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Can't We All Just Get Along?: Combining Behavioral and Developmental Naturalistic Interventions for Young Children with Autism |
Saturday, March 1, 2014 |
8:15 AM–9:05 AM |
Grand Ballroom A-B (Suite Tower) |
Area: AUT; Domain: Applied Research |
Instruction Level: Basic |
CE Instructor: Laura Schreibman, Ph.D. |
Chair: John D. Molteni (University of Saint Joseph) |
LAURA SCHREIBMAN (University of California, San Diego) |
Dr. Laura Schreibman, is director and principal investigator of the Autism Intervention Research Program at the University of California at San Diego. She also is a Distinguished Professor, Emeritus, of Psychology and Research at the University of California, San Diego, where she has been on the faculty since 1983. She earned her Ph.D. in 1972 at the University of California at Los Angeles, where she focused on the field of behavior analysis and treatment of childhood autism. Her research since her degree has continued in the same vein, with her current research interests focusing on the development and dissemination of naturalistic behavioral intervention strategies (Pivotal Response Training), the development of individualized treatment protocols, translation of empirically based treatments into community settings, analysis of language and attentional deficits, generalization of behavior change, parent training, and issues of assessment. She is the author of four books and more than 160 research reports, articles, and book chapters. The Science and Fiction of Autism, published in 2005 by Harvard University Press, is her third book. |
Abstract: Our increased ability to identify and diagnose children with autism at earlier and earlier ages provides us with both a huge opportunity and a huge challenge. Our knowledge of the significant, potential benefits of effective early intervention allows us to take advantage of the early intervention window. The challenge is how we can best fill this window. While there is a substantial research base supporting the effectiveness of behavioral interventions across the lifespan of autism, research has demonstrated that interventions based upon the principles derived via applied behavior analysis are being modified to meet the needs of the toddler autism population now being served. Two main modifications seem evident. The first is a move toward more "naturalistic" behavioral interventions, which are more child-directed and occur in more environmental contexts. The second is the integration of principles derived from developmental psychology. In fact, it appears that both of these approaches (behavioral and developmental) have evolved simultaneously in the development of early interventions. Also, it appears that there may be an increased "acceptance" of developmental contributions that are not directly tied to the behavioral model. Where are the common grounds of these approaches that impact intervention? What are commonalities in treatment components, implementation strategies, and assessment? This talk will focus on these issues and also point to research needs for both behavioral and developmental science. |
Target Audience: Psychologists, behavior analysts, practitioners, graduate students, and anyone interested in learning how to combine behavioral and developmental naturalistic Interventions for children with autism. |
Learning Objectives: At the conclusion of the event, participants should be able to:
--Describe common elements utilized with "branded" naturalistic behavioral interventions.
--Describe the importance of incorporating developmental science into the development of interventions for this population.
