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Dr. Chris’ Autism Journal
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When is my child ready to start using the computer?


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 There is no specific age that a child should start using the computer, but most people would agree that the child should be at least 2 years old. At this age, many children may be ready, but some will not, even at 3 or 4 years old. By the age of 5 years, most children are probably ready to start using the computer in one way or another. There is little research on when a child should begin using the computer, but there are a few signs that your child might be ready:

  1. Your child is at least 2 years old
  2. Your child is interested in visual stimuli such as the computer or television
  3. Your child attends to visual stimuli for at least 5 minutes (with or without your help)
  4. Your child is able to reach for items or point to desired items (so that they can touch the computer monitor or point to items on the screen) (not necessary for your child to use a computer mouse at first) (this one is not totally necessary as there are accommodations that can be made even for those children who cannot point to the screen)
  5. Your child can attend to and follow brief, verbal instructions (e.g. “sit down”) (for this one, it is worth trying the computer briefly to see what happens, for some children, they respond better to the computer than to verbal instructions).

How can I get a child started using the computer?

The best way to get a child started on the computer is to introduce it gradually with little demand on the child. The focus at first should be on showing the child that the computer is fun!

  1. Pick a stimulating program that your child is likely to love (this does NOT have to be educational – just fun for your child!) and have your child sit with you while you navigate through the program. If your child wants to grab the mouse or touch the monitor, let him, but do not give your child any instructions or place any demands on him or her.
  2. Once your child begins to show interest (which could be the very first time!), start placing your child’s hand on the mouse occasionally and physically prompt them to move it around and click. If you have a touch screen monitor, you can have your child start touching the screen to see what will happen. For this step, you should again choose a program that is reinforcing for your child, not necessarily a learning program.
  3. Now you can introduce a simple learning program (you will want to start with content that is relatively easy, but not boring, for the child). Begin with very short sessions such as 5 minutes and do several times throughout the day (2-3 times). Sit behind your child and provide extra reinforcement (e.g. praise, food, touch) to keep your child engaged. You may want to set a timer so the child knows how long they are expected to sit at the computer.
  4. Increase the difficulty of the learning program and increase the time gradually that the child sits at the computer (no more than 20 minutes for a young child, up to an hour for an older child).
  5. As your child gets more independent on the computer, you can fade your presence but it is recommended that you sit with your child for some of the computer sessions to work on expressive language and social interaction.
  6. To make sure it is working, you should collect data on the skills you are trying to improve.

What should I look for in purchasing software for my child?

  1. If only looking to entertain your child, not teach, pretty much anything will work – these kinds of programs are good rewards for your child to earn after using a learning program.
  2. For teaching, look for programs that are specifically designed for your child’s needs. For instance, if you have a child with an Autism Spectrum Disorder, you may want to purchase a program that is designed specifically for this population. Also, be sure to look at the ages the program is designed to teach. If your child is older, you will want to choose a program with age ranges that match your child’s developmental level.
  3. Look for programs that are based on science. Many programs claim to do this, so look at what “science” they are referring to.
  4. Look for companies that have done and continue to do research on their products! This one is extremely important, claiming something is “evidence-based” or “effective” without any research is a false claim. At minimum, the companies should provide a scientific framework that their products are based on.
  5. Identify programs that are visually interesting and have fun sounds – you will want your child to enjoy what they are doing! Most companies provide free demos of their products so that you can check out what the program looks and sounds like. Higher quality products are more engaging for most children.
  6. Programs that claim to be effective should provide a data collection system in the software. Having frequent progress reports on how your child is doing will help you decide if the program is working or not.
  7. One of the biggest issues with computer instruction is whether or not skills will generalize to off-computer activities. Programs that provide generalization solutions in the software and give suggestions for off-computer activities are ideal.
  8. Last, but not least, try to identify programs that will grow with the child so that you are not replacing software every month or so (this gets costly, results in loss of data tracking, and can be frustrating for your child).

Written by:

Christina Whalen, PhD, BCBA

President and Chief Science Officer

TeachTown, Inc.

www.teachtown.com

Autism and Online Role Playing Games


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Games such as Second Life may provide a great opportunity for opening social doors for people with Autism Spectrum Disorders (ASD).  This virtual world allows users to create characters and interact socially with others in an online world.  In a recent article, CNN reports on how this can be beneficial.  Created by an adult with Asperger’s Syndrome, Naughty Auties is a world where people with ASD can interact with one another in a more relaxed, less socially intimidating environment.  This sounds like a great solution for teaching social interaction and working on social skills.

