Tuesday, June 28, 2011

Best Practice Research: Autism and Joint Attention

Although there are no “absolute” clinical indicators of autism, some of the early “red flags” include: • Does not smile by the age of six months • Does not respond to his or her name • Does not cry • Does not babble or use gestures by 12 months and • Does not point to objects by 12 months. Children with autism typically experience delays in speech and communication skills. Not only will they often develop spoken language later, but they are less likely to develop non-verbal communication skills such as “joint attention,” pointing, or gesturing. 
Children seek to share attention with others spontaneously during the first year of life. “Joint attention” is an early-developing social-communicative skill in which two people (usually a young child and an adult) use gestures and gaze to share attention with respect to interesting objects or events. Before infants have developed social cognition and language, they communicate and learn new information by following the gaze of others and by using their own eye contact and gestures to show or direct the attention of the people around them. Impairment in joint attention is considered an important “red flag” of autism.
Researchers in Melbourne Australia, working on a long-term study of 1900 eight month old children, found that those with autism used fewer gestures to communicate than other kids. Speech pathologist Carly Veness, who led the research, said there was a pattern of low gesture use among autistic children between the ages of eight months and two years. "We found that there was a decreased use of gestures like pointing, showing and giving,” she commented. Children who were diagnosed with autism by age seven were compared with others who had language and developmental problems as well as those who had typical communication skills. Examining the data over the seven-year period, researchers found that the children with autism produced fewer communicative gestures at age two compared to other children. Some of these children had also demonstrated problems with their hand gestures as early as eight months. Future research is needed to determine how well the low use of gestures is at predicting a diagnosis of autism and whether certain gestures differentiate typical children from those with the disorder.

Friday, June 24, 2011

The Autism Bookshelf

I’m pleased to announce the creation of a new Linkedin group, The AUTISM BOOKSHELF. The objective of this group is to advocate, educate, and inform by providing a selective, comprehensive, and objective review of books and articles dealing with autism spectrum disorders (ASD) that will meet members’ informational needs. This includes a guide to the books we think are most deserving of your attention, links to relevant sites, including book review and publishers' sites from around the world and our own recommended list of ASD “best practice” resources. This group also provides a forum to discuss up-to-date information on scientifically validated assessment and treatment options for children with ASD. Created to be a practical and useful resource, autism bookshelf offers essential information for psychologists, speech/language pathologists, teachers, counselors, advocates, attorneys, special education professionals, and parents. We hope you will join us in sharing publications, resources, and information that present evidence-based strategies and tools for assessing and supporting children with ASD, and for connecting and partnering with families and other autism professionals.

© Lee A. Wilkinson

Best Practice Book Review: Pivotal response treatments for autism: Communication, social, and academic development.

This comprehensive text describes intervention strategies and outcome data related to Pivotal Response Treatments (PRT) for autism. The PRT approach focuses on normalizing child development for children with autism via a delivery model that uses both a developmental approach and applied behavior analysis (ABA). It has demonstrated empirical support in the literature. The chapters are well written and cover a range of topics related to interventions in the general education classroom, parent education programs, communication, social development, and strategies for addressing disruptive behavior. Case examples are also included. The chapter on combining functional assessment and self-management procedures to reduce disruptive behavior should appeal to school-based professionals such as school psychologists, special educators, and other support personnel. Overall, the text succeeds in describing an integrated and comprehensive approach to the treatment of autism. Those without experience or background in autism related research and practice might find some portions of the text to be a challenging read.

Koegel, R. L., & Koegel, L. K. (2006). Pivotal response treatments for autism: Communication, social, and academic development. Baltimore, MD: Paul H. Brookes Publishing.

Monday, June 20, 2011

Autism in Schools: Read it on Kindle!

Fully updated to reflect DSM-5 and current assessment tools, procedures and research, this second edition of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools provides a practical and scientifically-based approach to identifying, assessing, and treating children and adolescents with an Autism Spectrum Disorder (ASD) in school settings. Integrating current research evidence with theory and best practice, this book will support school-based professionals in a number of key areas including:
  • Screening and assessing children and youth on the autism spectrum.
  • Identifying evidence-based interventions and practices.
  • Developing and implementing comprehensive educational programs and providing family support.

