EBD Blog

Over on FAQAutism, Cathy Knoll has a pair of posts advising a student teacher about handling outburst by a student with Autism. The student teacher described the situation in this way:

The student teacher wrote that she is in an elementary classroom this semester, and is concerned about a youngster in the class. The student teacher reported the details of an episode that involved changing the regular classroom routine. She said, “One day I let the class vote on our reading activity. Their choices were (1) I would start a new book for our regularly scheduled ‘Read Aloud’ time, or (2) the students would read their new Scholastic News magazine independently at their desks. The class voted to read at their desk and finish a writing project for our bulletin board from earlier in the day. The girl with autism had voted for me to read aloud like I normally do at that time of day. However, the majority won. She couldn’t handle it and started yelling. I asked her quietly and calmly if she would like me to show her the new book that I would start reading to the following day. She screamed at me, ‘No. Never in a million years will I look at that book. I never want to hear you read anything ever again!’ Then she ran across the room and hid in a corner and started rocking back and forth.”

Ms. Knoll characterized the situation in terms of inflexibility and anger management. After remarking that she would not have students vote on activities, she makes a couple of sensible suggestions: (a) “The most effective way to prevent emotional meltdowns for an inflexible student is to develop a regular, predictable classroom routine” and (b) “Jot down quick notes every time he has a tantrum: the time it starts and the time it stops.”

I was pleased to see this tip-toe toward an antecedent-behavior-consequence analysis. Too bad that the recommendations do not go all the way to a functional behavior analysis. There are plenty of good resources on how to affect such analyses. It would be helpful to guide teachers to these methods of ascertaining what environmental features are sustaining a students “tantrums.”

Link to the two posts (#1 and #2) on FAQAustim advising a student-teacher about addressing tantrums.

On Wednesday 28 Jan 2009, reporting for National Public Radio (US) news, Jon Hamilton covered Simon Baron-Cohen’s recent entry into the market of products for individuals with Autism. Professor Baron-Cohen is affiliated with the department of Developmental Psychopathology at the University of Cambridge and Fellow at Trinity College, Cambridge (UK). In the ’90s he conducted studies about the popular idea of theory of mind in Autism. He also is affiliated with the Autism-Spectrum Quotient, a view that normal human development varies from Autistic to, well, to something. And he suggested that Autism is a special case he refers to as “systemizing ability.”

In his story, Mr. Hamilton reported this:

British researchers have found a way to use the fascination many autistic children have with trucks and trains to teach them about human emotions.

Children with autism often have trouble telling a happy face from a sad one. That’s partly because they tend to avoid looking at faces, says researcher Simon Baron-Cohen of the Autism Research Centre at the University of Cambridge in the U.K.

>>snip< <

A study found that children who watched the DVD for at least 15 minutes a day for a month became much more adept at recognizing facial expressions and the emotions behind them.

I’m encouraged by this finding, but not convinced. This is an individual study. The videos are cute (I got the press package, too), but I think we need replications and extensions. I keep thinking about the initial enthusiasm about the gradual extension of auditory perception reported by Paula Menyuck and associates in the 90s. Could this be the same?

Link to Mr. Hamilton’s “DVD Helps Kids With Autism Read Faces, Emotions.”

For schools and local education agencies that are doing a good job of working collaboratively with local mental health agencies or aspire to do so, here is a fine funding opportunity. Wrap-around systems of care have well-known benefits for children and youths with Emotional and Behavioral Disorders.

Grants for the Integration of Schools and Mental Health Systems (Federal Register: January 12, 2009 [CFDA# 84.215M])

Purpose of Program: Grants for the Integration of Schools and Mental Health Systems will provide funds to increase student access to high-quality mental health care by developing innovative approaches that link school systems with the local mental health system.

==> Applications Available: January 12, 2009.
==> Deadline for Transmittal of Applications: February 23, 2009.

Eligible Applicants: State educational agencies (SEAs), local educational agencies (LEAs), including charter schools that are considered LEAs under State law, and Indian tribes.

==> Estimated Range of Awards: $150,000-$400,000.
==> Estimated Average Size of Awards: $325,000.
==> Estimated Number of Awards: 15.

Link to the request for proposals. For more about wrap-around services, see the following sources.

