Grant Will Help Families Navigate Services for Children with Autism

$145,000 Challenge Grant Will Help Families Navigate Services for Children with Autism

Grant Marks Largest Foundation Gift Ever Made to QSAC

New York, N.Y., May 23, 2013 – Quality Services for the Autism Community (QSAC) and the New York Center for Autism Charter School (NYCACS), as a sub-grantee, have received a challenge grant for $145,000 from The Heckscher Foundation for Children in support of its “Pathways for the Future” initiative. This collaboration will provide families throughout the region with access to meaningful support for navigating key transition points throughout the life of a child with autism.

The $145,000 grant from The Heckscher Foundation for Children is a matching grant in that it will need to be matched with new donations from the community over the two years. In essence, any donation over the next two years will be doubled with the support from the Heckscher Foundation.

The Pathways program is an educational initiative for parents and providers on transition periods during the life of child with autism and the various programs children are eligible for. The project will also incorporate a one-on-one component regarding support and advocacy on behalf of parents seeking services for their children with autism, so as to assist with program eligibility and linkage to services.

These workshops and conferences will be tailored so as to address key transition points in the life of a child with autism. Specifically, those transition periods are (1) diagnosis, (2) early intervention, (3) preschool, (4) school, and (5) adulthood. This resource will help to inform families about existing public and private programs that their children may qualify for as well as link them to concrete services when possible.

All of the programs offered through this initiative will be free for the family members of children and adults with autism. In the coming weeks, the date and location of AUTISM 2014 will be announced. The annual conference will be open to family members, educators, professionals, and other individuals interested in learning more about services for people with autism and their families as well as the various processes involved with obtaining eligibility for services. .

QSAC’s Executive Director, Gary Maffei said, “The timing of this grant and initiative are critical in that it will coincide with the forthcoming changes associated with the funding of services for people with developmental disabilities. This generous grant from The Heckscher Foundation for Children will ensure that we are well-prepared to assist families as they seek to obtain much-needed services and programs for their loved ones under the current system as well as the future processes.”

This grants marks the largest foundation gift ever to QSAC. If you would like to learn more about the Pathways program or if you are interested in making a donation toward the match campaign, please contact Joseph Amodeo, Director of Development, at jamodeo@qsac.com or (212) 244-5560, ext. 2016.

ABOUT QSAC

Quality Services for the Autism Community is dedicated to providing meaningful educational, residential, habilitation, and support services for children with autism and their families. Today, QSAC serves more than 5,000 people per year throughout New York City and Long Island. Visit QSAC online at www.qsac.com.

ABOUT THE HECKSCHER FOUNDATION FOR CHILDREN

The Heckscher Foundation was founded in 1921 to promote the welfare of children in New York and elsewhere throughout the United States. Today, it provides grants to youth-serving organizations in the fields of education, family services, child welfare, health, arts and recreation.

In-Home Services

“Comm Hab”, “Respite”, “Family Support”, “Parent Training”…..In-home services for families who have a child with Autism Spectrum Disorders (ASD) can go by many names. This range of services and supports often means the difference between a family staying intact or coming apart at the seams. Jimmy’s in-home worker spent months building rapport, gradually coaxed him out of his room to play, and is now able to go with him to leave the house for necessary medical appointments. Elena’s worker helps her find places to visit in the city and together they plan how they will get there. And QSAC Respite providers enable parents to attend family events, to accompany siblings to school events, or simply to relax in another part of their home, knowing their loved one with ASD is in capable and caring hands.

There is strong research supporting in-home services. Parents who receive more social supports are better able to manage their child’s challenging behavior (Michelson, et al., Clinical Child and Family Psychology Review, v16 n1 p18-34 Mar 2013; Boyd, Focus on ASD Other Developmental Disabilities, Winter 2002 vol. 17 no. 4, 208-215), have better overall interactions with their children (Koegel, Bimbela, and Schreibman, 1996, Journal of ASD and Developmental Disabilities Volume 26 (3)), and see more skill gains in their children.

There are several aspects of in-home services that are distinctive. First, the relationship between families and in-home staff can be very close. Many times in-home workers stay with a particular family for many years, building a warm and caring relationship. In-home workers often have more interactions and more personal interactions with family members than might be possible in other education and social service settings. This presents advantages for both staff members and families. An easy and close relationship allows in-home staff members to see the daily impact of their work, and how their effort helps the family they’re working with. Families have a comfortable connection to someone who can provide the information and help that meets their individual needs.