      Each chapter features a consolidated and integrative description of best practice assessment and intervention/treatment approaches for children and youth with ASD. It brings the topics of assessment and intervention together in a single authoritative resource guide consistent with recent advances in evidence-based practice.  Illustrative case examples, glossary of terms, and helpful checklists and forms make this the definitive resource for identifying and implementing interventions for school-age children and youth with ASD.
      This Guide is intended to meet the needs of school-based professionals such as school psychologists, counselors, speech/language pathologists, occupational therapists, counselors, social workers, administrators, and both general and special education teachers. Parents, advocates, and community-based professionals will also find this guide a valuable and informative resource.
      Editorial Reviews  
      “It is rare that one book can pack so many resources and easy to digest information into a single volume!  Families, school personnel, and professionals all need the extensive, and up-to-date tips, guides, and ‘must-knows’ provided here. It’s obvious the author is both a seasoned researcher and practitioner – a winning combination.” — Dr. Debra Moore, psychologist and co-author with Dr. Temple Grandin, of The Loving Push: How Parents & Professionals Can Help Spectrum Kids Become Successful Adults

      “Dr Wilkinson has done it again. This updated and scholarly Second Edition reflects important recent changes regarding diagnosis and services for students with Autism Spectrum Disorder. With its numerous best-practice suggestions, it is a must-read for school psychologists, school social workers, and those who teach in general and special education.” — Dr Steven Landau, Professor of School Psychology in the Department of Psychology, Illinois State University
      “This book is an essential resource for every educator that works with students with ASD! The easy-to-read format is complete with up to date research on evidence-based practices for this population, sample observation and assessment worksheets and case studies that allow the reader to apply the information presented.” — Gena P. Barnhill, PhD, NCSP, BCBA-D, LBA, Director of Special Education Programs at Lynchburg College, Lynchburg, VA  

      A Best practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Ed.) is available from Jessica Kingsley PublishersAmazon.comBarnes & NobleBooks-A-MillionBook Depository, and other booksellers. The book is available in both print and eBook formats.

      Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book,  A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools and editor of the text in the APA School Psychology Book Series,  Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools. His previous book, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT, was recently honored as an “Award-Winning Finalist in the “Health: Psychology/Mental Health” category of the 2016 Best Book Awards.”

      Thursday, June 16, 2011

      Seizure Treatments for Children with Autism

      Although the association between autism and seizure disorder is not as yet firmly established, there appears to be a higher incidence of febrile seizures in children with autism compared to the general population. Although a majority of children will have only one febrile seizure in their lifetime, many children will progress to 'status epilepticus' (epilepsy). In fact, 15-20% of children with epilepsy have a history of a previous febrile seizure. Approximately 25 to 35 percent of people with autism will eventually experience full-scale seizures. Many others will have seizure-like brain activity, in which there is no obvious effect on muscles but potential effects on brain functioning, such as temporary loss of attention.

      Until recently, little has been known about which traditional treatments for epileptic seizures and commonly used non-traditional alternative treatments are most effective for treating seizures or epilepsy specifically in children and adults with autism. A study provides insight into which treatments are most beneficial in such cases. James Adams, a professor at Arizona State University conducted the research, together with Richard E. Frye, a physician specializing in child and behavioral neurology in the Department of Pediatrics at University of Texas-Houston. The complete study is published in the medical journal BMC Pediatrics.

      The researchers surveyed 733 parents whose children with autism experience seizures, epilepsy and/or seizure-like brain activity. They asked parents to rate the effectiveness of 25 traditional and 20 non-traditional medical treatments for seizures. The survey also assessed the effects and side-effects of those treatments. Overall, antiepileptic drugs were reported by parents to reduce the occurrence and severity of seizures but worsened problems with sleep, communication, behavior, attention and mood. Non-antiepileptic drugs were perceived to improve other symptoms but did not reduce occurrence of seizures or make them less severe to the same extent as the anti-epileptic drugs. Four anti-epileptic drugs: valproic acid, lamotrigine, levetiracetam and ethosuximide were reported to most often reduce the number or lessen the severity of seizures, with little positive or negative effect on other symptoms of autism. Certain traditional non-anti-epileptic drug treatments, particularly the ketogenic diet, were perceived to both lessen the number and reduce the severity of seizures and other symptoms. The results of this study should provide physicians with a guide for more effectively managing the treatment of children experiencing seizures related to autism. 

      Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers. He is also editor of a new Volume in the APA School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools.

      © Lee A. Wilkinson, PhD

      Tuesday, June 14, 2011

      Toddlers At Risk For Autism

      Researchers and practitioners advise that children identified with autism begin intensive behavioral treatment and receive educational services as early as possible in order to achieve the best possible outcomes. There is clear evidence that the early initiation of services is associated with a greater response to intervention and positive changes in language, social, or cognitive outcomes. In fact, the American Academy of Pediatrics (AAP) recommends that all children be screened for autism at 18 and 24 months of age.

