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COMPARING DIFFERENT APPROACHES
FOR SUPPORTING CHILDREN WITH AUTISM
Matching Best Practice with Needs
04 February 2014

Riyadh, Saudi Arabia

PRESENTED BY
Stephen Shore, Ed.D.
Tumbalaika@AOL.COM

www.AutismAsperger.net

1
A little
about me…

2
A

L I T T L E
A B O U T
Introduction

M E

The Autism Bomb

Loss of
speech
&
tantrums

Environmental
withdrawal

Self-stims

3
A CLOSER LOOK AT MY
PLACEMENT ON THE AUTISM SPECTRUM — 4

AGE
E
V

E
N
T

S

0

1.5

2.5

Typical
development
Turn over at
8 days
Rapid
physical and
motor
development

Autism
bomb hits
Withdrawal
from
environment
Tantrums

Putnam
evaluation of
atypical
development,
strong autistic
tendencies &
psychotic
Early
intervention
fromparents
who refute
recommendati
ons for
removal from
home

4

6

8

10

13

19

Enter Putnam
Condition improves to “neurotic”

The wonderful world of watch motors
Echolalia and return of speech

Self Awareness Eating baby food
4
S U C C E S S
W I T H
A U T I S AT
A CLOSER LOOK M MY
PLACEMENT ON THE AUTISM SPECTRUM — ADULT

AGE

E
V
E
N
T
S

0

1.5

2.5

4

6

8

10

13

19

Typical
development
Turn over at
8 days
Rapid
physical and
motor
development

Autism
bomb hits
Withdrawal
from
environment
Tantrums

Putnam
evaluation
of atypical
developme
nt, strong
autistic
tendencies
& psychotic
Early
intervention
from
parents who
refute
recommend
ations for
removal
from home

Enter
Putnam
Condition
improves to
“neurotic”
The
wonderful
world of
watch
motors
Echolalia
and return
of speech
Eating
baby food

Kindergarten
Social &
academic
difficulties
Discovered
making a
mess of
myself
while eating
BBQ
chicken
wings
Loved cats
but dogs…
Yikes bikes!

Cracking
rocks
Special
interests in
astronomy
and weather
Teacher
concerns for
reading and
math
difficulties

Concern
about
dropping the
letter “e.”
My friend
says “he
feels like a
pizza” and I
argue with
him that he
does not
look like a
pizza and
probably
does not
feel like one
either

Middle and
high school
Finally
getting it
together but
still often in
left field
Discovering
the band
room
Time to
focus more
on people
and not their
bicycles

College
More
friends
Dating
Others
really
do
think
differen
tly
Utopia!

Professor of Special Education at Adelphi University

5
Setting the Context

6
SETTING THE CONTEXT
Three Areas of Intervention
Educational/Behav
EducationalBehavioral

Sensory

Biomedical

•
•
•
•
•
•
•

DTT/ABA
Daily Life Therapy
TEACCH
Miller Method
DIR (Floortime)
RDI
SCERTS

Stephen Edelson, personal
communication, December, 2004

Sensory

Occupational Therapy to
Treat Imbalances of the
Outer and Inner Senses
• Sight
• Touch
• Taste
• Smell
• Hearing
• Vestibular
• Proprioception

Biomedical
Treating chemical imbalances caused by internal and external factors
• Digestion

• Nutrition

• Chelation

• GFCF Diet

• Vaccines
• Dysbiosis
• Immunology
• Feingold Diet
• Mercury and other heavy metal toxicities [metallothionein & glutathione]

7
SETTING THE CONTEXT
Three Areas of Intervention

EducationalBehavioral
Biomedical
Sensory

Stephen Edelson, personal communication, December, 2004

8
Navigating the sea
of interventions
• Educational •
9
SOME PROMISING INTERVENTIONS
Lovaas (ABA):
http://www.youtube.com/wat
ch?v=iyCx-OLzgJw

TEACCH:
http://www.youtube.com/wat
ch?v=ddGLJ2r4rcw

Daily Life Therapy:
http://www.youtube.com/wat
ch?v=Pn884qZS7t0

Miller Method:
http://www.youtube.com/wat
ch?v=AUReFlvYRTg

DIR (Floortime):

Watson, Skinner, Operant conditioning, Shaping
behaviors, Antecedent-behavior-consequence
Employs approaches based on the needs of a person’s
needs and emerging capabilities (Trehin, 1999).
Kito Kitihara, Platonic, Order of the physical, emotional
and intellectual.
Miller, Developmental-Cognitive Systems, Elevation,
Piaget, Vygotsky, Luria, Werner, Bertalanffy.
Greenspan, Developmental-Affective, Circles of
communication.

Relational Development Intervention: Gutstein, Experience sharing rather than instrumental
relationships.
SCERTS:

Prizant, Social-Communication, Emotional-Regulation,
Transactional Support.