--Describe research evidence for this approach. |
Keyword(s): Early intervention, natural environment |
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Practical Psychopharmacology of Autism Spectrum Disorder |
Saturday, March 1, 2014 |
9:15 AM–10:05 AM |
Grand Ballroom A-B (Suite Tower) |
Area: AUT; Domain: Applied Research |
Instruction Level: Basic |
CE Instructor: Christopher J. McDougle, M.D. |
Chair: Naomi Swiezy (HANDS in Autism, IU School of Medicine) |
CHRISTOPHER J. MCDOUGLE (Lurie Center for Autism at Massachusetts General Hospital and MassGeneral Hospital for Children) |
Christopher J. McDougle, M.D., is the director of the Lurie Center for Autism at Massachusetts General Hospital (MGH) and MassGeneral Hospital for Children (MGHfC). The Lurie Center for Autism combines comprehensive care with advanced research to better meet the needs of autistic individuals from early childhood through adulthood. He also serves as the Nancy Lurie Marks Professor in the field of autism at Harvard Medical School. A graduate of Valparaiso University, Dr. McDougle earned his medical degree from Indiana University School of Medicine. He subsequently completed a residency in psychiatry at Yale University School of Medicine and a fellowship in child and adolescent psychiatry at the Yale Child Study Center. After seven years at Yale, Dr. McDougle returned to Indiana University School of Medicine. In 2000, he was named chairman of the Department of Psychiatry. He has been awarded two Young Investigator Awards from the National Alliance for Research on Schizophrenia and Depression (NARSAD), an Independent Investigator Award from NARSAD, a grant from the Theodore and Vada Stanley Research Foundation, a Research Unit on Pediatric Psychopharmacology (RUPP) contract, a RUPP-Psychosocial Intervention (PI) grant and additional research grants from the National Institute of Mental Health for the study of autism and related pervasive developmental disorders. McDougle was elected to the American College of Neuropsychopharmacology in 1995. He was twice chosen as Teacher of the Year by the Yale psychiatry residents. In 2002, McDougle was selected as a recipient of the 12th annual Nancy C.A. Roeske, M.D., Certificate of Recognition for Excellence in Medical Student Education from the American Psychiatric Association, and in 2007 he was selected as a recipient of the annual Irma Bland Award for Excellence in Teaching Residents, also by the American Psychiatric Association. In 2003, he was appointed associate editor of the Journal of Autism and Developmental Disorders. |
Abstract: Significant progress has been made in the development of medications for treating many of the behavioral target symptoms associated with autism spectrum disorder (ASD). Double-blind, placebo-controlled trials have been published demonstrating the effectiveness of medications for motor hyperactivity and inattention; irritability (aggression, self-injury, severe tantrums); and to a limited extent for interfering repetitive, ritualistic behavior. Essentially no systematic research studies have been conducted for sleep disturbance (other than melatonin), depression/bipolar disorder, and anxiety disorders, despite the fact that these conditions commonly co-occur in individuals with ASD. To date, no medications have been found to consistently improve the core social impairment, communication impairment and repetitive, ritualistic behavior characteristic of ASD. Information from the published literature will be reviewed, ideas for future directions will be presented, and questions from attendees will be entertained. |
Target Audience: Psychologists, behavior analysts, practitioners, graduate students, and anyone interested in learning more about medications for treating many of the behavioral target symptoms associated with autism spectrum disorder. |
Learning Objectives: At the conclusion of the event, participants will be able to:
--Better understand the target symptoms associated with autism spectrum disorder (ASD) that may be amenable to pharmacological treatment.
--Better understand the type of medication that may be helpful for treating the target symptoms associated with ASD.
--Better understand the potential adverse events associated with medications used to treat the target symptoms associated with ASD. |
Keyword(s): Medication treatment |
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Emergence, Early Intervention, and Prevention of Self-Injury Exhibited by Very Young Children With Moderate to Profound Developmental Delays |
Saturday, March 1, 2014 |
10:30 AM–11:20 AM |
Grand Ballroom A-B (Suite Tower) |
Area: AUT; Domain: Applied Research |
Instruction Level: Basic |
CE Instructor: David M. Richman, Ph.D. |
Chair: Jennifer R. Zarcone (Kennedy Krieger Institute) |
DAVID M. RICHMAN (Texas Tech University) |