Another unique aspect of providing services in family homes is that the focus is on the exact skills that the child or adult will use at home and in the community. In-home staff members have the opportunity to work on skills that have a direct impact on the day-to-day life of an adult or child with ASD and his or her family. In-home supports also use the instructions that the child or adult will hear every day. For families and consumers, this focus leads to greater independence at home and in the community and access to a wider range of family and community activities. Instruction in homes and communities also provides opportunities for children and adults with ASD to generalize skills that were learned in school or at Day Hab.

Finally, teaching at home or in the community allows both families and staff members to use the natural supports available to the child or adult with ASD. Siblings, parents, other family members, neighbors, store owners, and others in the community can be peer models, social interaction partners, and natural reinforcers for new skills. This provides tremendous benefit to the family and consumer who gain support for new skills and gain skills that they can use right away. Using natural supports benefits the in-home workers as well. Using the other people in a child or adult’s life can make a teaching interaction rich and fun.

In home services, whether they are Respite, Community Habilitation, or another form of family and parent support, provide essential benefits for families and expand consumer skills. Working in homes and communities can create close staff-family relationships, lets staff work on functional skills, and makes use of the wide range of natural supports available to children, adults, and families. In-home services are an integral and important part of many consumers’ overall supports.

By Susan G. Izeman, Phd, BCBA-D

Sue Izeman is QSAC's Director of Family Services. This department provides in-home Respite and Community Habilitation services throughout New York City and Nassau County.

Sexuality education for students with autism spectrum disorders

Individuals with autism spectrum disorders (ASD) demonstrate the same needs for relationships as most of us do. Unfortunately, a deficit in social skills can make relationship building a challenge for the individual with ASD. Social skills training does not often target the skills required for adult relationships. These topics may get placed on the back burner, and/or are not addressed at all. There exists a hidden curriculum within adult relationships, and one such topic includes sex education. Individuals with ASD experience the same bodily changes as their typically developing peers.  The topic of sex education is an uncomfortable topic for many families, but one that requires attention. Individuals with ASD usually require instruction and support in order to develop appropriate sexual behavior. We are currently faced with a lack of research concerning sex education within the ASD population.

The following is a two part blog written by Dr. Peter F. Gerhardt, Ph. D. for the Sage Colleges Achieve Ideas.  Dr. Gerhardt discusses the definition of sexuality, its history, as well as guidelines and considerations for the instruction of sexuality. Dr. Gerhardt is a leading expert in the field of autism and issues such as sex education.

By Dr. Peter F. Gerhardt, Ph. D.

Sexuality education for students with autism spectrum disorders, Part I

Although generally difficult to talk about in an open and honest manner, sex and sexuality are central to understanding ourselves. Comprehensive sexuality instruction focuses primarily on who the individual is as a sexual being and what that may mean in his or her life. Sexuality education involves instruction beyond just basic facts and knowledge and includes issues such as personal safety, individual values, gender-role identification, physical maturation and an understanding of the complex social dimension of sexuality and sexual behavior. Therefore, sexuality education should be considered an integral element of education for learners with an autism spectrum disorder (ASD), assuming that the goal is for them to be a safe, competent and confident adults.

Definition of sexuality
Human sexuality presents us with very complex subject. As defined by the World Health Organization (2004), sexuality is:

a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behavior, practices, roles and relationships. Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, ethical, legal, historical, religious and spiritual factors. (p. 2)

Similarly complex is the process of sexual development, which has been described as a “multidimensional process intimately liked to the basic human needs of being liked and accepted, displaying and receiving affection, feeling valued and attractive and sharing thoughts and feelings” (Murphy & Elias, 2006, p. 398). What both of these definitions boils down to is that sexuality is simply part of being human. Avoidance of any discussion of sexuality and/or sexuality instruction as it pertains to learners with ASD constitutes, in effect, a tacit denial of their humanity which, I think we all agree, is unacceptable.

History
For much of our history the very concept of individuals with any disability label being viewed as sexual beings was, by and large, anathema to the thinking of the time. Up until fairly recently, the predominant method of addressing sexuality in learners with developmental disabilities was denial and suppression (Watson, Venema, Molloy & Reich, 2002). Not surprisingly, neither approach was effective. Learners with ASD are, by definition, sexual beings, and to deny them that status is to deny them appropriate access to a critical part of their life, their status as an adult and their ability to be safe from harm.

