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Summer 2013

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SCIENCE IN AUTISM TREATMENT


Vol. 10 No. 3 Summer 2013
Newsletter of the Association for Science in Autism Treatment

ASAT Celebrates its 15th Anniversary


David Celiberti, PhD, BCBA-D, Executive Director
The Association for Science in Autism Treatment (ASAT) is celebrating its 15th anniversary! I am proud to have
been part of ASAT for the last nine years. Since 1998, we have worked diligently to keep science at the forefront
of the conversation about autism treatment, and have developed and maintained a comprehensive website and
a quarterly newsletter. Our website and newsletter serve as primary sources of science-based information
against a backdrop of information overload, pseudoscience, and inaccuracies that distract consumers from
making the best possible treatment choices for their children. ASAT provides these and other resources with no
charge whatsoever to anyone.
Autism treatment is a multi-million dollar industry with 400+ “treatments.” For the
majority, science is overlooked and pseudoscience is marketed using heart wrench-
ing testimonials, surveys, and anecdotes providing outrageous claims about out-
comes. Poke around the internet and you will quickly see that parents are
promised the moon. Aggressive marketing of these so-called "therapies" and
"cures" make them appear quite compelling. Some marketing campaigns can be
absolutely overwhelming and serve to drown out accurate information for par-
ents who are desperate to help their children, and for providers eager to help
15
individuals realize their fullest potential. All of us at ASAT are committed to im-
proving the education, treatment, and care of people with autism, and believe
Years!
that we do no favors to individuals with autism and their families by ignoring quack-
ery and not countering baseless claims. In addition, we believe that it is critical to
provide tools to consumers and professionals so that they make informed treat-
ment decisions and become savvy decision-makers who hold all treatment accountable
for claims made.
Table of Contents Our mission is as follows:
We promote safe, effective, science-based treatments for people
Letter from the Editor .............................................. 1 with autism by disseminating accurate, timely, and scientifically
Interview with Jane Asher ....................................... 4 sound information; advocating for the use of scientific methods to
Research Review: Therapeutic Horseback Riding ... 8
guide treatment; and combating unsubstantiated, inaccurate and
Research Review: Facial Recognition Skills ........... 9
Treatment Summary: Rapid Prompting Method .. 10
false information about autism and its treatment.
ASAT Advisory Board ............................................. 11 ASAT is a not-for-profit organization run by a volunteer board of
ASAT Coordinators and Committee Members ..... 12 professionals and family members of children and adolescents
15 Ways to Celebrate ASAT .................................. 14 with autism (see page 24), as well as myself, as a part time, Exec-
Letter from the ASAT Marathon Leader ............... 16 utive Director. Almost half of the members of our Board of Direc-
Dairy Queen: Pennies DO Make Dollars ............... 18
tors have served for over five years. This level of longevity and
2nd Annual Autism Conference ............................ 19
Letter from Externship Coordinator ...................... 20
commitment is what enables ASAT to remain a strong voice for
Tastefully Simple Fundraiser ................................ 21 science and accountability.
Consumer Corner: The DSM-5 .............................. 22 I would be remiss if I did not mention our Professional Advisory
Shout Outs , Accolades, and Appreciation ........... 24 Board (see page 11), many of whom are actively involved with
ASAT Board of Directors ........................................ 24 ASAT. Dr. Bobby Newman manages our NYC Marathon team and
Central Basketball League: Points for Autism! .... 25 has been instrumental in helping us develop science-based lend-
Interview with Christina Danos ............................. 26
ing libraries. Dr. Sharon Reeve coordinates the efforts of her grad-
Clinical Corner: Integrating OT and ABA ............... 30
Media Watch .......................................................... 32 uate students at Caldwell College who author the research synop-
ASAT Sponsorship ................................................. 33 ses. Dr. Catherine Maurice, ASAT founder, has remained a staunch
ASAT’s Facebook Update ...................................... 34 supporter and sage advisor whose input remains highly appreciat-
ed and respected. Finally, we have scores of volunteers who serve
in a wide array of capacities such as Coordinators, Externs, Media

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 2
Science in Autism Treatment
Letter From the Editor continued...
(Continued from page 1)
Watch writers, and fundraisers. Many of these individuals, and their respective roles, are listed on page 12.
Since ASAT was established in 1998, it has been our goal to work toward adopting higher standards of ac-
countability for the care, education, and treatment of all individuals with autism; essentially to raise the bar. It
remains our goal to assure that the family of every person with autism has access to information that will help
their loved one receive the best intervention that science can provide, delivered with competence, clarity, and
compassion.
ASAT was the first autism organization to wholeheartedly embrace an empirical, science-based approach to any
statements made about the causes and proposed treatments for autism. This commitment has led many to
question if we were biased to supporting and promoting Applied Behavior Analysis (ABA). On a surface level,
there may indeed appear to be such a bias; however, it is the underpinnings of this discipline that inform our
advocacy. These include, but are not limited to:
 Reliance on and respect for published research;
Volume 10.3 Summer 2013

 The use of single subject research design in documenting outcomes and assessing functional relation-
ships between independent and dependent variables;
 An appreciation of the social validity of goals, methods, and outcomes;
 The transparency and potential for replication that results from explicit treatment descriptions;
 Objective definitions of treatment targets;
 Collection of inter-rater reliability data to ensure that measurement is accurate;
 Ongoing, objective data collection; and
 Data-based decision making.
In 1999, the first issue of Science in Autism Treatment (SIAT), ASAT’s quarterly newsletter, was published in
order to make information accessible to consumers of autism treatment. The original newsletter was published
for three years. In 2001, ASAT’s website (www.asatonline.org) was launched to increase the reach of our infor-
mation-sharing, including suggested reading lists, links, and key articles on autism and its treatments.
The last few years have been particularly important for ASAT. We are now comprised of six committees, each
with their own distinct, yet complementary, purpose and goals. In the Summer of 2009, we resumed publica-
tion of SIAT, which now has over 8000 subscribers. The newsletter is published free-of-charge, to ensure every-
one has access to accurate, helpful information. In many respects, the new format of our newsletter was more
comprehensive and multifaceted than the original publication. Currently, ASAT’s e-newsletter features:
 Invited articles by leading advocates of science-based treatment;
 A Clinical Corner which responds to frequently asked questions about autism treatment;
 A Consumer Corner which recommends resources that can guide and inform treatment decisions;
 A Focus on Science column designed to empower families to make educated treatment decisions by
highlighting elements of science-based interventions and warning signs of unsubstantiated treatment;
 Detailed summaries of specific treatments for autism;

Science in Autism Treatment’s Team

Co-Editors International Updates Treatment Summaries


David A. Celiberti, PhD, BCBA-D Daniela Fazzio, PhD, BCBA-D Tristram Smith, PhD
Daniela Fazzio, PhD, BCBA-D Research Synopses Subscriptions
Managing Editor Sharon Reeve, PhD, BCBA-D Kerry Ann Conde, MS, BCBA
Leanne Tull, MADS, BCBA Clinical Corner From The Archives
Copy Editor Nicole Pearson, PsyD, BCBA-D Laurie Brophy, LCSW, BCBA
Nicole Pearson, PsyD, BCBA-D Consumer Corner Advertising
Focus On Science Sabrina Freeman, PhD Alice Walkup, MS, BCBA
(Continued on page 3)
Daniel W. Mruzek, PhD, BCBA-D Media Watch
Barbara Jamison, BA

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 3

Letter From the Editor continued...


(Continued from page 2)
 Book reviews;
 Highlights of our Media Watch efforts and discussion of accurate and inaccurate portrayals of autism
and its treatment by the media;
 Reviews of published research to help consumers and professionals understand and gain access to the
science; and
 Interviews with those who advance science-based treatment and confront pseudoscience.
At this time, I want to take a moment to discuss a recent transition on the editorial team of SIAT. After serving as
Co-Editor for four years, Dr. Josh Pritchard has stepped down from this role. I am pleased to share that he is re-
maining on the Board of Directors and we look forward to his ongoing contributions, particularly in the arena of
public relations and dissemination. It goes without saying that our newsletter would never be where it is now
without the significant efforts of Josh. He was incredibly generous with his time and talent (it was a very im-
portant partnership for me, given my comparatively more limited technical skills). During his four-year tenure, 16
issues were distributed to readers in over 90 countries. These issues were comprehensive and enabled us to
generate considerable new content for our website. Given that Josh’s shoes will be hard to fill, we made a few
changes to the organizational structure of the Editorial team:
 Dr. Daniela Fazzio has assumed the role of Co-Editor, and I am pleased to report that this outstanding
issue of Science in Autism Treatment is the first example of her excellent work. I look forward to collab-
orating with her;
 Leanne Tull will serve as our Managing Editor and help ensure that content flows efficiently and that we
meet production deadlines;
 Dr. Nicole Pearson, our current Clinical Corner Coordinator, will serve as Copy Editor;
 Dr. Sabrina Freeman has assumed the role of Consumer Coordinator. We are very grateful to Kate Fiske
who previously served in this capacity;
 Alice Walkup, a current ASAT Extern, will help us expand our newsletter and web advertising within her
role as Advertising Coordinator;
 Laurie Brophy, a current ASAT Extern, will help us best integrate newsletter content in our existing web-
site within her role as Content Coordinator; and
 Kerry Ann Conde, who is behind our Shout Outs section, will help us increase our subscriber base both
here in the US and internationally.
Daniela and I are pleased to announce a new ongoing feature to our newsletter. In each issue, we will be inter-
viewing at least one individual from outside the United States. In this issue you will find interviews with UK-
based actress, author, and entrepreneur, Jane Asher, on page 4 and with Toronto-based advocate and fund rais-
er, Christina Danos, on page 26. In the Fall 2013 issue, we will feature an interview with Pooja Panesar, Found-
er and Director of Kaizora Consultants in Nairobi, Kenya.
We have also continued to expand and upgrade our website to develop user-friendly resources and make it
more accessible and relevant. In fact, we are amidst a major overhaul and have recently hired a Los Angeles-
based web designer to oversee that effort. ASAT is currently developing specialized sections catering to distinct
groups including the media, pediatricians, and parents of newly-diagnosed children (soon to be accessible on
our home page). We have developed systems to engage ten Externs and over 50 volunteers productively within
our organizational structure. Learn more about this by reading the article on page 20.
ASAT remains one of the foremost voices for this important mission: the dissemination of science-based infor-
mation about autism and its treatments, and the promotion of greater access to credible, effective, and safe
treatments. This is a time of rapidly accelerating scientific research on autism treatments (not only ABA but also
other treatment modalities), and we are dedicated to providing up-to-date information to ASAT readers.
15 years and still going strong! Can you help us continue our important work? We are celebrating this significant
milestone by launching a campaign designed to increase the visibility of ASAT and to increase support for our
mission and initiatives. The next few pages detail 15 ways to support ASAT’s work. I trust that a few of these will
resonate with you! We will be asking for your involvement and participation throughout August and September,
so stay tuned for regular posts about our campaign on our Facebook page.