This kind of solution for helping teens and adults with ASD may end up causing more harm than good.  In worlds such as Second Life, there are an unfortunate group of people called “griefers” whose sole purpose is to cause harm to others.  These people literally seek out vulnerable people in these online worlds and deliberately disrupt the world and cause harm, just because they can.  In worlds such as Second Life, there is no supervision, there are no limits, and anyone can get in and do whatever they want and say whatever they want.  This opens the doors for griefers and others will the wrong intentions.  For the ASD community, they are especially vulnerable due to their difficulties with understanding subtle social cues and often, language difficulties.

Although I support the idea of providing a virtual world for working on social skills and understanding, I am nervous about an open-ended world where people with disabilities are completely exposed and open to griefers.  Instead, I would like to see something similar that is not open to anyone wanting to join, and that operates in a more controlled space perhaps with computer players (like in the SIMS) or with invite-only people that have been screened.  The other issue to consider is how effective this kind of environment is for increasing skills, with no data collection or research on the effectiveness of doing this for someone with ASD, I would hesitate.  Research is clearly needed on this kind of program, particularly if it is described as an intervention or skill-building program.
In general, I think the idea is great, but people should be aware of the potential risks before jumping into a world with so many risks.

Exciting News in Medical Care


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 NEW YORK, NY (Dec 12, 2007) – Autism Speaks, the nation’s leading autism advocacy organization, today announced its Autism Treatment Network (ATN) would triple in size, expanding from five sites to fifteen sites across the United States and Canada. The ATN is a group of hospitals and medical centers dedicated to improving medical care for children and adolescents with autism spectrum disorder (ASD) and to standardizing the care those individuals receive.

The ATN’s multi-disciplinary approach includes collaboration among specialists in areas including, but not limited to, neurology, developmental pediatrics, child psychiatry, psychology, gastroenterology, genetics, metabolic disorders, and sleep disorders. The network aims to develop common clinical standards for medical care for individuals with ASD and to increase the pool of autism medical specialists through trainee mentorship and outreach to community-based physicians. As part of this effort, families receiving care at the sites can participate in a data registry that tracks children and adolescents receiving ongoing care at participating sites. The information in the database is a crucial part of developing the evidence to create and substantiate these clinical consensus standards.

“It is imperative that all children, no matter where they live, have access to excellent, evidence-based medicine,” said Autism Speaks President Mark Roithmayr. “The continuing expansion and funding of the ATN is a significant step in that direction.”

“This dramatic expansion of the Autism Treatment Network provides real opportunity to improve the quality of health care that children and youth with autism receive, and for more children to receive that care,” said Dr. James Perrin, Director, Clinical Coordinating Center, ATN, and Director, General Pediatrics, Massachusetts General Hospital for Children. “Developing common standards of medical care across fifteen sites will allow us to get answers to the questions parents ask about their children’s care much more quickly.”

The participating ATN sites are: University of Arkansas and Arkansas Children’s Hospital (Little Rock, AR); Kaiser Permanente Medical Care Program Northern California (San Jose, CA); University of Colorado Denver, School of Medicine and The Children’s Hospital (Denver, CO); Kennedy Krieger Institute and Marcus Institute (Baltimore, MD/Atlanta, GA); LADDERS/Mass General Hospital (Boston, MA); University of Missouri (Columbia, MO); Columbia University Medical Center (New York, NY); University of Rochester (Rochester, NY); Cincinnati Children’s Hospital Medical Center (Cincinnati, OH); Bloorview Kids Rehab, Surrey Place Centre and The Hospital for Sick Children (Toronto, ON, Canada); Oregon Health & Science University (Portland, OR); University of Pittsburgh (Pittsburgh, PA); Vanderbilt University Medical School (Nashville, TN); Baylor College of Medicine (Houston, TX); University of Washington (Seattle, WA).

The ATN began as a collaboration between the Northwest Autism Foundation in Oregon and Massachusetts General Hospital for Children in Boston. In 2005, the network was established with five founding sites that came together to establish multi-disciplinary practices for the evaluation and treatment of the underlying medical conditions associated with ASD. These sites currently provide services to approximately 2,000 new cases of ASD each year, and all have taken critical steps to broaden the services available to all children in these centers. The Autism Treatment Network merged with Cure Autism Now in 2006. In February 2007, Cure Autism Now merged with Autism Speaks.