Components of sexuality education
Sexuality education actually starts very early in life (differences between boys and girls; using the boys room or girls room, etc.) and continues well into adulthood (dating, marriage and parenting). Comprehensive sexuality education consists of instruction in three distinct (yet interrelated) content areas:

1) Basic facts/accurate information
2) Individual values and
3) Social relationships.

Effective sexuality education for learners with ASD can be complicated by the language/communication problems and social deficits associated with the disorder. And while sexual feelings and interest may be high, a primary information source available to neurotypical teens, (i.e., other teens), is often not available to learners on the spectrum (Volkmar & Wiesner, 2003). This often results in a situation where information is not taught in school, not addressed by family and not provided by friends resulting in little, if any, appropriate skill development. But make no mistake: teens will encounter information about sex as part of daily life, whether it’s from the media, overhearing locker room talk, watching the physical actions of couples at school or in the community or being the subject of insensitive, sexually-oriented teasing by others.

In light of the social challenges experienced by even the brightest learner with ASD, direct training and education about sexual issues needs to be provided, commensurate with each individual’s receptive and expressive abilities. This direct social skills instruction should be two-pronged: on one hand discussing the complexities of relationship building and on the other hand more concrete discrimination training as to who can, and who cannot, help in the bathroom, with menstrual care, at the doctor’s office, etc.

References
Murphy, N.A. & Elias, E.R. (2006).  Sexuality of children and adolescents with developmental disabilities. Pediatrics, 118 (1), 398-403.

Volkmar, F.R. & Wiesner, L.A. (2003). Healthcare for children on the autism spectrum: A guide to medical, nutritional and behavioral issues. Bethesda, MD: Woodbine House.

Watson, S., Venema, T., Molloy, W. & Reich, M. (2002). Sexual rights and individuals who have a developmental disability. In D. Griffiths, D. Richards, P. Fedoroff & S. Watson (Eds.). Ethical Dilemmas: Sexuality and Developmental Disability. Kingston, NY: NADD Press.

World Health Organization (2004). What constitutes sexual health?Progress in Reproductive Health Research, 64, Accessed on line (8/15/06) at http://www.who.int/reproductive-health/hrp/progress/67.pdf

Sexuality education for students with autism spectrum disorders, Part II

In general, there are three basic goals for sexuality instruction – sharing basic facts/accurate information; developing individual values and teaching appropriate social relationship skills – and these should form the structure of any program for learners with autism spectrum disorders (ASD). Age and functioning level will affect how information is shared, but adults should use care not to restrict education because of their own preconceived notions about what these learners ‘need’ or ‘want.’ Other guidelines include:

·         Think ahead and be proactive. Waiting until something inappropriate happens is not an option. For example, training in appropriate menstrual care should start prior to onset of a young woman’s first period if it is to be most effective (and potentially, less challenging).

·         Start when children are young. Don’t make the mistake of waiting until the individual expresses interest in sex for education to begin. Teaching children about personal safety issues such as good touch/bad touch, consent and personal boundaries should start at an early age.

·         Be concrete and factual in presenting information, but also calm and supportive in all your interactions. References to the “birds and bees” as an introduction to sex or comparisons of the vulva to “petals on a flower” will, in all likelihood, be misunderstood. Much of the information is factual, based on biology. Use visuals whenever possible.

·         Break larger areas of information into smaller, more manageable blocks (task analyze). For some individuals discussing the biological underpinnings of pregnancy may be quite appropriate while for another a more simplistic explanation may be sufficient.

·         Always remember that sexual behavior is social behavior and, therefore, the social dimension of sexuality needs to be addressed when and wherever appropriate. “Hidden rules” regarding sexual behavior are pervasive. Masturbation, not often thought of as having a social component, does indeed, and it includes such social rules as 1) don’t masturbate in front of others, 2) your bedroom is the appropriate place for masturbation and 3) close the door to your bedroom if you want to masturbate, etc.

·         Keep in mind that sexuality education needs to be consistent, and the skills learned may need to be monitored to make certain they are retained. Once a young woman learns who can/cannot help her with menstrual care, the hope is that this skill is rarely practiced in real life. It may have to be revisited at different times across her life to assure maintenance of these very important skills.