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 4

An Interview with Jane Asher, Actress, Advocate, and Entrepreneur


By David Celiberti, PhD, BCBA-D
Science in Autism Treatment

children unusually quiet, but that Soon after that day, I was asked
I recently had the wonderful
there was no interaction between by the National Autistic Society
opportunity to interview Jane
them: no shouting or joking – no (NAS) to open a new playgroup
Asher. Aside from her busy life as
squabbling or arguing. They didn’t they were going to run in a room
an actress and entrepreneur. Jane
even look at each other – indeed at their head office for some local
Asher is an actress, author and
they seemed completely unaware children with autism, and I was
businesswoman. She has been
of each others’ presence. The only too happy to do so. While I
working professionally in film,
difference from the behaviour of was there I learned even more
theatre and radio since she was 5
the other children was so marked about the condition, and spent
years old, and has run her own
that I asked one of their helpers quite some time with the children.
business, Jane Asher
Volume 10.3 Summer 2013

Cakes, based in Chelsea, London, where they were from (This ‘carer’
was Lorna Wing, whom, as I’m Clearly, although autism can be
since 1990, selling bespoke extremely distressing, even
celebration cakes and a wide devastating, for those affected
range of home baking equipment. and their families, it also entails a
way of seeing and interacting with
She has also written more than a
the world that is extremely
dozen books, including three best-
interesting and makes one
selling novels. Jane’s work in the
consider just what we
charity sector is well respected.
neurotypicals take for granted and
She is President of Parkinson’s
consider “normal.” I have huge
UK, President of the National
sympathy with the view of much of
Autistic Society and President of
the Asperger community that the
Arthritis Care, Vice President of
autistic way of looking at things is
Autistica, Ambassador for the
just as, or in some ways more
Prince’s Trust, Friend for Life,
than, valid as that of the rest of
Terrence Higgins Trust. She is a
us. The way neurotypicals talk
Patron of many other voluntary
nonsense in ‘social
organizations. communication’ for instance
Can you share with our readers (whether it’s talking about the
how you were first introduced to weather or casually lying without
autism? thinking twice). I found myself
sure you know, was one of the becoming more and more
I first became involved with
great pioneers in the autism world intrigued and interested – and,
autism when I went to a children’s gradually, more knowledgeable
and first described the ‘triad of
tea party in 1985. Children and engaged.
impairments’. So I had my first
representing various charities had
lesson from the top!). The children Eventually I found I could be
been invited, and I remember the
were, of course, autistic, and that useful to the NAS by not only
room being full of the noise and
was when my association – and, visiting schools and residential
excited laughter that one would
in some ways, fascination – with units and hopefully gaining a little
expect. One table, though, was
oddly different. At first I couldn’t autism began. publicity and spreading
think quite why it stood out from Your work within the autism awareness, but also by speaking
the other three - the children had community has grown about autism to people who might
no obvious disability and looked substantially since that initial know nothing about it or who
quite ‘normal’ - but after a few encounter. What has led up to could provide us with valuable
seconds of watching I could your heightened level of (Continued on page 5)
clearly see that not only were the involvement?

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 5

Interview with Jane Asher continued...


(Continued from page 4) harmful; but with autism being it may even be that such
such an individual and variable restricted diets are potentially
funding. Once drawn into the condition it can be very difficult harmful).
world of autism, few of us ever to construct standardised, double
leave it! -blind clinical trials. At the NAS we work very hard in
lobbying government and local
You are very knowledgeable In the UK, particularly in the authorities to do more for those
about the fact that there are so current economic climate, it can with autism (the Autism Act was a
many unsubstantiated be hard enough – still – to recent triumph in at least putting
treatments for autism, many of access a diagnosis of autism, the case for adults with autism
which are dangerous. Most lay and even harder to access the clearly on the agenda), but there
people have no idea that this is a correct educational and social is a long way to go. Not enough
huge challenge for the autism support that is the statutory right doctors, psychologists, nurses or
community as a whole, of every child with a disability. educationalists understand the
particularly for parents of newly- You can well understand why complexities surrounding autism,
diagnosed children who are people turn to unconventional let alone know just what it may
looking for clear answers and theories and implausible take to offer the best possible
expert guidance. What is the interventions. As a doctor’s hope of an improvement in
experience like for parents of daughter, naturally I fear for symptoms and a maximisation of
newly-diagnosed children in the those who make such the potential of the individual.
uninformed choices and only Every person with autism will
UK?
wish that everyone had access to show the effects of their
You are so right about the many someone with genuine condition differently and there
unsubstantiated ‘treatments’ – understanding and knowledge of will never be one solution that
even ‘cures’ - that are suggested this condition and its possible will work for all.
for autism (as, indeed, they are interventions. It’s vital that a fully
for so many other conditions). It’s informed choice is made. Parents Here in the United States,
so hard for any parent or and medical practitioners should families are bombarded by
caregiver to have their child be aware of the extent to which a information on the internet much
diagnosed with an incurable particular intervention has been of which is grossly inaccurate.
condition that it’s unsurprising shown to be safe and effective in Where can UK families turn for
that many turn to alternative or peer-reviewed scientific studies. accurate information?
complementary therapies. There So much is anecdotal (even the In the UK there is excellent
are large numbers of these very popular gluten-free diet has information available nowadays,
therapies which can be divided not yet been shown to be firstly via the National Autistic
into several rough categories; effective in scientific studies, and Society (particularly on our
from manipulation of various website, www.autism.org.uk),
parts of the body to the which is easily accessible and
channelling of ‘energy fields,’ puts across a balanced view of
from the removal of mercury from just what the parents of newly-
the body to changes in diet. Few diagnosed children should be
of these therapies are supported trying to access in order to help
by any clinical research, but you give their child the best possible
can easily see how a desperate outcome (also for newly
parent might leap at the idea of diagnosed adults of course).
some ‘miracle cure’ highlighted There is also the other
in one of the tabloids – organisation that I support,
something that sadly happens Research Autism,
Jane with one of the children at the
only too often. Some of these
National Autistic Society's Sybil Elgar www.researchautism.net, that
interventions are positively School. (Continued on page 6)

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 6

Interview with Jane Asher continued...


depressed when its wonders are
Science in Autism Treatment

(Continued from page 5)


ignored and pushed aside by
specifically researches pseudo-science or fantasy. For
interventions in autism and gives many years I was a patron of
balanced and scientifically-based another organisation of which I was
information on just what appears to very proud – SIMR, which
help, and – maybe more campaigned for public
importantly – what has no basis for understanding of the need for
claiming to do so. So the animal research. This organization
information is there, but naturally was started by a young man with
again, as with cancers, Friedrich’s Ataxia, who was deeply
degenerative diseases and other frustrated by the actions of the anti-
serious conditions, you will never vivisectionists. He sadly died a few
Volume 10.3 Summer 2013

stop people from searching for an years ago after many years of
answer; especially for that elusive excruciating pain and other
‘cure’; and we can all become problems. So I guess the subject of
irrational when confronted with promoting the understanding of
something so potentially science is a subject generally very
devastating and for which there is Jane with Dr. Lorna Wing
close to my heart.
no easy or obvious way forward.
Due to your knowledge in this area, a child with autism who had been
As an actress, there must be so do you have a vision about how we speaking and behaving in a
many different organizations lining need to go about educating neurotypical way up to the time of
up to ask for your help. We are so professionals, paraprofessionals an MMR jab and who had soon
grateful that you have chosen to and laypersons about the thereafter developed autism, it
use your celebrity status to support importance of following the science would have been only too easy to
the development and testing of before subjecting a person with have come to a totally misguided
science-based treatments. The autism to a treatment? conclusion. We just need more
concept that science is crucial in people spreading the word about
terms of treatment for people with No specific vision I fear… it’s all part the only approaches to autism that
autism is much more complex than of the major problem that I’ve appear to make a difference, and
simply supporting any organization touched on in the previous even that is not really researched
that helps children with autism paragraph. How do we combat the
enough to give unequivocal results.
swim with dolphins or access some rather fascinating, but ultimately As with so many important causes,
other specific treatment. Do you extremely damaging, instinct and
money comes into this, and also the
have a background in science? How tendency of the human species to teaching of science in schools,
did you become so involved in this believe in things for which there is which has not been as good as it
particular issue (advocating for absolutely no evidence– whether it
be the supernatural, rituals, luck, should be in the UK for some
science-based treatment)? years. For anyone keen to learn
magic or other paranormal areas, or
That’s an interesting question! I ‘miracle cures’ and their like - more, I highly recommend an Open
suspect it is largely due to the rather than trusting science and University course that I took a
influence of my father, Dr Richard modern medicine? And, as I couple of years ago – ‘Autism in the
Asher, a consultant endocrinologist mentioned before, it’s particularly 21st Century’ – which is a
who was renowned for his rational difficult to target the strong instinct beautifully constructed,
and well-informed approach to the of a parent to try almost anything, scientifically-based module that
complex field of medicine (and for no matter how expensive and/or really brought my information up to
his witty and inspirational lecturing unproven, in the desperate search date.
and writing: his ex-students include for something to help their child. We Finally, do you have any advice for
Oliver Sacks and the British doctor/ all know how easy it is to make parents of newly-diagnosed
theatre director Jonathan Miller). completely erroneous deductions
children?
I’ve grown up fascinated and from what appears to be clear
(Continued on page 7)
enthralled by science, and get very evidence, and I’m sure if I had had

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 7

Interview with Jane Asher continued...


Naturally it can be very distressing be needed. But I’m not going to say think it’s worth saying that, although
for any parents to have their child it’s easy – even if the best possible children with autism will grow up to
diagnosed with autism, but I think school is found, for example, it can be adults with autism, there is much
it’s really important to see that as be a legal and emotional nightmare to be done to ensure that they can
the first achievement in making the getting the funding put in place to live lives of dignity and fulfilment.
best possible life for him or her. access it. And this is why it can be Families in the UK can contact the
Without a diagnosis it’s impossible so tempting to try an National Autistic Society Helpline:
to access whatever support and unsubstantiated intervention that 0808 800 4104 (Monday-Friday
education may be the best way may be easily available, but I’d 10am – 4pm).
forward. It’s important, too, to definitely recommend that before
understand exactly what the trying anything, a call is made to the On behalf of the Association for
diagnosis means – the word autism NAS helpline. They can put parents Science in Autism Treatment, I want
now covers such a very broad in touch with the right person to to thank you, Ms. Asher, for taking
spectrum of conditions. It’s vital to help them. There’s also a very time from your very busy schedule
know exactly which one the child helpful leaflet on the website ‘After to participate in this interview. The
has and whereabouts on the range Diagnosis’ to download. For sure I’d autism community in the UK is very
of ability the condition falls. Early say don’t try anything that hasn’t fortunate to benefit from your time
intervention can make a real been recommended by a medical and talent, particularly given your
difference and if parents are not professional before checking for strong adherence to the notion that
automatically put in touch with certain that it will do no harm and science matters and that research
them, then it’s a good first step to that it won’t interfere with accessing should guide decision-making. We
contact the local social and something that can really make a certainly hope our paths cross
educational services – they’ll be the difference. Above all, with the again!
key contacts for providing what may knowledge that we now possess, I

From the Archives (Summer 2012 Issue):


Top 10 Questions Journalists Should Ask Before Writing the Next Autism Story

#1 Are there any published research articles in peer-reviewed journals documenting the efficacy of the
intervention method featured in my article or I am just finding hopeful testimonials? If not, why not,
and how should I pitch my article given the absence of supporting research? If so, are the studies
well designed?
#2 Who am I interviewing for this story and what are his/her qualifications? What does (s)he stand to
gain by this interview? Is (s)he making claims of efficacy or effectiveness that are not supported by
scientific data?
#3 Is there any evidence of harm associated with this intervention? What are the risks?
#4 How much does the intervention cost? Is the cost reasonable? How is it paid?
#5 What kind of training and supervision do treatment providers need to have before implementing the
intervention? If none or little, have I explored the ethics involved and asked if there is adequate con-
sumer protection?
#6 What position statements from respected professional organizations support or do not support this?
#7 Are already science-based interventions (such as applied behavior analysis) recommended by these
organizations?
#8 Have I consulted with an unbiased entity for their input?
#9 As described or discussed in this article, "Does the intervention encourage false hope or suggest un-
realistic benefits for a family coping with a pervasive developmental disability?"
#10 Have I provided readers with related resources and references that are objective, science-based,
and minimize the risk of coercion or manipulation?