      A new research study from the University of Utah suggests that a significant portion of at-risk children between 14-24 months can be identified through systematic screening by autism experts and providers working together. The study, published in Pediatrics, was designed to see whether a partnership between pediatricians and autism experts could identify at-risk children in a real-life, clinical setting. According to lead author, Judith S. Miller, Ph.D., formerly of the U Department of Psychiatry and now at the Children's Hospital of Philadelphia, "There has been limited research into how screening might occur in a real-life situation," "Our study demonstrated how collaboration between pediatricians and autism experts facilitates screening."

      Miller and her colleagues used two widely accepted questionnaires to screen 796 toddlers between 14 and 24 months of age at a large medical practice. The questionnaires included a 23-item checklist for parents called the Modified Checklist for Autism in Toddlers (M-CHAT), and the Infant Toddler Checklist (ITC), a 24-item broad-based screener of language and communication. The questionnaires were completed by caregivers (typically parents) and pediatricians for each child during all types of patient visits (well-child, follow-up, sick visits, and immunizations).

      Miller and her colleagues evaluated each questionnaire. If either the M-CHAT or ITC indicated a child had signs of ASD, the researchers then conducted a follow-up interview on the phone to verify the parent's responses. If the follow-up interview verified the potential signs of autism, the child was evaluated in person. Using both screening tests, 13 children were identified with early signs of ASD, 10 of who had not previously been evaluated for ASD.

      The study not only showed that a partnership between autism experts and providers can identify at-risk children at a much younger age, but also provided immediate help to 10 toddlers who may have otherwise been overlooked and lost critical time for intervention. "It was great to help parents see their child's strengths as well as areas of concern, and to try to help them access intervention before the signs of ASD had become severe." Miller said. "I hope it leads to a better outcome."

      J. S. Miller, T. Gabrielsen, M. Villalobos, R. Alleman, N. Wahmhoff, P. S. Carbone, B. Segura. The Each Child Study: Systematic Screening for Autism Spectrum Disorders in a Pediatric Setting. Pediatrics, 2011; DOI: 10.1542/peds.2010-0136

      Wednesday, June 1, 2011

      Meet Author and Psychologist Dr. Lee A. Wilkinson

      WHAT: Author talk and book-signing with Lee A. Wilkinson, PhD

      WHEN: Thursday, June 23, 2011, 6:30 p.m.

      Admission to Meet the Author is free and open to the public.

      WHERE: West Boynton Branch of the Palm Beach County Library System 9451 Jog Road Boynton Beach, FL 33437 (561) 734-5556

      Meet local author and school psychologist Lee A. Wilkinson June 23rd at the West Boynton Branch of the Palm Beach County Library System. Dr. Wilkinson will discuss his award winning book “A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools.” A book signing will follow. (60 min.) Preregister by calling 561-734-5556.

      Written by a practicing school psychologist with extensive experience in the field of  neurodevelopmental disorders, this authoritative, yet accessible book provides educators,  support professionals, and parents with a best practice guide to screening, assessment, and  intervention for school-age children with autism spectrum disorders.

      Autism Spectrum Quarterly calls the book “a landmark contribution destined to become a classic in the field of autism spectrum disorders” and comments, “Dr. Wilkinson has made an enormous contribution to the field by comprehensively and systematically illuminating not only what needs to be done, but also how to go about doing it.”

      The Journal of Autism and Developmental Disorders said of the book, "This book provides a complete source for parents, educators, researchers and clinicians seeking information related to assessment and interventions available for individuals (mostly children) diagnosed with Autism Spectrum Disorders (ASD). Parents will benefit from reading this book as it exposes variety of issues to consider when seeking assessment and treatment for their children."

      Wilkinson’s book was named the Winner in the Education/Academic category of the 2011 Next Generation Indie Book Awards and honored as an Award-Winning Finalist in the Education/Academic category of the "Best Books 2010 Awards” sponsored by USA Book News.

      Lee A. Wilkinson, PhD is an author, school psychologist and university educator with a practice and research interest in autism spectrum disorders (ASD). He resides in South Florida where his practice involves providing diagnostic and consultation services for children with autism spectrum disorders and their families. He is also a university educator and trainer, and teaches graduate courses in psychological assessment, clinical intervention, and developmental psychopathology. He has published widely on the topic of autism spectrum disorders.

      For more information about the book and its author go to author's website:  http://bestpractice.com

      A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools” is available from Jessica Kingsley Publishers, ISBN: 978-1-84905-811-7 and can be ordered directly from the publisher at http://www.jkp.com/ and all major booksellers, including http://www.amazon.com/ and http://www.barnesandnoble.com/.

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