Biomedical:

Medical-Chemical, Diet (GFCF), Adjusting chemical
imbalances, Persistent measles, Heavy metal toxicities.

Other:

Sensory integration, PECS, Inclusion, Social stories,
Power cards, CCT

10
www.behavior.org/autism

11
Functional Behavior
Assessment
12
FUNCTIONAL BEHAVIOR ASSESSMENT
Conducting the FBA
Looks beyond the specific behavior by focusing on identifying…
•

Social

•

Affective

•

Cognitive

•

Environmental

•

Medical

WHY?

Factors associated with
occurrence or non-occurrence
of the specific behavior
Adapted from the Center for Effective Collaboration and Practice http://cecp.air.org/fba/default.asp

13
Elements of Daily Life Therapy
Supported living
Continuing/New relationships

Life
experiences
Bonding
with others

MUSIC

VOC ED

ART

Intellectual Stimulation

Confidence

PE

Emotional Regulation

Structure

Physical Activity

Productivity and feeling of productivity

Routines
Self esteem
Group
dynamics
Needed
supports

www.bostonhigashi.org

INITIAL STAGE GUIDANCE
Elements of Daily Life Therapy
SOME PROMISING INTERVENTIONS
Miller Method
S

Y

S

T

E

M

…an organized unit of behavior around an object, event, or person.

Miller, A. (2000). Chapter 15. The Miller Method©: A Cognitive-Developmental Systems Approach with Children
Having Body Organization, Social and Communication Disorders. In Guide to Best Practices (Eds) Greenspan and
Wieder, Interdisciplinary Council for Developmental Disorders, Unicorn Foundation.
Miller, A. & Eller-Miller, E. (1989). From ritual to repertoire: A cognitive-developmental systems approach with
behavior-disordered children. New York: Wiley-Interscience.

16
www.millermethod.org

17
SOME PROMISING INTERVENTIONS
Miller Method
STEP SLIDE SYSTEM
http://www.youtube.com/w
atch?v=AUReFlvYRTg

1. Climb up the stairs.
2. Turn 90 degrees to the
left and Sit down.
3. Go down the slide.
4. Get up and walk back
the to stairs and repeat.

Stair and slide system. From page 226 of Ritual to Repertoire. Used with permission.

Stair and slide system: A system used as part of the Umwelt assessment at the Language
and Cognitive Development Center in Newton, Massachusetts.

www.millermethod.org

18
DIFFERENT WAYS OF PROCESSING INFORMATION
Word Contrasted with Photo-Realistic Thinking

Algebraists

Geometrists

Think this formula

Visualize this figure

2+b2=c2
a
Why require algebra
before geometry when
geometry was invented
first?

19
Thanks for your participation!

Stephen Shore
www.autismasperger.net
20
www.autismasperger.net

21

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Stephen Shore, Ed.D. - COMPARING DIFFERENT APPROACHES FOR SUPPORTING CHILDREN WITH AUTISM Matching Best Practice with Needs - IEFE Forum 2014