• Burchard, J. D. (2000). How wraparound can help overcome three common barriers to successful transition services. Reaching Today’s Youth, 2(4), 49-51.
• Duckworth, S., Smith-Rex, S., Okey, S., Brookshire, M., Rawlinson, D., Rawlinson, R., Castillo, S., & Little, J. (2001). Wraparound services for young schoolchildren with emotional and behavioral disorders. Teaching Exceptional Children, 26, 54-60.
• Eber, L., Nelson, C. M., & Miles, P. (1997). School-based wraparound for students with emotional and behavioral challenges. Exceptional Children, 63, 539-555.
• Eber, L. (1996). Restructuring schools through wraparound approach: The LADSE Experience. In R. J. Illback & C. M. Nelson (Eds.), School-based services for students with emotional and behavioral disorders (pp. 139-154). Binghamton, NY: Haworth.
• Eber, L., & Nelson, C. M. (1997). Integrating services for students with emotional and behavioral needs through school-based wraparound planning. American Journal of Orthopsychiatry, 67, 385-395.
• Epstein, M. H., Kutash, K., & Duchnowski, A. (Eds.), Outcomes for children and youth with behavioral and emotional disorders and their families. Austin, TX: Pro Ed.
• Malysiak, R. (1997). Exploring theory and paradigm base for wraparound. Journal of Child and Family Studies, 6, 399-408.
• Malloy, J., Cheney, D., & Cormier, G. (1998). Interagency collaboration and the transition to adulthood for students with emotional or behavioral disabilities. Education and Treatment of Children, 31, 303-320.
• VanDenBerg, J. E., & Grealish, E. M. (1997). Individualized services and supports through the wraparound process: Philosophy and procedures. Journal of Child and Family Studies, 5, 7-21.
• Walker, J. S., & Schutte, K. (2003). Individualized Service/Support Planning and Wraparound: Research bibliography. Portland, OR: Portland State University, Research and Training Center on Family Support and Children’s Mental Health.

For folks who are following press coverage of Autism, there are two items of potential interest in the New York (NY, US) Times. Under the headling “Book Is Rallying Resistance to the Antivaccine Crusade,” Donald G. McNeil, Jr., reports about the effects of Dr. Paul Offit’s book Autism’s False Prophets on efforts by some to dissuade people from vaccinating their children. According to a note appended to the story, another relevant article is pending: “Next week: In the Personal Health column, Jane E. Brody will write about efforts, so far fruitless, to find a cure for autism.”

Link to Mr. McNeil’s article.

Just a note to readers that a new little paper back (about 160 pages) that I authored with Rick Brigham (now of George Mason University) will be available before long. It might be used as a text in teacher education (special or general education) or as a resource by parents or anyone who works with children with emotional or behavioral problems. The reference is:
Kauffman, J. M., & Brigham, F.J. (in press). Working with troubled children . Verona, WI: Attainment.

It’s now available in an Advance Reader’s Edition (bound but uncorrected proofs), and we expect it’ll be available in final form in early spring. You may find Attainment Company at http://www.attainmentcompany.com/xcart/home.php . Here’s a Table of Contents:

Chapter 1 Recognizing Early Signs of Behavior Problems: An Overview of Early Intervention and Prevention
Cases in Point
Nathan
Pauline
Larry
Typical Responses to Early Signs of Behavior Problems
Understanding Normal Development and Differences
The Concept of Normal
Differences That Are Not Normal
Definitions of Disorders for Special Education
General Guidelines for Judging Signs of Behavior Problems
Signs of Problems in Infancy
Signs of Problems in Toddlerhood
Signs of Problems in the Early School Years
Signs of Problems in Middle Childhood
Signs of Problems in Adolescence
The Need for Early, Accurate Labels
The Dimensions of Early Intervention and Prevention
Summary
Chapter 2 Understanding Causes
Cases in Point
Mark
Tommy
Increasing and Decreasing Risk
Major Causal Factors
Biological Factors
Genes
Temperament
Brain Malfunction
Other Health-Related Issues
Family Factors
Family Definition and Structure, Including Substitute Parents
Family Interactions
School Factors
Insensitivity to Individuality
Inappropriate Expectations
Inconsistent Management
Instruction in Nonfunctional or Irrelevant Skills Ineffective Instruction in Critical Skills
Undesirable Models
Destructive Contingencies
Social and Cultural Factors
Mass Media: Television, Movies, and Music
Peers
Neighborhood and Urbanization
Ethnicity, Social Class, and Poverty
Summary
Chapter 3 The Dilemma of Early Identification: To Identify or Not to Identify
Cases in Point
Esther P. Rothman
Edith
True and False Identification: Trying to Get Labels Right
At-Risk and Response to Intervention: What Do They Mean?
The “At-Risk” Label
Meanings of Response to Intervention
What’s the Problem? A Caution
Spoiled Identity: Dealing with Pride and Prejudice
Expectations: Setting Them Not Too High and Not Too Low
Social Rejection and Isolation: Facilitating Peer Affiliation
Going From Bad to Worse: Facing The Ultimate Horror
Summary
Chapter 4 Why Responding to Trouble Immediately Is Important
Cases in Point
Dean
Larissa
Behavior Change Is Easier
Chances for Better Life Outcomes Are Enhanced
Academic Progress Is More Likely
Social Acceptance Among Helpful Peers Is Possible
Summary
Chapter 5 General Ideas for Making Things Better
Cases in Point
Derrick
Joshua
A Class That Is Separate and Better
The Centrality of Effective Instruction
The Help of School-Wide Discipline
The Usefulness of Structure and Routine
A Focus on the Positive in Behavior and Consequences
The Importance of Clear Communication
Why Consistent Follow-Through Is Essential
Understanding Cycles of Behavior and Implications for Prevention
Seeing the Cycle or Pattern
Responding Effectively to the Stage or Level
Anticipating the Next Level or Stage
The Use and Abuse of Medication
Summary
Chapter 6 Using Incentives Intelligently
Cases in Point
Rewards Versus Bribes
Andy
Try the Simplest Things First
Telling
Showing Examples
What to Use as Rewards
How to Use Rewards
Getting Started and Moving On
Being As Good As Your Word: Follow-Through
Thinking About Our Fears and Struggles
Summary
Chapter 7 Using Deterrents Deftly
Cases in Point
A Boy with Behavior Problems
Eddie
Commentaries on Punishment
The Necessity of Punishment
Punishment As Part of Teaching
Self-Perception
Keeping Punishment Nonviolent and Matter-of-Fact
Uses and Abuses of Time Out
Exceptions and Evidence Beyond Reasonable Doubt
Making Punishment Consistent, Informative, and Instructive
Making Punishment Stick: Follow-Through
Summary
Chapter 8 Finding Help
Parents as Sources of Support
Working with Consultants
Finding Help in the Literature
Summary

