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Understanding Applied Behavior Analysis (ABA)

Imagine that you are working in your front yard, which for some reason is not growing. You can see the yards of your neighbors, which are green and healthy.  You have watered and mowed your yard just as your neighbors do, but you just aren’t getting the same outcome.  You decide to go to the local hardware store to see if there is something you can use that will help your lawn to grow.  Upon entering the hardware store, you see shelf upon shelf of products all “guaranteeing” to work miracles on your lawn.  Some of them carrying a pretty hefty price tag.  Before you invest in any of these products, you wonder to yourself, “how can I be sure that these products will do what they claim?  After all, I will be investing money, time, and effort into using this product.”

You then notice your neighbor enter the store and remember that not too long ago, his yard had been in need of help.  Knowing that he likely has already faced a similar trial, you decide to approach and ask his advice.  Your neighbor responds that he spent a lot of time and resources trying different products to learn which ones worked, and which ones didn’t.  He goes on to say that he studied each product over time to determine which one yielded the absolute best results on a consistent basis, and then shared this information with you.  It felt so much better knowing that the product you chose had been “tested” over time and proven to be consistently effective.

Applied Behavior Analysis (ABA) is very much like the story above.  It is a field of study which continually evaluates the effectiveness of many strategies and approaches to working with children with autism and related developmental disabilities.  Fortunately, there are people who are trained and certified in the application of these strategies.  These individuals are able to use years of effective research based strategies to teach new skills and reduce unwanted behaviors, helping your child move closer towards realizing their full potential.


If you would like more information about the principles of ABA and how they can be used to help your family, please call Children’s Care Hospital and School at 605-782-2300 or ask your physician for resources close to your area.

Posted 26 June 2008 by Children's Care | Comments (0) Tagged: , ,

Autism and Vaccinations

A recent issue of Time magazine, dated June 2, 2008, highlighted a well written article entitled “How Safe are Vaccines?”  As a professional in the field of Applied Behavior Analysis, a field in which a main emphasis is data-based, objective decisions - I know that at this point, the data does not support a causal relationship between vaccinations and autism.  However, as a mom of a young son, I will admit that as the 18 month appointment drew near, I was anxious about the vaccinations.  The article in Time magazine did an excellent job emphasizing the risks of eliminating vaccinations.  Also discussed was statistical information in regards to the rate of autism.  The rate of occurrence of autism has not declined even with the elimination of thimerosal, the mercury-based compound, from vaccinations back in 2001.  

 As a parent, I encourage other parents to have discussions with the professionals that work with their child.  Many physicians are more than willing to identify a compromise with vaccinations.  For example, after speaking with my son’s physician, we opted to spread out the vaccinations over a few months time so that he didn’t receive them all at once.  As a professional, I encourage parents to research information from reliable sources to make the best possible decision for your child. 

 

Amber Bruns
Board Certified Associate Behavior Analyst
Behavior Coordinator

Posted 16 June 2008 by Children's Care | Comments (0) Tagged: , ,

How Do You Spell Relief?

Children with special needs have many unique conditions.  Some special needs children require Extended and Medical Care Services due to their diagnoses:  Cerebral Palsy, Traumatic Brain Injuries, Spinal Cord injuries, etc, - each of which brings different challenges.  One of those challenges is dealing with spasticity.  Spasticity is defined as an abnormal increase in muscle tone, causing stiff tight muscles especially in the arms and legs.  Spasticity can be mild to severe and is different for everyone.  It can have a negative impact on function and comfort.  Patients with spasticity may have loss of function, pain, permanent muscle shortening or contractures.  

There are different treatments for spasticity. Depending on the severity, treatments are typically used in conjunction with other therapies.  Different treatments for spasticity range from physical and occupational therapies, braces and splints, oral medications such as baclofen, botox injections, which are injections into the actual muscles, or intrathecal baclofen therapy. Additionally, orthopedic or neurosurgical procedures may be needed to manage the spasticity or the effects of the spasticity on bones or muscles.

Intrathecal baclofen therapy requires surgery to implant a baclofen pump.  Typically the pump is placed in the abdomen of the patient.  A catheter connects to the pump and is then connected in the spinal column typically in the low to mid back region.   The pump then dispenses the medication, baclofen, at a rate prescribed by the physician.  The rate, dosage, etc can be manipulated by the physician so maximum benefits can be achieved.  The baclofen pumps do need to be refilled, based on the type of pump and the rate/dosage, refills could be weekly, monthly, or as far as six months apart.  Specialized nurses refill the baclofen pumps under the direction of the physician.   