Dr. David M. Richman is a professor of educational psychology and leadership at Texas Tech University. He received his Ph.D. in school psychology and minor in applied behavior analysis from the University of Iowa, and he completed a research postdoctoral fellowship at the Kennedy Krieger Institute. Dr. Richman has previously been on faculty at the University of Kansas School of Medicine, University of Maryland Baltimore County, and the University of Illinois. Dr. Richman’s areas of research include assessment and treatment of problem behavior; phenotypic expression of genetic disorders correlated with intellectual disabilities and severe behavior problems; family resiliency, parenting stress, familial quality of life; and integrating quantitative measures of organism variables into behavior analytic research. |
Abstract: The ontogeny of self-injurious behavior exhibited by very young children with severe developmental delays is because of a complex interaction between neurobiological and environmental variables. This talk will cover variables that contribute to emerging self-injury in the developmental disability population with a focus on an operant conceptual model of how topographies of self-injurious behavior can change structurally and become sensitive to various environmental consequences. Data will be described in terms of extending our research focus from a reactive model of assessment and treatment of well-established cases of self-injury to an early intervention and prevention model. |
Target Audience: Psychologists, behavior analysts, practitioners, graduate students, and anyone interested in learning more about preventing self-injurious behavior. |
Learning Objectives: At the conclusion of the event, the participant will be able to (1) Identify topographies and functions of motor stereotypy that may be high probability for transitioning into self-injurious behavior (SIB); (2) Identify behavioral treatments matched to function that can be used for SIB early intervention; and (3) Identify behavioral procedures that may prevent the development of new topographies and functions of SIB currently maintained by some form of automatic reinforcement. |
Keyword(s): prevention model, Self-injury |
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An Empirical Model for Individualized Assessment and Treatment of Two Types of Elopement: Goal-Directed Bolting and Aimless Wandering |
Saturday, March 1, 2014 |
1:45 PM–2:35 PM |
Grand Ballroom A-B (Suite Tower) |
Area: AUT; Domain: Applied Research |
Instruction Level: Basic |
CE Instructor: Wayne W. Fisher, Ph.D. |
Chair: Jennifer R. Zarcone (Kennedy Krieger Institute) |
WAYNE W. FISHER (University of Nebraska Medical Center, Munroe-Meyer Institute) |
Wayne W. Fisher, Ph.D., is the H.B. Munroe Professor of Behavioral Research in the Munroe-Meyer Institute and the Department of Pediatrics at the University of Nebraska Medical Center. He is also the director of the Center for Autism Spectrum Disorders at the Munroe-Meyer Institute, a board certified behavior analyst at the doctoral level (BCBA-D), and a licensed psychologist. He was previously a professor of psychiatry at Johns Hopkins University School of Medicine and served as executive director of the Neurobehavioral Programs at the Kennedy Krieger Institute (Baltimore, MD) and the Marcus Behavior Center at the Marcus Institute (Atlanta, GA), where he built clinical-research programs in autism and developmental disabilities with national reputations for excellence. Dr. Fisher’s methodologically sophisticated research has focused on several intersecting lines, including preference, choice, and the assessment and treatment of autism and severe behavior disorders, that have been notable for the creative use of concurrent schedules of reinforcement, which have become more commonplace in clinical research primarily as a result of his influence. He has published more than 130 peer-reviewed research studies in 28 different behavioral and/or medical journals, including: the Journal of Applied Behavior Analysis, Psychological Reports, American Journal on Mental Retardation, Pediatrics, the Journal of Developmental and Behavioral Pediatrics, and The Lancet. Dr. Fisher is president of the Society for the Experimental Analysis of Behavior, chairperson of the Childhood Psychopathology and Developmental Disabilities Study Section for the National Institutes of Health, a past editor of the Journal of Applied Behavior Analysis, a fellow in the Association for Behavior Analysis, and recipient of the Bush Leadership Fellowship Award, the APA (Division 25) Award for Distinguished Contributions to Applied Behavioral Research, and the Distinguished Scientist Award from the University of Nebraska Medical Center. |