Sexuality education with learners with ASD is often regarded as a “problem because it is not an issue, or is an issue because it is seen as a problem” (Koller, 2000, p. 126). In practice this means we generally ignore sexuality as it pertains to learners with ASD until it becomes a problem, at which point we generally regard it as big problem. A more appropriate and, ideally, more effective approach is to address sexuality as just another, albeit complex, instructional focus, the teaching of which allows learners to be safer, more independent and more integrated into their own communities, resulting in a more positive quality of life. As noted by Koller (2000), the question no longer can be if sexuality education should be provided, but rather how it will be offered.

References
Koller, R., (2000). Sexuality and adolescents with autism. Sexuality and Disability, 18, (125-135).

Sobsey, D. (1994). Violence and Abuse in the Lives of Persons with Disabilities: The End of Silent Acceptance? Baltimore:  Paul H. Brookes Publishing.

Posted by Rocio E. Chavez, MA, MSEd, BCBA 

Attack [Guest Blog]

by Jeff Stimpson, QSAC Parent

I’m coming from the kitchen and just trying to balance a bowl of soup when I hear Ned’s shattering “Ow!”  What’s happened now? “He bit Ned!” Jill says as I round the corner.  Jill is my wife. Ned is my 12-year-old son, typically developing. "He" is Alex, my 14-year-old son with autism.

Ned’s head is in Jill’s lap, and I see the shaking shoulders that I have seen way too often. We all see it – except Alex, who charges his little brother. He plunges toward Ned with his forearm to his teeth. Then Alex sinks his teeth down on Ned's arm. I grab Alex’s arm and waist and his neck and arms in what my brother Lee in his martial arts period used to call “a full nelson”. I have my older son who has autism in a full nelson.

“Alex stop this. Stop this or you could wind up in some place where they’re not this nice to you and you will have a problem!” Think I like saying this to my son? I manhandle Alex over by the door – what the hell else am I supposed to do? – and he collapses to the floor, screeching. He wraps his arm around my legs and bites my legs. It’s not right that Alex is biting me. “Alex, you have to calm down...” He deflates at my feet and wraps his arms around my leg and sinks his mouth toward my legs where I feel the what he’s always saved for his own forearm but on this night went into Ned and soon after into my leg.  (“Did he break the skin?” Aunt Julie will ask the next day. “No, of course not.” Of course not.)

“Jill,” I say, “I need you to stay home tomorrow. I know Jill can’t: Her boss is tough and anyway I don’t mean it. What I mean, as I’ll assure her later, is that saying it meant something to me.

I get Alex to the couch; he plunges toward Ned again. We didn’t go through the last 14 years to wind up like this. “Alex, leave your brother alone. Get a grip on yourself-” I take his chin (look at the beard he refuses to shave!) and try to turn it toward my face. This always worked when he was a little boy, when all he did was bolt from our apartment and from restaurants. “Alex, get a grip on yourself or you’re going to have to go somewhere where they won’t be so nice to you.”

I don’t know what I mean by this; it seems to make Ned cry harder in Jill's lap. This moment peters out as Alex starts asking, “What’s wrong? What’s wrong?’ He slaps his own face. "

"Alex looks like’s about to cry," says Ned. (And Alex does, adding, “Sorry. Sorry.”) “I know what to do,” Ned announces. “Just let me go to my computer.” Ned plays Minecraft on his computer. “I’m building solar panels,” Ned says. “Just let me go do that.”

Jill and I sit at the dining room table and discuss eventualities. “Let’s get through this,” I tell her. I settle Alex down in his bed. Sometimes I listen to music on my iPod or play “Angry Birds” on his iPod while he goes to sleep. Not tonight. I stare at him as he falls asleep, then I come out to the table where Jill is sitting and staring at words of her own she’s written on her computer.

The rims of her eyes are red. I tell her we’ll get through this. “That’s not what I’m crying about,” she says.

Jeff Stimpson

Jeff Stimpson lives in New York with his wife Jill and two sons. He is the author of Alex: The Fathering of a Preemie and Alex the Boy: Episodes From a Family’s Life With Autism (both available on Amazon). He maintains a blog about his family at jeffslife.tripod.com/alextheboy, and is a frequent contributor to various sites and publications on special-needs parenting, such as Autism-Asperger’s Digest, Autism Spectrum News, the Lostandtired blog, The Autism Society news blog, and An Anthology of Disability Literature (available on Amazon). He can also be found on LinkedIn and on Twitter @Jeffslife.