  • 1. COMPARING DIFFERENT APPROACHES FOR SUPPORTING CHILDREN WITH AUTISM Matching Best Practice with Needs 04 February 2014 Riyadh, Saudi Arabia PRESENTED BY Stephen Shore, Ed.D. Tumbalaika@AOL.COM www.AutismAsperger.net 1
  • 3. A L I T T L E A B O U T Introduction M E The Autism Bomb Loss of speech & tantrums Environmental withdrawal Self-stims 3
  • 4. A CLOSER LOOK AT MY PLACEMENT ON THE AUTISM SPECTRUM — 4 AGE E V E N T S 0 1.5 2.5 Typical development Turn over at 8 days Rapid physical and motor development Autism bomb hits Withdrawal from environment Tantrums Putnam evaluation of atypical development, strong autistic tendencies & psychotic Early intervention fromparents who refute recommendati ons for removal from home 4 6 8 10 13 19 Enter Putnam Condition improves to “neurotic” The wonderful world of watch motors Echolalia and return of speech Self Awareness Eating baby food 4
  • 5. S U C C E S S W I T H A U T I S AT A CLOSER LOOK M MY PLACEMENT ON THE AUTISM SPECTRUM — ADULT AGE E V E N T S 0 1.5 2.5 4 6 8 10 13 19 Typical development Turn over at 8 days Rapid physical and motor development Autism bomb hits Withdrawal from environment Tantrums Putnam evaluation of atypical developme nt, strong autistic tendencies & psychotic Early intervention from parents who refute recommend ations for removal from home Enter Putnam Condition improves to “neurotic” The wonderful world of watch motors Echolalia and return of speech Eating baby food Kindergarten Social & academic difficulties Discovered making a mess of myself while eating BBQ chicken wings Loved cats but dogs… Yikes bikes! Cracking rocks Special interests in astronomy and weather Teacher concerns for reading and math difficulties Concern about dropping the letter “e.” My friend says “he feels like a pizza” and I argue with him that he does not look like a pizza and probably does not feel like one either Middle and high school Finally getting it together but still often in left field Discovering the band room Time to focus more on people and not their bicycles College More friends Dating Others really do think differen tly Utopia! Professor of Special Education at Adelphi University 5
  • 7. SETTING THE CONTEXT Three Areas of Intervention Educational/Behav EducationalBehavioral Sensory Biomedical • • • • • • • DTT/ABA Daily Life Therapy TEACCH Miller Method DIR (Floortime) RDI SCERTS Stephen Edelson, personal communication, December, 2004 Sensory Occupational Therapy to Treat Imbalances of the Outer and Inner Senses • Sight • Touch • Taste • Smell • Hearing • Vestibular • Proprioception Biomedical Treating chemical imbalances caused by internal and external factors • Digestion • Nutrition • Chelation • GFCF Diet • Vaccines • Dysbiosis • Immunology • Feingold Diet • Mercury and other heavy metal toxicities [metallothionein & glutathione] 7
  • 8. SETTING THE CONTEXT Three Areas of Intervention EducationalBehavioral Biomedical Sensory Stephen Edelson, personal communication, December, 2004 8
  • 9. Navigating the sea of interventions • Educational • 9
  • 10. SOME PROMISING INTERVENTIONS Lovaas (ABA): http://www.youtube.com/wat ch?v=iyCx-OLzgJw TEACCH: http://www.youtube.com/wat ch?v=ddGLJ2r4rcw Daily Life Therapy: http://www.youtube.com/wat ch?v=Pn884qZS7t0 Miller Method: http://www.youtube.com/wat ch?v=AUReFlvYRTg DIR (Floortime): Watson, Skinner, Operant conditioning, Shaping behaviors, Antecedent-behavior-consequence Employs approaches based on the needs of a person’s needs and emerging capabilities (Trehin, 1999). Kito Kitihara, Platonic, Order of the physical, emotional and intellectual. Miller, Developmental-Cognitive Systems, Elevation, Piaget, Vygotsky, Luria, Werner, Bertalanffy. Greenspan, Developmental-Affective, Circles of communication. Relational Development Intervention: Gutstein, Experience sharing rather than instrumental relationships. SCERTS: Prizant, Social-Communication, Emotional-Regulation, Transactional Support. Biomedical: Medical-Chemical, Diet (GFCF), Adjusting chemical imbalances, Persistent measles, Heavy metal toxicities. Other: Sensory integration, PECS, Inclusion, Social stories, Power cards, CCT 10
  • 13. FUNCTIONAL BEHAVIOR ASSESSMENT Conducting the FBA Looks beyond the specific behavior by focusing on identifying… • Social • Affective • Cognitive • Environmental • Medical WHY? Factors associated with occurrence or non-occurrence of the specific behavior Adapted from the Center for Effective Collaboration and Practice http://cecp.air.org/fba/default.asp 13
  • 14. Elements of Daily Life Therapy Supported living Continuing/New relationships Life experiences Bonding with others MUSIC VOC ED ART Intellectual Stimulation Confidence PE Emotional Regulation Structure Physical Activity Productivity and feeling of productivity Routines Self esteem Group dynamics Needed supports www.bostonhigashi.org INITIAL STAGE GUIDANCE
  • 15. Elements of Daily Life Therapy
  • 16. SOME PROMISING INTERVENTIONS Miller Method S Y S T E M …an organized unit of behavior around an object, event, or person. Miller, A. (2000). Chapter 15. The Miller Method©: A Cognitive-Developmental Systems Approach with Children Having Body Organization, Social and Communication Disorders. In Guide to Best Practices (Eds) Greenspan and Wieder, Interdisciplinary Council for Developmental Disorders, Unicorn Foundation. Miller, A. & Eller-Miller, E. (1989). From ritual to repertoire: A cognitive-developmental systems approach with behavior-disordered children. New York: Wiley-Interscience. 16
  • 18. SOME PROMISING INTERVENTIONS Miller Method STEP SLIDE SYSTEM http://www.youtube.com/w atch?v=AUReFlvYRTg 1. Climb up the stairs. 2. Turn 90 degrees to the left and Sit down. 3. Go down the slide. 4. Get up and walk back the to stairs and repeat. Stair and slide system. From page 226 of Ritual to Repertoire. Used with permission. Stair and slide system: A system used as part of the Umwelt assessment at the Language and Cognitive Development Center in Newton, Massachusetts. www.millermethod.org 18
  • 19. DIFFERENT WAYS OF PROCESSING INFORMATION Word Contrasted with Photo-Realistic Thinking Algebraists Geometrists Think this formula Visualize this figure 2+b2=c2 a Why require algebra before geometry when geometry was invented first? 19
  • 20. Thanks for your participation! Stephen Shore www.autismasperger.net 20