Saturday, December 12, 2009

NEWS: CNN reports on ABA-autism best-outcome story

CNN's Kiran Chetry reported on the American Morning program earlier this week of an autism treatment success story due to an early intensive applied behavior analysis, aka "ABA" or "EIBI", therapy program...and a video accompanying the story tells a million words.

Jake Exkorn was diagnosed with autism at 2, and after two years of an intensive ABA/EIBI program was able to have diagnosis removed. Now at the age of 13, Jake is a typical teen. Significantly, his parents chose applied behavior analysis/ABA because it was the scientifically evidenced treatment, and the treatment recommended to them. to start as soon as possible and as intensively as they could afford, by an expert in the field of autism and autism treatment.

Video 5:46 (there may be a brief commercial intro):





From the story,
“...He hit all of the developmental milestones. He walked, he talked, he played,” says Jake’s mother Karen Exkorn. But at 17 months, Karen says the light began to fade from Jake's face..'I knew that I wanted treatment for Jake that had science behind it. And a lot of treatments don't. But the one that had the most science behind it was a treatment called ABA.'...Day after day, 40 hours a week, they plugged away – hoping to help Jake relearn what autism had taken away.
'Going into this there were no guarantees. Nobody ever mentioned the word recovery to us so that wasn't our goal ever.'...After a year of ABA therapy, Jake showed progress. Then, at age four – a turning point. When Karen took him for ice cream, without prompting, Jake told the man what flavor he wanted: 'Nilla.'
'The man had no idea that this was this defining moment in my life, but this was huge. This was huge. And this marked the beginning of spontaneous language for Jake.'
What soon followed was an even bigger milestone. At Jake's 4 year check-up, Karen was told her son no longer had symptoms of autism. The doctor said Jake had recovered...."
FULL ARTICLE

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Note: Some legitimate points are raised in the reader comments at CNN that not all children may have the outcome in this story; at this time there are no interventions guaranteeing recovery or best outcome (as Jake's mother herself notes in the story), however behavior analytic interventions are currently the most scientifically evidenced and have an established track record as a treatment of choice for children with autism. Other comments were about lack of availability through public programs or insurance reimbursement, and even when available through private pay, of the inability to afford or finance an ABA therapy program of the intensity that Jake's family was able to apply. On an encouraging note, many commenters also shared that they know, have a family member, or have a child themselves who was able to have removal of diagnosis, development of typical skills and function, or significant improvement in ability and quality of life by application of an intensive ABA/EIBI therapy program.

ANNOUNCE: Early Registration for 2010 ABA International Autism Conference Ends Soon!


The Association for Behavior Analysis International (ABAI) has sent out a reminder of the December 18, 2009 early registration deadline for the two-day single-track event,

Translational Science and Effective Practice
Friday, January 22 – Sunday, January 24, 2010
Location: Hyatt Regency Chicago


( To obtain the special group rate for accommodations at the time of reservation, attendees must mention that they are with the Association for Behavior Analysis International. Cut off date for the group rate is December 30, 2009, although it is recommended that reservations be made as soon as possible).

BACB & APA CE credit is available for the presentations

An abbreviated description of the Autism Conference is below.

Friday January 22, 2010
Evening
  • Opening Reception, 
  • Poster Session 1
  • Exhibitors, Bookstore, and 
  • Author Signing Fair (8:00 p.m. – 9:00 p.m.)
Saturday January 23, 2010
Opening Remarks
Morning session
Chair: Gregory P. Hanley, Ph.D., BCBA (Western New England College)
Afternoon session
Chair: William L. Heward, Ed.D., BCBA (The Ohio State University)
Evening
Sunday January 24, 2010
Morning session
Chair: Travis Thompson, Ph.D. (University of Minnesota)
For questions or assistance, please contact  convention@abainternational.org.

Association for Behavior Analysis International
550 West Centre Ave, Suite 1
Portage, MI 49024
Phone: 269-492-9310
Fax: 269-492-9316
http://www.abainternational.org

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Website: Practitioner Issues in Behavior Analysis SIG
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Views and news expressed in this blog or by the PIBA SIG are those of the SIG and SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

Friday, December 11, 2009

NEWS: Behavioral Training Improves Connectivity and Function in the Brain

 Sat. 12/12/09 - added NPR All Things Considered radio interview of Marcel Just, where he discusses the importance of the intensity of the repeated reading practice applied to the children in the study experimental group, as well as the significance of white matter of the brain in synchronizing signals between different areas of the brain. The quality of the improvement of white matter correlated with the improvement in reading ability in the experimental group, and that reading programs of typical intensity did not effect these improvements. The program also touches on other skills and psychiatric disorders, including autism, that are influenced by the quality of white matter found in the brain.