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 8

In this newsletter, we have two very interesting article summaries. The first article summarized re-
Science in Autism Treatment

search conducted by ASAT’s own Vice President Dr. Florence D. DiGennaro Reed and her colleague on
an evaluation of therapeutic horseback riding. The second review summarized research conducted by
Tanaka and colleagues on the effectiveness of computer-based intervention in establishing facial
recognition skills. We hope you enjoy these summaries and find them informative!
Sharon A. Reeve, Ph.D., BCBA-D
Research Corner Coordinator

participants were assigned to a treatment group


that included a non-treatment baseline phase
followed by weekly 60-min THR therapy sessions,
and three participants were assigned to a waitlist
Volume 10.3 Summer 2013

control group in which no treatment was given. In


the treatment group, treatment started at differing
times for each participant, allowing for an
Jenkins, S. R., & DiGennaro Reed, F. D. (2013). An experimental test of whether the introduction of
experimental analysis of the effects of therapeutic treatment rather than the passage of time was
horseback riding on the behavior of children with associated with any behavior changes made by
autism. Research in Autism Spectrum Disorders, the participants. The following behaviors were
7, 721-740. doi: 10.1016/j.rasd.2013.02.008 observed during academic, art, game, and snack
centers at an after-school program and in
Reviewed by: ToniAnne Giunta, M.A., BCBA, participant homes: (a) happy versus unhappy
Caldwell College affect, (b) spontaneous initiations, (c) responses
to initiations, (d) off-task behavior, (e) compliance,
Why review this topic? and (f) problem behavior. For participants in the
treatment group, the above behaviors were also
Therapeutic horseback riding (THR), which measured during THR sessions, in addition to
involves teaching horsemanship skills (e.g., vocal/gestural commands to direct the horse and
holding a horse’s reins, controlling the horse with their posture. For all participants, pre- and post-
voice commands, using basic riding skills), has tests on standardized assessments (The Child
been reported to relieve symptoms in a variety of Behavior Checklist, CBCL/6-18; Teacher Rating
domains, including socialization, self-regulation Form, TRF) were also supplemented for
behaviors, expressive language, and motor skills. comparison.
Existing studies, however, have had significant
limitations. For example, investigators have relied What did the researchers find?
solely on parent ratings, instead of including other Participants in the treatment group showed
types of measures such as direct observations of minimal to no differences in all the behaviors
children’s behavior. Also, THR has implemented in measured during the center-based activities and
conjunction with other interventions (e.g., home visits (affect, spontaneous and responses
programmed reinforcement), making it difficult to to initiations, off-task behavior, compliance,
determine the effects of THR by itself. The problem behavior) when comparing the baseline
present study selected behaviors similar to those phase to THR treatment phase. Furthermore, their
analyzed in previous studies, but used more direct behavior levels throughout the study were
observations and a sound experimental design. comparable to the participants in the control
What did the researchers do? group, who did not receive THR treatment at all.
During the THR sessions, the researchers
Seven children with autism, ages 6-14 years,
participated in the study over nine weeks. Four (Continued on page 9)

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 9

(Continued from page 8)


detected some improvement in all participants for
overall posture improved for all participants.
However, responses to initiations and rate of
vocal/gestural commands to the horse remained
unchanged, spontaneous initiations either
remained unchanged or decreased, and
compliance either remained unchanged or
improved. For three of the four participants,
Tanaka, J.W., Wolf, J.M., Klaiman, C., Koenig,
problem behaviors were low during THR sessions.
K., Cockburn, J., Herlihy, L., Brown, C., Stahl, S.,
Two of the four participants in the treatment
Kaiser, M.D., & Schultz, R.T. (2010). Using
group, as well as all three participants in the
computerized games to teach face recognition
control group, showed improvements in their CBCL
skills to children with autism spectrum
scores from pre- to post-tests. Three of four
disorder: the Let’s Face It! program. Journal of
participants in the treatment group and one of
Child Psychology and Psychiatry, 51 (8), 944-
three in the control group showed some
952.
improvement in TRF scores.
Reviewed By: Jaime Mulcahy, Rutgers
What are the strengths and limitations of the
University
study?
The study examined an already-established Why study this topic?
treatment program (THR) yet failed to replicate the
previous studies’ positive effects, likely because of Prior research indicates that children with
the direct and repeated measurement used (as autism spectrum disorders have selective
opposed to subjective self-reports used impairments in attending to and recognizing
previously). Limiting factors to this study included faces as compared to typically developing
a shorter amount of exposure to THR than in peers. Some research has suggested that
previous studies, lessons that somewhat differed these impairments may be at the root of the
from previous studies, and minimal loss of data social dysfunction associated with ASD.
from a few sessions. Despite this finding, little research has been
published to show whether facial recognition in
What do the results mean? individuals with autism can be improved
THR did not produce clinically significant effects or through direct training.
meaningful improvements in any of the measured What did the researchers do?
behaviors in both the center-based and home
activities, contrary to previous research and The researchers in this study evaluated the
testimonials. Children who received THR showed effectiveness of the Let’s Face It! (LFI!)
improvements on the CBCL and TRF, but so did computer program in enhancing the facial
children in a waitlist control group. Therefore, it recognition skills of children with autism. The
cannot be concluded that THR was responsible for LFI! program consists of seven interactive
the changes noted in the participants on these computer games that address the following
measures. Although it may be possible to find an face processing deficits associated with
appropriate use of THR in future studies (e.g. autism: inattention to the eyes, impaired
attending a THR session after earning tokens recognition of identity, and failure to perceive
during academic programming), therapeutic faces holistically. The games employed
horseback riding is not recommended as a engaging graphics and music as well as high-
treatment for addressing symptoms of ASD. score tables to increase the children’s
(Continued on page 10)

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 10

participants in the active treatment group showed


Science in Autism Treatment

(Continued from page 9)


motivation to use the program. significant improvement in analytic and holistic
face processing skills. Specifically, recognition of
Participants in this study included 79 children,
eye and face features was enhanced, with the
adolescents, and young adults with autism
greatest improvements shown in analytic
spectrum disorders. Before beginning the study,
recognition when the face parts were tested in
participants’ facial recognition skills were
assessed using the LFI! Skills Battery, a computer- isolation. However, participants in the active
treatment group did not show significant gains
based battery that assesses perception of facial
relative to the control group in the following areas:
identity across various tasks. Participants were
detecting featural and configural face changes,
then randomly assigned to either an active
identifying faces across changes in expression
treatment group or a waitlist control group (with
and orientation, and recognizing faces over a
randomization stratified by mental age and
Volume 10.3 Summer 2013

diagnosis). Individuals in the active control group short retention.


received the LFI! computer game to take home What were the strengths and limitations of the
and were instructed to play the games for a study? What do the results mean?
minimum of 100 minutes per week. Play within The results indicate that improvements in facial
that time was self-paced and not directly recognition abilities of children with autism can be
monitored by the parents or caregivers. However, achieved through computer-based intervention.
families of the participants were provided with a This is the first time that such results have been
set of plastic token reinforcers to use to increase shown through a large-scale clinical trial. The use
motivation to comply with the intervention. of a computer-based intervention has the benefits
Compliance was monitored by the researchers of being inexpensive, easy to implement in home
through weekly log files generated by the LFI! or school settings, and not requiring direct
software. Participants continued with the program
supervision of the participants. The fact that
until total intervention time reached 20 hours participants in this study did not improve in
(over a two- to four-month period). Individuals certain areas of facial recognition, some of which
assigned to the waitlist control group underwent are important in social settings, suggests that
treatment as usual for a comparable period of some improvements may need to be made to the
time. Upon completion of the intervention period, Let’s Face It! program, or that a longer length of
the LFI! skills battery was re-administered to both treatment may be necessary for improved results.
the treatment and control groups. However, this study provides a first step toward
What did the researchers find? developing a more comprehensive program to
improve the facial recognition and processing
Compared to the waitlist control group,
skills of individuals with autism.

Description: In the Rapid Prompting Method (RPM), practitioners attempt to compensate for the assumed sen-
sory overload and apraxia in children with ASD by continually speaking and requesting responses so that the
children stay attentive. They may attach writing implements to children’s wrists and prompt the children to type
out messages.
Examples: Rapid Prompting Method, Soma, Alphabet Therapy
Research Summary: There have been no scientific studies of rapid prompting for individuals with autism spec-
trum disorders.
Recommendations: Researchers may wish to conduct studies with strong scientific designs to evaluate rapid
prompting method. Professionals should present rapid prompting method as untested and encourage families
who are considering this intervention to evaluate it carefully.

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 11

For more information about advertising, please visit http://asatonline.org/newsletters/advertisers.htm or


contact us at asatads@asatonline.org .

Advertisement on www.asatonline.org, Science in Autism Treatment newsletter, or other ASAT publication does not imply
endorsement by ASAT of the advertised company, service or product. All advertisements will be clearly labeled as such.
ASAT has no formal relationship with any of its advertisers. Although ASAT expects that all advertising organizations will act
in accordance with ASAT’s policy, ASAT does not assume responsibility for ensuring that advertisers engage in behavior that
is consistently congruent with the statements above. Complete policy and protocols here: http://asatonline.org/
newsletters/ advertisers.htm

F. J. Barrera, PhD, BCBA-D Gina Green, PhD, BCBA-D John Pomeroy, MD


Stephen Barrett, MD William Heward, EdD, BCBA-D Stephen Porges, PhD
Martha Bridge Denckla, MD Ronald Kallen, MD Sharon Reeve, PhD, BCBA-D
Curtis Deutsch, PhD Alan Leslie, PhD Joyce Rosenfeld, MD, FACEP
William V. Dube, PhD Bennett Leventhal, MD Arthur Toga, PhD
Deborah Fein, PhD Johnny L. Matson, PhD Paul Touchette, PhD
Eric Fombonne, MD Joyce E. Mauk, MD Roberto Tuchman, MD
Richard Foxx, PhD, BCBA-D Catherine Maurice, PhD Paul Yellin, MD
Bobby Newman, PhD, BCBA-D

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 12
Science in Autism Treatment

In addition to our Advisory Board a number of Coordinator, Externs, and other


Volunteers lend their time and talents to support ASAT's mission and initiatives. These are
our helping hands.

