Behavioral Intervention the initial assessment phase, it was deter- gagement. Given Skinner’s interest in the have outlined below two innovative meth- Technologies are applications that use mined that Ammon engaged minimally in use of technology for learning and behavior ods for supporting the education of chil- technologies such as mobile phones, com- the aforementioned activities, or not at all. change, we suspect that if he were walking dren, and rendering the educational process puters, tablets, and sensors to support be- Despite Ammon’s inappreciable family the streets of Cambridge, Massachusetts enjoyable, through the use of technology. haviors that improve health, including engagement, it was determined through today he would definitely have an iPhone mental health.” We have generalized the a strength-based assessment that Ammon in his hand (all right, we concede, maybe Behavioral Intervention findings of Northwestern University’s had a keen interest in sport teams, player’s it would be an Android). Nevertheless, we Technologies (BITS) “proof of concept” studies and, through statistics, and scores. He also had a strong suspect Skinner would be using mobile our own clinical work, have explored the interest in technology and a sociable technology to facilitate learning and hu- According to Northwestern Universi- utility of using Behavioral intervention man engagement for the compassionate ad- ty’s Center for Behavioral Intervention Technologies for supporting children with see Clinicians on page 38 PAGE 24 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

The Importance of a Visual Schedule

By Marieke Hoekstra pictograms or pictures made by themselves. do list. However, this manual approach takes Mother of Jan Research of the Indiana Institute on Dis- a lot of time and must be repeated every day. ability and Community has demonstrated We wanted to help our son Jan by provid- that children with an autism spectrum dis- ing him with visual schedules, but without t’s half past eight in the morning. Jan, order or with Down’s Syndrome benefit the daily manual labor. In the end we built a 10 year old boy with ADHD, wakes from a visual schedule (www.iidc.indiana. AutiPlan.com. This is a website with thou- up. His phone plays a nice, calm mel- edu/?pageId=394). It’s not only young chil- sands of pictograms in a database, ready ody to wake him from his slumber. dren who can benefit from using a visual to use. The program uses a drag-and-drop IWhen the music stops, he looks at the schedule - teenagers with autism or Down’s system to place these pictograms in a plan- screen of his phone to see a picture in black Syndrome also find it useful. A good sched- ning quite easily. You can adjust time and and white with a little man sitting on his ule provides predictability and structure, the text showing with the pictogram. Also, bed and is preparing to stand up. Next to thus reducing stress. A visual schedule is different activities, like waking up, brush- that picture is a small clock, which slowly also beneficial for people with Alzheimer’s. ing your teeth and dressing up can be made counts down from two minutes to zero. Because you don’t have to remember the into one timeslot. These visual schedules Jan sits down on his bed, copying the order of all the activities, you can focus on can be printed out on paper, or used direct- action he sees on the pictogram. After the what you are doing right now. At any time, ly from an app. The viewer also plays a two minutes have expired, he hears another you know what you are supposed to do and custom sound when it is time to move on signal and Jan looks at his phone again to you can always take a look at your planning the next activity. To help save even more see the next picture: another puppet wash- to see what the next activity is. This way you time Autiplan.com supports reusable tem- ing himself. Next to it is some text say- can mentally prepare for what is up next, al- plates so you don’t waste time adding the ing: “wash up and get dressed.” The app leviating the stress of the day to day routine. same items - such as getting dressed - each also speaks these instructions out loud in Marieke Hoekstra Of course, every system has its pros and day. This saves a lot of time and work ev- a calm, friendly voice. He can see the pic- cons. If it takes parents too long to create ery day, leaving you more time to spend ture of a man dressing up next to it, and he is also very convenient for his mother. In- visual schedules, they might begin to won- doing fun things with your children. can also see the little clock with 10 minutes stead of having to remind Jan of each step der if the benefits are worth the time. Most I know how tough it is for parents, which remaining. Jan begins. He goes through in his routine, she can instead spend time parents see a huge difference in their chil- is why Autiplan is free to use for personal his morning routine and checks off all the on her morning routine. She doesn’t have to dren’s behavior, so they don’t mind put- accounts. It contains everything you need to scheduled activities one by one. ask if he already has his shoes on, or chase ting in the time to create these schedules. get started with visual schedules. When you At 8 o´clock he is sitting at the table him around the house to make sure he will The quicker the schedules can be created, create an account there is also a one month for breakfast, with brushed teeth and fully not be late. Jan and his mother both start the the more likely it is that parents will use trial of the full version included, which dressed. This would not be possible with- day without stress or wasted time. them regularly. includes features such as the PlanViewer, out the visual support that the phone gave Visual Scheduling is creating a dai- There are a few systems to make the cre- Android-app, weekly schedules and using him. His entire day is planned like this, so ly schedule using pictures, also called ation of a visual schedule easier and less your own pictures in a Visual schedule. he gets a notification to get his coat and one pictograms. You can also use photos as time-consuming. One of the simplest ways is that tells him to ride his bike to school. This a pictogram. Most people use downloaded to print out pictures and place them on a to- see Schedule on page 30 AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 25

Special Education and College Readiness

Adrienne M. Nagy, MA vocate for their accommodations using this is what his or her cohort is doing? Director of Transition and Guidance current documentation (adult testing is Without a genuine interest in complet- Aaron School required, within the last three years of ing college-level work, students are like- the college application) and are typical- ly to struggle with work completion and ly offered less support than a specialized academic success. It is important to pre- pecialized college programs that college or a comprehensive support pro- emptively seek out support services that provide support for students with gram within a college or university. Some will be able to assist the student with the learning disabilities, non-verbal students fail to self-advocate for their ac- transition, prepare for a more challenging learning disabilities, and Autism commodations and attempt to leave their course load, and learn how to properly SSpectrum Disorders are continuing to disabilities behind them in high school. self-advocate. grow throughout the country. Although This can lead to a decline in grades, there is an increase in the number of pro- self-esteem, and a feeling of helplessness Level of independence: Has the student grams that will assist students in receiv- over their college experience. ever lived away from home before? Does ing academic and social coaching, how do In the area of college readiness, there are he or she have experience in caring for you know if a student is a good fit for a a few critical components to consider: themselves (washing clothes, organizing particular college program? Is there a hard materials, managing money, waking up on and fast rule that indicates a young adult is Awareness of disability: Can the student their own, etc.)? Has the student partici- ready to leave home, pursue college-level identify his or her disability? Does the pated in an overnight camp experience or coursework, and live on his or her own? student know what accommodations are overnight program at a college? Does the There are many aspects to consider in this needed in order to reach his or her full student commute to and from school inde- process and ways in which parents, coun- potential? Can the student advocate for pendently? Does he or she have an emer- selors, and educators can assist in foster- these necessary accommodations? Un- gency plan of action for their commute? ing college readiness. Adrienne M. Nagy, MA derstanding their disability and being Is he or she able to manage money on his First, it is important to consider what able to relay this information to receive or her own to purchase meals, transporta- supports are available at the college lev- cial coaching within a mainstream college the necessary accommodations from both tion costs, and recreational interests? Ex- el. Different levels of support are offered or university. These programs typically the office of disability services and their posing students to life skills such as these for students with a diagnosed disability, charge a fee to students who are accept- professors are critical to achieving suc- will increase their chances of a successful depending on the particular college. It ed in addition to tuition/room and board, cess at the college level. post-secondary experience. would be detrimental for a student to at- whereas a specialized college accepting tend a college that does not offer the type only students with disabilities will include Interest in pursuing a college degree: Has Executive functioning skills: Is the stu- of accommodations he or she needs in this fee under the umbrella of the entire the student demonstrated interest in pursu- dent able to wake themselves up in the order to be successful. There are colleges year’s tuition. ing education beyond high school? What morning for school with enough time to that exclusively accept students with dis- Every college is required by law to have does the student hope the degree will lead get ready? Does the student organize abilities, as well as comprehensive sup- an office of disability services. Through to in terms of a career path? Does he or port programs that offer academic and so- this office, students are required to ad- she want to attend college simply because see College on page 37 PAGE 26 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

Digital Storytelling Enhances Self-Expression for Individuals on the Autism Spectrum

By Lorraine Cohen, MS, CCC-SLP tion Systems says that this collaboration Assistive Technology Specialist using “mobile technology is giving indi- AHRC New York City viduals on the spectrum a critical edge in pursuing learning opportunities and life options, in partnership with enthusiastic t AHRC New York City, dig- and passionate undergraduate students of ital storytelling is enhancing the university.” Yuliya Khripunkova, an self-expression for individuals AHRC New York City Transition Devel- on the autism spectrum through oper, assists in pairing AHRC individuals Aa community service-learning partnership with Pace students according to similar in- with Pace University. AHRC New York terests and talents. Each semester, classes City is a large, family-governed, nonprofit meet weekly at the Seidenberg computer organization that has been serving individ- labs at Pace Plaza on Tuesdays and at the uals with intellectual and other develop- facility labs at the Middle High School on mental disabilities (“IDD”) for over sixty Fridays for semesters of fourteen weeks. years. Individuals on the autism spectrum The digital, person-centered projects being are integrated into the more than twen- worked on are directed by the individuals ty Adult Day Service programs located from AHRC New York City. A multi-media around the city and comprise the over- presentation of the productions of visuals whelming majority of the one hundred and storytelling is a course requirement, and at twenty students who attend AHRC New semester-end all projects are viewed by an York City’s Middle High School in Brook- audience that includes the Pace students, lyn. AHRC’s overarching commitment to AHRC individuals, their peers, and staff. technology is founded upon the belief that Digital storytelling is a powerful tool for technology is currently part of everyone’s gies to expand their communication, so- engaged in person-centered, digital sto- self-expression for individuals on the au- everyday life and provides opportunities cial, and technical skills while becoming rytelling projects where technology, and tism spectrum and success stories abound. for individuals not only to participate more integrated members of their communities. more recently, mobile technology, is used A young man of Chinese heritage was fully in daily activities but also to explore Since 2007, digital storytelling has been to enhance self-expression by showcas- proud to introduce his Pace partner to the their identity, enhance self-expression and the focus of AHRC New York City’s ser- ing talents, ambitions and dreams. Dr. Jim Chinese culture. They organized a trip to increase independence. The Pace Universi- vice-learning partnership with Pace Uni- Lawler, organizer of the partnership and Chinatown, ate lunch together and made an ty community service-learning partnership versity. Individuals on the autism spectrum Professor of Information Technology and iMovie about their experience. At the end provides a platform for individuals on the from both AHRC’s Adult Day Service Service-Learning at Pace’s Seidenberg autism spectrum to use mobile technolo- programs and Middle High School are School of Computer Science and Informa- see Self-Expression on page 32

Eric London, MD

Psychiatry Practice Specializing in Autism Spectrum Disorders

Director, Autism Treatment Research Lab, Institute for Basic Research Scientific Advisory Board, Autism Science Foundation Co-founder, National Alliance for Autism Research Parent of son with autism

4131 Richmond Avenue (609) 921-0332 Staten Island, New York 10312 AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 27