Abstract: The results of a number of within-subject studies have shown that individuals with autism elope for three main reasons: to gain access to preferred items, to escape undesirable settings or activities, or to gain attention from others (e.g., Piazza et al., 1997; Rapp, Vollmer, & Hovanetz, 2005). In contrast to this goal-directed bolting, some children with autism wander without a clear course because of skill deficits and/or a lack of recognition of potential dangers (e.g., oncoming cars, swimming pools). These children have not been successfully taught to discriminate between safe and unsafe environments or to monitor and maintain safe proximity to caregivers. Despite the clear impact elopement has on the health, safety, and well-being of these individuals and their families, no comprehensive treatment approaches to the assessment and treatment of goal-directed bolting and wandering have been empirically validated. In this presentation, Dr. Fisher will discuss a comprehensive model aimed at (a) distinguishing elopement from wandering and (b) developing treatments for problems of elopement and wandering that are uniquely tailored to assessment outcomes. The preliminary results suggest that this comprehensive model can lead to more effective treatments. |
Target Audience: Psychologists, behavior analysts, practitioners, graduate students, and anyone interested in learning more about treatment of elopment. |
Learning Objectives: Forthcoming. |
Keyword(s): aberrant behavior, Automatic reinforcement, self-injurious behavior |
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Long-Term Outcomes for Young Children With Autism Served in LEAP Preschool |
Saturday, March 1, 2014 |
2:45 PM–3:35 PM |
Grand Ballroom A-B (Suite Tower) |
Area: AUT; Domain: Applied Research |
Instruction Level: Basic |
CE Instructor: Phillip S. Strain, Ph.D. |
Chair: David A. Celiberti (Association for Science in Autism Treatment) |
PHILLIP S. STRAIN (University of Colorado at Denver and Health Sciences Center) |
Phillip Strain, Ph.D., is a professor of educational psychology at the University of Colorado Denver and director of the Positive Early Learning Experiences Center. He has written more than 300 professional papers in the early intervention field, has served on editorial boards of more than 20 professional journals, has been the principal investigator of grants totaling more than $50 million and has been recognized with distinguished career awards on three separate occasions. He authored the original grant that funded the development of the LEAP (Learning Experiences: An Alternative Program for Preschoolers and Parents) Preschool model for children with autism in 1980 and has continued to develop the model during the past 30 years. His primary research interests include intervention for young children with early onset conduct disorders, remediation of social behavior deficits in young children with autism, design and delivery of community-based, comprehensive early intervention for children with autism, and analysis of individual and systemic variables affecting the adoption and sustained use of evidence-based practices for children with severe behavior disorders. |
Abstract: This session will focus on the results of a follow-up study conducted on participants in the 2011 randomized trial of the LEAP (Learning Experiences: An Alternative Program for Preschoolers and Parents) Preschool model. Current data on children's social, language, cognitive, and academic competence will be reviewed. Particular attention will be paid to predictors of follow-up status and the influence of contemporaneous environments on children's developmental status. |
Target Audience: Psychologists, behavior analysts, practitioners, graduate students, and anyone interested in learning more about a follow-up study on the LEAP (Learning Experiences: An Alternative Program for Preschoolers and Parents) Preschool model. |
Learning Objectives: Forthcoming. |
Keyword(s): LEAP model |
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Challenges to Families and Providers in Obtaining Payment for Services |
Saturday, March 1, 2014 |
4:00 PM–5:20 PM |
Grand Ballroom A-B (Suite Tower) |
Area: AUT; Domain: Service Delivery |
Chair: Wayne W. Fisher (University of Nebraska Medical Center, Munroe-Meyer Institute) |
CE Instructor: Wayne W. Fisher, Ph.D. |
Panelists: CATHLEEN C. PIAZZA (University of Nebraska Medical Center's, Munroe-Meyer Institute), CHRISTY WILLIAMS (University of Nebraska Medical Center), STEPHEN FOREMAN (Bingham Gardens) |
