Evidence Based Treatments for Autism Spectrum Disorder (ASD)

NSU College of Psychology
2 Dec 202156:44

Summary

TLDRThis webinar, led by Dr. Taryn Goldberg and her team, delves into evidence-based treatments for Autism Spectrum Disorder (ASD). They highlight the importance of employing scientifically supported interventions, such as Applied Behavior Analysis (ABA), and discuss the National Standards Project's role in guiding treatment choices. The discussion also touches on the necessity of parental involvement and the need for ongoing training and competence among providers. The webinar provides a valuable resource for understanding effective ASD interventions and emphasizes the evolving nature of treatment approaches.

Takeaways

  • 🌟 Evidence-based treatments are crucial for individuals with Autism Spectrum Disorder (ASD), and they should be the foundation of any intervention plan.
  • 📈 The National Standards Project is a valuable resource for parents, caregivers, and professionals to understand and select effective treatments for ASD.
  • 🧠 Applied Behavior Analysis (ABA) is recognized as a gold standard for treating individuals with ASD and other significant behavioral disorders, focusing on functional communication and adaptive skills.
  • 🔍 Parents play a critical role in their child's treatment and should be active participants, advocating for their child and collaborating with treatment providers.
  • 🤝 Collaboration between parents and providers is essential for successful outcomes, with open communication and shared decision-making being key components.
  • 📚 Providers must have the appropriate training, competence, and stay up-to-date with current research to ensure they are offering the best possible interventions.
  • 🎯 Setting clear, measurable goals is important for tracking progress and making necessary adjustments to the treatment plan.
  • 🌐 Cultural, family structure, and financial factors should be considered when developing a treatment plan to ensure it fits the individual's and family's needs.
  • 💡 Emerging interventions show promise but may not have enough research to confirm their effectiveness fully; thus, they should be approached with caution.
  • 📝 It's important to use data-driven decision-making to assess the effectiveness of interventions and make necessary changes to the treatment plan.

Q & A

  • What is the primary goal of the webinar?

    -The primary goal of the webinar is to provide an update on the state of evidence for treatments for Autism Spectrum Disorder (ASD) and to describe the importance of using empirically supported treatments with clients.

  • What is the role of the National Standards Project in treating individuals with ASD?

    -The National Standards Project aims to answer the question of how to effectively treat individuals with ASD by reviewing and categorizing various interventions based on their level of evidence into established, emerging, and unestablished treatments.

  • What are the three categories of interventions that the National Autism Center groups ASD interventions into?

    -The three categories are established interventions (repeatedly effective), emerging interventions (show some evidence of effectiveness), and unestablished interventions (lack sound evidence of effectiveness).

  • Why is Applied Behavior Analysis (ABA) considered a gold standard in treating individuals with ASD?

    -ABA is considered a gold standard because it is based on learning theory and has been proven to be effective in teaching skills and reducing interfering behaviors in individuals with ASD through the use of behavioral techniques like positive reinforcement and functional analysis.

  • What are some of the established treatments for ASD mentioned in the 2015 phase 2 report?

    -Some of the established treatments include behavioral interventions, cognitive behavioral therapy, comprehensive behavioral treatment for young children, and medically based treatments to address challenging behaviors associated with ASD.

  • What are the main factors that parents should consider when seeking treatment for their child with ASD?

    -Parents should consider factors such as the evidence-based nature of the treatment, the competence and training of the treatment provider, the cultural and family context, financial considerations, and the fit of the treatment with their child's specific needs and their family situation.

  • How can parents ensure they are actively participating in their child's treatment?

    -Parents can actively participate by asking questions, being involved in treatment sessions, learning to implement interventions at home, advocating for their child's needs, and collaborating with treatment providers to set appropriate goals and adjust the treatment plan as necessary.

  • What are some resources available for families seeking information on evidence-based treatments for ASD?

    -Resources include the National Standards Project, Autism Speaks, the Center for Autism and Related Disorders (CARD), and Early Steps, which provide guidance, information, and referrals for evidence-based intervention options.

  • What is the significance of parent training in the treatment of children with ASD?

    -Parent training is significant because it helps in the generalization of skills from the clinical setting to the natural environment. It empowers parents to support their child's learning and development outside of therapy sessions, leading to more effective and sustainable treatment outcomes.

  • How does the webinar address the issue of comorbid mood disorders in individuals with ASD?

    -The webinar discusses the growing interest in treating emotion regulation difficulties in individuals with ASD, especially those with comorbid mood disorders like depression and anxiety. It highlights the potential efficacy of interventions like cognitive behavioral therapy (CBT), mindfulness-based interventions, and intensive outpatient programs (IOP) that focus on emotion regulation.

Outlines

00:00

🌟 Introduction to Evidence-Based Treatments for Autism Spectrum Disorder

The webinar begins with a welcoming introduction by Dr. Taryn Goldberg, a licensed psychologist, along with her colleagues Dr. Catherine Stubblefield, Dr. Danielle Silver, and Dylan Braun, a clinical psychology trainee. They are based at the Mailman Segal Center Building at Nova Southeastern University, specifically at the Children's Clinic Foundation, where they provide psychodevelopmental evaluations and community outreach presentations. The main topic of discussion is evidence-based treatments for individuals with Autism Spectrum Disorder (ASD), emphasizing the importance of reliable and well-researched interventions.

05:01

📚 Understanding Evidence-Based Treatments and the National Standards Project

The discussion shifts to the importance of evidence-based treatments, highlighting the National Standards Project conducted by the National Autism Center at May Institute. The project aims to determine effective treatments for individuals with ASD, with the first report released in 2009 and the second phase in 2015, currently being updated. The benefits of evidence-based treatments are emphasized, including their impact on families and the potential for children to lead more adaptive and independent lives. The talk includes a video case study of a 16-year-old with ASD, showcasing the profound impact of early intervention.

10:03

🎯 Established, Emerging, and Unestablished Interventions for ASD

The presentation outlines the categorization of interventions for ASD into three groups: established, emerging, and unestablished. Established interventions, which have been repeatedly shown to be effective, are primarily based on Applied Behavior Analysis (ABA) principles. Emerging interventions show promise but lack sufficient evidence for full endorsement. Unestablished interventions lack solid evidence of effectiveness. The importance of focusing on established and emerging practices is stressed, as these have demonstrated effectiveness in wide groups of children with ASD.

15:05

🤔 Parental Decision-Making and the Role of Professional Advice in ASD Treatment

The conversation addresses the challenges parents face when selecting treatments for their children with ASD, often overwhelmed by the vast amount of information available. Research indicates that parents heavily rely on professional advice when deciding on treatments. However, many parents are not fully aware of the gold standards or best treatments for their child with ASD. The discussion emphasizes the need for parents to understand and choose reliable treatments based on empirical support and professional guidance.

20:10

🧠 The Science Behind ABA and Its Application in Treating ASD

A detailed explanation of Applied Behavior Analysis (ABA) is provided, highlighting its basis on learning theory and its focus on teaching skills and reducing interfering behaviors. ABA is provided by trained, certified therapists in various settings and requires intensive hours of therapy. The treatment goals of ABA include improving functional communication skills, language acquisition, social skills, and reducing maladaptive behaviors. The discussion also includes a video that further explains ABA and its techniques for teaching complex skills through breaking them down into smaller, manageable parts.