Technology and Autism ners, albeit unwilling, in tackling autism. Consequently, if one subscribes to the be- havioral modification theory, we might echnology is a beautiful thing. It be convinced that if the stakes are high can change lives. Years ago, our enough, flexibility could be induced by the friend Charlie, who has since dangling carrot, candy, video, train game, passed away, remarked that twirling top, or any other inflexible rou- T“someday, we will be able to collect all of tine. Basically, we hold the abhorrent be- our information and store it in a device the havior hostage, and make it work for us. size of a credit card.” Charlie did not live Clearly Annie Sullivan was successful in to see his auspicious vision. So here we are developing communication with Helen today, using our phones to purchase items, Keller. She too, used a behavioral model. take pictures, chat with friends, check our Initially, our disabled toddler seemed balance, and research information in a mat- very content in his world. He did not tan- ter of seconds. How can this work for the trum or cry unless he was hurt. However, autism community? we never allowed him to perseverate or When our quadruplets were toddlers, dwell on rigid ritualistic behavior. I re- I needed the tentacles of an octopus to member sabotaging his obsessive design of simultaneously reach each crying baby. salt, pepper and napkins that were grouped The miracle of Disney on videotape was in a line on our kitchen table. Every time my new friend; a nanny of the technolo- he tried, I went in there and messed it up. gy kind. Walt Disney had no idea that “A We were operating on gut feeling, and Dream is a Wish Your Heart Makes” would somehow fighting an unknown opponent. be the catalyst to propel words from our Perseverative behavior is a powerful Historically, human beings affected by When our son remained non- verbal autistic son’s mouth. Our beloved speech force. Sometimes it is so seductive that even autism, are governed by levels of rigidity at age 3, and the masters in the field ad- therapist, Dr. Nancy Schwartz, used the parents and therapists don’t realize that it is and inflexibility. The variables depend on vised us to get a sign board (as used for the television as the catalyst for the prompt. taking place. Utilizing computer games or areas of understanding and functioning in hearing impaired) because he would nev- “Turn it…?” she started the phrase. Pau- television might be fruitful if it is offered as the spectrum of pervasive developmental er speak, we instinctively knew that there lie walked up to the TV, pointed and said a “supply and demand” exercise. The story disorders. I do believe that man is innately must be another way. I am keenly aware “On.” One single word changed our lives. below exemplifies the power of allowing the reactive, and responds to conditioned reflex- that there are many children who are able He could talk! And then came the hard dangling fruit or candy or television show or es, as in Pavlov’s experiment. Consequent- work. computer device to evoke language. ly, flexibility and rigidity might be part- see Robin’s Voice on page 35 PAGE 28 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

Assistive Technology Need Not Be So Technical

By Matthew J. Ratz, MEd and address and his likes and dislikes— sewing matching colored dots along the Vocational Trainer for can be considered “technology.” The less creases so that individuals have a guide Adults with Autism intrusive and less obtrusive a tool is, the via which they can make consistent and more likely an individual with autism is to accurate folds. Physical assistive technol- be able to use said tool in the school, the ogies like jigs and visual cues can make an hen most people think of home, and the workplace. A pocket-sized adult’s job much easier and can both im- the word “technology,” they book of PECS (Picture Exchange Com- prove the quality of his work and the like- imagine iPads, tablet PCs, or munication System) can be a priceless re- lihood of maintained paid employment. internet-ready glasses. Tech- source for individuals who are non-verbal Similar tools can be applied to academic Wnology, though, just means machinery or in unfamiliar environments. Easy fixes that environments. A wooden board with pre- equipment developed for practical purpos- can be speedily and efficiently reproduced drilled holes that is equipped to secure es. This different understanding of the word can make a huge impact on the lives of in- drawer knobs and handles can help stu- “technology” can shift a practitioner’s dividuals with autism. Again, much of my dents complete loosening and tightening focus from high-tech tools like iPads and job is spent identifying low-tech solutions tasks as they work on fine-motor skills and electronic voice-boxes to any device that to consistent vocational problems and exe- other occupational therapy. Again, any de- can help a person complete a practical task. cuting these solutions on a large scale for vice that helps to achieve a practical task is A simple machine like a lever, a pulley, or vocational training. considered a piece of assistive technology. a wedge can be considered technology, and Working from a low-tech paradigm can Many people without disabilities use as- these low-tech tools are both simple and save time, money, and frustration. What sistive technology. Those who wear glass- powerful in that they are found easily but follows are some examples of low-tech es, use GPS systems, recline on back pil- can enhance a person’s natural strengths solutions. A simple solution to the per- lows, or type on ergonomic keyboards all to help him complete a task successfully. sistent issue of the quality of folded shirts, use assistive technology. Tools that aide in- In my professional role as a coordinator both at home and in retail environments, dividuals with autism do not have to have of vocational training, I spend much of Matthew J. Ratz, MEd is a shirt-folding board, sometimes called all the “bells and whistles” of electronic my time coming up with simple solutions a “jig,” that consistently folds shirts along devices nor do they need to be the latest to stubborn workplace problems. For in- Technology for autism does not need to the same creases for easy stacking and product for sale; simple, easy, and inex- dividuals with autism—be they children, be restricted to Durable Medical Equip- storing. Such a device can easily be pur- pensive solutions to everyday problems— adolescents, or adults—low-tech assistive ment like expensive communication or chased online for around $15 or made at when applied consistently and thoughtful- technology can be immeasurably helpful transportation devices; something as sim- home. A similar issue is the consistency of ly—can be truly life-changing. as new academic and workplace skills are ple as a laminated information card with folded towels and washcloths in a hospi- For more information, please contact learned and mastered. vital information—and individual’s name tality setting; a quick fix for this issue is Matthew Ratz at [email protected].

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Building Skills in the Classroom with Smart Tablet Applications

By Elizabeth Perez, MS bers right so are the schools, but this is the progress of technology will allow them Special Education HS Teacher not a study of the economics of education. greater access to future success. Association for Metroarea This was a study of how technology can The introduction of the smart tablet into Autistic Children, Inc. (AMAC) aid students in achieving automaticity of the classroom provides teachers and re- basic math functions without dependence searchers with increasing abilities to reach, on calculators. Failure to master the basic engage, and motivate students. Smart tab- echnology and teaching are be- operations can further delay if not derail a lets also aid in keeping classroom records coming increasingly intertwined. student with Autism. and data. Another aspect of the evolution Students in the twenty-first cen- Visually-aided instruction is often a vital of the teacher within special education is tury will interact with the world element in working with students on the the instruction to acclimate students to the Tthrough a technological lens. Technology Autism Spectrum, such as those found in use of Information and Communication is changing how and what we learn, al- the evolution of computer technology; en- Technology (ICT) supports. I examined lowing students access and directing them ter the smart tablet. And returning to eco- how smart tablet apps allowed students to those advancements which will deter- nomics for a moment, the smart tablet is on the Autism Spectrum to practice basic mine future academic success. This arti- a more economical solution to supplying math functions in a visual realm. The study cle outlines a case study conducted in my students in classrooms with limited space helped to determine if repeated use of the self-contained ninth grade classroom to and it is also easier to share among a group apps had any effect on students’ fluency test the effectiveness of Smart tablet math of students. Tablet applications are often and automaticity in solving addition, sub- applications for students with Autism who more affordable and more adaptable than traction, multiplication, and division prob- struggle with math fluency. academic computer software programs. lems. This experiment evaluated the effec- An understanding of basic math con- Applications are visually stimulating, tiveness of current technology, namely the cepts (addition, subtraction, multiplica- graphically interesting, and continually smart tablet. The intervention designed for tion, and division) is unarguably essential evolving; these elements help promote this study was structured as a supplemental knowledge to which a student must be ex- Elizabeth Perez, MS engagement for students’ learning. For intervention incorporated into the Algebra posed, and master to continue in academic teachers, constant evolution is the art and content material. Students were allowed learning and to function successfully in ity in basic math functions to increase fu- science of teaching, so incorporating new ten minutes per day, three days a week, for society. Students often fail to develop au- ture chances for success. technologies into lessons and classroom the duration of eight weeks to engage with tomaticity of these functions and find great Mathematics software programs aiding exploration may influence students to learn the math application on the smart tablet. difficulty in keeping up with the concepts students in gaining fluency and automa- with increasing independence. The evolu- The focus material utilized for this study of advanced math that follow in mathe- ticity have been implemented into math tion of the textbook is the smart tablet, so was specifically the application Math Rac- matics. Technology is math and today’s curricula across the United States with teachers must begin to expose students to er. However, for future replications any students are very interested in technology, success, but giving every student access learning through this new technology. In- simple interface math application may be so teachers who can help students learn to individual computers and the necessary teracting with technology will be unavoid- just as effective. Assessment tools provided through this interest may help students software can be an economic challenge. able in the future, so preparing students in gain the necessary fluency and automatic- If students are struggling to get the num- the classroom to build an understanding of see Classroom on page 35

PERSONAL GPS LOCATOR FOR WANDERING PREVENTION AND FALL DETECTION

The GPS locator is a wrist-worn device for individuals who are cognitively impaired or have special needs, particularly Autism Spectrum Disorder (ASD), dementia or Alzheimers.

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www.iloctech.com 1-855-987-4562 PAGE 30 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

Guide from page 1 has an intrinsic interest in a game, an app, brand in which you might be interest- or another type of technology (even if it ed. Be wary of sites that are giving you augmentative communication device? Is wasn’t made for individuals with ASD), “research” information about a product, the purpose to provide the child with an use it as a springboard for conversation and also trying to sell you the very same escape that involves educational games in with others who might also have an inter- product. It is important to go to a neutral lieu of first-person shooter games? These est in the technology. The first step toward source to if you want to get neutral infor- are straightforward applications that have “reciprocal” social interaction is finding a mation about a product. When you look at many viable options. However, many shared interest, and technology might be research on a particular type of technolo- products are advertised as having the abil- a good window of opportunity. Recent- gy, make sure to check who paid for the ity to treat ASD, and this is a much harder ly, our research team at Notre Dame has research. For example, a study of an iPad claim to prove. been developing a summer science camp application could be funded by the com- We must understand that technology, in for high schoolers (both with and without pany who made the application. Neutral and of itself, does not treat ASD, regard- ASD) who have an interest in robotics. sources of funding, such as the National less of how interesting the child might They get to learn how to program ad- Institutes of Health, the National Science find it. In fact, if used incorrectly, it could vanced robots, but the challenge is that Foundation, or the Autism Science Foun- be detrimental to the social development they must work in teams. We believe that dation are good examples of reputable of individuals with ASD. Individuals with a shared intrinsic interest in a topic is es- funding sources. ASD, by definition, have difficulties with sential when it comes to social commu- In sum, with numerous products on social interaction, although these difficul- nication, and if we provide opportunities the market for use with individuals with ties can vary greatly from individual to in- for individuals with ASD to engage in ASD, it is important to take a planful ap- dividual. Giving a child a tablet computer conversation over a shared interest, social proach when considering the appropri- does not teach a child to be social, even performance will improve. ateness of these products for a particular if the applications/games are purported to individual. If a child shows an interest do so. In many cases, a tablet computer Evaluating Technology in a type of technology, it is important or a game can become a way to escape Joshua John Diehl, PhD to examine whether it will create or in- from social interactions, or a barrier from Once you have found an intrinsic in- hibit social opportunities. Moreover, it is entering into social interactions. There- these skills with a human partner. Alter- terest, and you have a therapeutic or essential to become adept at distinguish- fore, we must be strategic in how we use nately, technology could be used in con- educational approach in mind, the next ing between good science and marketing technology if the goal is to improve social junction with another person (e.g., a game step is to evaluate the available technol- ploys. interaction. in two player mode) to elicit person-to-per- ogy. Many products make claims, and There are common sense strategies for son interactions. Either way, the important there are a few tricks to help you sepa- Joshua John Diehl, PhD, is the William using technology to increase social skills. component is to use the technology in a rate marketing ploys from science. First, J. Shaw Assistant Professor of Psychology First, if the goal is to increase social skills social way. search for information on a product on at the University of Notre Dame. with technology, then it should be used in Another approach is to use an interest sites that are not trying to sell you some- If you have any questions, feel free to con- a social manner. For example, if an indi- in a specific type of technology as a way thing. For example, a search on “Google tact Dr. Diehl at [email protected], 574-631- vidual with ASD is learning skills while to find “shared interests” with others and Scholar” (scholar.google.com) will give 5729, or visit our website at www.funlab. interacting with a type of technology, they use the shared interest as a way to engage you recent studies on a particular type of nd.edu. You can also follow us on Twitter at should then get the opportunity to practice in reciprocal communication. If a child technology, and possibly even a specific @ND_FUN_Lab or #funlab.