Abstract: Children with autism often have co-occurring behavioral health disorders, such as feeding disorders (70%), aggression (26%), or self-injurious behavior (19%). Insurance companies often attribute these co-occurring disorders to the individual's autistic disorder, a problem referred to as diagnostic overshadowing, and then use this attribution to deny payment for treatment. This panel will include a discussion of a process that has been used to preauthorize patients for day-treatment feeding and severe behavior programs. Nearly 80% of all initial treatment requests are denied by insurance companies and thus must be appealed by the service provider. Often, it is necessary to have the family ask human resources personnel to contact the insurance provider as a part of the appeal process. In addition, claim follow-up is an essential component of the process to ensure that full negotiated payment is received for the services provided. Documentation and perseverance are perhaps the most critical elements in obtaining an authorization for a client to begin services. Using these procedures, the Munroe-Meyer Institute has obtained prior authorization and payment for about 90% of the patients for whom it makes initial requests. |
Instruction Level: Basic |
Target Audience: Psychologists, behavior analysts, graduate students, and any one interested in learning about how to obtain preauthorization for treatments from insurance companies when diagnostic overshadowing is involved. |
Learning Objectives: Forthcoming. |
CATHLEEN C. PIAZZA (University of Nebraska Medical Center's, Munroe-Meyer Institute) |
Cathleen C. Piazza, Ph.D., is a professor of pediatrics and director of the Pediatric Feeding Disorders Program at the University of Nebraska Medical Center in Omaha. She previously directed similar programs at the Marcus Institute in Atlanta and at the Johns Hopkins University School of Medicine in Baltimore. Dr. Piazza and her colleagues have examined various aspects of feeding behavior and have developed a series of interventions to address one of the most common health problems in children. Her research in this area has been among the most systematic in the field and has firmly established behavioral approaches as preferred methods for assessment and treatment. In her roles as clinical, research, and training director, Dr. Piazza has mentored a large number of interns and fellows who have gone on to make significant contributions to the field. Highly regarded for her general expertise in research methodology, Dr. Piazza is a former editor of the Journal of Applied Behavior Analysis. |
CHRISTY WILLIAMS (University of Nebraska Medical Center) |
Christy Williams is the program associate for the Center for Autism Spectrum Disorders at the Munroe-Meyer Institute (MMI) in the University of Nebraska Medical Center. She has more than 30 years of administrative experience and has particular expertise in negotiating with behavioral health insurance providers. She currently serves as the insurance liaison supervisor for the Severe Behavior Program, Pediatric Feeding Disorders Program and the Early Intervention Program at MMI. She assisted in the development and growth of these programs with Drs. Wayne Fisher and Cathleen Piazza, and she has served as the lead administrator for these programs since their inception in 2005. Since that time, these programs have served more than 1,000 patients, and revenues have grown to more than $2 million per year. Ms. Williams also has served as an expert consultant for Florida Institute of Technology, Western Michigan University, and Keystone Pediatrics in Jacksonville, FL, regarding insurance clearance. Before joining UNMC, Ms. Williams worked for the United States Government in Europe and Korea. |
STEPHEN FOREMAN (Bingham Gardens) |
Stephen Foreman has worked with the special needs population for more than 10 years. He began his career in the classroom, where he discovered the use and practice of applied behavior analysis. Mr. Foreman earned his board certification as a behavior analyst in Florida and worked as a practitioner specializing in providing behavior supports to individuals with intense physical aggression in residential and family settings. In addition to his field work, he was also a select member of the Local Review Committee, in which he assisted in the clinical review and approval of local behavior support plans. Mr. Foreman then moved to Kentucky in 2009, where he had the opportunity to grow and direct one of the largest behavioral support companies in the state providing behavioral programming to hundreds of children and adults on various programs.Throughout his career, he has had the privilege to supervise students and other behavior analysts across multiple states and enjoyed watching their clinical skills blossom. He currently works as a behavior analyst for Bingham Gardens in Louisville, which is an intermediate care facility, working with adults with severe challenging behaviors. In addition, Mr. Foreman serves as the vice chair of the Behavior Analysis Licensing Board in Kentucky and is one of the founding members of the Kentucky Association for Applied Behavior Analysis and is currently the president-elect. |
Keyword(s): diagnostic overshadowing, Insurance preauthorization, service authorization |
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