The benefits from a baclofen pump could include relief from the pain and discomfort of spasticity, increased  range of motion, ease in stretching and providing care, improved function, and mobility and the potential to decrease the need for some orthopedic surgical procedures.

As with all treatment options, baclofen pumps need to be managed by a specialized physician.  Teaching of parents and care givers is vital to the success of treatment. Caregivers need to know the signs and symptoms of baclofen withdrawl and overdose.   Immediate physician intervention is needed if suspected withdrawl or overdose.

Again, baclofen pumps are not for everyone as everyone is unique and responds differently to spasticity.  Patients and their families must work closely with their physician to decide if the pump may be best for them.

Rebecca Weeldreyer, RN
Extended & Medical Care Manager

 

Posted 08 May 2008 by Children's Care | Comments (0) Tagged: , , , , , , , ,

It’s About Love

Children with special needs are all around us.  Some of them we see every day - while shopping, on vacation or in school.  These children are visible because of the assistive devices they may require such as wheelchairs, braces, crutches or other means.  It is human nature to watch these children go by or to stare.  We watch how they walk or roll by, curious about their condition and at how they live their day.  Then there are others - those who we can’t detect who have special needs because they appear quite typical.  But they are a bit different in their developmental abilities.  We might see these disabilities manifest themselves in grunts or groans when they attempt to communicate.  We might see them having difficulties as their parents attempt to guide them in the right direction.  Regardless of the circumstances, one thing does hold true:  whether in a wheelchair or not, whether walking differently or not, whether acting differently or not, children with special needs are children.  And children need love.

Imagine a day, where at no fault of your own, you find yourself a child once again.  In addition, you’re now a child who is not able to talk as you normally would or to walk as your normally would - or to breathe as you normally would.  You might be fortunate to have devices to help you, but as you go out onto the sidewalk or attempt to do your everyday things, you find yourself unable to keep up with others around you.  You hear laughter, you see differences in others and you want to change.  But you don’t know how.  You might have problems rationalizing as you go about your day.  You can’t dress yourself or may not be able to determine what matches.  Stairs become your worst enemy.  You are now dependent on others to get you through the day.  On top of all of these differences, you wish things were different for you, but you still long for love.  And acceptance.

Children need love no matter their appearance, disability or condition.  Don’t wait until a special month comes along to recognize children who might be different from your children.  Educate yourself and your children about differences as well as similarities.  Volunteer at a children’s facility.  As you give love from your heart to those who deserve it, you teach them what the world can be like.  And you might learn something about yourself at the same time.

Posted 02 May 2008 by Children's Care | Comments (0) Tagged: , ,

Is it Autism or autistic?

A significant amount of attention has turned to autism because of increasing rates of occurrence and increased awareness.  Along with that there is the natural tendency to be curious and ask more questions about autism.  A question that I have commonly been asked to explain is the difference between “a child with autism” and “an autistic child.” 

In the mid 1980’s, our society began to make a conscience effort to become more politically correct.  From this, the idea of People First Language emerged.  People First Language aims to eliminate generalizations and stereotypes by focusing on the person first and the disability second.  People First Language suggests stating “a child with autism”.  Proponents of People First Language suggest that we should not equate a person with a disability, as the labels are simply diagnoses.  People First Language also states that an individual should not be defined by his/her condition.  For example, a cancer patient would not be described as cancerous, nor would a child with autism be described as autistic. 

Some individuals disagree with the People First Language approach and state that autism cannot be separated from the individual and are in favor of stating that a person is autistic.  Others also argue that using People First Language is stating that the label is so negative that there is an overwhelming desire to separate oneself from the label. 

And yet, there are still some people in the middle.  Others ask, “what does it matter?”  Those that are in the middle ground state that a musician can be described as musical, and an artist can be described as artistic, so why can’t a person with autism be described as autistic?

So is it a “child with autism” or “an autistic child?”  I prefer the wisdom from this quote by Mark Twain:  ”The difference between the right word and almost the right word is the difference between lightning and the lightning bug.”