Eyes from page 6 References Letter to the Editor This decline in attention to others’ eyes Jones W, Klin A. Attention to eyes is present was somewhat surprising to the researchers. but in decline in 2-6-month-old infants later In opposition to a long-standing theory in diagnosed with autism. Nature, Nov. 6, 2013. Dear Ira, David and Members of the Boards the field—that social behaviors are entirely of Mental Health News Education, Inc. absent in children with autism—these re- Grant: R01MH083727 and Autism Spectrum News, sults suggest that social engagement skills are intact shortly after birth in children with About the National Institute autism. If clinicians can identify this sort of Mental Health (NIMH) t was truly a great honor to be the of marker for autism in a young infant, in- first recipient of your first “Beacon of terventions may be better able to keep the The mission of the NIMH is to trans- Hope in Advocacy and Philanthropy” child’s social development on track. form the understanding and treatment of award at the Autism Spectrum News “This insight, the preservation of some mental illnesses through basic and clinical IFirst Annual Leadership Awards Reception early eye-looking, is important,” explained research, paving the way for prevention, re- on November 6, 2013. To be surrounded Jones. “In the future, if we were able to use covery and cure. For more information, vis- by a roster of the most distinguished col- similar technologies to identify early signs it the NIMH website www.nimh.nih.gov. leagues and friends working today in the of social disability, we could then consider field of Autism as professionals, leaders interventions to build on that early eye-look- About the National and devoted supporters was humbling, and ing and help reduce some of the associated Institutes of Health (NIH) to receive a Leadership Award with my disabilities that often accompany autism.” dear friend Dr. Charles Cartwright was an The next step for Jones and Klin is to NIH, the nation’s medical research awesome enhancement of this tribute. translate this finding into a viable tool for agency, includes 27 Institutes and Centers Since its inception, Autism Spectrum use in the clinic. With support from the NIH and is a component of the U.S. Depart- News has lived up to its mission of provid- Autism Centers of Excellence program, the ment of Health and Human Services. NIH ing its readership with a trusted source of research team has already started to ex- is the primary federal agency conducting science-based Autism education, informa- Linda Walder Fiddle, Esq. tend this research by enrolling many more and supporting basic, clinical, and transla- tion, advocacy and community resources. babies and their families into related long- tional medical research, and is investigat- The donations received from the Leader- cations that serve the needs of the Autism term studies. They also plan to examine ing the causes, treatments, and cures for ship Awards Reception will enable this community, and that provide up-to-the additional markers for autism in infancy in both common and rare diseases. For more exemplary publication to expand its reach minute stories and resources to the public order to give clinicians more tools for the information about NIH and its programs, so that more people within the Autism and it is vital that we support the dissem- early identification and treatment of autism. visit the NIH website www.nih.gov. community and those who would like to ination of science-based information so learn more about Autism can now benefit that progress and awareness can flourish. from the wealth of top-notch information My best wishes and again heartfelt thanks Schedule from page 24 Because he knows exactly how much this needed publication provides. to all of you for this wonderful recognition. time is remaining for each activity, he I encourage all of you to continue to It helps me and my family every day - I does not get as many panic attacks as support Autism Spectrum News by writing Sincerely, want it to help yours too! before. He gets on his bike and goes to articles, sharing the publication with fam- Since Jan uses his app, he does not get school relaxed. ily, friends and colleagues and if you are Linda Walder Fiddle angry when little problems arise, because able to, sponsoring the publication with Founder and Executive Director he can concentrate on his tasks. Now he For more information, please visit www. an ad or donation. There are so few publi- The Daniel Jordan Fiddle Foundation knows exactly what is expected of him. autiplan.com. AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 31

Inclusive from page 1 to “scale” the dissemination of effective Conclusion practices, and strengthen fidelity of imple- Measuring Progress vs. Process mentation in the classroom. Making a true commitment to inclu- Incorporating online meetings into dis- sion will require districts to re-envision One of the problems districts face in im- trict practices, much like other industries how they train staff members, ensure on- plementing and evaluating inclusion is the have been doing for years now, presents going collaboration, and measure student ambiguity of terms like “Least Restrictive another opportunity for more frequent col- success. In an educational culture that in- Environment” and “maximum extent ap- laboration. In large districts, this format creasingly relies upon data as the evalua- propriate,” both of which are intentionally allows expert staff to meet more frequently tive measure for making decisions about ambiguous in order to accommodate the with teachers dispersed across large geo- everything from policy to pedagogy, it has varied and individual needs of the students graphic areas, and be more responsive to never been more crucial that meaningful to which they refer. The individualized na- requests for support. In smaller and rural methods for teaching and quality measures ture of special education and the necessary districts, this format can be used to en- for evaluating the progress of special ed- ambiguity of the terms that describe it, courage isolated special educators to in- ucation students are in place. Technology however, have made it difficult for districts teract with their colleagues in neighbor- can play a key role in facilitating reform to evaluate their own success in educating ing schools or districts, as well as access initiatives, but districts must pay careful students with special needs and in imple- remote consultants. Districts should also attention to how these technologies are menting a wide-reaching model of inclu- consider online lesson planning and data rolled out, and should plan for ongoing sion. It is not a one-size-fits-all solution. management tools that allow for student training and support of staff members and The manner in which districts evalu- information sharing amongst staff mem- other stakeholders - including parents - to ate their inclusive practices (eric.ed.gov bers, thus allowing asynchronous review see them successfully adopted and their /?id=ED185767) is driven by federal IDEA of goals, intervention strategies, progress benefits fully realized. requirements, and is significantly lacking. notes and data. Metrics focus on the percentage of stu- Finally, in addition to the required This article originally appeared in Issue dents served in each “environment,” and IDEA reports on LRE, districts must be- 7 of Education Magazine - https://itunes. the amount of time students with IEP’s are gin adopting standardized practices for apple.com/us/app/education-magazine-ed- spending in general education classrooms. Jamie C. Pagliaro tracking progress with respect to IEP ucational/id593725339?mt=8. Specific attention is also paid to how IEP goals. Ideally, every teacher, principal and goals are written (e.g., whether they are challenges associated with developing an district leader should be just as familiar Jamie Pagliaro is Chief Learning Officer measurable and standards-driven), without inclusive education system. It is important with how the district is tracking against and part of the founding management team addressing whether or not these goals are that leaders carefully consider technology IEP goals as they are with standardized of Rethink, a NYC-based educational tech- actually being met. So while these metrics options, and develop thoughtful plans for test scores. This metric has the potential nology company with a focus on inclusion. focus on the “process” of including stu- introducing them to staff. to present a clearer picture of progress Previously, Mr. Pagliaro was Executive Di- dents, they do not tell us anything about There are a number of cost-effective and across students, and to facilitate more rector of the NY Center for Autism Charter whether students are making meaningful multi-modal formats for providing on-the- critical evaluation of inclusion models. School, a program that has received national progress in these settings. job training and follow-up coaching after With the proliferation of online and mo- recognition from both the media and profes- a traditional professional development bile-friendly electronic data management sional publications as a model for children The Role of Technology session. Use of live and recorded webi- tools, districts should have no problem se- with autism in the public school system. nars, eLearning systems, video-modeling lecting a tool or set of tools that help them To learn more about Rethink, please visit Technology offers several promising av- and remote observation via web-cam or capture and analyze these data at each lev- www.rethinkfirst.com or email info@re- enues for addressing some of the common recorded video present a variety of ways el of the school system. thinkfirst.com.

Brain from page 4 Zoltán Molnár and his colleagues reported database of autism candidate genes spon- talCortexNetwork.html. from mouse brains earlier this year3. sored by the Simons Foundation, SFARI. Gene networks are ultimately limited, ANK2, CHD8, CUL3, DYRK1A, GRIN2B, “Looking at how co-changing genes org’s parent organization.) Another set of however, by the postmortem data used to KATNAL2, POGZ, SCN2A and TBR1. form a network is a very powerful ap- more than 400 genes identified in a previ- create them, which were heavily concen- State and his colleagues created a series proach,” says Molnár, professor of devel- ous study of postmortem autism brains also trated on the cortex. The same types of of networks with each of the seed genes at opmental neurobiology at the University of turns up in these three modules. analyses could be done on other brain ar- the center, connected to other genes that are Oxford in the U.K., who was not involved The researchers also found that FMRP, eas, such as the cerebellum, and other or- the most similar with respect to the timing in the new studies. the protein disrupted in the autism-related gan systems, such as the gut, placenta and and location of their expression in the brain. disorder fragile X syndrome, regulates au- immune system. Of these networks, the researchers fo- Mixed Modules tism genes in modules 2, 16 and 17. This “Autism is an extremely complex dis- cused on the ones that happen to be en- fits with an earlier study showing that ease where the environment is playing on riched with an independent set of 122 In the second study, Geschwind and his many of FMRP’s targets are hit by spon- an unfolding genetic program,” Molnár ‘probable’ autism genes, defined as those colleagues first used BrainSpan to track the taneous mutations in children with autism, says. “We shouldn’t ignore some of the in which one person from the exome stud- expression of 15,585 genes — essentially Geschwind notes. systems which might feed into this.” ies carries a loss-of-function mutation. every protein-coding gene expressed in the To confirm that these network associa- Despite the diverse biological roles of cortex — across early development, from tions are autism-specific, the researchers News and Opinion articles on SFARI. the seed genes, the researchers found them 8 weeks after conception to 1 year of age. compared autism genes with those in- org are editorially independent of the Si- to be surprisingly convergent, meaning From these data, the researchers identi- volved in intellectual disability, which oc- mons Foundation. This article was origi- that many of the genes are expressed at the fied clusters, or ‘modules,’ of genes whose curs in about one-third of individuals with nally published on SFARI.org and is re- same time and place. expression tends to be synchronized, turn- autism. They found that a set of 401 intel- printed with permission. You may view The networks that include a dispropor- ing on and off together across early devel- lectual disability genes is not enriched in the original article, published 21 Novem- tionately high number of autism genes tend opment. Genes within each module have any of the modules. ber 2013, at sfari.org/news-and-opinion/ to be expressed during mid-fetal develop- similar functions. Genes in modules 2 and This comparison shows the importance news/2013/studies-map-autism-gene-ex- ment (10 to 24 weeks after conception) in 3, for example, are primarily involved and specificity of the autism gene conver- pression-across-brain-development. the prefrontal cortex. What’s more, they in the transcription of DNA into RNA, gence, Allman says. “It’s a real strength of are brimming with genes related to gluta- whereas those in modules 13, 16 and 17 the study.” References mate neurons in layers 5 and 6, the deepest are involved in synapse function. The researchers all agree that these net- layers of cortex. Several of these modules turn out to be work analyses are bound to be important 1: Willsey A.J. et al. Cell Epub ahead “We were really amazed at how strong enriched in autism genes. For example, the resources for the field at large. of print (2013) Abstract - dx.doi. the evidence was for this initial set of researchers showed that a set of 113 genes If a scientist is interested in making a org/10.1016/j.cell.2013.10.020 genes,” State says. “We thought maybe implicated by whole-exome sequencing mouse model of a particular autism gene, we’d need to start with 50 or 100 genes be- studies of autism are significantly over- for example, he or she could refer to the 2: Parikshak N.N. et al. Cell Epub fore we would see an identifiable pattern.” represented in just two modules: 52 of the networks to choose the period of brain de- ahead of print (2013) Abstract - dx.doi. State is careful not to overstate the results, genes are enriched in module 2 and 61 velopment and the brain regions to focus org/10.1016/j.cell.2013.10.031 however. As more autism genes are added genes in module 3. on. Geschwind’s team has created an inter- into the analyses, many other convergence In contrast, a set of 155 genes that the re- active network browser that is freely avail- 3: Hoerder-Suabedissen A. et al. Proc. points are bound to pop up, he says. “This is searchers identified from SFARI Gene are able on his laboratory website at http:// Natl. Acad. Sci. U.SA 110, 3555-3560 not a unifying theory of autism.” overrepresented in modules 13, 16 and 17, geschwindlab.neurology.ucla.edu/sites/all/ (2013) PubMed - www.ncbi.nlm.nih.gov/ Overall, his results are similar to what the study found. (SFARI Gene is a curated files/networkplot/ParikshakDevelopmen- pubmed/23401504 PAGE 32 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