It will be interesting to watch what happens if Dr. Sanjay Gupta becomes US Surgeon General and a chief advisor on public health policy for the Obama administration, as many news sources are reporting is likely to happen. Of special interest to those who are concerned about Emotional and Behavioral Disorders will by how Dr. Gupta addresses issues associated with Autism. Vaccines? Facilitated communication?

As Harold Doherty noted about a year ago on Facing Autism in New Brunswick, in his public career on the news-and-information source CNN Dr. Gupta has promoted discussion of some questions from his CNN pulpit. However, there is a lot more to Autism than providing a forum for people to brandish their often-ill-informed opinions about vaccines.

CNN is one of the world’s great communication and education organizations. People around the world listen to CNN and learn about the world from CNN. Hopefully Dr Gupta means it when he says he wishes to report on ALL aspects of autism. He might start by visiting the Long Island residential care facility where a middle aged woman who could not communicate at all was repeatedly abused by staff until outed by a conscientious co-worker and video recordings. The good doctor could also interview people with knowledge of the life of Tiffany Pinckney who died in Toronto from starvation and neglect while living in “the care” of her adoptive sister. Or he could talk to parents whose autistic children wandered into traffic to be lost forever or who have been restrained physically, left in a brick walled isolation room for hours, or simply sent home from school.

The list could continue: Parents who have taken out mortgages to secure financing for the private therapy their children desperately need but that schools will not provide. Promulgation of best-evidence interventions. Coordination of services across the disparate agencies that affect the services individual children receive. Respite care so that parents can catch their breath for a weekend. Etc. And we haven’t even begun to list medical, behavioral, or educational research needs. (Add other potential foci in the comments, please.)

As the holder of one of the most influential posts in public health, Dr. Gupta will need to wade into some difficult issues. He will have to go beyond simply making statements that solicit viewer interaction while avoiding alienating them, a strategy that serves one well in promoting discussions. Discussions are nice, but US health policy—about Autism and many other issues closely connected to Emotional and Behavioral Disorders—needs bold leadership informed by the best available science. Such leadership is likely to cause dissatisfaction among those who receive their wisdom from anecdotes told on popular mass media shows, give as much credence to evidence-based presentations as to an individual’s illogical assertion of correlation, and embed ad hominem attacks in their anonymous comments on discussion boards.

How would Dr. Gupta respond to questions posed by folks representing diverse views about Autism (see, e.g., Kristina Chew’s note about the participation of the Autism Self-Advocacy Network in discussions with the Obama administration)?

Review Mr. Doherty’s comments from his post about Dr. Gupta in January of 2008. For a sample of the interactions about Autism that have been engendered by Dr. Gupta’s work on CNN, see this discussion of vaccinations. Consider saying something about Dr. Gupta’s CNN pieces on FC.

Updates (of a more general nature):

• PZ Myers of Pharyngula—I’m not so sure about this pick;
• Orac of Respectful Insolence—Dr. Sanjay Gupta Surgeon General? Yawn.;
• Matthew Nisbet of Framing Science—Quick Thoughts on Sanjay Gupta and CNN Science;

More: Huffingtonpost post: Conyers: Obama Should Not Nominate Sanjay Gupta;
.

Happy anniversary

Four years ago today, I published the first entry on EBD Blog, so we’re starting our fifth spin around the blogosphere.

If you have your own sparkle (and yes, the contents of that glass are from Champagne), raise a glass. If you have recommendations for coverage for the next year, please pass ‘em along in the comments. Thanks!