Procedures For Self-Stimulatory Behavior Reduction

It is known that many behavior problems in individuals with Autism and developmental disabilities are maintained by social reinforcement, positive and negative (provided by other people), however some behaviors persist in the absence of social contingencies and appear to be maintained by sensory stimulation that is directly produced by the person. Examples of such behavior include repetitive and rhythmic actions (such as rocking, flapping hands, twirling objects), certain destructive behaviors (such as tearing clothes) and some forms of self-injurious behavior, (such as hand mouthing or head banging). Usually these behavior responses are called ‘stereotypy,’ ‘self-stimulation,’ and ‘ritualistic behavior.’

Several interventions have been developed as treatment options for behavior maintained by automatic positive reinforcement.

One intervention frequently reported in the literature is sensory extinction (EXT). Sensory extinction involves elimination or attenuation of stimulation produced by a behavior, while still permitting responding to occur (for instance carpeting a table top in order to attenuate sound, effectively reduces an individual’s object twirling on the table, placing vibrators on the back of the person's hands reduces finger and arm flapping, padding devices reduces some forms of SIB). EXT procedure actually includes manipulation of the physical environment and although it has been shown to be effective it does not directly establish alternative forms of appropriate behavior.

Another procedure for behavior maintained by automatic reinforcement is differential reinforcement, which is usually implemented in either differential reinforcement of other behavior (DRO) or differential reinforcement of alternative behavior (DRA)contingencies. For example, stereotypy can be reduced by delivering praise and food contingent on the completion of intervals during which inappropriate behavior did not occur (DRO), or by having a therapist provide social reinforcement contingent on object manipulation (DRA). One possible explanation for the limited effectiveness of DRO and DRA procedures with individuals who engage in stereotypic behavior is that stimulation produced by the behavior is continuously available and other reinforcers cannot compete with that, unless they are extremely potent or if little effort is required to obtain them.

One of the most effective interventions include noncontingent reinforcement (NCR) or often called environmental enrichment. Several research showed that the use of NCR decreases variety of stereotypic behavior problems when individuals were given free (noncontingent) access to leisure items or when object manipulation was provided within an alternative activities. In some studies it has also been shown that NCR is more potent than EXT. The main advantage of NCR over both EXT and differential reinforcement is that, when reinforcement is delivered in the form of noncontingent access to leisure (manipulable) materials, behavior is suppressed in the absence of a programmed contingency. Additionally, NCR generally does not produce extinction bursts, does not require the use of potentially restrictive devices, and eliminates deprivation that may occur when an individual fails to meet criterion for reinforcement in a differential reinforcement contingency. Also, in cases when the alternative activity requires some form of object manipulation, NCR may strengthen and maintain appropriate behavior.

Overall the success of this treatment is dependent on selecting stimuli that provide sensory stimulation that matches the reinforcing qualities of the automatically maintained behavior.

Nevena Savic, MA

ASAT: The Association for Science in Autism Treatment

by Anya Kurtz Silver, QSAC Assistant Director of Adult Behavior Services

ASAT is a not-for-profit organization of parents and professionals committed to improving the education, treatment, and care of individuals with autism. Since autism spectrum disorders were first identified, there has been a long history of failed treatments and fads, imposed on vulnerable individuals as well as on their families. From the scandal of the “refrigerator mother” theory, to the ongoing parade of “miracle cures” and “magical breakthroughs,” history has been dominated by improbable theories about causation and treatments.

In March 2013, the CDC (Centers of Disease Control) reported that the prevalence of autism is 1 in 50 school age children. Unfortunately, countless families spend thousands of dollars on unproven or harmful treatments for their child with autism, wasting both valuable time and money that could otherwise be directed toward effective intervention.

ASAT's core mission is to disseminate accurate information about autism treatments, to empower families to identify and choose the most effective, scientifically-validated intervention for their children. All families should have timely access to clear, accurate and science-based information about autism and treatments. This information will help these families distinguish between the fads and “miracle cures” that have plagued autism intervention for decades, and effective science-based intervention.

ASAT also works on educating the public about effective autism treatment through proactive contact with the media. There is a media watch committee whose sole responsibility is to respond to inaccurate information or proposed treatments described by the media and to support accurate media depictions of empirically–sound interventions for individuals with autism spectrum disorders.

