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Dr. Chris’ Autism Journal
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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.

Autism Awareness Month, 2007


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000_19_Bill_painting.pngAutism Awareness Month was established in 1972 by the Autism Society of America, since then, we are seeeing more and more awareness every year.  When I started my career in 1993, most people I talked to had not heard of autism, or if they had, they had only seen Rainman and thought that all people with autism were savants. 

This year is probably the most productive I have seen in getting the word out about autism!  It is unfortunate though that so many people still do not know about autism, and I have parents tell me all the time, even now, that their child with autism was told to be “fine” by their pediatrician only to find out a few months later that their child has autism and that they have missed out on months (or years) of intervention.

2005_11Nov.jpgI am encouraged by the increase in media attention that autism is receiving, and I was thrilled to see that Oprah FINALLY did a show about it, which included the most active group in the media, Autism SpeaksThe View also did a show about autism, as have many news shows this month.  Jenny McCarthy will also appear on The View on May 3rd to talk about her story and her son Evan.

Many magazines, including Discover, have published articles about autism this month and Oxford University Press released 2 very helpful blog postings regarding autism:

Stress and Coping: http://blog.oup.com/2007/04/stress_coping/

Helping Children With Autism Learn: http://blog.oup.com/2007/04/children_autism/
Awareness is the first step and it is nice to see that more and more people are talking about autism, but, it is my hope that we will start to see more and more people talking about solutions for children today! 

Do you live in Wisconsin?


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000_52_Eric_reading.pngThe cost of treatment for children with autism is so high, and even if you are lucky enough to find a good intervention for your child, it is hard to get the money. 

LOGO2_Sm.pngIn case you were thinking that nobody out there wants to help, check out this organization, Angel, Inc., who provides grants to individual families who have children with autism to get help with treatment!

I thought this was such a great thing to offer families, but you have to live in Wisconsin.  Funding is for up to $500 and you can apply quarterly!

For those of you who think TeachTown might be a good fit for your child, this is more than enough to cover an annual subscription!

They also provide education and networking for families who have children with autism.

000_25_Abby_smiling2.pngYou can help with this great cause by buying your Avon products through www.youravon.com/jmongillo and 20% will be donated to Angels, Inc. to help more families. 

If you know about other organizations like this in other states, please post here to let others know!

Positive Behavior Support (PBS)


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index_r2_c1.gifThe goal of PBS (Positive Behavior Support) is to apply the principles of behavior analysis in the community to reduce problem behaviors and increase appropriate behaviors which promote a rich lifestyle.  PBS is a type of ABA and is not necessarily in competition (despite the controversy among some that they are different approaches) with other types of ABA as it is often very suitable to use in conjunction with other treatments such as Discrete Trial Training, Pivotal Response Training, Picture Exchange Communication System, and other popular ABA techniques.  PBS typically refers more to dealing with challenging behaviors such as aggression, tantrums, self-injury, etc. and focuses on teaching more appropriate replacement behaviors such as functional communication.

The Association of Positive Behavior Support describes PBS and provides success stories and useful links and resource guides that you can download.  They also host an annual conference, the next one is March, 2007 in Boston, MA and they are now accepting proposals for presentations.  They also have a good newsletter which is free to download and print.

From the Association of Positive Behavior Support:index_r1_c1.gif

Positive behavior support (PBS) involves the changing situations and events that people with problem behaviors experience in order to reduce the likelihood that problem behaviors will occur and increase social, personal, and professional quality in their lives. It is an approach that blends values about the rights of people with disabilities with a practical science about how learning and behavior change occur.  PBS is a set of research-based strategies used to increase quality of life and decrease problem behavior by teaching new skills and making changes in a person’s environment. Positive behavior support combines valued outcomes, behavioral and biomedical science, validated procedures; and systems change to enhance quality of life and reduce problem behaviors such as self-injury, aggression, property destruction, pica, defiance, and disruption. The overriding goal of PBS is to enhance quality of life for individuals and others within social settings in home, school, and community settings. 

biting.jpgPBS is now used in many different situations and settings and with different types of social challenges. Children with and without disabilities participate in the PBS process in schools, at home, and in community settings. In school settings, PBS strategies are used to build a positive climate and include all students, not just children who may engage in more serious problem behavior. Adults with disabilities are actively involved in PBS team processes regardless of their age and where they live and work. The Association for Positive Behavior Support (APBS) has been created to build a community of individuals who are interested in the PBS process and who represent many different voices and perspectives. Family members, school professionals, psychologists, adult service providers, higher education professors, researchers, and community members are all involved in APBS. Regardless of the different settings and individuals involved in PBS processes, the key elements remain the same for individual planning. The PBS process involves a team of individuals working together collaboratively to gather information and create strategies for preventing problem behavior.

Functional Assessment. The cornerstone of PBS is the design anportrait_showcase_children_50.jpgd use of functional (behavioral) assessment to understand what maintains an individual’s problem behavior. Individuals engage in a behavior because it is functional; it helps them acquire some form of reinforcement (e.g., they get something desirable or pleasant, or they avoid something undesirable or unpleasant). A person may engage in problem behavior because circumstances in both the internal and/or external environment (i.e., antecedents, setting events) trigger or ‘set the stage’ for behavior to occur. Functional assessment is a process for identifying the events that trigger and maintain problem behavior. This process involves information gathering through record reviews, interviews, and observations and the development of summary statements that describe the patterns identified. Primary outcomes of the functional assessment process include:

  • A clear description of the problem behaviors
  • Events, times, and situations that predict when behaviors will and will not occur (i.e., setting events)
  • Consequences that maintain the problem behaviors (the function)
  • Summary statements or hypotheses
  • Direct observation data to support the hypotheses

Comprehensive Intervention. The team that forms around a child or adult in order to create a PBS plan should represent all of the situations and settings that are part of the person’s life. Information that is gathered from a functional behavioral assessment helps this team develop and implement behavioral intervention plans that are positive, proactive, educative, and functional. PBS plans include a number of interventions that can be implemented across situations and settings. These interventions include: 1) proactive strategies for changing the environment so triggering events are removed, 2) teaching new skills that replace problem behaviors, 3) eliminating or minimizing natural rewards for problem behavior, and 4) maximizing clear rewards for appropriate behavior. A hallmark of PBS planning is emphasis on improving overall lifestyle quality (relationships, activities, health) as an integrated part of behavior support.

Mindy2sm.jpgLifestyle Enhancement. PBS focuses not only on reducing behavior problems, but on enhancing a person’s overall quality of life. Outcomes include lifestyle improvements such as participation in community life, gaining and maintaining satisfying relationships, expressing personal preferences and making choices, and developing personal competencies. Such improvements in quality of life are facilitated by establishing a positive long-range vision with the individual and his/her family (e.g., through person-centered planning) and establishing natural supports through effective teamwork.

jpbi.jpgA great resource for staying on top of the research and clinical work in PBS is to subscribe to one of my favorite journals, the Journal of Positive Behavior Interventions (JPBI).  If you are going to subscribe to one journal and you work with or have a child with autism, this is one of the most practical journals I have seen as  the research is very applied and accessible to anyone.

Another useful journal, which is a free online journal, on PBS is the Journal of Early and Intensive Behavior Intervention

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