Advertising Coordinator Externs ASAT’s Newsletter,


Alice Walkup, MS, BCBA Rachel Binder, MS Science in Autism Treatment
Laurie Brophy, LCSW, BCBA Justin DiScalfani, PhD
Bio-medical Advances Coordinator Elizabeth Callahan, BA, BCaBA Elizabeth Neumann, MA, BCaBA
Leanne Tull, MADS, BCBA Cathy Curcio, MSW Sage Rose, PhD
Jacqueline Hamor Caroline Simard-Nicolas, MS, BCBA
Donor Drive Coordinator Steven Rodriguez, BS
Cathy Curcio, MSW Mark Sullivan, BA Website Newsletter Content
Volume 10.3 Summer 2013

Leanne Tull, MADS, BCBA Science in Autism Treatment


Externship/Volunteer Coordinator Alice Walkup, MS, BCBA Kerry Ann Conde, MS, BCBA
Lauren Schnell, MEd, BCBA Caroline Simard-Nicolas, MS, BCBA
ASAT Public Relations Amanda Wadsworth, MSEd, BCBA
Grant Research Coordinator Courtney Aponte, MA
Alice Walkup, MS, BCBA Nicole Mammina, MSEd
Lewis Mazzone, MA
International Dissemination Nancy Philips, BA
Co-Coordinators Sage Rose, PhD
Audrey Meissner, MEd, BCBA Alyssa Rosenberg, BA
Jennifer Hieminga, MEd, BCBA
Media Watch Initiative
Social Media Coordinator Emily H. Callahan, PhD, BCBA-D
Renita Paranjape, MEd, BCBA Geoffrey Debery, MA, BCBA
Justin DiScalfani, PhD
Sponsorship Coordinator Deborah Finkelstein, MADS, BCBA
Caitlin Reilly, MA Mary Philips, BA
Sharon Reeve, PhD, BCBA-D
Subscriptions Coordinator Anya K. Silver, MA, BCBA
Kerry Ann Conde, MS, BCBA Shannon Wilkinson, MADS, BCaBA

Website Content Coordinator


Laurie Brophy, LCSW, BCBA

Coming up in the Fall 2013 Issue of Science in Autism Treatment!

 Research Summaries, including one on environmental enrichment as a treatment for autism;


 Clinical Corner installment on autism genetics and recurrence risk in families;
 Book Review of Behavioral Foundations of Effective Autism Treatment (Mayville and Mullick,
2010), by David Celiberti;
 Book Review of Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine,
(Offit, 2013), by Dr. Lori Ernsperger;
 Interview with Dr. Joyce Mauk, ASAT Advisory Board Member;
 Interview with international service provider, Pooja Panesar, from Nairobi, Kenya.
And so much more! Subscribe today at www.asatonline.org/signup

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 13

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 14

shop/). A portion of their proceeds will be do-


Science in Autism Treatment

#1
nated to Association for #Science in #Autism
Bid, bid, bid (and encourage others to do the Treatment. You can read more about this ef-
same)! The Association for Science in Autism fort on page 26.
Treatment ASAT is hosting an online auction
through Bidding for Good to celebrate our 15th
anniversary. We have over two-dozen great #5
items for sports fans, entertainment enthusi- Support ASAT by purchasing quick, delicious
asts, as well as those seeking professional re- drinks, snacks, spices, soups, and more from
sources and training opportunities related to Tastefully Simple (www.ts4asat.com) and 15%
autism treatment. Some of our great silent of your sales go to ASAT! Don’t forget to ‘like”
auction items include autographed albums by the Facebook page for this fundraiser and
Volume 10.3 Summer 2013

Bruce Springsteen and the Rolling Stones, a ‘share’ to spread the word!!
Marc Jacobs handbag, sports memorabilia www.facebook.com/TastefullySimpleASAT
signed by the very best, and registration to the
upcoming Autism New Jersey conference in
Atlantic City to name a few! #6
https://www.biddingforgood.com/auction/ Email ASAT’s newsletter link to 15 friends and
AuctionHome.action?auctionId=199297297 colleagues and encourage them to sign up for
our free, informative quarterly newsletter
If you are interested, there is still time to do- (http://www.asatonline.org/newsletters/
nate an item for the online auction. Please signup). If you do, our 2013 goal of 10,000
email dceliberti@asatonline.org subscribers will be quickly realized. Since the
summer of 2009, we have published 16 issues
#2 of our newsletter, Science in Autism Treat-
ment, which now has over 8,000 subscribers.
“Like” ASAT on Facebook and encourage oth-
ers to do the same so we can surpass our
7,000 fan goal for 2013 (https:// #7
www.facebook.com/ASATonline). See updates Support Team ASAT in the 2013 NYC mara-
from ASAT, Media Watch announcements, thon on November 3! The Association for
and information about upcoming conferences. #Science in #Autism Treatment is participat-
We welcome your active participation and en- ing in the marathon. You can donate money
courage you to post comments and share con- on behalf of the individual runners of Team
tent with your own friends on Facebook. ASAT (http://www.crowdrise.com/
#3 ASATnyc2013)
Follow ASAT on Twitter https://twitter.com/
asatonline and retweet our posts. We have #8
843 followers. Help us surpass our 2013 goal
of 1,000 followers. Help celebrate our 15th anniversary by volun-
teering for the Association for #Science in
#Autism Treatment. ASAT’s success rests on
#4 the volunteer service of family members, pro-
fessionals, and community members. Do you
Purchase a t-shirt at “Kettlebells 4 Autism”
have a special talent or a little time to offer
online store (http://kettlebells4autism.com/
our organization? If you are interested, please
visit http://asatonline.org/about_asat/

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 15

volunteer.html #12
Show your support for ASAT and enjoy the
#9 benefits of being a sponsor, including recogni-
tion and online or newsletter advertisements!
Display ASAT donation jars at a wide array of We have two types of sponsorship options
business establishments to help educate con- each with several levels: professional (http://
sumers and to raise money to support our asatonline.org/about_asat/professional-
mission. We encourage you to place a dona- sponsors#learn) or community (http://
tion jar in your place of business! ASAT will asatonline.org/about_asat/community-
provide the materials needed (donation jars, sponsors). Please also encourage your supervi-
an ASAT information insert card for the jar, sor or provider to do the same.
business cards, and signage) for any partici-
pating business. Contact asatevents@aol.com
for arrangements. You can read newsletter ar- #13
ticles about participating businesses at http:// Help ASAT celebrate its 15th anniversary by
asatonline.org/about_asat/ proudly displaying our brochures or other
fund- raising.html promotional materials in your workplace or
other venues, such as coffee shops and
#10 bookstores. Doing so will spread the word
about ASAT and the importance of science in
15 In honor of the treatment of autism. If you are interested,
our 15th anni- please contact dceliberti@asatonline.org.
versary,
Years! please encour-
age 15 #14
friends to do- Be a proud supporter of our mission by dis-
nate $15 to the tributing ASAT’s flyer or brochure to medical
Association for providers and educators in your community.
Science in Autism Treatment If you are interested, please contact dceliber-
(through http://fundly.com/ ti@asatonline.org.
asatonline). These funds will support a wide
array of initiatives including the development
and distribution of materials to educate medi- #15
cal professionals about evidence-based treat- You can help spread ASAT’s message of the
ment. importance of science in the treatment of au-
tism! At your next professional event, include
#11 a slide about ASAT at the end of your presen-
tation or distribute sign-up sheets for our free
Help us identify new newsletter subscribers at quarterly newsletter. If you are interested,
your place of business. Please download a sign please email us at info@asatonline.org.
up sheet at http://asatonline.org/pdf/
subscribeme.pdf. You can scan completed
sheets and email to newsletter@asatonline.org
or mail to ASAT PO Box 3250 Hoboken, NJ
07030

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 16
Science in Autism Treatment

ASAT is looking forward to participating in the NYC marathon because this year the NYC marathon will
have more meaning than ever before. This will be the first post-Sandy NYC marathon and the first
since the Boston terror attack. On November 3, 2013, Team ASAT will proudly be at the NYC
Marathon, ready to run.
The first New York City Marathon in 1970 was a relatively small event with a course contained within
Central Park, and only 55 runners crossed the finish line. In 1976 Fred Lebow revised the race to
Volume 10.3 Summer 2013

course through all five boroughs from Staten Island through Brooklyn, Queens, and the Bronx to
Manhattan.
This prominent event is now one of the world’s greatest marathons, pursued by more than 100,000
applicants annually. As stated on their website www.nycmarathon.org, “The race attracts many world-
class professional athletes, not only for the more than $600,000 in prize money, but also for the
chance to excel in the media capital of the world before two million cheering spectators and 315
million worldwide television viewers. As any one of the more than 700,000 past participants will
attest, crossing the finish line in Central Park is one of the great thrills of a lifetime.
This great event will be Team ASAT’s first NYC marathon. ASAT’s mission is to disseminate
information regarding evidence-based treatments for the Autism Spectrum Disorders. ASAT is
committed to helping parents, providers, and other consumers understand the difference between
sensational claims of how to help or cure autism versus science-based research that guides effective
intervention.
ASAT is looking forward to the NYC Marathon and hopes you will
consider supporting Team ASAT, by checking out our runners’
Crowdrise links, where individual donations can be made. Team
ASAT is made up of Bobby Newman, Randy Horowitz, Sheila
Jodlowski, Alex and Jamie Schneider, and ASAT board member
Barbara Wells Reimann. We are very
excited to share a bit of background
about our runners:
Bobby Newman serves as Team ASAT’s
captain and has been working in the field
of Applied Behavior Analysis for over 25
years. His books are popular
introductions to ABA and the Autism
Spectrum Disorders. This is Bobby's tenth
marathon and second NYC, following in
the footsteps of his marathoner father,
Leo Newman.
Randy Horowitz is the Associate
Executive Director at Eden II Programs.
Randy Horowitz
(Continued on page 17)
Bobby Newman

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 17

Ms. Horowitz has a Master of Science in Education from Queens College and
Certificate of School Administration from the College of New Rochelle. She is
an adjunct lecturer at Queens College and has presented at local, national
and international conferences on topics relating to educating students with
autism.
Sheila Jodlowski has been working with children with autistic spectrum
disorders for more than 15 years. She received her doctorate in Behavior
Analysis from Teachers College Columbia University. She provides academic
and behavior management consulting services for families in Westchester,
Putnam, Dutchess, Orange and Columbia counties. You can support Sheila
on her Crowdrise page http://www.crowdrise.com/ASATnyc2013/fundraiser/
sheilajodlowski and contribute to her goal!
Alex and Jamie Schneider are 23 year old identical twins. Each is profoundly
Sheila Jodlowski
autistic with limited communication skills or understanding of safety in
the community. However, both are accomplished runners and love to
run! Both young men have completed five marathons to date, including
two Boston Marathons, two Hamptons Marathons, and one Marine Corp
Marathon. The New York City Marathon will be their sixth; and for the
first time they will be running to raise funds for ASAT. Alex in particular
has an incredible gift of speed when he races; he just recently
completed the 2013 Boston Marathon in 3 hours and 23 minutes. Alex
and Jamie are not able to run alone. They will be running with guides
whose sole responsibilities are to set the pace, help the boys navigate
the course and hydrate when needed. If not for the altruism of the
running guides, the Schneider twins would not be able to compete in
these races. To support them, visit http://www.crowdrise.com/
ASATnyc2013/fundraiser/alexandjamieschneider To read more about
the Schneider twins, please visit www.autismrunners.com.
Barbara Wells Reimann has been an
integral member ASAT’s Board of
Directors since 2006 and currently
serves as the Treasurer. She is a mother Alex and Jamie Schneider
of an adult son with autism and dedicated her life to promoting
evidence-based interventions for individuals with autism. Help Barbara
reach her goal by donating on her Crowdrise page at http://
www.crowdrise.com/ASATnyc2013/fundraiser/barbarawells1.