ASAT has achieved some notable accomplishments this year, including the development of a formal externship program, an increase in the use of social media to reach the public, and a focus on an international presence for ASAT. Please check out the ASAT website to find out more. And be sure to sign up for the newsletter!

You can also friend us on Facebook!

http://www.facebook.com/ASATonline

DECANTING AN IRREVOCABLE TRUST

by Andrew M. Cohen, Esq.

In previous articles, I have written about the importance of a Supplemental Needs Trust and, more specifically, how it enables a person with a disability to have money and assets accumulated for him/her (typically managed by a family member or friend) without affecting or jeopardizing eligibility for means based public benefits such as SSI and Medicaid.

An all too common scenario arises when a relative (typically a grandparent) – with the best of intentions to aid a family member with special needs – establishes an Irrevocable Trust which would be considered a resource for the disabled beneficiary and thus preclude that person from receiving public benefits. An Irrevocable Trust is, by its terms, typically unable to be altered, modified or changed.

In 2011, New York’s “decanting” statute was expanded and, as a result, provides a welcome relief for the scenario described. Decanting is defined as pouring or transferring from one vessel to another. This process is most commonly associated with wine, where the liquid is moved from its original bottle to another vessel, to allow it to aerate or breathe. Under New York’s decanting law, when the right facts and circumstances are presented, a Trustee of an Irrevocable Trust is permitted to take the assets from the original trust and move them to a new trust with new provisions to meet the needs of the beneficiary.

In the case scenario above, the “grandparent” trust would be invaded and the assets moved to the new or “appointed” trust which complies with New York’s Supplemental Needs Trust Law (EPTL 7-1.12). As a result of decanting the prior trust, a disabled individual who would have been barred from Medicaid and its wide range of services and programs due to financial constraints resulting from the terms of the original trust, would now qualify for the much needed benefits. Once decanting has been completed, the corpus of the new trust would be able to provide the disabled individual with goods and services not covered by the government – such as clothing, furniture, electronics, etc. – to further enhance the quality of his/her life while remaining eligible for public benefits.

Under the decanting law, certain procedural safeguards (notice provisions) must be met. Further, a Trustee who seeks to use this recently created power must be cautious of some unanticipated tax ramifications of modifying the original trust.


The New York decanting statute has become a model law for several states and provides a broad and flexible platform to remedy a circumstance that could otherwise have a significant and detrimental effect on a disabled individual.

Andrew M. Cohen, Esq. is the principal of the Law Offices of Andrew M. Cohen. The firm concentrates in the areas of Trusts & Estates, Guardianships, Elder Law and Estate Planning, with an emphasis on planning for special needs families and disabled persons. Mr. Cohen has a Juris Doctorate and an L.L.M. in Taxation. The firm’s offices are located in Garden City and mid-town Manhattan and can be reached at (516)-877-0595 or www.amcohenlaw.com. 

1 in 50 Children has Autism

In March 2013, the Centers for Disease Control and Prevention (CDC) announced that autism diagnosis rates were now one in fifty school-aged children based on a new study conducted by the CDC. The CDC’s full report is available online at http://go.qsac.com/cdc2013.

Commenting on the new statistics, Gary Maffei, QSAC’s Executive Director said, “These statistics demonstrate the importance of providing person-centered services for children and adults with autism. QSAC remains steadfast in its commitment to ensuring that all children have access to meaningful programs and services.”

Antecedent-Based Intervention to Reduce Challenging Behaviors

Behavioral intervention specialists have been using functional behavior assessment (FBA) to identify the consequences that maintaining challenging behaviors and modify them to encourage appropriate behaviors (“consequence-based intervention.”)  The role of the consequences to increase appropriate behaviors and decrease maladaptive behaviors has been widely demonstrated in the literature (Iwata, et.al, 1994; Paclawskyj, et.al 2000).

New attention is being focused also on the influence of antecedent variables (“antecedent-based intervention”) on severe problematic behaviors (e.g. self-injurious behaviors, physical aggression, property destruction, and elopement) (Lennox, et, al, 1988).  According to Iwata (1997), the antecedent variables may include processes as discrimination, deprivation and satiation, emotional state, and aversive stimulation. “Antecedent-based interventions,” in contrast to “consequence-based intervention,” use a series of techniques, which are implemented before the occurrence of challenging behaviors to reduce the probability of these behaviors. (Luiselli, 2006). These interventions have been associated with reductions in presentation of challenging behaviors and they have become a foundation of the positive behavior support approach (Carr et al., 2002).