25:13

🌱 Emerging Interventions and the Future of ASD Treatment

The conversation turns to emerging interventions for ASD, particularly those for individuals under 22. While these interventions show promise, they have not been studied extensively enough to be fully endorsed. The importance of considering these interventions, even if they are not categorized as well-established, is discussed. The group also speculates on the potential advancements in treatment options, such as technology-assisted interventions and sensory processing treatments, that may emerge in the next update of the National Standards Project.

30:14

💡 Insights on the Evolution of ASD Treatments and Parental Involvement

The discussion emphasizes the evolving nature of ASD treatments and the critical role of parents in their child's treatment journey. The importance of parent training and involvement in therapy sessions is highlighted for the generalization of skills from a controlled environment to real-life situations. The webinar also addresses the need for parents to be active participants, advocating for their children and collaborating closely with treatment providers to ensure the effectiveness of interventions.

35:15

📈 Evaluating and Adapting Treatment Strategies Based on Data

The importance of data-based decision-making in treating individuals with ASD is discussed. Clinicians are encouraged to collect and analyze data to determine the effectiveness of treatment and make necessary adjustments. The role of parents in this process is also emphasized, as they should be informed about their child's progress and have the right to advocate for changes in the treatment plan if needed. The discussion underscores the collaborative nature of treatment and the importance of adapting strategies based on empirical evidence and the unique needs of each child.

40:16

🌐 Resources and Support for Families and Providers in ASD Treatment

The webinar concludes with a focus on available resources and support for families and providers in the journey of ASD treatment. Several organizations are mentioned, including the National Standards Project, Autism Speaks, and the Center for Autism and Related Disorders (CARD), each offering guidance, referrals, and a wealth of resources. The importance of staying up-to-date with current research and maintaining open communication between providers and families is stressed, as well as the right of parents to ask questions and be actively involved in their child's treatment process.

Mindmap

Keywords

💡Autism Spectrum Disorder (ASD)

Autism Spectrum Disorder (ASD) is a developmental disorder characterized by challenges with social interaction, communication, and repetitive behaviors. In the video, it is the central topic of discussion, with various evidence-based treatments being explored for managing symptoms and improving quality of life for individuals with ASD.

💡Evidence-Based Treatments

Evidence-based treatments refer to therapeutic interventions that are supported by extensive research and proven to be effective for a specific condition or disorder. In the context of the video, these treatments are crucial for providing effective care to individuals with ASD, ensuring that the methods used have a strong foundation in scientific research.

💡Applied Behavior Analysis (ABA)

Applied Behavior Analysis (ABA) is a scientific method for changing behavior through understanding and modifying the environmental factors that influence it. ABA is a well-established treatment for ASD that focuses on teaching new skills and reducing challenging behaviors through positive reinforcement and other behavioral techniques.

💡Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a type of psychological treatment that helps individuals identify and change negative thought patterns and behaviors. In the context of ASD, CBT can be used to address specific challenges such as anxiety or depression that may co-occur with the disorder.

💡Parent Training

Parent training involves educating and supporting parents of children with ASD to help them effectively respond to their child's behaviors and implement therapeutic strategies at home. This approach is crucial for generalizing skills learned in therapy to the natural environment.

💡National Standards Project

The National Standards Project is an initiative conducted by the National Autism Center aimed at identifying and promoting effective treatments for individuals with ASD. It provides a resource for parents, caregivers, and professionals to determine the best course of action for treating autism based on empirical evidence.

💡Early Intervention

Early intervention refers to the provision of services and support to young children with developmental delays or disabilities, including ASD, to improve their developmental outcomes. It is a critical aspect of treatment because it can significantly enhance a child's ability to learn and adapt.

💡Functional Communication Training (FCT)

Functional Communication Training (FCT) is a behavioral intervention that teaches individuals with ASD to replace challenging behaviors with more appropriate communication strategies. The goal is to understand the function of a behavior and provide alternative, more effective ways to communicate the same need or desire.

💡Comorbid Conditions

Comorbid conditions refer to the presence of one or more additional disorders or conditions co-occurring with a primary condition, such as ASD. In the context of the video, it is important to address these comorbid conditions, like anxiety or depression, as they can impact the overall well-being and functioning of individuals with ASD.

💡Treatment Providers

Treatment providers are professionals, such as psychologists, therapists, and educators, who deliver interventions and support services to individuals with ASD. Their role is to assess, plan, and implement evidence-based treatments, ensuring that the care they provide is effective and tailored to the needs of each client.

Highlights

The webinar focuses on evidence-based treatments for Autism Spectrum Disorder (ASD).

Dr. Taryn Goldberg is a licensed psychologist and nationally certified school psychologist.

The presenters include two postdoctoral residents, Dr. Catherine Stubblefield and Dr. Danielle Silver, and a clinical psychology trainee, Dylan Braun.

The clinic, called The Chil at Nova Southeastern University, provides psychodevelopmental evaluations for autism and other developmental delays.

Evidence-based treatments are crucial for effective intervention and support for individuals with ASD.

Parents often rely on professional advice when deciding on treatments for their children with ASD.

The National Standards Project by the National Autism Center aims to identify effective treatments for individuals with ASD.

Early intervention is emphasized as profoundly impactful for children with autism and their families.

Applied Behavior Analysis (ABA) is recognized as a gold standard for treating individuals with autism and other significant behavioral disorders.

Cognitive Behavioral Therapy (CBT) and mindfulness-based interventions are noted for their potential efficacy in treating comorbid mood disorders in individuals with ASD.

The importance of parent training and involvement in the treatment process is highlighted for better generalization of skills.

The need for culturally sensitive and family-inclusive treatment approaches is discussed.

The role of clinicians in staying up-to-date with research and employing data-based decision-making is emphasized.

The webinar provides resources such as the National Standards Project and Autism Speaks for further guidance and support.

The importance of assessing and tailoring treatment based on individual needs, including considering factors like cultural background and family structure, is underscored.

The webinar concludes with an encouragement for ongoing learning and collaboration between providers and families to ensure the best outcomes for individuals with ASD.