Please consider joining us on November


3rd to help cheer on and support Team
ASAT!
Barbara Wells Reimann

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 18
Science in Autism Treatment

On behalf of the Board of Directors of ASAT, I would like to take this


moment to express our heartfelt gratitude to Larry and Kathy Hannon,
owners of Dairy Queen stores in three locations in Maine: in the Bangor
Mall, in Old Town, and in Freeport. The Hannons recently made a $1,500
donation to ASAT and through the generous support and patronage of
Dairy Queen customers over the last 4 years, have raised almost
$10,000 from donation jars placed on their counters and at their drive-
thru window!
This story would be incomplete without a bit of background. Seven years
Volume 10.3 Summer 2013

ago, the Hannon’s daughter was diagnosed with autism. The evaluating
psychologist informed the Hannons that her prognosis was quite poor,
and that she may not learn to talk. Fortunately, their daughter was
already enrolled in an inclusive preschool with a team of people, well
versed in Applied Behavior Analysis, incorporating a broad spectrum of ASAT donation jar
effective teaching techniques, intensive one-on-one instruction, related
services by providers committed to collaboration, reverse mainstreaming to provide meaningful and
structured opportunities for skills to generalize within interactions with typically developing peers, and
carefully planned and delivered shadowing in the classroom. Almost immediately, the Hannons
observed that their daughter was acquiring important skills and was responding very favorably to
treatment. Fast forward 7 years and she has blossomed into a fun-loving, inquisitive young lady with a
beautiful singing voice and honor roll grades. She has just completed fourth grade and participates in
a general education classroom and curriculum for most of the day with fading supports.
Discovering ASAT through their internet research, the Hannons were comforted to know that they were
on track and that the decisions they made for their daughter were not only scientifically sound, but
demonstrated best practice. Back in 2009, Larry was quoted as saying, “I’m a realist- I believe in facts
-but sometimes parents don’t know if the information they find online is fact or fiction. This is why
ASAT is such an important organization for the autism community.” Today, Larry elaborates, "The only
appropriate education is an effective one — one based in science. It is so sad that many families will
get stuck in their pursuit of miracle cures.”
As the years pile on, Larry and Kathy’s commitment to giving back to ASAT has been unwavering.
Every April for Autism Awareness month, the Hannons set up tables displaying an array of information
about autism and best practices. Furthermore, they have
shared hundreds of business cards and fliers showcasing
ASAT’s resources, such as our newsletter and website.
Stay tuned for further updates from this wonderfully
supportive and dedicated team from Maine. For those of
you in Maine or traveling to Maine, please stop by the
Bangor Mall, Old Town, or Freeport Dairy Queen and let
Kathy and Larry Hannon know that you join us in our
heartfelt appreciation of all they do to support families, to
raise awareness, and to help every person with autism
have a greater chance of accessing science-based
treatment. And while you are there, buy yourself a
Blizzard! Austism Awareness Month display table

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 19

On Friday, June 7th, the Association for Science in


Autism Treatment, in conjunction with Achieve
Beyond, held its second annual Autism conference. This all day conference took place in Flushing, NY
and was attended by over 80 parents and professionals. We were able to offer 4.5 BACB Type II CEUs
to behavior analysts.

This educational event featured several vendors, networking opportunities, and presentations by
ASAT board members, including keynote speaker Daniel W. Mruzek, PhD, BCBA-D., Mary E. McDonald
PhD., BCBA-D and Ruth Donlin, MS. Presentations included a range of treatment related topics, in-
cluding:
Scientist-Practitioners in the Classroom: Using Data to Guide Our Students’ Progress:
Daniel W. Mruzek, PhD., BCBA-D
In an age when educators and school-based therapists increasingly feel the pinch of growing de-
mands, decreased resources, and busier school days, Dr. Mruzek discussed how to use the meth-
ods of science to promote progress for learners with autism. He brought together examples of
“real world” educational conundrums and offered science-based solutions. Most importantly, he
reviewed key principles of the scientific method and how they can be used to aid decision-making,
measure outcomes and plan next steps in the promotion of our students’ independence and qual-
ity of life.

Increasing Flexibility in Students with Autism Spectrum Disorders:


Mary E. McDonald, PhD., BCBA-D
Dr. McDonald provided an overview of behavioral and cognitive flexibility and the importance of
focusing on these areas with students with ASD, who often adhere to fixed routines, rote repeti-
tive responding, or appear to have limited repertoires of responses. This workshop focused on
research in cognitive and behavioral flexibility and provided specific practical strategies for im-
proving behavioral and cognitive flexibility in individuals with ASD.

Using Research to Increase Intervention Outcomes for Visual Learners


Ruth Donlin, MS
Ms. Donlin described how individuals with autism struggle to infer meaning and context in social
interactions and in nonverbal communication. The neurological functioning of the brain and the
ability to understand and build social and emotional awareness were discussed. This presenta-
tion highlighted research regarding what individuals with autism tend to focus upon in social and
emotional situations, as well as the corresponding treatment implications.

Achieve Beyond provides pediatric therapy and educational services to children, students, and fami-
lies throughout the United States including the greater Los Angeles, California (CA) area, northern Vir-
ginia (VA) / Maryland / DC area, the greater Dallas, Texas (TX) area and New York (NY). These ser-
vices include: Speech Language Therapy, Occupational Therapy, Physical Therapy, Special Education,
Autism Services, Behavior Consultation, and Counseling. For more information, please visit
www.achievebeyondusa.com.

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 20

Do You Believe in Science-Based Autism Treatment? So Do We.


How About a Volunteer Opportunity with ASAT?
Science in Autism Treatment

Lauren Schnell, M.Ed., BCBA, ASAT Externship Coordinator

The great work that ASAT does in promoting science-based treatment for individuals with autism
could not happen without our volunteers. Currently, ASAT has over 40 volunteers and externs who
work tirelessly to fulfill their commitment to evidence-based autism treatment. Volunteers have the
opportunity for professional growth and networking through collaboration with an array of knowl-
edgeable, seasoned professionals who aim to promote the advancement of science-based treat-
ments for autism.
There are many important roles that “I am honored to be involved with an organization that
Volume 10.3 Summer 2013

volunteers play within the organization. is committed to helping families and professionals
Some of these activities include, but draw the line between unsubstantiated treatment
are not limited to: options and behavior analytic interventions, grounded
in the best available scientific evidence. Working
 Helping to promote our website,
alongside knowledgeable board members has provided
www.asatonline.org; me with many valuable research, writing, and social
 Helping to promote our newslet- media opportunities. Thank you ASAT!” ~ Leanne Tull
ter, Science in Autism Treatment; (Toronto, Canada)

 Writing journal article synopses


and other content related to au-
tism treatment;
 Monitoring and/or responding to misinformation from the media and promoting accurate in-
formation through our Media Watch efforts;
 Reviewing website content and monitoring website navigation;
 Helping to compile and update links and resources for visitors to our website;
 Creating databases; and
 Participating in and assisting with fundraising activities.
To learn more please see our Volunteer Announcement. If you are interested in becoming a volun-
teer, please submit the ASAT Volunteer Application. It is important that volunteers communicate
their specific interests so that their service to ASAT can be a mutually satisfying experience.
If you are interested in a more extensive and structured experience, please consider a 150 hour
Externship with ASAT. We accept Externs with a wide arrange of backgrounds from high school
through advanced graduate training. Externship activi-
ties revolve around the following:
"The Externship has been a valuable  Writing for our quarterly newsletter or for our website
professional experience that has helped
(e,g., Clinical Corner);
me to develop a variety of professional
skills while also contributing in a  Proofreading content of our quarterly newsletter;
meaningful way to the dissemination of
quality information on science-based  Learning how to critically evaluate published re-
autism treatment. “ ~ Elizabeth Callahan
(Hoboken, New Jersey) (Continued on page 21)

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 21

Do You Believe in Science-Based Autism Treatment? Continued...


(Continued from page 20)

search;
 Learning about grant writing and participating in all aspects of the process starting with grant re-
search and selection, and culminating in actual submission;
 Learning how to evaluate and critique media representations of autism treatment;
 Learning about fundraising conceptualization, development, and execution both at the community
and national levels;
 Actively participating in social media and learning
about its use to convey information to the autism com- “Working with ASAT has been a great
experience. I’ve had the opportunity to
munity;
use my strengths and build upon them
 Learning about autism services in other parts of the by writing in the newsletter, learning
world and engaging in efforts to promote dissemination about the grant application process,
and awareness of science-based treatments; and collaborating with other team
members. Most of all, my experience
 Working alongside Board Members in an array of writ- has enhanced my skepticism and ability
ing, editing and fundraising activities; and to look for the facts.” ~ Alice Walkup
(Los Angeles, California)
 Participating in monthly Extern conference calls to
share ideas, update on externship activities, and dis-

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 22
Science in Autism Treatment

The long awaited and highly anticipated Diagnostic and Sta- Why was the ASD diagnostic criteria
tistical Manual of Mental Disorders (DSM-5) has arrived. revised?
However, the shift in diagnostic criteria for Autism Spectrum By: Leanne Tull, M.ADS, BCBA
Disorders (ASDs) has certainly evoked some questions and
confusion among parents, professionals, and educators. In
this issue of Consumer Corner, Leanne Tull will attempt to The DSM-IV-TR describes Pervasive
address the various issues that have arisen due to the DSM Developmental Disorder (PDD) as the
-5. Readers will find a link to a more extensive article on diagnostic umbrella, with five sub-
the subject at the end of this piece. types: 1) Autistic Disorder; 2) Asper-
ger’s Disorder; 3) Rett’s Disorder; 4)
Sabrina Freeman, PhD Childhood Disintegrative Disorder; and
Volume 10.3 Summer 2013