Amber Bruns
Board Certified Associate Behavior Analyst
Behavior Coordinator

Posted 23 April 2008 by Children's Care | Comments (0) Tagged: , ,

Did You Know?… Brutal Facts about Autism

In light of Autism Awareness Month, here are some startling statistics provided by a national autism group that many people are not aware of:Facts

  • Autism is the fastest-growing serious developmental disability in U.S.
  • Boys are four times more likely than girls to have autism
  • 1 in 94 boys is on the autism spectrum
  • 67 children are diagnosed per day
  • Found equally in all walks of life and in all populations around the world a new case is diagnosed almost every 20 minutes
  • More children will be diagnosed with autism this year than with, diabetes, and cancer combined
  • Autism receives less than 5% of the research funding of many less prevalent Childhood diseases
  • Autism costs the nation over $90 billion per year, a figure expected to DOUBLE in the next decade
  • 90% of those costs are in ADULT services (The cost of lifelong care can Be reduced by 2/3 with early diagnosis and intervention)
  • In just TEN years, the annual projected cost will be $200-400 BILLION

    • This provides a few more reasons why autism needs help, funding and answers. Anyone disagree?

    Based on information from the following sources:  Centers for Disease Control and Prevention (2007), (2001), and 2000 U.S. Census figures of 280 million Americans; U.S. Department of Education’s “Twenty-First Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act” (1999); Jarbrink K, Knapp M, 2001, London School of Economics study: “The economic impact on autism in Britain,” 5 (1): 7-22; estimations from Autism Society of America (February 2003)
Posted 15 April 2008 by Children's Care | Comments (0) Tagged: , , ,

Autism and the Internet

The internet is a fabulous tool for just about anything you need to research or look up.  I remember when my husband and I first got married we invested in a complete set of Encyclopedia Britannica and faithfully purchased the annual “Yearbook” each year.  I am not sure how many Encyclopedia salesmen (oops, persons) you would find today???  Much has changed since 1979 and not just with the use of computers:  Autism was considered a rare disability and many times was diagnosed as mental retardation or childhood schizophrenia; Applied Behavior Analysis (ABA) was only practiced by a select few (The Lovaas Institute, Eden Institute); mothers of “autistic” children we just beginning to loose the “refrigerator mother” label; IDEA was passed in 1975 but few children with autism and severe behavior disorders were served; and most children with severe autism were still sent to institutions - I am sure we could go on and on.

I must caution the use of the internet as your sole source of information.  As I am sure many of you have found out, there are unscrupulous people out there and they have just been waiting for something like autism to come along.  Please make sure that what you are trying with your child is research-based and approved by a knowledgeable medical professional.  A big caution here!!!!  BEWARE OF THOSE SELLING WHAT THEY SAY YOU MUST HAVE, AND BEWARE OF THOSE WHO PROMISE A CURE.  Autism is a developmental disability and not a disease.  With early detection and intense early intervention, the symptoms may be mitigated to the point of minimal detection; still, the child will most likely be in need of some level of lifetime support, even if it is only social coaching.  

The Autism Society of America (ASA) is a trusted website and you have a promise from Children’s Care that we will only provide you with the most reliable and researched information available. 

Let us know what YOU think.

Vicki Isler
Vicki L. Isler, Ed.D., BCBA
Program Director
Behavioral Care Services
Children’s Care Hospital & School

Posted 09 April 2008 by Children's Care | Comments (0) Tagged: , , , , ,

How You Can Participate in Autism Awareness Month

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Today marks the first day of April which is also Autism Awareness Month.  Many autism organizations will commemorate this month by offering walks and other events to support a cure.  April 2 is the first global observance day for autism - World Autism Awareness Day.  With so many births resulting in children being diagnosed with autism, this subject has taken the main stage in many homes.  Studies show that if autism is diagnosed early (before the age of 3), the child has a better potential for entering the public school system with children their own age.  Early intervention and treatment can save a lot of money in future therapy costs.  If you or someone you know has a child that shows some of the symptoms of a child with autism, there are several programs that can evaluate and help children with this diagnosis.  To learn more, talk to your physician or go to http://www.cchs.org/autism to learn more about some of these services available.

Posted 01 April 2008 by Children's Care | Comments (0) Tagged: , , ,

How to Use Blogs with RSS Feeds

RSS Feed ButtonIf you missed our first two posts, you can click here for our first post and here for our 2nd post.  In our last post we discussed what BlogTalk is all about and how it allows us to converse.  Today’s post is intended to point out a few tips about how you can actually subscribe to this conversation so you never miss a beat.  