A newly published study in Neuron shows that neuronal myelination and connectivity, as detected by diffusion tensor imaging (DTI). is enhanced by intensive behavioral training.





Children with poor reading skills who underwent an intensive, six-month/100 hour training program to improve their reading ability showed increased connectivity in a particular brain region, in addition to making significant gains in reading, according to a study funded in part by the National Institute of Mental Health (NIMH). The study was published in the Dec. 10, 2009, issue of Neuron.


While the relationship between training, performance and brain function has been well known, the significance is that the diffusion tensor imaging (DTI) neuroimaging was able to show specific changes within the brain of improvements towards typical structures and suggest what those improvements consist of,

"We have known that behavioral training can enhance brain function." said NIMH Director Thomas R. Insel, M.D. "The exciting breakthrough here is detecting changes in brain connectivity with behavioral treatment. This finding with reading deficits suggests an exciting new approach to be tested in the treatment of mental disorders, which increasingly appear to be due to problems in specific brain circuits.

One of the study authors, Carnegie-Mellon researcher Marcel Just, reiterated Director Insel's point,
"Our findings support not only the positive effects of remediation and rehabilitation for reading disabilities, but may also lead to improved treatments for a range of developmental conditions related to brain connectivity, such as autism," noted  Just."

The article is, Keller, T.A.& Just, M.A. Altering cortical connectivity: Remediation-induced changes in the white matter of poor readers. Neuron, 64(5), 624-631.
doi:10.1016/j.neuron.2009.10.018

Summary/Abstract
Neuroimaging studies using diffusion tensor imaging (DTI) have revealed regions of cerebral white matter with decreased microstructural organization (lower fractional anisotropy or FA) among poor readers. We examined whether 100 hr of intensive remedial instruction affected the white matter of 8- to 10-year-old poor readers. Prior to instruction, poor readers had significantly lower FA than good readers in a region of the left anterior centrum semiovale. The instruction resulted in a change in white matter (significantly increased FA), and in the very same region. The FA increase was correlated with a decrease in radial diffusivity (but not with a change in axial diffusivity), suggesting that myelination had increased. Furthermore, the FA increase was correlated with improvement in phonological decoding ability, clarifying the cognitive locus of the effect. The results demonstrate the capability of a behavioral intervention to bring about a positive change in cortico-cortical white matter tracts.
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References:
Image source: Timothy Keller, Ph.D.; Marcel Just, Ph.D.

National Institute of Mental Health (NIMH)
Press Release
December 09, 2009
Behavioral Training Improves Connectivity and Function in the Brain

Keller, T.A.& Just, M.A. Altering cortical connectivity: Remediation-induced changes in the white matter of poor readers. Neuron, 64(5), 624-631.
doi:10.1016/j.neuron.2009.10.018

Excellent media article on the study with background info on brain white matter research and its significance in other skills, IQ, and psychiatric disorders, as well as recent research demonstrating levels of brain plasticity thought improbable in the relatively recent past.
Learning, adaptation can change brain connections, CMU researchers say
Thursday, December 10, 2009
By Mark Roth, Pittsburgh Post-Gazette

March/April 2006
MIT Technology Review
Diffusion Tensor Imaging

Diffusion Tensor Imaging (.pdf)
www.usa.siemens.com/medical
MRI Hot Topics
Keith Heberlein, PhD, John Grinstead, PhD, Heiko Meyer PhD,
Christopher Boyea, MBA, RT(R)(MR), Milind Dhamankar, MD,
Siemens Medical Solutions, USA

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Website: Practitioner Issues in Behavior Analysis SIG
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Views and news expressed in this blog or by the PIBA SIG are those of the SIG and SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

Wednesday, December 9, 2009

NEWS: Ohio House Passes Autism Insurance Reform Legislation

**1/24/10- Update: According to the Ohio Legislative Service Commission, the status of HB 8 is that it is currently in the Senate Committee on Insurance, Commerce & Labor**
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The Ohio House of Representatives on Tuesday December 8, 2010 passed an amended House Bill 8