Consumer Corner Coordinator 5) PDD-NOS (“Not-Otherwise-


Specified”). The aim of the DSM-5 is to
improve diagnostic criteria that are not
precise, such as combining subgroups of ASD and reducing diagnoses currently called “Not Otherwise
Specified”. The DSM-5 reduces the well-known triad of impairments to a dyad:
Impairment of social interaction and communication (now regarded as one combined domain); and
restricted repetitive and stereotyped patterns of behavior (Wing, Gould, & Gillberg, 2011).
Despite a reduction in underlying impairments, the latest diagnostic criteria expand to include four
symptom domains. To diagnose ASD, all of the four criteria must be met. Current research shows that
DSM-5 diagnostic criteria may, when compared to earlier DSM editions, alleviate or reduce over-
diagnosis and misdiagnosis (Lord, Petkova, Hus, Gan, Lu, Martin, et al., 2012; McPartland, Reichow,
& Volkmar, 2012), but it may also deny individuals with “sub-threshold disability” (i.e., individuals pre-
viously diagnosed with Asperger’s Disorder) access to services.
Where is the Asperger’s Disorder diagnosis?
The “disappearance” of Asperger’s Disorder has created a lot of confusion. DSM-IV-TR differences in
communication and social deficits across Asperger’s Disorder and autism were not clearly delineated.
As a result, in the DSM-5 the disorder was removed as a possible diagnosis. Currently, we do not
know whether Asperger’s Disorder is genetically identical to, or distinct from, autism. To many par-
ents, professionals, and educators, Asperger’s Disorder describes a population of individuals who may
respond to a different set of interventions than those with typical autism (e.g., cognitive behavioral
intervention).
Many individuals and families affected by Asperger’s Disorder fear losing a diagnosis could also result
in a loss of benefits and services. Fortunately, a well-established DSM-IV diagnosis of Autistic Disor-
der, Asperger’s Disorder, or PDD-NOS will likely be given the diagnosis of ASD. In addition, researchers
anticipate that individuals who previously met diagnostic criteria for Asperger’s Disorder may be
moved into the new category of ‘Social (pragmatic) Communication Disorder’ (SCD) (Lai, Lombardo,
Chakrabarti, & Baron-Cohen, 2013). Optimistic consumers hope there will be just as many services
available for individuals diagnosed with SCD as there are for its well-recognized cousin, autism.
How will changes affect ASD prevalence rates?
With an estimated prevalence of 1 in 88 children, ASD is one of the most common neurodevelopmen-
tal disorders; however, the changes in DSM-5 diagnostic criteria may address a criticism of prior DSM

(Continued on page 23)

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Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
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(Continued from page 22)

editions that have been associated with increased preva-


lence rates (McPartland et al., 2012). Researchers pre-
dict that the prevalence of ASD diagnoses will dramati-
cally decrease with the introduction of the proposed DSM
-5 criteria (Worley and Matson, 2012; Matson, Hattier, &
Williams, 2012). Although the definition of autism, as a
neurodevelopmental disorder, has certainly evolved, a
large change in prevalence rates from the DSM-IV-TR to
the DSM-5 should not be unexpected.
Despite these changes to the DSM-5 diagnostic criteria,
at least one critical point remains the same: early detec-
tion of autism and timely, high-quality, science-based in-
tervention is key to promoting optimal independence for
individuals with ASD. The Center for Disease Control and
Prevention provides a list of possible “red flags” for au-
tism at http://www.cdc.gov/ncbddd/autism/signs.html.
Parents and caretakers who have concerns about the
social or communicative development of their child can
review these “red flags” with their child’s health care pro-
vider as part of their determination of whether or not ad-
ditional testing is warranted.
For a more detailed analysis of the recent changes to the DSM, please click (http://asatonline.org/
resources/articles/dsm.htm) to read the full length article on this topic.

References:
Lai, M-C., Lombardo, M. V., Chakrabarti, B., & Baron-Cohen, S. (2013). Subgrouping the autism
“spectrum": Reflections on DSM-5. PLOS Biology, 11, 1-7.
Lord, C., Petkova, E., Hus, V., Gan, W., Lu, F., Martin, D. M., et al., (2012). A multisite study of the
clinical diagnosis of different autism spectrum disorders. Archives of General Psychiatry, 69, 306-
313.
Matson, J. L., Hattier, M. A., & Williams, L.W. (2012). How does relaxing the algorithm for Autism
affect DSM-V prevalence rates? Journal of Autism and Developmental Disorders, 42, 1549–
1556.
McPartland, J. C., Reichow, B. R., & Volkmar, F. R. (2012). Sensitivity and specificity of proposed
DSM-5 diagnostic criteria for autism spectrum disorder, Journal of American Academy of Child
and Adolescent Psychiatry, 51, 368–383.
Wing, L, Gould J., & Gillberg, C. (2011). Autism spectrum disorders in the DSM-V: Better or worse
than the DSM-IV? Developmental Disabilities Research Reviews, 32, 768–773.
Worley, J. A., & Matson, J. L. (2012). Comparing symptoms of autism spectrum disorders using the
current DSM-IV-TR diagnostic criteria and the proposed DSM-V diagnostic criteria Research in Au-
tism Spectrum Disorders, 6, 965–970.

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Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 24
Science in Autism Treatment

ASAT’s mission is to promote safe, effective, science-based treatments for people with autism by
disseminating accurate, timely, and scientifically sound information; advocating for the use of sci-
entific methods to guide treatment; and combating unsubstantiated, inaccurate and false infor-
mation about autism and its treatment. With this in mind, ASAT is striving to reach 10,000 sub-
scribers by the end of the year. We are currently at 8,024 subscribers. Help us reach 10,000 sub-
scribers by clicking on the following link: http://asatonline.org/newsletters/signup. You can also
“like” ASAT’s Facebook page at https://www.facebook.com/
ASAT Board of Directors ASATonline.

Mary E. McDonald, PhD, BCBA-D If you are a supervisor or administrator, please consider pass-
President ing along a sign-up sheet to help us recruit new subscribers.
Volume 10.3 Summer 2013

We have an individual version and group version. After these


Florence DiGennaro Reed, PhD, BCBA-D
Vice President
are completed, they can be emailed to newslet-
ter@asatonline.org or mailed to ASAT PO Box 3250 Hobo-
Barbara Wells ken, New Jersey 07030.
Treasurer ASAT would also like to recognize those individuals and or-
Daniela Fazzio, PhD, BCBA-D
ganizations who strive to support our mission. Specifically, we
Secretary
would like to thank and send a “shout out” to…
 Dr. Linda LeBlanc for forwarding the ASAT newsletter,
David Celiberti, PhD, BCBA-D SIAT, to all staff at Trumpet Behavioral Health
Executive Director
 Little Star Center in Indiana for providing a link to ASAT on
Dana Battaglia, PhD, CCC-SLP their website and for providing ASAT fliers to the families they
Leigh Broughan, MA, BCBA serve
Preeti Chojar, MCA  Rethink Autism for posting about ASAT on their Facebook
Kathryn Dobel, JD page
Ruth Donlin, MS If you would like to share information about any initiatives you
Elizabeth Dyer, MA, CCC-SLP have undertaken to support ASAT, please write us at publici-
Joseph Forgione, MBA ty@asatonline.org.
Sabrina Freeman, PhD
Sara Jane Gershfeld, MA, BCBA
Peggy Halliday, MEd, BCBA
Barbara Jamison, BA
Scott Myers, MD, FAAP
Daniel W. Mruzek, PhD, BCBA-D
Joshua K. Pritchard, PhD, BCBA-D
Dena Russell, MS
Tristram Smith, PhD
Bridget Taylor, PsyD, BCBA-D Help us reach our goal! Share
ASAT the newsletter with friends,
PO Box 3250
Hoboken, NJ 07030
family and colleagues, and
support dissemination of
E-mail: info@asatonline.org
Website: www.asatonline.org evidence-based autism
Facebook: www.facebook.com/
treatment.

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 25

By Ruth Donlin, MS
stated, “We have a lot of noise in
The Central Basketball League
the autism community that is
(CBL) is a professional minor bas-
based on theory and not fact, and
ketball league that has chosen to
ASAT is based on scientific evi-
support ASAT’s mission and com-
dence. As a family, we tried nu-
mitment to the autism communi-
merous interventions. We even
ty.
had a doctor tells us Seth could
The CBL consists of 5 franchises outgrow his autism. There are a lot
within the league, hailing from 5 of professionals out there who
different states, playing a total of subscribe to wacky theories which
12 games each. The CBL’s first creates roadblocks for families.”
spring 2013 season came to a Seth is now in a behaviorally-
close on June 23rd. Congratulations, St. Louis based program that promotes greater main-
Hawks, for winning the League Championship! streaming opportunities. John felt strongly about
partnering with an autism charity and wanted CBL
to be a platform for educating the community.
CBL’s efforts have been noteworthy, including
making educational fliers about autism available
to their basketball crowds and publicizing ASAT’s
mission to provide information to those affected
by autism. In addition, we are thankful to CBL for
raising over $100 for ASAT on their very first pro-
motional night!
St. Louis Hawks, League Champions!
CBL
is made up of professionals who have been in-
volved in various sports related positions over the
years. ASAT is grateful to John Guy, the Operations
Director, and the Central Basketball League for
promoting science-based treatments for autism .
John has been instrumental in collaborating with
ASAT to broaden autism awareness and begin lo-
cal and regional initia-
tives to promote science Hornets Take Down Storm!
-based treatment.
John developed a per-
The CBL teams, Bowling Green Hornets, Dayton
sonal interest in autism
Air Strikers, Middle Tennessee Storm, River City
intervention after learn-
Panthers, and St. Louis Hawks will commence
ing that one of his
their second season this fall.
adopted grandchildren,
Seth, who is now an Learn more about the teams, schedules, and stats
eight-year-old, has au- at the CBL website: http://
tism. The reason John www.centralbasketballleague.com/ or on Face-
chose to collaborate book at https://www.facebook.com/
with ASAT is because of John’s grandson, Seth Oliver CentralBasketballLeague
ASAT’s scientific approach to the disorder. John

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Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 26

Interview with Christina Danos, Founder of Kettlebells 4 Autism


By Alice M Walkup, MS, BCBA
Science in Autism Treatment

Here at ASAT we are always excited to collaborate


with organizations and businesses who share our
commitment to evidence-based autism treatment.
One such organization is Kettlebells 4 Autism, a
Canadian-based effort dedicated to raising autism
awareness through fitness. I had the opportunity
to interview Christina Danos, an entrepreneur and
advocate from Toronto, Canada who founded Ket-
tlebells 4 Autism (KB4A) with the intention of us-
ing kettlebell training and sport as a platform to
raise awareness and funds for autism.
Volume 10.3 Summer 2013