Transcripts

play00:01

hello everyone welcome to our webinar

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entitled evidence-based treatments for

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autism spectrum disorder or asd

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as you're starting to sign on please

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trickle in in the chat where you're

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logging in from so we kind of have a

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good sense of where everyone's located

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if you also want to put down

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where you work or if you're a student

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what field you're in anything like that

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could be helpful to help generate our

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conversations

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so welcome everyone my name is dr taryn

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goldberg i am a licensed psychologist in

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the state of florida as well as a

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nationally certified school psychologist

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i am joined here with two postdoctoral

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residents in the field of psychology we

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have dr catherine stubblefield

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and we have dr danielle silver

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we're also joined here by mr dylan braun

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who is a clinical psychology trainee at

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our clinic

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so we are located at nova southeastern

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university in davey fort lauderdale

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florida specifically we are in the

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mailman segal center building

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at a clinic called the chil the unicorn

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children's clinic foundation

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developmental assessment clinic so what

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we do is we provide psychodevelopmental

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evaluations to test children for autism

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as well as other developmental delays

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and as you can see we also deliver

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community outreach presentations

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today we're presenting on evidence-based

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treatments for this population who have

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autism

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so with that said i will let the team

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take it away

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all right thank you for that

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introduction dr goldberg

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we're honored that you all chose to

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spend some of your thursday afternoon

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with us thank you

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so today we're going to be providing an

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update on the state of the evidence for

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treatments for autism spectrum disorder

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we're going to describe the importance

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of using empirically supported

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treatments with our clients and

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of course we'll describe some of the

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main evidence-based interventions that

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are used in practice today

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we'll also discuss some important

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considerations for both treatment

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providers as well as for families

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and i will leave you with some treatment

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resources and referrals so you have

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something to take away with you so

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we have a lot of ground to cover so i'll

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pass it along to dr silver

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okay thank you dylan

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so to start off and you can all just

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type this in the chat but i'm curious to

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know what you know about treatments for

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autism spectrum disorder

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so let some of those responses trickle

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in one thing to make note of is

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oftentimes what we do know about these

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treatments

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are

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coming from google word of mouth

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the news

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they're not always necessarily

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reliable

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right so we want to make sure that when

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we talk about treatments for autism

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spectrum disorder that we are

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considering reliable treatments that

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have a lot of support and a lot of

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research

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i see aba um in the comments we'll talk

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a little bit more about that

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awesome behavior modification as well

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so why don't we

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get started and talking a little bit

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more about some of those treatments

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so when a parent first gets an autism

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spectrum disorder diagnosis for their

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child one of the first things they might

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do is they might go to google and start

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searching for available treatments and

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this can be very overwhelming because if

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you do that you realize that you come

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with over 300 million results

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so again that's a lot of information to

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kind of try and sit through and can be

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very overwhelming

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more empirically um we're going to be

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looking at this study that was conducted

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in 2016.

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what the researchers found was that

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parents rated getting professional

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advice as the most influential source

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for deciding which treatment to use

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meaning that parents are relying pretty

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heavily on the advice given to them by

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practitioners as to what treatments are

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going to be best for their child

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they also found that more than 35

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percent of parents listed interventions

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that were not part of the national

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standards report and the majority of

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parents only agreed with nine out of the

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26 identified treatments

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so really what this is telling us is

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that parents don't really have a strong

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understanding of what the gold standards

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or the best treatments are for their

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child with autism

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so what are evidence-based treatments

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and why are they important before we get

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started um talking about that what i do

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want to point out is a project um it's

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the national standards project which is

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conducted by the national autism center

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at may institute and the aim of this

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project was really to answer this big

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question how do we effectively treat

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individuals with autism spectrum

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disorder so this project started i

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believe in the early 2000s um in the

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first report or the first phase was

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released in 2009 the second phase is

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what is supplying the information that

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we're going to be reviewing here today

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and that was released in 2015

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and they are currently in the process of

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updating this information for phase

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three

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so we might see a few different changes

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and that's going to be coming out

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sometime in the near future

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so really i mean if we think about about

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this project it's great because it's a

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resource that can be used by parents by

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caregivers providers

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educators to really determine what's the

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best course of action for their child

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one major benefit to know about these

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evidence-based treatments is that they

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really help to impact families and they

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help children live more adaptive and

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independent lives we're going to go

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ahead and watch this video it really

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helps show the importance of early

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intervention

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sixteen-year-old paul whitsy cruder

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takes autism one step at a time paul is

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spunky

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he's funny

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he has a lot of energy

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just in general good natured

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paul was diagnosed with a moderate form

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of autism when he was two soon after his

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parents enrolled him in an autism school

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at cleveland clinic he started as a

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little boy who couldn't communicate was

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easily frustrated and having tantrums

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didn't know how to play with any toys

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didn't know how to use objects

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functionally it was non-verbal so they

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taught him

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first they told him to eat

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then his name

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you know he called his name and he'd

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actually look at you

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research shows young children with

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autism benefit from early intervention

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over the years paul has developed

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adaptive skills and learned how to

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communicate and socialize

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we still think he has a lot of room for

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growth but the things we're working on

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now are so different you know

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independent living and

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um you know maybe he can have a job

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where he attends for two hours at a time

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that's where the family business comes

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in a granola company inspired by paul's

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dietary challenges he does a variety of

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things he um

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uses the best buy date gun

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recently he's been filling some of the

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bags which is a big deal because he has

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to have gloves on he has to use a scale

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when you step back and realize how much

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effort it takes for him to learn

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something

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it's just

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it's unbelievable paul has also overcome

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two organ transplants a kidney and a

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liver but you'd never know the adversity

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he's faced by his happy helpful demeanor

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he's really is kind of sweet and simple

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and pure he has come a long way and it's

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still like

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he's smiling all the time he's totally

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in the present i mean we should all live

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this way at cleveland clinic i'm erica

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foreman

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thank you so as you can see from the

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video

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really the impact of of appropriate and

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early intervention is profound not just

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for the child but for their family as

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well

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so what is an evidence-based treatment

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i'm going to be referring to

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evidence-based treatments a lot so

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the type of services

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that we're going to be speaking about

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they fall under this category of

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evidence-based treatments and what that

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essentially means is that this these

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types of treatments have shown

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scientifically that one group who got

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the intervention showed improvement

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while another group who did not get that

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specific intervention did not improve in

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the same way

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so if a child is going to be exposed to

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a treatment there should be some

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evidence that it works right at least

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for a significant group of p of children

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so for example

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if you have a group of children with

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autism who have no words and you want to

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know if a specific teaching intervention

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will help there needs to be some sort of

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control so it's important that what

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happens is the group is split into two

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one group gets an intervention one group

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does not and then in the end you'll be

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able to compare what happened between

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the two groups so you'll see that

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over here even in the group that didn't

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get the intervention there were two

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individuals who gained some words and we

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would expect that because with normal

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passing time they're going to be kids

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that learn on their own and that are

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able to gain these skills

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but if we look at the intervention group

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above 50 more kids so a total of four

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were

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progressing to using two words right so

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we can say that there was a better

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chance of children learning words if

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they got this specific teaching

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intervention

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so knowing that there is an overwhelming

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amount of information and research out

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there the national autism center went

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through all of the research um on these

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types of interventions for children with

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autism and they group these

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interventions into three categories

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established interventions which have

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been shown to be repeatedly effective

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emerging interventions

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which show some evidence of

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effectiveness but not enough to make

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sure that they're truly effective and

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then finally unestablished interventions

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which do not have sound evidence of

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effectiveness and although it's

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important to treat every child as an

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individual these evidence-based

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treatments have shown to be effective so

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those established treatments they're

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they're shown to be effective in wide

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groups of children with autism spectrum

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disorder meaning that the more

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established and

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the more emerging practices are likely

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going to be more effective

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okay so let's jump into some of these

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established treatments so according to

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again the 2015 phase 2 reports there are

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14 established treatments most of these

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treatments are based on the principles

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of applied behavior analysis

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there are some that come out of the

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special education and developmental

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psychology field as well as medically

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based treatments to address challenging

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behaviors that are associated with

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autism so if we kind of look through

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this list we have some behavioral

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interventions this primarily

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encompasses interventions that look at

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the antecedents of behaviors so