Machalicek and colleague (2007) reviewed 10 research studies using “antecedent-based interventions” and each of these studies reported positive results. By using antecedent intervention strategies prior the exhibition of the challenging behaviors, we can influence the challenging behavior and prevent its occurrence.

The following are antecedent interventions techniques that can be used to control or prevent challenging behaviors:

1.       Providing choices: Providing choices allows the individual with autism spectrum disorder to feel empowered and in control of their environment and gives the sense of self-determination. 

2.       Changing the physical environment: This intervention stems from the understanding that extreme temperature, loud noise, rigid schedules, lack of privacy, hunger, limited accessibility, positioning, boredom, may influence challenging behaviors.   

3.       Modifying activities/routines

4.       Non-contingent reinforcement (NCR). There is a notion that individuals act out behaviors to attain a reinforcing factor. Take for example of an individual who is constantly engaging in challenging behavior for attention. Through this technique, we can “flip” the situation by giving the individual attention throughout the day at scheduled intervals. 

5.       Scheduling: Many individuals with autism spectrum disorder become anxious when they do not know what to expect. Implementing a predictable daily schedule often, helps calm the individual. There are several forms of activity schedules, the most famous consisting of line drawings or photographs with Velcro on the back.

6.       Functional Communication Training (FCT).  Many individuals with autism spectrum disorder (ASD) are easily frustrated because they cannot communicate their needs and feelings appropriately.  Language deficits are common within the ASD population as the development of language and communication may be slow to mature, idiosyncratic, or odd. Using augmentative or assistive technology, Picture Exchange Communication System (PECS), teaching relaxation, alternative replacement behaviors may influence the behavioral presentation (O’Reilly, et. al 2012).

1.       Antecedent Exercise: Some research studies have demonstrated the efficacy of antecedent exercise for reducing severe challenging behaviors such as stereotypical behaviors, self-injurious behaviors and aggression ((Bachman & Sluyter, 1988; Bachman & Fuqua, 1983; Baumeister & MacLean, 1984; McGimsey & Favell, 1988).

2.       Social Stories: A social story is a short simple story written from the perspective of the individual that provides instruction on positive, appropriate social behaviors (Gray & Garand, 1993). According to Kern (2010), social stories are more effective when addressing inappropriate behaviors than when teaching social skills.

3.       Video Modeling: Video modeling is an antecedent-based intervention in which a behavior intervention specialist shows a video of desired behaviors or interactions to an individual or small group of individuals. Video modeling and video self-modeling are both effective means of providing a visual representation of a desired behavior or skill (Sherer et al., 2001).

4.       Self-management: It refers to actions purposefully taken by individuals to change or maintain their behavior (Shapiro & Cole, 1994). It represents some skills or behaviors that individuals can engage in to become more self-contained. Self-management has proved effective in development alternative replacement behaviors (Peacock, et.al 2010).

The Importance of Parental Support Groups for Parents of Children with Autism

Raising any child is a daunting task, even as enjoyable of an experience as parenting can be. Receiving a diagnosis of an autism spectrum disorder often elicits strong emotional reactions from parents of the diagnosed child, but caring for an autistic child can be more than overwhelming. Having a child with autism affects the entire family and puts a strain on both marriages and siblings. Many parents report feeling guilty, as if there was something they could have done differently, or wishing they had more time to spend with their spouses or other children. Parents are often very overwhelmed, with so much to do and process, it is hard to know where to start. Follow-up services and continued support for these families is a necessary component to help families adapt and meet their children’s needs. 

There is no reason to carry the burden alone. There are many resources available that can help parents cope with the difficulties of raising a child with autism. Group support can offer parents the knowledge, understanding, and acceptance they seek. In the immediate aftermath of receiving a diagnosis, the encouragement and assistance gained through the mutual aid process of a support group can be invaluable in helping parents to get through this challenging time. Research indicates that having access to a support network and receiving support related to their child had the greatest benefit for parents of children with autism (Guralnick et al., 2008).

QSAC offers several support groups for parents and siblings of children with autism. The support groups offer both a support component and a training component so that family members are given both the emotional support and practical tools they need to feel empowered and take specific actions.

Workshops are free for parents and $15.00 for professionals. Please click here for schedules and more information.