The Talk from page 19 • Where did I get it? brown-haired the boy beneath the diagnosis. As it turns out, we didn’t have to say any- But that I can’t imagine him without it, thing. His ten-year old brother did it for us. And then, all at once, the balloon deflated. Standing before Jack in our kitchen I without the beauty and wonder and color it Joey turned to his younger brother, and It was a Sunday morning in late Septem- briefly wished we were having the Sex adds to our world and our family. with a mouthful of buffalo chicken burri- ber—the day after my birthday. I was fuzz- Talk instead—I longed for the concrete- That Sunday night I knelt next to his bed, to he’d ordered off the adult menu, he told ily turning pancakes on the griddle while ness of fallopian tubes and ovaries and this where he was sleeping with beloved Bun- him, “Jack. I think you’re better with it.” Jack perched at the counter flicking the top is how babies are made. ny on the pillow. His weighted blanket was “Yeah,” Jack said thoughtfully, his own to the syrup open and closed and open and I mean, how I tell my nine-year old pulled to his ears, his blue rimmed glasses mouth full of corn dog. “Maybe.” He closed. I was just about to tell him to stop that I love his autism but I also hate it placed carefully on the shelf above him. In glanced over at Joey, and behind the thick doing that, it’s gross to put your hands all and it’s beautiful but sometimes it’s so the quiet room, I started to whisper. I said lenses of his glasses I glimpsed the small- over the lid, when he asked, “Why was I very, very ugly. something like this: est spark in his blue eyes. born with autism?” How do I tell him there are days I literal- Jack, your autism is great. It is not some- That night, I knelt next to his bed once Quickly, my husband Joe and I shushed ly want to pull my hair out by the handfuls thing to be embarrassed about or want to again and whispered to my sleeping boy: the other four and motioned for quiet, be- and run into the street screaming just mea- change about yourself. I love it. I mean, we You are better with it. cause both Joe and I knew our time with sure the effing polygon so we can be done all love it. It’s so interesting the way you I thought for a second more, and whispered: his open mind was short, that we had just a with homework; that time and time again I see the world. I can’t wait to know more We are better with it. precious few moments before the steel trap am brought to my knees with frustration, about it from you. I love you no matter I rose up from the side of the bed and in his brain snapped shut and moved on to with heartache, with fear. what, I hope you know that. turned to leave, and on my way out of the how old Rosa Parks was when she died. Or how anxiety—a sneaky sidekick to But we weren’t done yet. room I saw Joey’s book about the human “Well, Jack, it’s a part of you, just like his Autism Spectrum Disorder—came Two weeks later we were having din- anatomy. And it occurred to me that some- your eyes are blue and you have big feet.” in one February like a thief in the night, ner at Shorty’s, our local Mexican restau- day, we’re going to have to tell Jack about “Do all people with blue eyes have it?” threatening to steal his joy, his happiness, rant. Our meals had just arrived, and in sex, and trying to have the Sex Talk with “No, it’s not really about your eyes. It’s the very smile on his face. And how the the midst of napkins and salsa and tipping someone who has autism, well, that could like how you learn things.” teeny-tiny white pill he swallows before cups, a robotic voice. be a whole new level. And then, in rapid fire, these questions: bed keeps the thief at bay, keeps the occa- “I don’t want this autism anymore. I I think I’ll leave that one up to Joe. sional giggle in his voice. don’t want it in me.” • Do grown-ups have it? How his father and I are constantly sifting I just didn’t even know what to say. Sit- “What Color Is Monday?” is available through the flood of information and advice ting in a booth at a Mexican restaurant and on Amazon.com and BarnesandNoble.com. • Who else has it? about hyperbaric chambers and gluten-free hearing my son say he wants to rid himself You can also follow Carrie on her weekly pretzels and advanced behavior therapy; of something that is so fundamentally his, blog: www.WhatColorIsMonday.com and • Will I always have autism? sifting and sorting to concentrate on the well, it broke my heart open wide. Facebook.com/WhatColorIsMonday.

Twitter from page 16 Beth Yurman, PsyD, a Licensed Psy- chologist, and a certified school psychol- his/her social skills. Just as direct instruc- ogist in Connecticut, specializes in cog- YAI Mourns the Loss of Thomas Dern tion is useful in the classroom, we have to nitive-behavioral therapies (CBT) and be teachers for our children and use the related interventions, to treat anxiety and most direct, meaningful speech possible mood disorders in adolescents and adults The YAI Network when conveying concerns. with extensive background and exper- This article was originally published tise within the field of ASDs. Her private in the fall 2013 issue of the Asperger and practice is in Manhattan and Brooklyn, homas A. Dern, the Chief Op- High Functioning Autism Association’s NY. For more information, please contact erating Officer of YAI, a New (AHA) print publication, On The Spectrum. Beth at [email protected]. York City-based nonprofit orga- nization, passed away on Mon- Tday, December 9, at his home in Bald- win, NY. Self-Expression from page 26 ity and also recites a poem she wrote ex- Mr. Dern, who oversaw one the largest pressing her thoughts on what being “nor- systems of group residences for people of the semester, their iMovie, captured the mal” is all about. Additional digital stories with developmental disabilities in New sights and sounds of Chinatown and was include short biographies that showcase York State, dedicated his more than enjoyed by all. Another young man with a talents such as expressing a love for show 35-year-career to promoting the rights passion for music and coffee, wrote a song tunes (and singing a few), or drawing and and abilities of individuals with disabil- about coffee, used the Garage Band app displaying sketches. ities, such as autism, Down syndrome to create and record the music instrument We all have “stories” to tell. Through and other intellectual disabilities. by instrument and further incorporated the the AHRC New York City and Pace Uni- “Tom was a cherished colleague and song into a slide presentation using the versity Service-Learning partnership, we formative leader whose contributions to Keynote app. Technology not only facili- anticipate more individuals on the autism the agency and the field are hard to over- tated his ability to express his passions, but spectrum will have the opportunity to tell state,” said Stephen E. Freeman, YAI’s also empowered him to share those pas- their stories in the coming years. CEO. “There will be a time for tributes sions with others. In the past, a young man AHRC’s overall commitment to tech- and remembrances for a man who made initiated an animation project by drawing nology is evident by the computer labs, a remarkable difference in the lives of Thomas A. Dern cartoons on paper. He was then provided laptops, Smart boards, large flat-screen many, many families and was a passion- a Wacom Bamboo tablet, a sophisticated, TVs, and both low-tech and high-tech com- ate advocate for people with disabilities. and NIPD/NJ are YAI network members. touch-sensitive device that works with im- munication devices used daily in various But right now we are deeply shaken and A graduate of St. John’s University, aging software such as Photoshop. When environments for diverse purposes by indi- saddened by the loss of our friend. Our Mr. Dern earned his Master’s of Social mobile technologies arrived on the scene, viduals on the autism spectrum as well as hearts are with Tom’s wife Patty, his son Work from Hunter College. the story was transferred onto an iPad where individuals with other intellectual and de- Marc, and the entire Dern family.” Recognized as an expert in the field, an animation app totally revolutionized the velopmental disabilities. Snoezelen rooms Mr. Dern joined YAI as a counselor in Mr. Dern held a variety of leadership po- project. In fact, the characters in the story allow individuals to experience a relaxing, the agency’s Astoria Residence, which sitions in the field and is a member of had then morphed from superheroes into multi-sensory environment. Nintendo Wii, was the second community-based res- numerous professional associations. He a self-portrait. Talk about self-expression! Wii fit, Exer-gaming equipment and fitness idence for people with developmental was a Fellow of the American Associa- The Keynote app was also used by young bikes permit users to have fun while keep- disabilities to open in New York State. tion on Intellectual and Developmental woman to design a brochure describing her ing fit. GPS technology has been used by Mr. Dern’s served as Associate Exec- Disabilities. He served as chairman of ideal workplace-a day care center. Another many individuals to assist them in becom- utive Director of the YAI before being the InterAgency Council’s of Mental young woman, who attends an AHRC New ing “travel trained,” a very empowering promoted to Chief Operating Officer in Retardation and Developmental Dis- York City Career and Community Studies achievement and a skill that increases com- 2009. He oversaw more than 100 YAI abilities Residential Committee. He also Program located in a local community col- munity success and social independence. residential programs, as well as the helped prepare a future generation of so- lege, also participates in the Pace program. Mobile technologies, particularly iPads, are Rockland County Association for Learn- cial workers by mentoring staff, and by She has a passion for self-advocacy and her extremely popular and the ever-expanding ing Disabilities (RCALD), and the Na- teaching at several colleges, including current iMovie is a face-to-face, sit-down universe of apps allows individuals a means tional Institute for People with Disabili- Hunter and Adelphi colleges, St. John’s talk with her audience. She encourages her by which to express their unique interests as ties of New Jersey (NIPD/NJ). RCALD University and Long Island University. audience not to be defined by their disabil- well as meet their particular needs. AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 33

Real Person from page 8 iPads, PC tablets, speech applications, etc. questions about his day, and Jerry would dividual develop social skills. “My focus We focus on a person’s needs, wants and only be able to respond to my questions in has always been to help them to try and in the spring of 2012, in Queens and the beyond. In Jerry’s case, he no longer has one word answers. understand. But look at [Jerry]. It’s the real Bronx. YAI is expanding the program to to wait to be asked, “What would you like I’m working with Jerry to use more com- person – who has been trapped inside – Long Island, with evaluations available in for a snack?” and await choices or respond plex sentence structures. As I show him a coming out.” Mineola and Brentwood. just to yes-no questions. Having received new page or key, he will grab hold of my I am constantly inspired by the indi- Evaluating and then training an individ- his own device in the fall, he now proudly finger. It helps him with motor memory viduals I work with at the AAC Center. ual with autism or another developmental initiates conversation and comments on a and perhaps allows him to focus on new Whether it’s an individual using his com- disability to utilize a communication sys- variety of topics throughout the day. information. Since obtaining the device, munication system to tell his mother that tem is life-changing; not only for the per- Within a day of receiving training on his we can now focus more on social skills, for the first time that he or she loves her, son, but just as much for his or her family, Nova Chat device, Jerry was in his day pro- like meeting a new person or participating or an individual finally having the oppor- peers, and staff. gram editing his communication system. I in and maintaining a conversation, as he tunity to express his dream to open his Before Jerry or any individual receives observed him photographing different staff previously did not have a consistent, func- own business, the individuals here at the his or her device, I send home an eight- members so that he could create a button tional means of communication. YAI AAC Center are using their newly page questionnaire for the family to fill for each person, enabling him to say good “He’s very enthused about his device acquired voices to express themselves in out. This entails providing names of all morning to a person by name, or to ask to and wants to let you know what’s inside their own unique ways. With a voice, the family members, including close cous- speak or see a staff member. of him,” said Petal Morris, Supervisor of individuals we support are now able to de- ins, aunts and uncles, pictures of fami- He displays total ease with typing and YAI’s Kew Gardens Day Services. “He’s a velop relationships and friendships, build ly members, names of pets, likes and accessing different keys and pages, some- new person.” their social skills, and in some cases, ob- dislikes, recent vacations and outings. thing you might expect after a person has “He’s so much more independent with tain employment. Their lives are changed I program this specific information into the device for a year. In fact, he often tells the device,” said Denise Rutherford-Gill, forever. And through working with them, the device – so that the device is tailored me about certain upcoming events of which another Supervisor at the program. “Be- so is mine. to the individual. I am not aware. For instance, during a pre- fore he started using the device, he would In addition to conducting comprehensive vious session, he was able to tell me that a charge into my office and I would have to Maegan Meneses, MA, CCC-SLP, is a evaluations for individuals of all ages at new movie was coming out in theaters, and stop what I was doing. Now he comes in, Speech Language Pathologist at the YAI the AAC Center, we also provide therapy proceeded to provide me with the exact and if I’m on the phone, he waits. He’s say- Center for Specialty Therapy’s Augmenta- and train new users, their family members, date of its debut. He can now tell me which ing a lot more than ‘Hello.’ Just by pausing, tive and Alternative Communication Cen- caregivers, staff and educators on how to volunteer site he attended that day, what and recognizing that I’m busy, he’s saying, ter. For more information about the Aug- utilize devices or communications sys- his job responsibilities were, and how the ‘I want to have a conversation with you.’” mentative & Alternative Communication tems. We program devices which some day went. Before the acquisition of his de- Denise admits she never imagined that Center or other services, call YAI LINK at individuals may already own, including vice, I would have to ask numerous yes/no a communication device could help an in- 212-273-6182.