To find out more about the Autism Treatment Network, or to get connected to a site in your area, visit www.autismspeaks.org/science/programs/atn/index.php or email: atn@autismspeaks.org.

The above article is reprinted with permission and can be found in its entirety at http://www.autismspeaks.org/press/atn_network_expanded.php

Parents: Preparing for the Winter Holidays


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The winter holidays can be a difficult time for children with ASD and their families. Difficulties may arise from too much free time, changes in routine, and gift giving.

BoyTreePic.JPG

Most school-age children are off school for two to three weeks for the winter holidays, leaving six to eight hours of unstructured time for families to fill each day. You’re not alone if you dread the school holidays; past experience has taught you that a lot can go wrong in two or three weeks. If you haven’t already done so, now is the time to plan how you will structure that free time for your child with ASD. Plan activities for each day of the vacation, and create simple visual supports (e.g., print a picture of a park from the Internet if you will be taking your child to the park) to prime your child about the activities you have planned. If possible, allow your child to help decide on the activities you are planning. During the vacation, review the schedule for the day the night before and on the morning of the day to which the schedule refers. Of course, you can’t plan for everything, and you will invariably have to make changes to the schedule. Let your child know of any changes as soon as possible, and provide visual supports to make the changes concrete for your child. If your family will be traveling during the vacation, changes to the schedule such as flight delays are even more likely. Prepare your child that more than likely, there will be changes to the schedule, perhaps through the use of a social story. Don’t forget to bring an assortment of things for your child to do such as coloring, books, games, or a laptop computer. plane travel.jpg
Where your child will go and what he or she will do in a day are not the only changes that may be upsetting during the winter holidays. Many people visit with friends and relatives during this time that they rarely see during the rest of the year. These people may feel like strangers to your child, and he or she may behave accordingly. Forcing your child to hug Aunt Mary because “She came all the way from Boston to see us,” is likely to induce challenging behaviors from your child and to make Aunt Mary very uncomfortable. Aunt Mary insisting on a hug may produce similar results. Inform Aunt Mary that your child may view her as a stranger and she should not be offended before Aunt Mary arrives at your home (or you at hers). If possible, show your child pictures of friends and relatives you will visit and review the names of these people before the visit.

Mansnowman.jpgy people exchange gifts during the winter holidays. This can be a source of great disappointment for family and friends of a child with ASD. As a behavior therapist, I once special ordered a beach magnet set for a child I worked with one-on-one, three hours a day, five days a week. I was sure he would love it. I imagined all the exciting language he would produce when we played with those magnets. I heard in my mind spontaneous comments he would make and squeals of delight he would emit. As you probably guessed, the boy opened the magnet set, said nothing, put it down, and picked up another toy. I tried to engage him with the magnets through my enthusiasm. Nothing worked. I have heard similar stories from parents and educators time and again. Even when the child showed intense interest in a toy when it belonged to someone else or requested the toy, the same toy is often of little interest to the child when received as a holiday gift.  As a parent, there is nothing you can do to prevent this. If you have a neurotypical child, you may have complained that he or she only played with a new toy for a day and lost interest. This is part of being a parent, but it is especially disheartening when your child is on the Autism Spectrum, has limited interests, and you worked so hard to find that special gift. Remember that your effort is special regardless of the immediate reaction to the gift. And time may reward your effort. I heard that the beach magnet set became a preferred toy for the boy I worked with over a year later.

TeachTown Receives Federal Funding for Autism Software Development


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teachtown cloud background.JPGWith the success of our first program, TeachTown: Basics, we were getting very antsy to start our next product to help school-age children with autism.  We are thrilled to announce that we have received a Department of Education Stepping Stones Technology grant to develop our next product and to do the initial research to help make this product effective, appropriate, and of the highest quality.  Stayed tuned for further updates about this upcoming product, we are anticipating using the new program with children starting in 2008!

To read more about our exciting news, check out the press release at: http://www.medicalnewstoday.com/medicalnews.php?newsid=69034

Continue checking back to this site and the TeachTown website for announcements and opportunities to participate in our research and development process.

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