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modifying those situational events that

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precede a behavior as well as the

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consequences of those behaviors

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then we also have cognitive behavioral

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therapy

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comprehensive behavioral treatment for

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young children so this

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is kind of what encompasses aba so it

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looks at um kind of early behavioral

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interventions that target a range of

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essential skills whether that's

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communication skills social skills

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uh and so forth then we have some other

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interventions we're going to primarily

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focus on aba but just to touch on a few

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um scheduling right so this kind of

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refers to the use of

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visual schedules um

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that can essentially help these children

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increase their independence

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as well as parent training i'd like to

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point out so that involves teaching

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parents effective ways to respond to

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their child's behaviors

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so aba is an evidence-based approach to

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treating individuals with

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autism and other significant behavioral

play12:41

disorders one of the key ideas of aba is

play12:44

to understand how the environment

play12:47

triggers and maintains behaviors in

play12:49

order to then change difficult behaviors

play12:52

so that they're more functional and more

play12:54

adaptive

play12:55

and aba is provided by trained certified

play12:58

therapists and it can be conducted in a

play13:00

lot of different settings like clinical

play13:02

settings the home school even the

play13:05

natural environment

play13:06

and aba requires very intensive hours of

play13:09

therapy based on the severity and needs

play13:12

it can range anywhere between 25 to 40

play13:15

hours a week if provided in the home

play13:18

setting so treatment goals include

play13:21

functional communication skills general

play13:24

language acquisition

play13:26

social skills

play13:28

reduction of maladaptive behaviors

play13:30

increasing appropriate plan leisure

play13:32

skills enhancing motor skills and so

play13:35

forth

play13:36

and the instruction and the skill

play13:38

acquisition is really based on proven

play13:41

behavioral principles so for example

play13:43

positive reinforcement and functional

play13:45

analysis

play13:46

that are used to really shape the

play13:48

child's behavior

play13:50

in terms of the aba therapists they must

play13:52

undergo pretty rigorous training

play13:55

and collect data all while providing

play13:58

um instructions and incorp incorporating

play14:01

behavioral techniques to really help the

play14:03

child to improve

play14:06

so here's a nice video explaining aba in

play14:09

a little bit more detail

play14:16

so aba is

play14:18

short for applied behavior analysis and

play14:21

this is a technique that's based on

play14:23

learning theory

play14:25

and

play14:26

it has two aims one is to teach skills

play14:30

and the other is to try to work on

play14:32

problem behaviors or interfering

play14:34

behaviors so the interfering behaviors

play14:37

might include avoidance of eye contact

play14:41

sort of obsessive interests about

play14:43

strange things um

play14:46

sensory self-stimulation

play14:48

like this kind of thing

play14:50

and that can really interfere with

play14:52

developing social relationships and with

play14:54

learning from the environment

play14:56

so there are and then there are other

play14:58

problem behaviors of course like

play14:59

aggression

play15:00

or property destruction or refusing to

play15:02

do what an adult is asking

play15:05

and those things can be targeted with

play15:07

things like planned ignoring reinforcing

play15:10

alternative ways of expressing it

play15:14

so there are a whole variety of

play15:15

behavioral techniques to try to really

play15:17

reduce these interfering behaviors and

play15:19

then the other big main thrust of aba is

play15:22

to teach skills that the children are

play15:25

not learning the way typically

play15:27

developing children are learning just

play15:29

naturally from the environment

play15:31

so if you have a three-year-old child

play15:33

with autism who is not yet speaking just

play15:36

giving them normal language input has

play15:38

not been sufficient to trigger their

play15:40

language learning so instead you break

play15:43

down these complex skills into very

play15:46

small

play15:47

pieces and you teach them one at a time

play15:50

with prompting and then you fade out

play15:52

your prompting and a lot of liberal use

play15:54

of all kinds of different rewards or

play15:56

reinforcers and it's really amazing

play16:00

how fast some children can learn given

play16:03

these conditions

play16:08

okay

play16:10

so we're going to go ahead and talk

play16:11

about a few of the other

play16:14

types of interventions um so emerging

play16:17

interventions for

play16:19

for individuals under the age of 22 and

play16:22

just as a reminder

play16:24

emerging interventions are those ones

play16:25

that they show promising outcomes in

play16:28

some studies but they haven't been

play16:31

studied enough to be fully confident

play16:33

that those interventions are truly

play16:35

effective and it's also important to

play16:38

know when we're looking at this list

play16:40

that

play16:41

you know something like exercise or

play16:44

music therapy for example

play16:46

they may not be effective at treating

play16:49

autism or categorized as a

play16:51

well-established

play16:52

intervention but that doesn't mean that

play16:54

exercise or music may not be something

play16:56

that your child will enjoy or will

play16:58

benefit from so something to keep in

play17:00

mind when we we think of these emerging

play17:03

interventions

play17:06

and then we have the unestablished

play17:08

interventions so

play17:11

these interventions typically

play17:13

don't have enough quality research

play17:16

research hasn't necessarily been

play17:18

replicated

play17:20

or

play17:21

you know not a lot of research has been

play17:23

published on the topic

play17:25

or the topic has been studied and has

play17:28

been shown to be

play17:30

ineffective so again there's this long

play17:33

list of approaches that have been shown

play17:36

to be effective right and and even um

play17:39

even emerging interventions so really

play17:41

it's a better option to not choose an

play17:43

intervention that is unestablished but

play17:45

to focus on those emerging and

play17:47

well-established treatment interventions

play17:52

okay so thank you dr silver now we have

play17:54

some questions for all of you please

play17:57

type your responses in the chat and

play17:58

we'll try to address them and also as a

play18:01

reminder we'll have a chance to answer

play18:03

questions towards the end of this

play18:04

presentation

play18:06

so first question given the 2015 phase

play18:09

two update report that dr silver

play18:11

discussed you know as well as your own

play18:13

experience and your knowledge that you

play18:15

bring to the table

play18:17

please tell us what stood out to you

play18:36

you know i think for me if some of the

play18:37

stuff that stood out um you know while

play18:39

we kind of wait for people to add their

play18:41

responses

play18:42

um definitely i saw that functional

play18:44

communication training was still an

play18:45

emerging um whereas i feel like that's

play18:47

something that we focus on a lot in uh

play18:51

you know aba

play18:52

um so you know i guess just keeping in

play18:54

mind that this was done in 2015 so just

play18:57

be interesting to see

play18:59

you know

play19:00

that aspect um

play19:02

and then i think also the fact of

play19:05

animal assisted interventions would be

play19:06

in unestablished although we see

play19:09

oftentimes people trying to advocate for

play19:11

you know therapy dogs for children with

play19:13

autism and things like that so those

play19:15

were kind of the things that

play19:16

stood out for me

play19:18

absolutely we've gotten some responses

play19:20

so someone pointed out that a lot of the

play19:22

treatment interventions that are

play19:23

available are directed towards younger

play19:24

children but there is a you know deficit

play19:27

when it comes to teenagers adolescents

play19:28

adults

play19:30

and some people are surprised by the

play19:32

location of various interventions like

play19:36

music therapy or animal assisted

play19:38

therapies so

play19:39

um again this is from 2015. so

play19:43

where uh sort of a thinking you know six

play19:46

years down the line where do you think

play19:48

some of these emerging or unestablished

play19:49

treatments will be in the next update

play20:10

so as we're waiting for responses i

play20:12

think that technology-assisted

play20:13

interventions were probably still in

play20:15

their infancy in 2015 so i'm interested

play20:19

to find out where those are going and as

play20:21

we get more and more

play20:23

support for those kind of approaches

play20:28

absolutely especially now with

play20:30

telehealth and all the use of augmented

play20:32

devices such as like the ipads for

play20:34

communication and things like that

play20:37

um

play20:38

you know and the sensory processing uh

play20:40

treatments

play20:41

since where there's more you know out

play20:43

there about like the importance of

play20:45

sensory

play20:47

things for children with autism so i

play20:48

agree with you dylan for sure

play20:52

okay lots of responses

play20:54

a big push for more support and more

play20:58

additional resources outside of

play21:00

behavioral modification

play21:02

um

play21:05

maybe more targeted approaches for

play21:07

example the sensory aspect of asd

play21:10

so very interesting ideas

play21:13

um

play21:14

and then finally what uh

play21:17

what do you think will be added to the

play21:18

list where do you see sort of the next

play21:20

steps going and i think some of these

play21:22

blend together but

play21:26

as uh providers uh

play21:28

we value your input

play21:41

[Music]