Please tell us a little about how you became in-


volved in autism treatment.
I became involved shortly after a cousin began
Intensive Behavior Intervention (IBI therapy). After
observing one of his sessions I was hooked! An
Instructor Therapist position became available
shortly thereafter, so I applied, and was hired. sian name, Girevoy Sport (GS). Athletes aim to
That was in 2003 and since then I’ve worked as complete as many repetitions as they can in a 10-
an Instructor Therapist, then Senior Therapist in a minute set, without setting down the kettlebell.
publicly funded IBI program, and recently as a Be- There are three main events or disciplines: Jerk,
havior Consultant with a new initiative in Ontario, Snatch, and Long Cycle, in addition to Biathlon,
providing ABA-based services to individuals with which is Jerk set followed by a Snatch set. For the
an Autism Spectrum Disorder (ASD) diagnosis. Jerk and Long Cycle event, male athletes compete
I’m also pursuing a Master of Science degree in with two kettlebells, and one kettlebell for the
ABA. Snatch event. With the Snatch event, competitors
can switch hands once during the set. Women
Can you describe what kettlebells are for our compete with one kettlebell for all events, and are
readers who are not familiar with this particular permitted to switch hands once during the set.
fitness program? During a competition, each athlete completes
A kettlebell looks like a cannonball with a handle. their set before a judge who will determine if a
Its history can be traced to Ancient Greece and repetition is counted or not counted, based on
18 Century Russia, where its use evolved from a form/technique; for example, if the athlete’s arm
th

rudimentary weight to a functional strength and doesn’t fully extend overhead but remains bent at
conditioning training tool. Kettlebells are cast the elbow, it’s a “no count.” The winner is deter-
iron, and differ from a dumbbell or barbell in that mined by the most repetitions per body weight
the shape lends to the bulk of the weight being category, per kettlebell weight, and event.
located in the centre of the kettlebell, and the There are so many autism causes from which to
handle allows the user to maintain neutral wrist choose. How did you choose ASAT and the Gene-
position. Full body movement is required to pull va Centre for Autism as your recipients?
the kettlebell via a “swing” motion with the aim of
completing high repetitions at submaximal load, I’ve known about ASAT for some time, and have
therefore targeting both musculosketal and cardi- used the website as a resource. I mentioned to a
ovascular training. friend that I was looking for beneficiaries for the T-
(Continued on page 27)
There is also kettlebell sport, or known by its Rus-

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Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 27

Interview with Christina Danos continued…


(Continued from page 26) tices that have a proven evidence base. Kettle-
shirt campaign, and she mentioned ASAT. bells4Autism is dedicated to moving this aware-
ASAT’s mission is completely in line with the ness forward and will support four organizations
goals of KB4A, and I think it’s an excellent re- per year with ASAT and Geneva Centre being the
source for parents and professionals. Since I live first two.
in Toronto, I wanted to support a local initiative We are so grateful that you are committed to evi-
too which is how I became involved with The Ge- dence-based autism treatment. Please tell us
neva Centre for Autism. Their Monarch Café pro- about your website and your products.
gram is a vocational training program for adults
with autism. They are working toward developing The website is a work in progress, and I’ll take
a “case study style” digitized manual and other this opportunity to request assistance from any
support tools to help replicate the café in other interested readers. We have a big event coming
areas of Canada with the goal to transitioning up in February 2014, our second annual Kettle-
more adults with autism into long-term success- bell Swings Event, with all funds donated to our
ful employment. Again, this initiative is in line beneficiaries. All of my time is donated, and I
with the goal of KB4A. have had the support of some great friends
when needed (Thank you, Shawn and Sara of
There are many sites that claim autism aware- Agatsu, Cynthia and Erika!). Last year this event
ness is their passion. More specifically, why did raised over $5000, and it looks like we’ll have
you decide to emphasize the evidence-based more than double the number of participants
practices? this year. I’m aiming for the website to be simi-
As a professional working closely with families, I lar to Movember or Ride to Conquer Cancer,
see how confusing and stressful it can be to nav- where donors can sponsor a participant, and all
igate through the information available about donations are tracked online. I’m in the process
interventions, and the vulnerable position care- of updating the website to accommodate this
givers are in when they are seeking what is best event.
for their child. I also know that science-based
interventions typically require more effort, from
all involved in providing treatment, including
caregivers. As professionals, this puts us in a dif-
ficult position, but we need to be open and un-
derstanding of parent’s wishes, while remaining
committed to providing high quality service, and
while competing with other interventions that
may require far less effort and possibly make
broader claims for success. The equivalent ex-
ists in the fitness community, which is why so
many “quick fix” and “low effort” gimmicks exist
that ultimately aren’t effective, continue to
thrive. With KB4A, I chose to focus on supporting In terms of our products, the T-shirts are great!
evidenced based treatment, because I want to The designer, Joel Tellier, created an amazing
bring more attention to practices that are likely logo, and I’m getting fantastic feedback. They
to provide individuals with autism and their fami- are a cotton- polyester blend, the cost is $30
lies the best possible outcome. I’d say that de- plus shipping, and all proceeds raised through T-
spite the many fundraising campaigns that cur-
shirts sales will be divided and donated to ASAT
rently exist for autism, there are only a few spe- and Geneva Centre for Autism. Funds raised
cifically aimed at supporting evidence-based from a comedy night fundraiser in Toronto, and
practices. As such, there remains a need to in-
crease awareness that emphasizes those prac- (Continued on page 28)

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Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 28

Interview with Christina Danos continued…


beneficiary this year, then double the funds raised
Science in Autism Treatment

the Kettlebells Swings Event in 2014 will also be and number of beneficiaries the next year. In terms
donated to these two beneficiaries. Following the of raising awareness, I hope that those who buy the
Kettlebell Swings Event, two new beneficiaries will T-shirts or participate in the Kettlebells Swings
be chosen. event learn a little more about ASD, which can lead
to compassion and support for those affected by
We will certainly share more information about this
autism.
event as the date approaches. I also understand
that the T-shirts are being sold at several locations Christina, we appreciate that you took the time to
as well. You may not be aware but we have a few tell us more about your program and fundraiser.
hundred subscribers who reside in the province. Physical fitness is important for everyone, and if you
Yes, I am happy to report that a number of gyms are haven’t found a routine that works for you, perhaps
selling the T-shirts for a limited time. These include: it can be found in kettlebells. Supporting Kettlebells
Volume 10.3 Summer 2013

4 Autism helps support ASAT and spreads the word


The Academy of Lions at 64 Ossington Avenue in
about science-based autism treatment. Getting in-
Toronto, ON, SPEED Strength and Conditioning at
7551 Jane Street in Vaughan, Ontario, and Agatsu volved is easy. Visit http://kettlebells4autism.com/
to find out about upcoming fundraising events and
Academy at 202 Prom Ronald Montreal West in
get a great looking Tshirt!. Check out the 2013 Ket-
Montreal, Quebec. Readers should also check the
tlebell Swings Event here:
website for an up-to-date list of locations carrying
the T-shirts. http://www.youtube.com/watch?v=kvyaaLi1WgY
That is wonderful! What are you hoping to accom- Many thanks, Christina! We will certainly keep our
plish with this fundraiser? readers apprised of your fantastic efforts!
I would like to raise a minimum of $5,000 for each

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Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 29

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Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 30
Science in Autism Treatment

"My child is enrolled in an ABA-based program Many children with autism receive occupational ther-
where he also receives some OT services. How apy services as part of their early intervention and
can occupational therapy benefit my child's ABA educational programs. In this edition of Clinical Cor-
program?" ner, Amy McGinnis provides an overview of the occu-
Answered by Amy McGinnis, MS, OTR, BCBA pational therapy assessment process and shares
how occupational therapy programs can complement
Occupational therapy (OT) can be beneficial as a sup- a child's ABA-based programming to further skill de-
plemental treatment to your child’s ABA program. The velopment across a variety of areas.
goal of occupational therapy is to support an individu- Nicole Pearson, PsyD, BCBA-D
al’s health and participation in life through engage- Clinical Corner Coordinator
ment in occupations or everyday tasks (AOTA, 2008).
The occupational therapy process begins with an eval-
uation. The evaluation helps to determine whether
Volume 10.3 Summer 2013

cits, occupational therapy can help your child learn the


your child has met developmental milestones in a wide
mouth movements necessary for chewing and drinking
variety of occupations. The occupational therapy evalu-
(Eckman, Williams, Riegel, & Paul, 2008; Gibbons, Wil-
ation can help your child’s behavior analyst choose
liams, & Riegel, 2007). Occupational therapy can also
developmentally appropriate goals to be included in
help older children and adolescents learn more ad-
his ABA program. The OT evaluation may also be help-
vanced ADLs, like independent bathing (Schillam, Bee-
ful in understanding why a child struggles with a partic-
man & Loshin, 1983). Occupational therapists are
ular task. For example, if your child struggles with writ-
trained in identifying multiple ways to perform routine
ing, the evaluation can determine whether this difficul-
tasks, and can recommend an approach that will work
ty stems from an inappropriate grasp, poor posture,
best for your child and can be integrated into your rou-
muscle weakness, visual memory, or lack of eye-hand
tines at home (Kellegrew, 1998).
coordination. Pediatric occupational therapy typically
As individuals with autism age, occupational therapists
addresses the following domains:
can help teach skills that will lead to greater independ-
 Play
ence at home and in the community (McInerney &
 Activities of Daily Living
McInerney, 1992). These include preparing meals,
 Education
managing money, shopping and using public transpor-
 Social Participation
tation. Often these skills are more complex and may
Play is the primary occupation of childhood, and is of-
require an activity or task analysis that breaks the task
ten an area of need for children with autism. Occupa-
down into simpler steps. With extensive training in de-
tional therapy can be effective in helping children learn
veloping task analyses, occupational therapists can
new play skills (Stagnitti, O’Connor, & Sheppard,
share these analyses with your child’s ABA team so
2012). Many pediatric occupational therapists use a
that skills can be taught across settings. If tasks are
play-based approach to their sessions, exposing chil-
still difficult, an occupational therapist may recom-
dren to a variety of toys, games, and different ways to
mend adaptive equipment to make a task easier.
play. If your child engages in repetitive play behaviors
Occupational therapy can also help your child partici-
or has limited interests, the occupational therapist
pate more fully in his or her educational program. Oc-
may be helpful in finding other activities that share
cupational therapy can help young children acquire
similar sensory properties of the toys your child already
tasks such as coloring and cutting (Case-Smith,
enjoys. Some of the sensory activities used in occupa-
Heaphy, Marr, Galvin, Koch, Ellis, & Perez, 1998), as
tional therapy may function as reinforcers, which could
well as help older children acquire skills such as hand-
be used in your child’s ABA sessions as well (McGinnis,
writing (Denton, Cope, & Moser, 2006). If your child
Blakely, Harvey, Hodges & Rickards, 2013).
has difficulty moving through the school setting or ac-
Occupational therapists typically include an assess-
tively participating in movement activities, occupation-
ment of activities of daily living (ADLs) as part of the
al therapy can help your child develop functional mo-
evaluation. ADLs include those basic self-care tasks
bility skills.
that an individual performs each day, such as eating,
Social participation can be challenging for many indi-
grooming, dressing, and using the bathroom. Occupa-
viduals with autism. Occupational therapists may en-
tional therapy can help to build the strength, coordina-
gage your child in activities that promote functional
tion, and perception skills needed to perform these
communication, sharing, taking turns, and following
tasks. For example, if your child has oral motor defi-
(Continued on page 31)