We have already talked about how you can communicate back to us on posts/articles we write through the comments section below each post.  Rookie blog readers may not always comment at first after reading a post, but in time you’ll have something you will want to share or to ask.  Reading or commenting is purely up to you, but by participating it’s a lot more fun.  As you’ll find out, reading the comments can be just as fun as reading the posts - plus you’re able to comment on other’s comments as well!  Just be respectful of others as you would have them be respectful of you.
That orange looking symbol you see on this page is the RSS Feed button.  RSS Feed buttons are magical buttons that allow you to subscribe to blogs in a few simple steps.   RSS stands for Really Simple Syndication.  Rather than check in to the website every day to see if a blog has updated material, an RSS Feed will show only the blog posts and note when there are new posts.  In a few steps you’ll be connected to this blog in no time!
One way to get connected to a blog when using Internet Explorer (version 7 or greater) on a PC is to:
  1. Click on the RSS Feed button (on our blog it is the button in the right hand margin).  
  2. After you click this button you’re taken to a screen that shows the posts of the blog you’re reviewing and there will be an area near the top of the page that shows a star with a “+” sign on it.  
  3. Click on the ”+” sign and you’ll be subscribed to the blog’s feed.  To access the feed when you like, click the Favorites star, then click on Feeds and you’ll see the blogs you have RSS feeds for.  If you have used Google Reader or have a Google account then see below.
  4. If you want to access your blog feeds from anywhere there is a computer, then you can also use Google Reader.  To use Google’s Reader:
  5. Establish a Google account/email account.  Once you’ve done this, you can access the Google Reader by the menus on the Google screen or by Googling the term.  Once you access Google Reader, you’ll want to bookmark it to your favorites for faster access in the future.  
  6. Add RSS Feeds to Google Reader by clicking on the RSS Feed Button.  
  7. Copy the website’s URL/address at the top of the screen and then go to the Google Reader site.  
  8. Within that page, you’ll see a green bar that says “Add Subscription.”  Click on that link and then paste the URL of your blog feed into this area.  You may do this each and every time you wish to subscribe to a blog feed.  What’s nice about using Google Reader is that you can view many blogs in a very convenient fashion no matter where you are in the world and no matter whose computer you’re using.
  9. If you’re a Mac user and need assistance, leave a comment on this blog and we can assist our Mac website users.

    Some of these steps may sound laborious at first, but as you practice and repeat, you’ll be a pro in no time!  Or, if it’s simply just too tough to figure out, simply visit www.cchs.org/blog each time you are on the Internet and you’re guaranteed to keep up with the conversations at Blog Talk.

Posted 28 March 2008 by Children's Care | Comments (1) Tagged: ,

What’s a Blog Anyway?

WWW Blog

In case you stumbled across this blog post or you returned from our last blog post,  welcome back!  Welcome back to BlogTalk.  Now, you might have a lot of questions about what is BlogTalk.  And that’s OK.  So, let’s begin…

Blogging is a new form of “social media” that has increased in amazing popularity in the last five years or so.  There are already over 113 million blogs in the world!  A blog is a “weblog,” a transaction of thoughts, opinions, exchanges of information as well as a journal put onto a website.  There are blogs about photography, politics, computers and many other subjects.  We’ve named ours BlogTalk because we want you to talk with us as we talk with you - only online.

BlogTalk is a communication vehicle.  If you think about it, newspaper articles, radio and TV commercials are one-sided.  With BlogTalk, we can communicate what is going on and then through our comments section below, you can then communicate back with us.  We’re all excited about this because there are many questions and many topics to be covered in a world where children have special needs.  Now WE can talk to whomever cares to participate.  Best of all, you can follow the conversation between Children’s Care and anyone who comments.  From time to time we may refer you to a topic or other site by using hyperlinks.  Hyperlinks are words that are underlined and when you click on them with your mouse, you are sent to another area of our website or perhaps a new website altogether.  For example, Wikipedia, an online library has a more definitive answer to what a blog is, so click on blog to find out what that looks like.BlogTalk will address medical issues from time to time and in those cases we will base our findings and research on evidence based medicine.  It’s how we approach our children and it’s how we’ll address things here as well.  

There’s even more to blogs than what was mentioned here, so in our next discussion, we’ll give you information about that funny orange button up above called an RSS Feed button.  It will make your following this blog a lot more helpful and allow you to join the conversation on an ongoing basis.  We look forward to your comments, so feel free to let us know your thoughts after reading this and what posts you’d like us to talk about in the future.  Click on the word “Comments” below to add your comments or view other comments.

Photo courtesy of Emiliano Bertoli

Posted 27 March 2008 by Children's Care | Comments (0) Tagged: ,
“I like volunteering at Children’s Care. It is neat to see the progress children make from week to week.”
– Kara Homandberg, Volunteer