play21:46

i think just personally having done my

play21:47

own little research out there i think uh

play21:49

it'd be interesting to see if

play21:50

mindfulness-based therapies or

play21:52

acceptance and commitment treatments for

play21:54

like the higher functioning individuals

play21:56

um would be added to the list because

play21:58

there's more i think there's more

play22:00

recent information out there about how

play22:02

that can help with emotion regulation

play22:04

and for individuals with comorbid mood

play22:06

disorders so for me i think that would

play22:08

be something that could be added

play22:11

absolutely packages of interventions

play22:13

trans diagnostic interventions i think

play22:15

this is where we're headed as a field

play22:17

because

play22:18

comorbidity is the rule even

play22:20

in the case of asd especially in the

play22:22

case of asd

play22:27

communication support sibling training

play22:29

very interesting yeah

play22:31

the family system

play22:33

plays an important role in in treatment

play22:34

as we'll discuss a little bit later in

play22:36

this presentation

play22:43

so we will have time at the end to

play22:45

discuss more and answer some questions

play22:47

um but let's dive in a little bit more

play22:49

into the evidence

play22:52

thanks so much dylan for

play22:55

leading the discussion so now that we've

play22:58

kind of taken a look at uh the project

play23:00

even though it was published in 2015 uh

play23:02

what we kind of decided to do was let's

play23:04

take a look at some of the more recent

play23:06

literature

play23:07

and what we did is we looked at between

play23:09

2016 to 2021

play23:11

and although there was a lot of

play23:12

information to sift through we kind of

play23:14

chose some of the ones that maybe are a

play23:16

little bit more

play23:18

relevant to the topic so this article

play23:20

was an annual research review and it

play23:22

looked at the state of intervention

play23:24

science so basically looking at the

play23:26

targeted psychological as well as

play23:28

biological mechanisms for treatment

play23:31

and also talked about future prospects

play23:34

so you know looking forward to what can

play23:35

be done in research

play23:37

and basically um there's still a big

play23:40

need for higher quality research in the

play23:42

field of autism treatment

play23:44

although we know that aba is the gold

play23:47

standard and behavioral interventions

play23:48

are the gold standard

play23:50

there is still difficulty with having

play23:52

high quality research and meaning

play23:55

research that looks at uses randomized

play23:58

controlled trials

play23:59

and some of the difficulties with this

play24:01

has been that although you know there's

play24:03

a lot of information out there about the

play24:05

interventions

play24:06

to use with children with autism a lot

play24:08

of the research methods vary

play24:11

greatly and not just in the us but

play24:13

internationally and when the methods

play24:15

research methods vary that much it makes

play24:17

it difficult to replicate which could

play24:19

make it difficult to then have you know

play24:22

these treatments be emerging or

play24:24

evidence-based because again it's not

play24:25

replicable

play24:27

um also this article discussed that of

play24:29

the evidence-based treatments available

play24:31

emphasizing that aba remains the gold

play24:34

standard

play24:35

but again recognizing that most of the

play24:37

research is based on small or single

play24:39

case designs

play24:40

there needs to be a push for again

play24:42

randomized control trials looking at aba

play24:45

and also looking at the long-term

play24:47

effects of this intervention

play24:50

they also found that early intensive

play24:52

behavioral interventions that include

play24:54

parent training remains most effective

play24:57

so really targeting individuals on the

play24:58

spectrum at a young age and including

play25:00

the parents to help with that

play25:01

generalization

play25:03

and then there's also just the need for

play25:05

study on the biological mechanisms i saw

play25:07

someone in the chat mention that about

play25:09

the you know the metabolic aspects

play25:12

but also uh treatments in terms of

play25:14

pharmaceutical um you know obviously

play25:17

there's nothing that is

play25:19

shown to be

play25:20

um approved right now um but maybe

play25:23

research in the field of looking at like

play25:26

what medications can be paired with

play25:28

non-non-pharmaceutical interventions and

play25:30

if that is even useful or effective for

play25:32

children with autism or individuals in

play25:34

general

play25:37

this next article reviewed the

play25:40

current available behavioral and

play25:42

developmental educational approaches to

play25:44

treatment that are usually used with

play25:47

individuals and children with autism

play25:49

this is really it was more of a review

play25:51

so it wasn't really a study and it also

play25:54

emphasized the efficacy of each

play25:57

so looking at this um all the

play25:59

interventions that were included look

play26:01

were looked at across various domains so

play26:03

this included behavioral developmental

play26:06

school-based language communication

play26:08

skills social skills and sensory

play26:11

integration

play26:12

um and of course just kind of looking at

play26:14

the list here we have aba discrete trial

play26:17

training early intensive behavioral

play26:20

interventions with those being the most

play26:22

effective um and again this was

play26:24

published in 2019

play26:26

and then you have the parent mediated

play26:29

and then in school based you have early

play26:31

denver or teach autism program

play26:33

picture exchange systems all of these

play26:36

showing to be effective

play26:38

including you know social skills groups

play26:40

and video modeling

play26:41

what was interesting that they did bring

play26:43

up social sensory integration therapies

play26:47

however they did note that although

play26:48

they're being used they're still very

play26:51

sparse research in this field in this

play26:53

area of interventions and so they really

play26:56

couldn't say if it was effective or not

play26:58

and this was again just in 2019 so

play27:01

there's a need for more research

play27:03

in some of these aspects even though

play27:05

they are being used

play27:07

prominently in the fields

play27:11

and then this last article looked at the

play27:14

clinical update um implementing

play27:16

evidence-based emotion regulation

play27:18

treatments for clients with autism which

play27:20

i kind of foreshadowed in my discussion

play27:23

this was looking at trying to help

play27:25

individuals with autism who may also be

play27:27

struggling with

play27:29

comorbid mood disorders such as

play27:31

depression and anxiety

play27:33

okay so they provided a synthesis of

play27:34

treatment on emotion regulation for

play27:36

treatment with autism and they also

play27:38

provided suggestions for clinicians who

play27:40

do not specialize in asd treatment

play27:43

so this may be the provider who has you

play27:45

know private practice or who's working

play27:47

in clinic in a general type of setting

play27:50

but then has a patient who comes in and

play27:52

indicates that they're on the on the

play27:54

autism spectrum

play27:56

but is endorsing depression or anxiety

play27:58

so um you know as someone who may not be

play28:02

familiar with working with people with

play28:03

autism um this article provides some

play28:05

suggestions and we'll get into that list

play28:07

in the follow in the next slide

play28:09

um

play28:11

moving on they found that there's little

play28:12

research that has been conducted that

play28:14

looks specifically at the treatment of

play28:16

emotion regulation in children with our

play28:19

individuals with autism but there's some

play28:21

there has been some literature so it's

play28:22

not that there hasn't been any

play28:25

research

play28:26

but the interest is starting to grow and

play28:28

i feel that having worked many years

play28:30

with individuals with autism

play28:32

unfortunately this is an area that has

play28:33

been ignored because even like dylan

play28:36

said you know people with autism aren't

play28:38

you know immune from struggling with

play28:40

anxiety or depression so it is important

play28:43

for us as clinicians and providers to

play28:45

start you know looking at what are some

play28:47

of the non-aba

play28:49

treatments that could be helpful

play28:51

so in this article they looked at a few

play28:53

of the treatments so far that are

play28:55

starting to show some efficacy and they

play28:58

found cbt cognitive behavioral therapy

play29:01

specifically for anxiety although not

play29:03

much evidence for depression

play29:05

they also looked at mindfulness-based

play29:07

interventions

play29:08

specifically for children and teens with

play29:10

anxiety it was also helpful with

play29:13

depression and just overall emotion

play29:15

regulation

play29:16

um so even individuals who don't have

play29:18

depression or anxiety are just feeling

play29:19

you know very overwhelmed

play29:21

mindfulness-based interventions were

play29:22

also useful

play29:24

and then they also found uh intensive

play29:26

outpatient programs that focus on

play29:28

emotion regulation treatment or what

play29:29

they call io pert and that they combine

play29:33

that with uh either cbt or

play29:35

mindfulness-based interventions and apa

play29:38

so that's what these this io pert

play29:41

combines these three aspects

play29:43

and they've found that that has also

play29:44

been very effective and helpful for

play29:46

individuals

play29:47

you know so far

play29:49

um with autism and comorbid emotion

play29:52

regulation difficulties

play29:56

so some of the recommendations or

play29:58

suggestions that the article presented

play30:00

for the providers and this

play30:02

you know who might not be familiar

play30:04

working with individuals with autism

play30:06

but might have someone who's

play30:08

experiencing depression or anxiety um

play30:10

here are some of the suggestions and

play30:11

some examples so just to kind of touch

play30:14

up on a few um you know maybe add a

play30:16

training and emotion psycho-education

play30:18

so this could be help the client

play30:20

understand that emotions are natural um

play30:22

you know even why they even when they

play30:24

feel bad

play30:25

um some other

play30:27

examples include using visuals to make

play30:29

other you know

play30:30

you know concrete make even though

play30:32

emotions can be very abstract

play30:34

which is something that we know

play30:36

individuals with autism may struggle

play30:37

with using something as visuals or to

play30:40

make it more concrete and more relatable

play30:43

so this includes using maybe an

play30:44

emotional thermometer

play30:46

using specific examples to help them

play30:48

anchor and understand better like you

play30:50

know for their own means maybe using

play30:53

work worksheets or props

play30:55

and maintaining structure in in session

play30:58

okay

play31:00

and then the other thing could be maybe

play31:01

adjusting the session duration frequency

play31:04

or location

play31:05

so just really tailoring treatment to

play31:07

the individual that's in front of you

play31:10

while understanding their cognitive

play31:12

needs

play31:15

so here's a little video about you know

play31:17

how do you understand you know what

play31:19

treatments are safe and effective for

play31:21

autism we're not going to play the whole

play31:22

video just the the first part to kind of

play31:24

summarize what we've discussed so far

play31:28

[Music]

play31:29

[Applause]

play31:29

[Music]