Psychotherapy from page 9 with ASD. As such, she is currently seeing women visited New York for consultation apy setting, it is essential to identify a four women for individual therapy via the or an assessment prior to starting telether- computer-accessible location that is free therapy, computer-assisted therapy, or in- computer who live in different states. For apy services. However the current status from distraction. Parents should negotiate ternet-mediated therapy. The most widely two of these women, there are no local pro- of state licensure regulations poses a sig- an arrangement that includes a balance of used format entails conducting sessions viders who have experience treating adults nificant barrier to families and individu- privacy and monitoring based on therapist through live video messaging (e.g., Skype), with ASD, let alone who understand the als who desire to receive services from a recommendations. Furthermore, the sensi- but email exchanges, online chatting, tele- nature of ASD in females. Overall, the ex- practitioner whose home state is different tive and stimulating process of psychother- phone sessions, and text messages are also perience of participating in teletherapy has than theirs. Again, this directly affects in- apy may occasionally trigger emotional or sometimes encompassed in teletherapy. been highly positive for Dr. Nichols, and by dividuals for whom services from a spe- behavioral incidents that, under traditional The practice of teletherapy within the feedback, for her clients. The anxiety one cialist are most appropriate, or who live circumstances, would be managed by the scope of its potential reach is still in its woman feels while outside of her apartment in rural areas. Take for example in the therapist. In the case of teletherapy, proac- infancy, yet psychology researchers are can create a heightened state of arousal and medical field, a patient who has a highly tive planning is necessary and may reduce scrambling to gather clear information discomfort that lasts for hours. Being able rare form of cancer and needs to see a spe- emergency occurrences and severity. about its feasibility and effectiveness. Most to participate in therapy from home enables cialist oncologist in Oregon despite their Psychotherapy, whether conducted in a studies have pointed to similar client success her to be more focused and engaged in the living in Florida. Dr. Nichols is currently traditional clinical setting or utilizing the rates between in-person and teletherapy in therapeutic process, even when discussing licensed in NY, CO, MO, and IA, each of expanding range of technological tools, terms of goal attainment, satisfaction (with the goal of leaving her apartment. Most which have their own fees, requirements often provides monumental benefits in the exception of occasional technical frus- therapeutic activities can be modified for for licensure, continuing professional edu- the growth, adjustment, and well being of trations), and client-therapist relationship presentation via computer (e.g., materials cation, etc. It is unfortunately not feasible individuals on the autism spectrum (Gaus, (Backhaus et al., 2012). Exceptions have emailed ahead of time), and for some pur- for a single clinician to become licensed in 2011; Scarpa & Reyes, 2011; Scarpa, primarily centered around less success in poses, the teletherapy format is most bene- every state within which potential clients White, & Attwood, 2013; Sze & Wood, teletherapy with a group of clients (Kallay ficial (e.g., being able to see a room when a seek therapy. 2007; Wood et al., 2008). The impending & Michlea, 2010) and quicker success in therapy goal is directly related to that room As a culmination of the aforementioned establishment of clear practice guidelines, teletherapy with individuals diagnosed – organization, sleep hygiene). research findings, practical experiences, privacy safeguards, and evidence-based with anxiety disorders (DeAngelis, 2012). At the same time, our firsthand experi- and general considerations, we hope to interventions in teletherapy promises When it comes to children and adolescents, ence, in combination with concerns that equip interested parents and telethera- to allow wider psychotherapy access in their universal engagement with technolog- have been raised among colleagues and py-seekers with tools to ensure a comfort- combination with individualization of ical tools may actually enhance the appeal regulatory agencies, underscores the in- able and constructive experience. When treatment. Awareness of this therapeu- of participation in therapy. Furthermore, herent dilemmas associated with reliance beginning a relationship with a thera- tic approach, especially in its potentially proponents have highlighted opportunities upon technology during therapeutic inter- pist who provides teletherapy services, unique appeal to children and adults with for accessing therapists, particularly within ventions. Challenges Dr. Nichols has expe- it is sometimes helpful to hold an initial social learning concerns, may be influen- specialty areas such as ASD, whom indi- rienced include losing a connection during in-person meeting when plausible (Ma- tial in paving the way for future develop- viduals would normally be deterred from a particularly salient moment in therapy, heu, 2013). More importantly, however, ment and success. contacting due to geographical constraints. and encouraging her clients to be able to a well-matched therapist should be iden- Indeed, research has consistently demon- see the virtual “therapy room” as the same tified through careful assessment of profi- Alyson H. Sheehan, PhD, is a strated that such connections can be facil- safe place for sharing intense emotions and ciency in techniques specific to both psy- Post-Doctoral Fellow and Shana Nich- itated by teletherapy arrangements, as can experiences as during an in-person session. chotherapy with individuals on the autism ols, PhD, is the Director and Licensed greater choice in mental health providers Unexpected interruptions can occur (e.g., spectrum and exclusive to teletherapy. Psychologist at ASPIRE Center for overall (Herbert et al., 2012). a client’s cat knocking over their laptop), Policies related to payment, cancellations, Learning and Development. as can the potential for therapy to be per- interruptions in internet connection, and ASPIRE Center for Learning and De- Teletherapy and ASD in Action ceived as less serious (e.g., a client is high- contact between sessions should be clear- velopment is a multidisciplinary prac- ly anxious and avoidant when particular ly outlined. tice in Melville, NY that specializes in Within the context of our practice at topics are raised). Concerns regarding privacy should be assessment, consultation, and treatment ASPIRE Center, we have found substan- In the interest of providing ethical and carefully considered, foremost in terms for Autism Spectrum Disorder, disrup- tial benefit in the opportunity to provide appropriate services, Dr. Nichols has had of security breach risks associated with tive behavior disorders, and other social services to clients who may be reluctant to seek licensure in each state in which general internet use. Programs have been learning difficulties. Detailed informa- to engage in face-to-face sessions or are her clients reside, including having had developed explicitly for facilitating tele- tion can be found on our website at www. unable to find similar specialty services in to fly to one state in order to complete an therapy, and that are HIPAA compliant, but aspirecenterforlearning.com, by calling their area. For example, Dr. Nichols has a in-person jurisprudence examination. She confidentiality must be directly assessed. (631) 923-0923, or by sending an email specialty practice working with females has been fortunate in that three of the four In the context of broader options for ther- to [email protected]. PAGE 34 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

iPads from page 6 working in classrooms with individuals on dren with autism gained spoken language of Health to conduct a five-year, multisite the spectrum. One teacher last year report- faster when play-based therapy included clinical trial. The NIH grant comes through Many of the iPads were donated to adults ed the strides her class had made as a result speech-generating devices such as iPads. its Autism Centers of Excellence program, on the spectrum. iPads have been found to of the addition of the iPad to her class- This study of 62 children seen over a and the researchers include Ann Kaiser of improve the vocational skills of individu- room. “My class and I use the iPad every nine-month period found that using the Vanderbilt University, Connie Kasari of als with autism providing them with more day,” she said. “I have seen improvement speech-generating device together with UCLA, Cathy Lord of Cornell Weill Medi- job opportunities that can be so difficult to in communication skills for my low func- spoken language yielded significantly cal School and Tris Smith of the University find. “The iPad has given my daughter a tioning students. My students have also greater improvement in spoken language of Rochester. voice for the first time in 27 years,” said learned math skills, sight words, and how in comparison to the same intervention “Innovative technologies, including iP- the father of an adult with autism. “My to read using this tool. My student with without access to the SGD. ads and other devices, continue to show daughter never had a way to communicate severe autism has started communicating “Many children with autism use aug- promise for non-verbal individuals with until she was blessed with the donation more because of apps that I have down- mentative communication devices,” said ASD,” said Alycia Halladay, Autism of the iPad. I remember her face the first loaded. It has been a true blessing.” Lauren Elder, Ph.D., Autism Speaks as- Speaks senior director for environmental time she learned to use the iPad to com- sistant director of dissemination science. and clinical sciences. “This research study municate. She pushed a picture of Lion Scientific Background “This study showed that these devices can will help document in a scientific study the King the Movie on her iPad. I then replied, help children with autism develop spoken extent to which this happens.” ‘Okay you want to watch Lion King.’ Na- A study earlier this year supported by a language, which is often the most pressing taysha stopped in her tracks and had a look grant from Autism Speaks, conducted by a concern for parents.” The study also add- Autism Speaks has collected a database on her face, as if to say ‘finally, someone research team that included investigators ed to recent research suggesting that many of hundreds apps that have been recom- understands me.’ Normally we would have at University of California, Los Angeles, nonverbal children with autism can and do mended to us by families and profession- a meltdown for hours while I played a Vanderbilt University and the Kennedy develop spoken language, Dr. Elder adds. als in the autism community. Visit www. guessing game of what she wanted. This is Krieger Institute, tested a developmen- “It also gives therapists an evidence-based autismspeaks.org/autism-apps to search by one example of how the iPad has changed tally-based, behavioral intervention for treatment technique they can use to help age, category, device and ratings. not only my daughter’s life, but my whole teaching spoken language using speech these children.” To stay tuned for future iPad grant an- family’s life.” generating devices (SGD), including iPads, Building on the success of that pilot nouncements, visit the Autism Speaks web- As was the case last year, approximate- in addition to spoken language. The study study, this November the researchers won site www.autismspeaks.org and sign up for ly a quarter of the recipients were teachers found that minimally verbal schoolchil- a major grant from the National Institutes the Community Connections newsletter.