Representatives Ted Celeste (D-24), Nancy Garland (D-20) + 42 co-sponsors introduced 02/17/09
As Passed by the House, 128th General Assembly, Regular Session, 2009-2010
   
Am. Sub. H. B. No. 8"
"A BILL
    To amend section 1739.05 and to enact sections 1751.68 and 3923.84 of the Revised Code to prohibit health insurers from excluding coverage for specified services for individuals diagnosed with an autism spectrum disorder..."
Applied behavior analysis is included in HB 8; some clauses of interest regarding delivery and provider of services,

     "(a) The person is licensed, certified, or registered by an appropriate agency of this state to perform the services assigned to the person in the treatment plan.
    (b) The person is directly supervised by an individual who is licensed, certified, or registered by an appropriate agency of this state to perform the services assigned to the person in the treatment plan. "

About who determines medical necessity
"(B) Coverage provided under this section shall be delineated in a treatment plan developed by the attending psychologist or physician and shall not be subject to any limits on the number or duration of visits an individual may make to any autism services provider, except as delineated in the treatment plan, if the services are medically necessary."

Some online comments are that last-minute amendments added to the bill set a $36,000/year cap on coverage, review of treatment plan by the insurer every 6 months, and a mandate that treatment be provided, or overseen by, a licensed, certified or registered provider, and delayed the implementation date to January 2011. There are limits on the type of plan to which H.B.8 would apply, and insurers would be allowed to opt out if the mandate increases insurer costs or premiums by more than 1%. To date, other states with similar coverage have reported cost increases of 0.8% or less.


H.B. 8 now goes to the Ohio Senate for consideration.

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Other stories and references:

Ohio General Assembly

Ohio Legislative Service Commission


House OKs bills on autism, diabetes
Wednesday,  December 9, 2009 3:02 AM
Jim Siegel
THE COLUMBUS DISPATCH


Notice of passage of HB 8 at Autism Votes 
with additional information on past insurance legislation activity in Ohio

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Website: Practitioner Issues in Behavior Analysis SIG
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Views and news expressed in this blog or by the PIBA SIG are those of the SIG and SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

NEWS: Easter Seals North Texas merges with DFW Center for Autism

This merger has been announced in the press today,

Fort Worth (TX) Business Press
Easter Seals North Texas merges with autism center
BY BETTY DILLARD
December 09, 2009


Some of the article highlighted below; see the full article for full text or the announcement at Easter Seals North Texas,
"The DFW Center for Autism  in Grapevine has merged with Easter Seals North Texas and adopted a new name, Easter Seals North Texas Center for Autism...there will be no disruption in treatment or care...

The Grapevine center was founded in 2003 and serves families and children with its Texas Star Academy full-inclusion preschool and through research, training and behavior programs. Easter Seals North Texas, a leading provider of services for people with autism, serves families in 34 North Texas counties overcoming challenges caused by disabilities.
'The center’s programs will remain fully intact and function just as we have in the past providing high-quality treatment and inclusive, intensive intervention using Applied Behavior Analysis,' ...
The center said it will continue to offer and expand its research and collaboration with the Department of Behavior Analysis at the University of North Texas , support and training for public and private educational treatment entities and outreach services designed to support and educate families and children."
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Website: Practitioner Issues in Behavior Analysis SIG
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Views and news expressed in this blog or by the PIBA SIG are those of the SIG and SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

NEWS: H.R. 4247 - The Preventing Harmful Restraint and Seclusion in Schools Act

 **Updated 12/25/09 to add video from the 112/9/09 press conference**

Earlier today during a press conference, U.S. House Representatives George Miller D- 7th district, CA,  and Cathy McMorris Rodgers, R-5th district,WA, unveiled,

The Preventing Harmful Restraint and Seclusion in Schools Act 
H.R. 4247: To prevent and reduce the use of physical restraint and seclusion in schools, and for other purposes



Representative George Miller (CA), Chair of the House Committee on Education and Labor, and co-sponsor of H.R. 4247 - Preventing Harmful Restraint and Seclusion in the Schools Act


This bill would establish the first federal standards to protect students from misuse of restraint and seclusion and ensure the safety of everyone in the classroom. It would apply to public schools, private schools and preschools receiving federal education support.