play31:32

hi i'm donna murray i'm vice president

play31:33

of clinical programs for autism speaks

play31:35

and today we're going to be talking

play31:37

about how do i know which autism

play31:39

treatments are safe and

play31:43

effective

play31:46

at autism speaks we encourage families

play31:48

to seek out evidence-based practice

play31:50

although we know that's a challenge one

play31:52

evidence-based intervention that we know

play31:53

about is behavior therapy and it's

play31:55

proven to be effective across the

play31:56

lifespan in learning new skills

play31:58

addressing communication skills as well

play32:00

as social skills in addition to behavior

play32:02

therapies there are a number of supports

play32:04

that have also been proven to be

play32:05

effective things like using visual

play32:07

supports or schedules as well as using

play32:10

modeling and you can use real person

play32:12

modeling in real time as well as video

play32:14

modeling challenging behaviors can be

play32:16

very concerning for families one thing

play32:18

that we really recommend is that before

play32:20

you start an intervention for

play32:21

challenging behaviors you have a

play32:23

functional behavior assessment that

play32:25

helps your provider understand what

play32:27

might be triggering those behaviors and

play32:29

then you can employ some of the behavior

play32:30

therapies that we talked about or if

play32:33

you're still or the child is still

play32:34

experiencing behavior challenges may

play32:36

also be combined with medication but

play32:39

it's really important to work closely

play32:40

with your provider when coming up with a

play32:42

plan for challenging behaviors

play32:44

some of the work that we've been doing

play32:45

in the autism treatment network is doing

play32:48

a better job of understanding some of

play32:49

the medical and mental health conditions

play32:51

that co-occur with autism and sometimes

play32:53

when we can treat these medical and

play32:55

mental health conditions we see improved

play32:57

functioning the common co-occurring

play32:59

conditions that we've been looking at in

play33:00

the autism

play33:01

so this video can go on for a minute we

play33:04

kind of just wanted to play that first

play33:06

part uh just to really emphasize what

play33:07

we've been discussing so far um and you

play33:10

know this latter part of the video is

play33:11

you know

play33:12

best suited for a different topic but

play33:14

just again emphasizing currently what's

play33:16

being used is you know the behavioral

play33:17

interventions and then understanding

play33:19

that we need to

play33:23

and mental understand issues that

play33:24

individuals with autism also experience

play33:28

so now that we've kind of discussed a

play33:31

lot about the evidence-based treatments

play33:33

we're going to go into the factors oh

play33:35

sorry some of the factors and roles that

play33:38

parents and providers take

play33:40

so understanding that parent role is

play33:43

finding the right treatment for their

play33:45

child it is up to the parent to really

play33:47

figure out if the treatment that they're

play33:49

trying to take their child into is

play33:52

really effective and fits right for them

play33:54

it's also part of their role to be

play33:56

active a active participant in their

play33:58

child's treatment um you know it's not

play34:01

very effective for a parent to just kind

play34:02

of drop off the child to therapy and

play34:04

then you know come and pick them up

play34:06

after

play34:07

um it's really shows that parent

play34:09

training is very very helpful and

play34:10

important for the generalization of the

play34:12

skills not just in the treatment setting

play34:14

but outside in the natural environment

play34:17

and it's also part of the parent's role

play34:19

to ask as many questions as possible to

play34:21

their providers and to individuals to

play34:23

ensure that their child is getting the

play34:25

services that they need in order to

play34:27

succeed

play34:28

so parents need to ask a lot of

play34:29

questions and be active and as involved

play34:31

as possible to advocate for their

play34:33

children

play34:35

as providers or clinicians our roles are

play34:38

including to be as empathetic as

play34:39

possible

play34:41

to build rapport with the child and the

play34:42

family so understanding that yes even

play34:44

though you're treating the child again

play34:47

to encourage parent training and parent

play34:49

involvement you need to build that

play34:50

establish that rapport with family

play34:53

um going back to being empathetic it's

play34:55

important for us as clinicians to

play34:57

understand that even though we have the

play34:58

training and the understanding of

play35:00

working with children with autism we

play35:02

don't live with them so we might be

play35:04

present for the child in the family one

play35:06

hour a week or depending if you're doing

play35:08

aba

play35:09

several hours a week but ultimately the

play35:11

parents and the families are with the

play35:12

child 24 7. so we need to be

play35:14

understanding and empathetic of the

play35:16

parents and the families when they come

play35:18

to us with stress or difficulties okay

play35:22

um it's also part of our role to have

play35:23

the proper training and competence to

play35:26

understand current literature which is

play35:27

why we're here today

play35:29

to encourage and again encourage and

play35:31

promote parent involvement

play35:32

have that collaborative approach with

play35:34

the family and to have strong clinical

play35:37

judgment that is based not just on the

play35:39

research but also clinical experience

play35:41

and the research

play35:45

so a few factors to consider when

play35:47

seeking or providing treatment include

play35:49

various aspects one of the first

play35:51

components is for the parent is for them

play35:54

to

play35:54

be able to know like the the fact that

play35:57

their child cannot talk or for

play35:58

themselves or for others this may be

play36:00

increasing some aggressive behaviors

play36:02

okay so kind of the parent understanding