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Developing from page 12 ing. The regulation of these two branches connected to the emWave, they could see a responsibility to do all that we can to has been demonstrated to play a direct role on the desktop monitor how if they were improve the lives of the individuals with participant rated themselves as “part of the in emotional regulation, shifting attention, frustrated or stressed they had a jagged autism that we work with. Carefully select- group.” Staff rated the teen in this way as resiliency, behavioral flexibility and the heart rhythm and when they were feeling ed technology can be a promising tool in he often paced during discussions. Anoth- ability to adapt to effectively to stress and calm or peaceful their heart rhythm was guiding individuals with HFA and AS to er teen challenged the thinking of staff by environmental demands (Appelhans, B.M smoother and more like a coherent wave. lead lives of resilience and optimism. stating, “you call yourself a psychologist & Luecken, L.J. 2006). Participants learn HRV was displayed in a bar graph indicat- don’t you know he’s autistic and he pac- that, in simple terms, these branches repre- ing “heart coherence” (a term coined by For information about Aspire/MGH, es!” Staff indicated that they understood sent the brake and gas pedals of their body HeartMath). Participants learned a variety please contact [email protected], call that pacing is something that individuals and that they can help regulate how much of stress management techniques some 617-365-7293 or visit www.mghaspire.org. with ASD engage in; however we wanted gas or how much braking is needed, which specific to HeartMath (i.e. Heart Focusing, Apsire was previouly named YouthCare. him to understand that others would think ultimately will assist them in being able to Neutral and Quick) others not (i.e. mind- For information about Symtrend, Inc., differently about the behavior. A rich dia- adapt effectively and deal with stress. We fulness, progressive muscle relaxation, vi- please contact Minna Levine, President logue ensued about perspective taking and also highlight that stress is a part of life and sualization, etc.) to help them manage their at [email protected] and visit www. how others (i.e. high school classmates that learning to cope is essential to happi- stress and develop resiliency. The emWave symtrend.com. For information about Heart- and general education teachers) less famil- ness, ease and well-being. allowed them to observe the neurological Math visit www.heartmath.com and www. iar with the characteristics of ASD would HeartMath’s Inside Story curriculum impact of their thinking, their feelings, heartmath.org. interpret his behavior. These dialogues are was developed for “typical” teens and their breathing, and their utilization of spe- intended to provide knowledge, share alter- adults. They also have other curriculums cific relaxation techniques on their heart. References native perspectives and encourage decision for preschoolers to adults. Since it was de- The ultimate goal being to be able to rec- making/problem solving in relationship to veloped for typical learners we modified ognize one’s triggers of stress, how one’s Lucci, D., Levine, M., McLeod D.S., and self and others - not specifically to try to and supplemented their curriculum. We body feels when stressed (i.e. heart racing, Challen-Wittmer, K. (2013) Technologies change behavior. Using Symtrend™ facil- used these curriculums in conjunction with tense muscles, etc) and to be able to prac- to Support Interventions for Social-Emo- itated the teens’ participation and interest HeartMath’s Desktop system emWave to tice stress management techniques in real tional Intelligence, Self-Awareness, Per- in discussing their and others perspectives. help individuals with AS and HFA under- time without being “on the emWave.” sonal Style and Self-Reflection. In K. Another example is when teens rated their stand how their inner and outer worlds are HeartMath as a stress management tool Boser, M. Goodwin and S. Wayland (Eds.) own individual participation in a group connected. and Symtrend™ as a data collection and Technology Tools for Students with Autism and then had to rate the overall group func- HeartMath’s Desktop system, emWave, instructional tool were integral to learning. (pp.201-226). Baltimore, M: Brookes. tioning, by viewing the comparison chart is a stress management tool that utilizes Many of them were able to improve their teens were able to “see” that when they as a finger or ear sensor that monitors heart social competency, self-awareness, stress Levine, M. (2013) No More Clipboards! an individual were positively engaged the rate (HR) and heart-rate variability (HRV). management and self-reflection and devel- Mobile Electronic Solutions for Data Col- overall group functioned better. The sensor collects real time, beat-to-beat op increase resiliency. They developed an lection, Behavior Analysis, and Self-Man- Stress management, relaxation and resil- HR and HRV. It portrays the HR and HRV awareness of themselves and others while agement Interventions. In K. Boser, M. iency were addressed through HeartMath’s in graph form and, as one becomes more improving perspective taking skills. They Goodwin and S. Wayland (Eds.) Technol- emWave Desktop system as well as The proficient, a gaming platform can be uti- learned that heart focus is kind, gentle and ogy Tools for Students with Autism (pp.229 Inside Story and The Science of Me curric- lized. It allows the abstract to become vi- calm and when in this feeling state they - 246). Baltimore, M: Brookes. ulum. In the Science of Me curriculum par- sual. HR and HRV act as an indicator of are better regulated and happier. Both of ticipants learn about the parasympathetic physiological resilience that allowed our these technology tools proved invaluable Appelhans, B.M., & Luecken, L.J. (2006) and sympathetic branches of the autonom- participants to “see” the connection be- in getting participants to “buy in” to their Heart rate as an index of regulated emo- ic nervous system and how these systems tween their thoughts and feelings on their personal growth work and being a part of tional responding. Review of General Psy- play a role in overall health and well-be- heart. When wearing the sensor and being a group process. As professionals, we have chology, 10(3), 229 – 240. AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 35

Robin’s Voice from page 27 recent years, specifically stressing that the efficacy of this process. Nevertheless, • Use a behavioral model; make those procuring language by creating motiva- if a behavioral response is elicited from a devices work for your child! to communicate effectively employing the tion through relatedness is the essential child who craves playing with his iPad, it use of signing. Nevertheless, parents must conduit for successful interaction. Ideal- can work productively. • Collect data trust their instincts at some juncture, and ly, you don’t want one without the other. I digress from the issue at hand to make this was our most significant determination Dr. Schwartz has enhanced her process a point. When my typical children tell me • Visual learning is common for chil- thus far. to ‘humanize’ (my word) children on the that they “talked” to someone, I mistakenly dren with autism; designer programs We found a speech therapist that created spectrum. The downside of simply regur- interpret that they moved their mouths and may prove effective by adjusting to a model that worked for our son. Her name gitating words creates a robot or automaton held a phone. No, it might actually mean your child’s needs is Dr. Nancy Schwartz, and I say, without like behavior. that they talked on Facebook chat, or tex- exaggeration, she changed our lives. Uti- I must admit, that when our boy could ted. The art of communication is sorely For adult children: lizing a type of Gestalt, she would choose a not speak, we did not care how we got challenged in this arena. Perhaps it does habit that our son was drawn to, in his case language. Given our desperation, we were not truly impact their lives in a negative • Utilize technology to practice social he was mesmerized by Disney videos. She determined that we would ‘hone’ his social way, but if an individual with autism clings communication; facial recognition would allow him to watch a segment, and delivery in the future. The years flew by, to the computer or iPad, it just might re- midstream, turn it off. She followed with and our son continued to escalate his level strict communication. • Research job opportunities in the tech- a simple phrase…”turn it o_?” making the of speech, but the delay remained in social The point is that while technology is a nology arena ‘ah’ sound. Remarkably, within a week our understanding. Ultimately, creating moti- powerful force, it is up to individuals who nonverbal child was filling in the blanks, vation through relatedness was the key. work with the autism community, to be • Practice interviews with simple words like “on” and “more.” I reiterate that every case is truly unique. pro-active. As parents, we need to trust our I am not a Pollyanna, who believes in Dr. Schwartz applauds our son’s inter- instincts, yet glean from professionals who • Utilize the telephone for practicing miracles, or that a few words made our son nal motivation. One of his brothers aptly show data about successes and failures. speaking and listening; oftentimes normal. Yet, we all must have a vision for coined the expression “snowflake,” de- My suggestions are practical. Make your most difficult without a visual growth, and are compelled to start some- scribing people affected by autism. No two own list. It is empowering. where. Nearly twenty years have passed, snowflakes are alike. Nearly twenty years For younger children: Finally, be flexible. The world is an ev- and I continue to believe that a behavioral ago, we were advised that our main aspi- er-changing entity. What worked for your approach plays a significant piece in con- ration should be that he never plateau, an • Research a speech therapist who uses child a year ago, may have changed into quering autism. Dr. Schwartz’s no non- auspicious goal. technology as a tool, not a crutch - a new reality, new motivations required, sense approach is hardly a candidate for However, and this is a huge caveat, Repetition and echolalia are part and and hopefully, goals reached, and new a popularity contest. She makes no apol- when technology becomes a crutch, make parcel to many behaviors in autistic vistas ahead. ogies for her assault on autism, yet often it worthwhile. There have been such ad- children. It further invites children into induces results. Dr. Schwartz has treated vancements in assistive technology with their own world of inanimate objects, Robin Hausman Morris is a freelance hundreds of children over the years, and regards to hearing impaired individuals. rather than human interaction. Aiding writer and can be reached at RobinHaus- clearly emphasizes that no cases are ex- Cochlear implants have altered lives. Fa- and abetting that powerful isolation is [email protected]. Robin is a parent actly alike. cilitated communication, utilizing hand counterproductive to progress. examiner for Examiner.com - www.exam- She has developed a certain method- over hand prompts on a keyboard device iner.com/autism-and-parenting-in-nation- ology that has gleaned positive results in has faced scrutiny. I cannot comment on • Use technology to elicit speech al/robin-hausman-morris.

Classroom from page 29 I subject content due to the accommo- Student 3 contributed to greater cognitive V.L. (2011). An Examination of Teacher dations they had developed reliance on delays which were not addressed with the Acceptance of Handheld by AIMS web (www.aimsweb.com) were throughout elementary and middle school specific application at the time of interven- used before intervention for a baseline; stu- education. Their dependency on counting tion. In conclusion of the evidence pre- Computers. International Journal of Spe- dents received an assessment test at the end hash marks and using calculators allowed sented, incorporating technology-based in- cial Education, 26(3), pages not numbered. of each week during intervention. The de- these students to avoid internalizing the terventions in the classroom does support pendent variable was the total of correct re- knowledge of addition and multiplication students in building skills. The necessity of Grandin, T. (2006). Perspectives on Educa- sponses to basic math problems answered facts. Without the automaticity of recall- engagement with technology in real world tion from a Person on the Autism Spectrum. in one minute. The form of the dependent ing these basic facts, these students were situation only reinforces the evidence that Educational Horizons, 84(4), 229-234. variable changed only in that the operation lost as they entered secondary education taking learning out of the textbook will of the problems progressed based on stu- where possession of this knowledge is tak- benefit our students long term. Exposing Ke, Fengfeng (2007). A case study of com- dent skill mastery level. en for granted as students engage in more students to various methods of learning puter gaming for math: Engaged learning Multiple baseline data were collect- complex math functions. aids in the generalization process and cre- from gameplay? Computers & Education, ed from AIMS web assessments where The treatment probes determined if the ates learners who seek to be engaged in 51(2008), 1609-1620. students are not permitted to use tools to intervention had an effect on students’ flu- evolutionary progress that informs aca- answer problems. Tools are defined as ency gains. The following chart displays demic learning. Kauffman, J. M., McGee, K. & Brigham entering problems into a calculator, manip- the progress of the participants by compar- M. (2004). Enabling or Disabling? Obser- ulative counting items, or a scratch sheet. ing the intervention average to the baseline Elizabeth Perez, MS, is a special educa- vations on Changes in Special Education. The application allowed students to focus average. The middle column contains the tion high school teacher for The Associa- Phi Delta Kappan, 85(8), 613-620. all of their cognitive skills on building basic highest score attained by each participant tion for Metroarea Autistic Children, Inc. computation skills. Each student was timed to show the achievement possible perhaps For information about the school, visit Little, Mary E. (2009). Teaching Mathe- and each participant’s score was recorded with extended use. www.amac.org or call (212) 645-5005. matics: Issues and solutions. Teaching Ex- as a feature of the app. Another advantage Student 1 began treatment with an av- ceptional Children Plus, 6(1), 1-14. to applications in the classroom is that erage of 25 percent accuracy of multipli- References physical data collection tasks are reduced. cation problems answered correctly in one Price, A. (2011). Making a Difference with The score keeping can be used to motivate minute and reaching a high score of 65 Adiguzal, T., Capraro, R.M., & Willson, Smart Tablets. Teacher Librarian, 39(1), 31-34. students in a competition or just allow them percent. His overall average was around to see their own quantitative progress. The 60 percent accuracy. Student 2 showed im- application’s interface was minimal, the se- provement immediately after intervention lections for practice are: addition, subtrac- implementation but maintained an average tion, multiplication, division, addition/sub- of 50 percent during intervention. Student traction together, multiplication/division 3 nearly doubled his score when treatment together, and all combined. was introduced earning a score of 38 per- This study was designed to decrease cent. His average was 50 percent accura- students’ dependency on calculators, hash cy overall. Student 4 began baseline with marks or various other crutches to solve an average of 5 percent. He did triple his basic single digit math problems. The most average though only reaching 15 percent current application software in a smart accuracy during the intervention. He did tablet was utilized to determine the effec- not demonstrate increased fluency with tiveness of visual technology to increase subtraction through implementation of the internalization of basic sums, differences, intervention and continued to rely on hash products, and quotients. The four partici- marks during probes, significantly imped- pating students selected were encounter- ing internalization of sums and differences. ing great difficulties accessing the Algebra It is thought that the severity of Autism in PAGE 36 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