Specifically H.R. 4247 would:
  • Establish important minimum federal safety standards in schools, similar to the protections already in place in hospitals and other non-medical community based facilities
  • Limit physical restraint and locked seclusion, allowing these interventions only when there is imminent danger of injury, and only when imposed by trained staff;
  • Outlaw mechanical restraints, such as strapping kids to chairs, and prohibit restraints that restrict breathing;
  • Require schools to notify parents after incidents when restraint or seclusion was used;
  • Call on states, within two years of enactment, to establish their own policies, procedures, monitoring and enforcement systems to meet these minimum standards;
  • Encourage states to provide support and training to better protect students and prevent the need for emergency behavioral interventions; and 
  • Increase transparency, oversight and enforcement tools to prevent future abuse.
The Education and Labor Committee plans to mark up the bill early next year.

Excellent Fact Sheets and descriptions are provided at the U.S. House Committee on Education and Labor's website on provisions in The Preventing Harmful Restraint and Seclusion in Schools Act (H.R. 4247) including,

FACT SHEET: Preventing Harmful Restraint and Seclusion in the Schools Act
on December 9, 2009 11:30 AM  Kittredge, Betsy Miller
Protecting All Children in School
also,

Definitions of Terms Used in the Preventing Harmful Restraint and Seclusion in the Schools Act




Curt Decker Executive Director of the National Disabilities Network





Mike Resnick Associate Executive Director of the National School Board Association





Nicole Danhof-Holden and Alan Holden, parents Muskegon, MI


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Other references and past blog posts

Autism Speaks endorses H.R. 4247

TODAY: Bipartisan Lawmakers to Introduce Legislation to Protect All Children in Schools from Abuse
December 9, 2009 9:08 AM
House Committee on Education and Labor blog

Preventing Harmful Restraint and Seclusion in the Schools Act
December 9, 2009 11:30 AM
House Committee on Education and Labor blog

NEWS: December 9 Introduction of Federal Bill on School Restraint and Seclusion
Tuesday, December 8, 2009
Practitioner Issues in Behavior Analysis SIG blog

Lawmakers Unveil Restraint And Seclusion Bill To End ‘Nightmare Of Abuse’
Michelle Diament
Disability Scoop, December 9, 2009

Bill aims to protect students from abuse in schools
Patricia E. Bauer, December 9th, 2009

Lawmakers Seek Halt To Abuses Of Disabled Kids In School
National Public Radio Health Blog, December 9, 2009


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Website: Practitioner Issues in Behavior Analysis SIG
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Views and news expressed in this blog or by the PIBA SIG are those of the SIG and SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

Tuesday, December 8, 2009

NEWS: December 9 Introduction of Federal Bill on School Restraint and Seclusion

 [Edited 12/8/09, 11PM - to add additional useful references - see below**]


On Wednesday December 9, 2010, U.S. House Representatives George Miller D- 7th district, CA,  and Cathy McMorris Rodgers, R-5th district,WA are expected to introduce bipartisan legislation in the U.S. House to address a serious national problem of abusive restraint and seclusion within U.S. schools. A press conference is scheduled for 11:00am EST on December 9 which will be webcast from the website of the House Committee on Education and Labor. Senator Chris Dodd, D-CT is anticipated to shortly introduce similar legislation in the U.S. Senate.

The impetus for the bill's creation was a GAO report issued on May 19, 2009 and testimony before the House Committee on Education and Labor which documented cases of inappropriately applied restraint and seclusion resulting in trauma, injury and in some cases, death. The report and testimony illuminated a disturbing situation and evoked strong reactions by the legislators and administration representatives.


The Obama Administrations Education Agenda: Sec. Duncan on Seclusion & Restraint
Education Secretary Arne Duncan responds to the May 19 hearings

Some practices went beyond misapplication to the point of abuse; where procedures meant to be applied in strictly defined situations or as emergency procedures were used routinely and for the purposes of punishment. Issues raised during the May 19 hearings were lack of accountability, training of those applying these procedures, and that there are available underused alternatives such as Positive Behavioral Interventions and Supports.


Examining the Abusive and Deadly Use of Seclusion and Restraint in Schools: Rep. Andrews - Q&A
Comments of Representative Rob Andrews, District 1, NJ May 19, 2009 during the House Committee on Education and Labor hearing

Currently there are no Federal policies for these practices in schools - in contrast to hospitals, group homes and residential treatment facilities. States' policies are inconsistent, with only 7 states at the time of the hearing requiring training in use of restraint, and 19 states having no defined standards in the use of restraint and seclusion.