play36:04

what are the factors that are affecting

play36:05

my child and that are influencing my

play36:08

child's behaviors

play36:09

um so when a parent is speaking to the

play36:11

therapist it's important that they

play36:13

express the concerns that the parent has

play36:15

so my child has these difficulties these

play36:17

are my concerns i need to communicate

play36:19

this with

play36:21

the therapist or therapist to be

play36:23

okay and then the therapist's role is to

play36:25

understand that some concerns may be

play36:28

more urgent than others and so helping

play36:30

the family have a collaboration that

play36:32

open communication with them um to help

play36:34

tease out which

play36:36

concerns need to be addressed more uh

play36:38

more like apprehending more frequently

play36:41

or more earlier on than others okay

play36:44

um and then the clinician also

play36:47

it may be able to see some areas of

play36:48

concerns that maybe parents overlook so

play36:51

some parents might not see a certain

play36:53

delays or developmental delays because

play36:55

maybe they don't know so as a clinician

play36:57

it's also important for us to be able to

play36:59

bring up those concerns with the family

play37:00

and discuss that with them

play37:05

another important thing to consider are

play37:07

factors to consider is goal setting so i

play37:08

think we all here understand that goals

play37:10

need to be concise observable measurable

play37:13

right

play37:14

we need to be able to make sure that the

play37:16

goals identify the conditions under

play37:18

which the behavior is demonstrated so

play37:20

the setting events and to also

play37:22

understand what conditions or factors

play37:24

maintain the behaviors so the

play37:26

reinforcement

play37:28

what happens directly after that's going

play37:30

to have keep the behavior happening

play37:32

and then also knowing that behavior and

play37:34

goals need to be continually reviewed

play37:37

you know this needs to be a working

play37:39

document a working process collaborating

play37:41

with the family

play37:43

in order to make sure that treatment is

play37:45

being effective and progressing as it

play37:46

should

play37:49

so thinking of goals as targets okay so

play37:52

what are the main targets we need to

play37:54

talk about um you know understanding

play37:56

that every clinician needs to identify

play37:58

clear targets for behaviors meaning they

play38:00

should not be vague okay they need to be

play38:04

as concrete as possible meaning

play38:07

increased so for example increasing

play38:10

social engagement is not as good as a

play38:12

target behavior versus increased child's

play38:15

responding when greeted by another okay

play38:17

so you want to be able to have goals

play38:19

that you can actually measure

play38:21

another example could be

play38:23

increase how quickly child responds with

play38:25

parental requests within under five

play38:27

minutes i mean sorry five seconds um you

play38:29

know so you're able to see okay is the

play38:31

child complying within five seconds etc

play38:38

other factors to consider for both the

play38:40

parent and the clinician is that

play38:42

ensuring that the clinician has the

play38:45

training and the background and the

play38:47

experience to work with the child on the

play38:49

spectrum um specifically okay um this i

play38:52

mean and this goes for any fields right

play38:54

so working within our competence okay um

play38:57

if and now it's important to understand

play38:59

if a clinician is within a training

play39:01

setting an institution such as nova

play39:03

university um you know it's important

play39:06

for the clinician or the therapist to

play39:08

to divulge that information to the

play39:10

family to disclose you know i'm the

play39:13

therapist in training but however i am

play39:15

receiving appropriate and adequate

play39:17

supervision to work and provide

play39:19

treatment to your child

play39:21

um and then even though

play39:23

and then this goes for even you know

play39:26

clinicians in training or established

play39:28

clinicians we still need to be able to

play39:30

gather really good background

play39:32

information so when you're first meeting

play39:34

with the family understand what's going

play39:36

on

play39:37

and then you also need to be familiar

play39:39

with current research and up-to-date

play39:41

information so as an established

play39:43

therapist who may have been doing

play39:45

treatment for the last 15 years but

play39:47

hasn't really been kept up to date with

play39:49

the research

play39:50

might not really be doing what's most

play39:53

effective um especially if you know as

play39:56

you can all see with the project things

play39:58

change over time as more research comes

play40:00

out so it's really important for our us

play40:02

as clinicians to stay up to date

play40:04

and then also using data based decision

play40:07

making meaning as clinicians especially

play40:09

in aba a lot of data is collected but

play40:12

even as providers you know just

play40:14

collecting on how information how the

play40:16

child is progressing over time and then

play40:18

using that information to

play40:21

decide how treatment is going to

play40:22

progress is it even progressing are

play40:25

there difficulties are there you know

play40:27

setbacks and using that data to make

play40:29

decisions to move forward

play40:34

and then when it comes to licensure and

play40:36

certifications knowing that first of all

play40:38

it's our roles as providers to be

play40:40

properly certified and trained right i

play40:43

think i've already mentioned that but

play40:44

it's also the parents right and their

play40:46

role um to really ask a lot of questions

play40:50

so they should parents should not be

play40:51

afraid to ask a therapist or their

play40:53

supervisor about their credentials

play40:56

you know their past experiences working

play40:58

with the population um that's similar to

play41:00

their child

play41:02

any kind of training that they've had

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how many years they've been practicing