Social from page 22 Level 5, expand upon choices - Intro- Video Modeling Guidelines the key points and then take the mobile duce the social nuances that allow one device with you to practice when he is visual learners. Because of this visual in- to compare and contrast similar sce- The primary rule of video modeling is standing in line at school for non-verbal clination, video modeling of social skills narios to determine the most accept- to present real people in real scenarios, cueing. Further, use the mobile device meets these students where they learn able pragmatic language and behavior rather than cartoons or drawn images. It to eventually video the student himself best (Corbett & Abdullah, 2005). in any given situation. Because social is critical to focus on facial and body completing the target behavior. awareness is so subjective, this allows expressions to convey both verbal and Taking advantage of the technology Levels of Skill Progression the student with whom you’re working nonverbal cues and to use same-age that surrounds us will not only engage to make a detailed analysis of the bet- peers whenever possible. your student, but make social interac- The following levels of skill progres- ter versus the best outcome. “That boy When you begin planning your DIY tion come alive. Students on the autism sion provide an outline for dissection and was yelling in the store because they did video modeling project, first evaluate spectrum need skill examples to be con- discussion of the video scenarios that not have his favorite ice cream. What is your student; what are their challenges crete, and we now have unprecedented lead to social awareness and integration: your favorite ice cream? Do you like and needs? Communication between capability to make the abstractness of other kinds of ice cream? What are some parents, therapists and teachers is essen- social skills become tangible. When Level 1, build vocabulary - Treat the vid- other things you could do if the store did tial to key in to specific behaviors to tar- you follow the outlined steps to dissect eo footage like a picture book, describ- not have your favorite flavor?” get together. Each video should focus on social videos with your student, they ing what the children are doing, such as, one concrete skill. Keep the video very will grow in understanding and confi- “The children are standing in a line.” Beyond the Basics: short, no more than 30 seconds. Don’t dence to master these elusive skills and Introduce vocabulary words like facial Using a Pre-Made Product overload the student with too much ac- continue to progress toward the goal of expression, body language, and expected tion or too many choices that will cause incorporating social understanding into and unexpected behaviors. These words Using a pre-made product like the them to lose focus. It is important to their natural environment. will help cue a child on what to be aware curriculum from Social Skill Builder eliminate even small distractions, such of as they are watching the scene. provides you with a guide for building as a t-shirt with words or pictures, and Laurie Jacobs, M.A. CCC-SLP, is your library of videos. I sometimes lik- background noises or activity that can co-founder of Social Skill Builder, a Level 2, use vocabulary to introduce en video modeling software available cause the student to fixate on something company launched in 1999 to provide choices - As the videos become stories, for purchase and other pre-made video other than the task at hand. computer-based tools for teaching so- begin to offer choices that encourage sources to the solid basics of a good Having the video on a portable device cial skills to children affected by Au- your student to engage in the scenario. wardrobe: it has the jeans, the shoes, the allows you to refer to it during daily tism Spectrum Disorder (ASD). Laurie, Choices build options for those strug- socks, the sweaters. Everyday scenarios situations that arise, and ask the stu- along with her sister and co-founder gling with the knowledge or language are already covered, such as standing in dent about what they just watched when Jennifer Jacobs, M.S. CCC-SLP, devel- to elicit their own response. “When we line without cutting, talking or pushing, they are in the situation themselves. Get ops software and social apps for pre- stand in line, what should we do? (Pause eating quietly and politely in the caf- the student into the habit of pulling the school through high school cognitive for response.) Should we stand still or eteria, taking turns on the playground, videos from their memory as a guide to ages based on the unique needs of the push each other? Should we wait our turn bully awareness and hundreds of daily, make better social guesses and to make ASD community. Visit www.socialskill- or run to the front of the line?” basic scenarios. Buying video model- the video learning experience an inte- builder.com for software demos, find ing software programs or using other grated part of their daily life. the Social Skill Builder App on iTunes, Level 3, use vocabulary to expose feel- pre-made videos for basic social behav- Keep things positive! Show the ex- and look for our free instructive online ings - This level assumes a solid use of iors will save so much effort and time pected way to do something first, and videos at www.youtube.com/socialskill- basic vocabulary and provides a build- that any initial investment will quickly then encourage the student to predict the builder. Find us on Facebook at www. ing block toward the critical social skill be surpassed by their intrinsic value. positive outcome of a expected behavior facebook.com/socialskillbuilders, or of predicting outcomes. At this level, You don’t need to reinvent the wheel, with the goal of gradually introducing email [email protected] for focus on feelings through the video sub- but you can build upon what is readily the consequences of unexpected behav- more information. ject’s words or body language. Focus available to get the best possible out- ior. Always keep in mind the objective on telling the story through emotions. come for your student. You will add to of meeting the students’ pragmatic needs References “What would you do if you saw your the “wardrobe” by creating custom vid- and goals. teacher crossing her arms and clearing eos that address your student’s specific Chen, S.H. and Bernard-Opitz, V. (1993). her throat? (Pause for response.) “Pay needs, otherwise known as “do it your- Maximize Time, Money and Effort Comparison of Personal and Comput- attention” is correct. Do you think your self” (DIY) video modeling. er-Assisted Instruction for Children with teacher is frustrated or angry? You’re Think about how to maximize every Autism. Mental Retardation, 31(6), 368- right. When someone crosses their arms DIY Video Modeling is part of your videos to extract the full 376. it means they are upset. Now that you Economical and Feasible learning value, as well as the time and have noticed how your teacher is feel- money that have been invested. For ex- Corbett, Blythe A., and Maryam Ab- ing, how do you think your expected The technology available now is per- ample, pull a still photo from a video dullah. “Video Modeling: Why Does it behavior of ‘paying attention’ will make fect for DIY video modeling, because and discuss it with the student. Point Work for Children with Autism.” Journal your teacher feel?” it is economical, readily available, and out posture, facial expression, eye con- of Early and Intensive Behavior Inter- easy to use (Alcantara, 1994). It is no tact, personal space, etc. You can use a vention2.1 (2005): 2-8. Level 4, feelings and body language longer necessary to rent or purchase still photo or a small clip from a vid- lead to inferences - It is important to complicated AV equipment, because eo to stop the action and break down a D’Ateno, Patricia, Kathleen Mangiapa- discuss contextual cues in the video most of us already have mobile phones skill into smaller steps in order to en- nello, and Bridget Taylor. “Using Video subjects’ body language, behavior and with cameras or digital cameras, and tab- sure learning. Break down the lessons Modeling to Teach Complex Play Se- emotions. While this seems similar to lets. Compared to past devices, modern into more basic chunks and ultimately quences to a Preschooler with Autism.” Level 3, it is critical to teach and re- technologies that serve multiple uses can build the skills up to the full level. Journal of Positive Behavior Interven- inforce because so many ASD learners be very economical, plus the technology For portable cuing of social situations, tions. Vol 5.1 (2003): n. page. Web. 28 struggle with nonverbal communication is convenient and easy to manage. Many import the video into a mobile phone Jun. 2013. cues and making inference. Take the great editing programs are also available, or tablet and take this cue into the stu- discussion further; “What is the girl in to help shorten and customize your vid- dent’s own environment. For example, Nikopoulos, C and Keenan, M. (2006). the video doing with her body to show eos. One example, iMovie, can also be if a student is having trouble waiting in Video Modeling and Behavior Analysis. that she is sad?” mastered in no time. line, play the video with him dissecting 1st. London, Philadelphia: print.

Please Tell Our Advertisers That Provide Quality Treatment and Support Services: “We Learned About Your Organization in Autism Spectrum News!” AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 37

Improvement from page 18 tive holds and much more. Each database uated by the clinical team to identify ar- team that understands your organization has a front-end program to make data-en- eas for all-staff training, individual staff and its procedures in detail. bed-checking hardware and software. try a quicker and easier process than paper that could use retraining or client protocols Finally, an on-site project manager must The data from all of these sources are and pen, a workflow to ensure the elec- that could be improved, just to name a few. be selected that has both the technical available for real-time analysis and are tronic forms are routed to the appropriate The possibilities for powerful, actionable skills and the academic and clinical skills prepared for formal analysis every two employees for review and electronic sig- data are only inhibited by the amount of to guide the team through the project de- weeks. Some of the databases include natures, output capability for sending the data and the quality of the data recorded. velopment and implementation phases. business processes as well: if a client has completed reports to governmental agen- Custom databases and applications pro- no bowel movement after three days, the cies, parents and other parties, and report- Where to Start vide an organization the tools it needs to program detects and reports that; or if an ing capabilities for regular review by the make competent, evidence-based deci- overnight staff member misses their 15 senior clinical team. Developing a custom database is often a sions for their clients and for the organi- minute bed-check, a supervisor is auto- When many people think of graph- long and cumbersome task, but as you can zation, and can save thousands of hours matically and immediately notified by text ing organizational data, they think num- see, the benefits are well worth it. While of time filling out forms and reporting message alarms. bers like frequency of events or amount there are innumerable considerations in- on data manually. While no database of time involved in incidents. While volved in designing a database application or computer application will ever re- Organizational Solutions important, the real gold in the data is in from scratch, a few basic guidelines can place competent staff, teachers and cli- mining actionable information that guides help you get started. nicians, technology, when designed and Whether it’s policies or procedures, en- improvement, and that is found in the de- The first step to designing a database implemented thoughtfully and pragmati- vironment variables or staff support and tails. For example, rather than looking at is writing a complete “functional speci- cally, should be embraced. training, every organization has room for how many incidents occurred in a partic- fication” – a report that explains in great improvement. Strategically selected data ular residence, a well-designed database detail every field and feature, including Andrew Shlesinger, MSW, is the Direc- sets – when regularly analyzed by a quali- will show you that behaviors or inci- automation and business processes (work- tor of Clinical Technology at Melmark. He fied team of clinicians and administrators – dents are more likely to occur in the lower flows) that you want the program to do. has been with the organization for over ten provide the information the organization bathroom than the any other room. This This is the guiding document for the devel- years and has extensive experience in da- needs to guide continuous improvement is actionable information; a clinician can opment of the program, so make sure to be tabase /application programming and ac- in outcomes for clients. The key to orga- access that particular location and make as complete as possible. ademic and clinical treatment of children nizational data analysis is discovering just physical changes to the environment to re- Once your functional specification is on the Autism spectrum. He can be reached the right type of data to take and the best duce the issues and then continually assess written, you can present it to software de- at [email protected]. way to report on that data for analysis: too the data for trends to ensure the changes velopment vendors for quote. The ideal Frank Bird, MEd, BCBA is the Chief much data and important findings get lost are effective. Another example of action- candidate for a programming team is one Clinical Officer at Melmark. Frank has in the static, too little and the data bears able information is reporting on staff in- that has not only an exceptional program- over 30 years of experience in the field of no fruit. juries across the organization; trends can ming resume but one that has at least some community-based human service delivery Melmark has several organization-wide be established comparing staff injuries to members in the education field or who systems. Over his career, he has developed database applications that track de- who they were working with, where they are willing to learn the teaching method- over 50 programs in support of individuals tailed data regarding unusual incidents, were working and in what activity they ologies your school utilizes. You cannot with disabilities. Frank can be reached at Workers’ Compensation claims, protec- were engaged. These trends can be eval- underestimate the importance of having a [email protected].