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Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 31

Clinical Corner continued…


(Continued from page 30) V., Ellis, M. G., & Perez, I. (1998). Fine motor and
functional performance outcomes in preschool chil-
rules. If your child requires a form of augmentative dren. American Journal of Occupational Therapy, 52,
communication to interact with others, the occupa- 788–796.
tional therapist may play a role in improving your Clark, G. F. & Miller, L. E. (1996). Providing effective
child’s dexterity or modifying signs. Occupational occupational therapy services: Data-based decision
therapists can also help select an appropriate assis- making in school-based practice. American Journal
tive technology device, and teach your child how to of Occupational Therapy, 50, 701-708.
use their device (Shull, Deitz, Binningsley, Wendel & Denton, P. L., Cope, S., & Moser, C. (2006). The ef-
Kartin, 2004). fects of sensorimotor-based intervention versus
When children display atypical responses to sensory therapeutic practice on improving handwriting per-
experiences that interfere with their daily routines, formance in 6- to 11-year-old children. American
occupational therapy can play a role in overcoming Journal of Occupational Therapy, 60, 16–27.
these challenges. If your child tends to avoid certain Eckman, N., Williams, K. E., Riegel, K., & Paul, C.
sensory stimuli, such as noises, textures, or move- (2008). Teaching chewing: A structured approach.
ment, your child’s occupational therapist and behav- American Journal of Occupational Therapy, 62,
ior analyst can work together to develop a treatment 514–521.
plan to progressively and systematically teach your Gibbons, B. G., Williams, K. E., & Riegel, K. E. (2007).
child to calmly tolerate these experiences. If your Reducing tube feeds and tongue thrust: Combining
child seeks sensory experiences by engaging in inap- an oral–motor and behavioral approach to feeding.
propriate or unsafe behavior, the occupational thera- American Journal of Occupational Therapy, 61, 384
pist may help identify more appropriate alternative –391.
behaviors that provide a similar type of input. Kellegrew, D. H. (1998). Creating opportunities for
During your child’s occupational therapy sessions, occupation: An intervention to promote the self-care
the occupational therapist will document your child’s independence of young children with special needs.
progress. Documentation of progress can vary across American Journal of Occupational Therapy, 52, 457-
different types of settings, and across therapists. It 465.
may be helpful to request that the therapist record McGinnis, A. A., Blakely, E. Q., Harvey, A. C., Hodges,
data on the amount of assistance your child needed A. C., & Rickards, J. B. (2013). The behavioral effects
to complete a task, how many times the child com- of a procedure used by pediatric occupational thera-
pleted the task, or how long your child engaged in a pists. Behavioral Interventions. 28, 48-57.
particular task. These data can be plotted on a line McInerney, C. A. & McInerney, M. (1992).A mobility
graph, and analyzed to see how your child is pro- skills training program for adults with developmental
gressing (Clark & Miller, 1996). disabilities. American Journal of Occupational Thera-
It is important to note that there are a variety of treat- py, 46, 233-239.
ment approaches that can be used in pediatric occu- Ratzon, N. Z., Efraim, D., & Bart, O. (2007). A short-
pational therapy. Some of these approaches are not term graphomotor program for improving writing
scientifically based, and may not produce the desired readiness skills of first grade students. American
effects. Given that your child is receiving ABA, you will Journal of Occupational Therapy, 61, 399–405.
want to find an occupational therapist who uses a Schillam, L. L., Beeman, C., & Loshin, P. M. (1983).
behavioral approach to occupational therapy, and is Effect of occupational therapy intervention on the
open to collaborating with your child’s behavior ana- bathing independence of disabled persons. Ameri-
lyst. When your child’s behavior analyst and occupa- can Journal of Occupational Therapy, 37, 744-748.
tional therapist work together to create goals, man- Shull, J., Deitz J,, Binningsley, F., Wendel S., & Kartin
age problem behavior, teach new skills, and analyze D. (2004) Assistive technology programming for a
data, your child is more likely to reap the benefits of young child with profound disabilities: a single-
a comprehensive, evidence-based program. subject study. Physical and Occupational Therapy in
References: Pediatrics, 24, 47-62.
American Occupational Therapy Association. (2008). Stagnitti, K., O’Connor, C., & Sheppard, L. (2012).
Occupational therapy practice framework: Domain Impact of the Learn to Play Program on play, social
and process (2nd ed.). American Journal of Occupa- competence and language for children aged 5-8
tional Therapy, 62, 625-688. years who attend a specialist school. Australian Oc-
Case-Smith, J., Heaphy, T., Marr, D., Galvin, B., Koch, cupational Therapy Journal, 59, 302-311.

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 32
Science in Autism Treatment

Media Watch is a subcommittee of the Public Relations Committee whose primary initiatives are:
Educating the public about effective autism treatment through proactive contact with the media; Re-
sponding to inaccurate information or proposed treatments described by the media (as it relates to
scientific findings about their effectiveness); And supporting accurate media depictions of empirically–
sound interventions for individuals with autism spectrum disorders.
We seek to increase awareness of the scientific underpinnings surrounding autism treatment that can
lead to real hope for those touched by this disorder.

We have been busy since we last ASAT Responds to Texas Observ- ASAT Responds to CNN.com's
updated you on our Media er’s "Autism Inc.: The Discredited "CDC: Higher number of children
Watch efforts in the Winter Science, Shady Treatments and with autism" (April 22, 2013)
Volume 10.3 Summer 2013

issue! Here are the articles thatRising Profits Behind Alternative CDC's latest numbers for preva-
caught our attention and Autism Treatments" (March 27, lence of autism spectrum disor-
received our feedback. 2013) der in children are disturbing:
Journalist Alex Hannaford de- one in 50.
scribes the journey of several http://asatonline.org/
ASAT Responds to WPMI Local
duped parents -- once amazed media_watches/104
15 News "Local Family Using
by the gamut of so-called
Breakthrough Autism Treat-
“miracle cures” -- but now in-
ment" (February 03, 2013) ASAT Responds to Triblive.com's
formed, and able to draw the line
Could the Integrated Listening "Pa. Autism Services Hope to
between quackery and science.
System be the next make inroads in work-
"breakthrough treatment" for au- http://asatonline.org/ place" (April 25, 2013)
media_watches/102 Attention to post-graduation em-
tism?
http://asatonline.org/ ployment should be begun early,
media_watches/99 carried out extensively, and
planned meaningfully.
http://asatonline.org/
ASAT Responds to The New York
media_watches/105
Times "Some With Autism Diag-
nosis Can Overcome Symptoms,
Study Finds" (February 26, ASAT Responds to Springfield
2013) News-Leader.com's "Parents can
A new study from the University get help with autism is-
of Conn. claims the hope of sues" (May 31, 2013 )
"recovery" for some children with Parents should be encouraged to
autism. ASAT Responds to be wary of “miracle cures” and
http://asatonline.org/ FoxPhilly.com’s "Parents Of Au- treatments that are not based in
media_watches/100 tistic Children Worry What Life scientific evidence.
Will Bring When They're http://asatonline.org/
Adults" (April 01, 2013) media_watches/106
ASAT Responds to Fox.com's
"Study Looks at Worm Therapy to The tsunami of young adults on
Treat Autism" (March 04, 2013) the autism spectrum is a growing Read all posts online. If you have
Worm therapy - is it viable? concern for parents and caregiv- any comments or would like to
http://asatonline.org/ ers. contribute, contact us at in-
media_watches/101 http://asatonline.org/ fo@asatonline.org
media_watches/103

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 33

Does Your Agency Share information and asking the between scientifically
ASAT’s Values? right questions. validated treatments and
ASAT believes that individuals When all providers will be treatments that lack
with autism have the right to guided by science when scientific validation.
effective treatments that are selecting and implementing 4.Consumers should be
scientifically-demonstrated to interventions. informed that any treatment
make meaningful, positive lacking scientific support
change in their lives. What It Means to Be a should be pursued with
We believe that it should not Sponsor: great caution.
be so challenging for families ASAT’s sponsors have 5.Objective data should be
to find accurate information indicated their support of the used when making clinical
about the efficacy of various following tenets: decisions.
autism interventions.
ASAT works toward a time... 1.All treatments for individuals Become a 2013 Sponsor
When all families will be with autism should be Now!
empowered with skills in guided by the best available These sponsorships not only
identifying and choosing the scientific information. provide financial support used
most effective, scientifically- 2.Service providers have a specifically for our
validated interventions for responsibility to rely on dissemination efforts, but also
their child. science-based treatments. send a clear message that
When the media will educate 3.Service providers should ASAT's vision is shared by
and not confuse parents by take steps necessary to help others within the professional
providing accurate consumers differentiate community.

ALLIANCE $500 Autism Research and Treatment


PARTNER $5,000 The Bay School
Autism Intervention Services
Behavior Analysis Center Autism New Jersey Beacon Services
for Autism Connecticut Center for Child Behavior Development Solutions
Child Study Center of Fort Worth
Development Commonwealth Autism Services
CHAMPION $3,000 Eden II Programs Coyne and Associates
Little Star Center Four Points, Inc. Different Roads to Learning
Quality Services for the Autism Gary Mayerson & Associates
CHAMPION $2,000 Community (QSAC) Institute for Educational Achievement
STE Consultants , LLC Thivierge & Rothberg Kansas City Autism Training Center
Virginia Institute of Autism Lizard Children’s Learning Centre
Autism Partnership Lovaas Insitute Midwest
Organization for Research PATRON $200
MECA/PAAL
NYCA
and Learning A Bridge to Learning
Pyramid Educational Consultants, Inc.
Aging with Autism
Quest Autism Program
BENEFACTOR $1,000 Alpine Learning Group
Room to Grow
ELIJA Foundation Asperger Syndrome and high
SKF Books
ELIJA School Functioning Autism Association (AHA),
Somerset Hills
Rethink Autism Inc.
Working with Autism Autism Awareness

IMPORTANT DISCLAIMER: ASAT has no formal relationship with any of the sponsor organizations. Furthermore, their stated
endorsement of the above tenets is not verified or monitored by ASAT. Although ASAT expects that all sponsoring organizations will act
in accordance with the above statements, ASAT does not assume responsibility for ensuring that sponsoring organizations engage in
behavior that is consistently congruent with the statements above.

ASAT
Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment
Page 34
Science in Autism Treatment
Volume 10.3 Summer 2013

With your help, we are reaching out to more and more people every
day, united in their commitment to accountability, respect, and science in
autism treatment. Individuals with autism deserve nothing less! Join us on
Facebook to stay connected and get immediate content updates.
www.facebook.com/ASATonline

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Providing Accurate, Science-Based Information - Promoting Access to Effective Treatment

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