play41:05

etc

play41:06

because at the end of the day the parent

play41:08

should be again advocating as much as

play41:10

possible for the child and they need to

play41:12

make sure that the provider is giving

play41:16

training or therapy within the scope

play41:18

so when i say within the scope meaning

play41:20

an occupational therapist should not be

play41:22

given nutritional information or us as

play41:25

clinical psychologists should not be

play41:27

giving information or advice on

play41:29

pharmaceuticals or medical interventions

play41:31

right and parents need to know that

play41:33

right so if a parent is asking questions

play41:36

to a clinician and the clinicians may be

play41:38

giving out questions or suggestions

play41:40

outside of their scope that should maybe

play41:42

be a little bit of a red flag

play41:44

and parents should be aware of that

play41:47

and then as clinicians again practicing

play41:49

within your competence

play41:52

and then going back to data and make

play41:54

using data to drive your decision so

play41:56

understanding that

play41:58

especially in aba a lot of data is taken

play42:00

you know data points data points data

play42:02

points and then even as a you know

play42:04

clinical psychologist we also take data

play42:06

over time to make sure treatment is

play42:08

progressing and seeing how things are

play42:09

going

play42:10

um and that is our responsibility

play42:12

because otherwise how do we determine if

play42:14

what we're doing is working okay

play42:17

it's our

play42:19

responsibility to be able to provide

play42:21

this information or this data to the

play42:22

parents and to have con you know ongoing

play42:26

review and discussion with the family

play42:27

and the caregiver and maybe even the

play42:29

individual if you're treating someone

play42:31

who's older maybe not just a child in

play42:33

order to demonstrate to them how you

play42:35

know hey look what we're doing is

play42:37

working or it's not working or you know

play42:38

how do you feel about this let's let's

play42:40

kind of see where we need to go from

play42:42

here okay

play42:43

and it's also important to know when you

play42:45

do present data presented in a way

play42:47

that's easy to digest and understand for

play42:49

the family

play42:50

you know maybe don't present this very

play42:52

complex elaborate graph

play42:55

but do it in a way that the families can

play42:57

understand as well

play43:02

and i know i've kind of discussed this

play43:03

already but understanding that you know

play43:05

parents participation is very very

play43:08

important like i said they

play43:10

live with the child they are with a

play43:12

child all the time unless they're

play43:13

outside you know outside of school um so

play43:16

it's very important that parents

play43:18

participate in order to help the skills

play43:20

that we're working on in treatment

play43:22

generalized into the natural environment

play43:24

meaning a person who goes into treatment

play43:27

they may know how to do things in a

play43:29

controlled clinical environment but when

play43:31

you then take them out of that

play43:32

environment put them into the real world

play43:35

then they might get stumbled they might

play43:37

stumble and get stuck so really having

play43:39

that parent involvement can help these

play43:41

individuals um including children maybe

play43:44

older adolescents

play43:46

put those skills into practice if the

play43:48

parent is involved and knows how to help

play43:49

them through the challenges

play43:51

[Music]

play43:56

and then some other factors to consider

play43:58

include some of these cultural work

play44:00

consideration family structure and

play44:02

financial factors so as a clinician when

play44:04

you're putting together a treatment plan

play44:06

it's very important to look at all of

play44:08

these different aspects and see

play44:10

is this going to fit the family so for

play44:12

example for cultural variables is there

play44:14

something specific about the family that

play44:16

would impact treatment

play44:18

this could be religion this could be you

play44:20

know cultural background so for example

play44:22

it's known that in some cultures

play44:24

it is actually considered very rude to

play44:26

look at someone in the eye

play44:28

however many or if not most of aba

play44:31

interventions for children with autism

play44:33

focuses on eye contact so it's important

play44:35

to understand in the context of the

play44:37

family's culture is this appropriate

play44:41

in terms of family structure so it's

play44:43

important to know who lives in the home

play44:45

who will be involved in treatment so

play44:47

is this a multi-generational family is

play44:50

it just mom and dad or just mom or just

play44:52

dad um does grandma and grandpa live

play44:54

there um because when you're trying to

play44:56

get involved that parent training then

play44:59

maybe it's not just parent training it's

play45:00

also family and grandparent training

play45:02

right

play45:04

i can just say from personal experience

play45:06

i've worked with families where their

play45:07

grandma lived in the home and although

play45:09

if i did parent training if grandma

play45:11

wasn't on board then kind of everything

play45:13

we worked on would get washed away right

play45:15

um so it was it's really important to

play45:17

involve all the caregivers in the home

play45:20

so considering family structure okay

play45:23

um work and career considerations

play45:25

especially with people with multi-income

play45:27

homes are people working all the time

play45:29

um you know does that is that going to

play45:32

our schedule is going to impede the

play45:33

family's ability to do

play45:35

multiple sessions a week so considering

play45:38

you know the dose you know the treatment

play45:40

dose and how many times a week you'll do

play45:41

that and does that fit with the family's

play45:42

schedule

play45:44

and then financial factors obviously

play45:46

treatment without

play45:47

insurance even with insurance can be

play45:49

very costly so if you're suggesting

play45:52

you know doing multiple sessions a week

play45:54

is that going to fit in the family's

play45:56

financial you know bracket or is that

play45:58

going to fit you know their budget

play46:01

so as clinicians we need to take into

play46:02

consideration all of these factors when

play46:05

coming up with a treatment program

play46:09

and then

play46:10

as the parent when they're looking at

play46:12

this treatment plan it's important for

play46:14

them to consider their family so your

play46:17

family as a parent so they need to

play46:19

decide and have a conversation does does

play46:22

this fit with me and my family and the

play46:24

factors all here and is it really right

play46:27

for me okay and also for parents to

play46:29

understand that they're not stuck

play46:32

with whatever intervention they start

play46:34

with okay

play46:35

um if the parent decides or notices that

play46:38

maybe the treatment plan isn't really

play46:39

working or is as effective as they would

play46:41

have hoped for it to be and they have

play46:43

the right to have a discussion with the

play46:45

provider

play46:46

and to collaborate and to see what they

play46:48

can do to change um you know maybe it's

play46:50

too much for them because of work

play46:52

considerations or financial factors

play46:55

so you know having that open discussion

play46:57

with the provider and the parent and

play46:59

knowing that the parent has every right

play47:00

to advocate and to change things as

play47:03

needed and also the provider has a

play47:05

responsibility to help the parent

play47:07

understand

play47:08

why some of the suggestions are being

play47:11

made so again a very collaborative

play47:12

conversation between the two

play47:19

all right so now we have some resources

play47:21

for all of you

play47:23

um feel free to take a picture of this

play47:25

uh next slide for for reference uh

play47:28

there's some some great uh referrals

play47:30

there so first we have the national

play47:32

standards project which provides a

play47:35

source of guidance for parents

play47:38

for educators i see we have a lot of

play47:40

educators present today

play47:42

and and treatment providers on

play47:44

evidence-based

play47:46

uh intervention options for asd

play47:49

so a good resource there we also have

play47:51

autism speaks we saw a video

play47:53

from that group it's another great

play47:55

resource they have a number of other

play47:56

videos that sort of provide

play47:59

families with information about how to

play48:02

pursue the process basically not just

play48:03

the options but all of the ins and outs

play48:05

that they need to know

play48:07

over this