College from page 25 success in college. derstanding of the accommodations of- high school. Assessing college readiness The commonalities among the above fered and those necessary for academic is not a simple task, but one to consider his or her own backpack, binder, school questions are motivation and initiation. success can aid students in gaining an based on a wide array of factors. Speak- assignments, and after-school sched- Both can increase the chances of success understanding of whether or not they are ing with a child’s guidance counselor, ule? How does the student organize academically, socially, and emotionally, ready for college. Working closely with a teachers, camp counselors, as well as homework and long-term assignments? whether going straight to college is the student’s guidance counselor can be very watching him or her interact with their Does he or she use an electronic plan- appropriate path after high school, or if helpful in determining what options exist peers may provide valuable information ner, iPad, homework pad, or iPhone? It it is finding a job and entering the world and which ones are the best “fit” for the and insight that can assist in this deci- is critical that students take the driver’s of work. Many students feel ambivalent student. Understanding the concept of sion-making process. seat on these tasks that require advance about the prospect of college, which is initiation and self-advocating with pro- planning, organizational skills, and time natural and to be expected. Touring cam- fessors, disability offices, and various For more information, please visit www. management. Practicing these skills puses, participating in college summer learning specialists will aid a student in aaronschool.org or contact Adrienne at during high school can lead to greater programs, and having a thorough un- reaching his or her fullest potential after [email protected].

Free Support Group For Families of Adults with Asperger’s Syndrome and High Functioning Autism The focus of the support group is to assist families in understanding the complex issues related to their adult child impaired with Asperger’s Syndrome or High Functioning Autism. At many of our meetings, we have speakers address various topics of importance related to these syndromes.

For more information, visit our website www.FAAHFA.com or contact the facilitators: Bonnie Kaplan - [email protected] | Judith Omidvaran - [email protected]

Socialization and Life Skills Group For Asperger’s Syndrome and High Functioning Autistic Adults Focused on: Employment &Issues, College Coaching & Supports, Socialization Self-Advocacy, Dating, and Relationships

For further information contact the facilitators: Patricia Rowan, LMSW - (914) 736-7898 - [email protected] | Susan Cortilet, MS, LMHC - (845) 406-8730 - [email protected]

Upcoming Meeting Dates: 2014 - 1/26, 2/23, 3/23, 4/27, 5/18, 6/22

Westchester Arc The Gleeson-Israel Gateway Center 265 Saw Mill River Road (Route 9A) Hawthorne, NY 10532 PAGE 38 www.mhnews-autism.org AUTISM SPECTRUM NEWS ~ WINTER 2014

Engaging from page 13 ministrators compiled student engagement Standards Report has cited exercise as an dance using hands and feet to set in mo- data in three classrooms. Students were emerging treatment with promising poten- tion sounds and colorful graphics. During to be the ones that foster expressive com- considered “engaged in instruction” if at tial for individuals with Autism Spectrum a two month period, ACA trialed the Eye- munication. The iPad provides an afford- the end of a 5 second interval, they were Disorder (ASD). It is well-established that Play to determine whether students could able alternative to existing communication looking at the instructionally appropriate exercise has benefits beyond just an increase effectively use the device, and if it could devices. Speech generating devices, which place such as the teacher, correct mate- in physical activity. Exercise targets various function as an additional tool to increase are systems used to supplement or replace rials or wall marker board. Overall, the aspects of brain functioning and has broad physical activity. In surveys, staff who verbal language for individuals that are data showed a low percentage of students effects on overall mental health; it has been worked with students involved in the trial nonverbal or minimally verbal, have long consistently “engaged in instruction.” In- shown to reduce stress, depressive symp- reported that the device was easy to use been successful in fostering communi- creased engagement was noted when the toms, and anxiety. Exercise also provides and accessible to a wide range of students. cation in people without verbal language teacher was speaking specifically to a stu- a boost in learning and memory, as well as Initial observations showed that a major- skills. Data from studies with adolescents dent or prompting their attention in some increases in immunity and metabolism. De- ity of the students who used the device with intellectual disabilities have also sug- way. The same observation tool was uti- spite the plethora of benefits that physical enjoyed the games and effects, and had gested that the use of speech generating lized after interactive “white boards” were activity offers it is sometimes difficult to fun interacting with the device and with device contributes to gains in receptive installed in the same three classrooms. The encourage interest in exercise among indi- their peers. The EyePlay appeared to be a and expressive communication (Romski & data showed an overall increase in individ- viduals with ASD, as conventional physical preferred activity to several students who Sevcik, 1997). Now, with the availability ual student engagement as well an increase activities are often unappealing. were able to remain engaged with the de- of applications or “apps” that imitate those in student sustained engagement (absence “Exergaming,” a term used for video vice for several minutes. Overall, staff felt expensive devices, the iPad offers a more of prompting from teacher). Over time, games that serve as a form of exercise, may the device showed potential for staff-as- accessible, less stigmatizing, cheaper and all (23) classrooms had interactive white help increase physical activity levels in us- sisted engagement for children with ASD. more user-friendly way to help children boards installed. Feedback from teachers ers. These types of gaming devices rely on We look forward to incorporating the po- with autism to communicate. Although no has been overwhelmingly positive. They technology in conjunction with the user’s tential this device offers into other realms empirical studies to date have been con- report the ability to create richer lesson body movements in order to operate. Some of our students’ daily routine. ducted regarding tablets with speech gen- plans that incorporate highly motivating popular devices that use this type of inter- erating application and the enhancement visual and auditory components. Often, action have been shown as more physical- Amanda Coons, MS, BCBA, is a Behav- of expressive language for children with students who had difficulty with computer ly demanding than conventional sedentary ior Analyst, Rebecca Stanmyer, BS, CCC- autism, anecdotal data has been promising. or mouse manipulation on a PC, demon- game consoles. While there are inconsis- SLP, is a Speech Language Pathologist, With the availability of the iPad, therapists strate adeptness with the interactive “pen” tencies in current research regarding how and Kathleen Marshall, BA, MA, SAS, is can assess every student on their caseload used with the whiteboard. Some teachers much energy is expended during use of Director of Children’s Services at the An- as a potential candidate for a speech gener- noted that students who had difficulty these devices, any amount of physical ac- derson Center for Autism. For more infor- ating device. This accessibility, along with tracking images or words presented on a tivity is a step toward a more healthful life- mation, please contact (845) 889-9534 or the ease of evaluation has been significant PC monitor are able to easily do so via the style and may act as an appropriate starting www.andersoncenterforautism.org. for both therapists and students. whiteboard. It’s important to ensure that point for otherwise sedentary individuals. A combination of individual and group the white board is not the only instruction- The EyePlay is an interactive gaming de- References instruction is employed in most ACA class- al tool used in a lesson, especially for stu- vice offered by EyeClick Ltd. that engag- rooms. Group instruction has its challenges dents with significant learning challenges. es users in a fun, exciting, and innovative Romski MA, Sevcik RA. (1997) Augmen- as maintaining student attention and keep- Overall, white board technology has pro- way. This highly-advanced video game tative and Alternative Communication for ing students actively engaged for the du- vided teachers with countless options for platform with motion-activated games can Children with Disabilities. Mental Retar- ration of lessons can be a tall order. Using creating highly engaging lessons. be played with users’ entire bodies, allow- dation and Developmental Disabilities Re- an informal observation tool, school ad- The National Autism Center’s National ing multiple users to run, jump, twist, and search reviews3:363-368

Clinicians from page 23 the web-based intervention resulted in the al circumstances (i.e., text message rap- self-control, self-efficacy, and self-de- percentage of fulfilled obligations shifting port building) and Piers quickly became termination. As clinicians, we put a pre- relationship with the clinician that support- from a low of 31% prior to the introduction a text-messaging virtuoso. During this mium on such outcomes when working ed his home-based program. Therefore, of the web-based plan (based on 14 days) phase of the mobile phone intervention, with children with an Autism Spectrum based on Ammon’s personal strengths and to 97% over the most recent seven days of Piers and his clinician developed their Disorder. interests, a web-based intervention was de- the intervention. In addition to the web- own SMS shortcuts. For example, Piers signed that: based clinical system motivating and sup- decided that if he sent an instant message Conclusion porting Ammon, it also appreciatively im- consisting of the single word “Orange,” • Emphasized self-monitoring and pacted his relationship with his family and then his clinician would allow him to exit We believe that the two case studies pre- self-reporting resulted in the generation of healthy inter- an uneasy situation. Once Piers was outfit- sented would have sent B.F. Skinner wan- actions. Essentially, the program resulted ted with a mobile phone, text messaging dering around the 22.4 acres of Harvard • Provided a practical structure for adher- in a pivotal change in Ammon’s home cir- capability, a reliable (and honored) system Yard. And during the process, he certainly ence to a daily reporting requirement cumstances. Moreover, the individualized for communicating his needs, and a prov- would have sent us a Snapchat Story about program was, at once, strength-based and en arrangement for exiting uncomfortable the smart use of technology to support both • Emphasized daily connectedness with technology enabled. situations, he volunteered to join a social useful and enjoyable behavior change. In his clinician via web-based email cor- skills group for the first time. The inter- our opinion, the esteemed researchers from respondence Mobile Phone Intervention: vention resulted in a multitude of desirable Northwestern University’s Center for Be- A Case Study outcomes, including: havioral Intervention Technologies are in • Supported a multi-source feedback the forefront of creative technology-en- system (e.g., Ammon, his mother and In another case study, we used an inno- • Piers’ active participation in a social abled intervention, and the procedures they father, and the primary clinician), and vative mobile intervention program model skills group have introduced are heraldic of a new way to support a young boy (we will use the of working with individuals that require • Allowed for a web-based social and pseudonym Piers to refer to him) to ad- • Spontaneous communication and con- behavioral support to facilitate changes technological interface conducive to dress his enervating anxiety around other tributions within the context of social in their quality of life. As clinicians, we the promotion of socially significant children. Although Piers valued personal skills group meetings (e.g., a discus- support the use of technology as a medi- behavior change friendships, he was unable to remain in the sion about pets) um for coordinating the delivery of evi- presence of another child long enough to dence-based practices and are proud to be Specifically, the web-based intervention forge any kind of relationship. Moreover, • Contextualized use of text messages to living and working during this new era of designed for Ammon required him to email he resisted joining any of the social skills communicate with his clinician technology-enabled clinicians. his personal scorecard (i.e., the total per- group meetings facilitated by his clinician. centage of household obligations he ful- In an effort to address Piers’ social anxi- • The ability to exit a social context Michael J. Cameron, PhD, BCBA-D is filled during the course of the day) to his ety, a mobile phone with a short message upon texting the code word “Orange” the Chief Clinical Officer for Pacific Child clinician at the close of each day. In turn, service (SMS) component was purchased. to his clinician, and and Family Associates (PCFA). Melissa he would receive a reply from her with It should be noted that Piers had a mon- Cline, MSEd, BCBA is a Clinical Super- validation and instructive feedback. The sterful interest in both mobile phones and • The ability to return to the group meet- visor for Autism Services North (ASN), an personal scorecard appealed to Ammon’s text messaging and had been asking his ing, on his terms, after regulating his affiliate program of PCFA. Rebecca Hise, established interest in data and connected parents to buy a phone for his personal heightened emotional state MS, BCBA is a Clinical Supervisor for to his propensity to talk about scores, facts, use. Subsequent to the purchase, Piers’ Autism Intervention Specialists (AIS), an and figures. The outcome of the interven- clinician began communicating with him, Essentially, the mobile phone interven- affiliate program of PCFA. For more infor- tion was impressive. More to the point, via text messages, under non-emotion- tion resulted in personal empowerment, mation, please visit www.pacificchild.com. AUTISM SPECTRUM NEWS ~ WINTER 2014 www.mhnews-autism.org PAGE 39

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