Dodd Discusses New Report on Use of Seclusion and Restraint in Schools
Senator Chris Dodd comments on report, "School is Not Supposed to Hurt: Investigative Report on Abusive
Restraint and Seclusion in Schools". National Disability Rights Network, January 2009
Jan 14, 2009
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References and past blog posts:

Congress To Address Abusive Restraint And Seclusion In Schools
By Michelle Diament
Disability Scoop
December 7, 2009, updated December 8, 2009

Announcement: FEDERAL LEGISLATION TO BE INTRODUCED!!!!!!!!!
The Coalition for Positive Behavioral Interventions and Supports
December 7, 2009
[Note: A press release is posted at this site]

**Position Statement of the Association of Professional Behavior Analysts (APBA)
The Use of Restraint and Seclusion as Interventions for Dangerous and Destructive Behaviors
Adopted November 7, 2009

NEWSFLASH: GAO Report and House Committee hearing on Seclusion and Restraint in Public and Private Schools
Practitioner Issues in Behavior Analysis SIG blog
May 19, 2009
[links to the GAO report, report on the testimony, and other media stories and reports on improper use of restraint and seclusion in schools]

**Use of Restraint and Seclusion in Schools Decried
Bazelon Center for Mental Health Law Reporter
5/27/09

**Report Points Way to School Success for Children with Mental Health Needs
Documents Integration of School-Wide Positive Behavior Support with Mental Health
Bazelon Center for Mental health Law
"...June 7, 2006— “Way to Go—praise for a child and a roadmap for policymakers”..."

**Restraint Rules for Children's Psychiatric Residential Treatment Centers
Bazelon Center for Mental health Law

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Website: Practitioner Issues in Behavior Analysis SIG
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Views and news expressed in this blog or by the PIBA SIG are those of the SIG and SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

Monday, December 7, 2009

ANNOUNCE: Dec. 11, Interagency Autism Coordinating Committee full committee meeting

Announcement below from the Interagency Autism Coordinating Committee (IACC) on the next full committee meeting, December 11, 2009, 9AM-1PM EST. The meeting will be phone & webinar only. Please see the details for registration and accommodations in the forwarded message. 

Background: The IACC coordinates all efforts within the Department of Health and Human Services (HHS) concerning autism spectrum disorder (ASD). Through its inclusion of both Federal and public members, the IACC helps to ensure that a wide range of ideas and perspectives are represented and discussed in a public forum.
The IACC mission is to:
  • Provide advice to the Secretary of Health and Human Services regarding Federal activities related to autism spectrum disorder.
  • Facilitate the exchange of information on and coordination of ASD activities among the member agencies and organizations.
  • Increase public understanding of the member agencies' activities, programs, policies, and research by providing a public forum for discussions related to ASD research and services.
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MEETING ANNOUNCEMENT
The Interagency Autism Coordinating Committee (IACC) will be holding a Full Committee Meeting on Friday, December 11, 2009 from 9:00 AM – 1:00 PM ET.  The meeting will be conducted via telephone conference call and webinar only.
 
The purpose of the IACC meeting is to continue discussing recommendations for the annual update of the IACC Strategic Plan for Autism Spectrum Disorders Research.
 
The meeting will be conducted and available to the public via a telephone conference call phone number and a webinar conducted using a web presentation tool on the Internet.  Registration is not required.  Members of the public who participate using the conference call phone number will be able to listen to the meeting, but will not be heard. 
 
To access the conference call:
USA/Canada Phone Number: 888-455-2920
Access code: 9984461

 
To view the webinar:
 
Individuals who participate using this service and who need special assistance, such as captioning of the conference call or other reasonable accommodations, should submit a request to the contact person listed above at least seven days prior to the meeting.  If you experience any technical problems with the web presentation tool or conference call, please-mail IACCTechSupport@acclaroresearch.com.
 
The latest information about the meeting can be found at: http://www.iacc.hhs.gov/events/2009/full-committee-mtg-announcement-December11.shtml
 
 
The IACC also can now be found on Twitter (www.twitter.com/IACC_Autism).
 
Please note: This phone call may end before or after 1:00 PM ET, depending on the needs of the Committee.
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Practitioner Issues in Behavior Analysis SIG
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Views and news expressed in this blog or by the PIBA SIG are those of the SIG or individual SIG member authors and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website,