One in 68 Children has Autism

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Applied Behavior Analysis (ABA) Integrated With Psychotropic Medications

September 21, 2009 1:20 am Published by

Treatment plans for autistic individuals are uniquely tailored with the person in mind and under the premise that every autistic person is impacted differently and may benefit from individualized treatments or interventions. Nevertheless, there exists a growing consensus that among the various treatments for autism, Applied Behavior Analysis (ABA) integrated with psychotropic medications is more effective at targeting physical aggression, self-injurious behaviors and property destruction in autistic individuals, especially for those individuals with dual diagnosis such as Autism and Bipolar Disorder, Not Otherwise Specified or Impulse Control Disorder, NOS.

Applied Behavior Analysis ( ABA) – which encompasses behavioral intervention – can produce comprehensive and lasting improvements in many skill areas for most people with autism. There have been no other treatments besides ABA that have shown sufficient evidence of effectiveness, especially if the treatment begins early in infancy. (Baer et al., 1968; Lovass & Smith, 1989; Schreibman, 1988; Schreibam, Charlop, & Milstein, 1993; Smith, 1993).

Applied behavior analysis ( ABA) is a systematic process of studying and modifying observable behavior through a manipulation of the environment. ABA methods are usedto increase and maintain desirable adaptive behaviors, reducemaladaptive behaviors or teach new skills, and generalize behaviors to new environments or situations. (Baer et al., 1987; 1968).

Functional Behavioral Analysis, which falls under the purview of Applied Behavior Analysis, is useful in identifying antecedents and consequences that are associatedwith increased frequency of behaviors. One of the most widely used descriptive analysis is the A-B-C procedure (Antecedent-Behavior-Consequence) (Bijou, et al., 1968). The underlying hypothesis of this procedure is that, over time, a careful recording of the “ABCs” of a target behavior will permit the identification of a specific antecedent and/or subsequent (function or cause of behaviors) to the target behavior that predict high and low frequency of the behavior.

Determining the source of control of a behavior (cause) is critical to determine the appropriate intervention. One of the challenges of behavior analysts is to identify the function or cause of a maladaptive behavior (e.g. self-injurious behavior, physical aggression outburst or property destruction) and to control a complex environmental context or contingency relationships due to the fact that some maladaptive behaviors may have been controlled by multiple variables (Smith, Iwata, Vollmer, & Zarcone, 1993).

It is extensively investigated that Applied Behavior Analysis or interventions based on the function (cause) of a behavior have proven to be very effective in changing and controlling challenging behaviors in autistic individuals. However, the problem becomes more complex when the challenging behaviors are multi-factorial and determined by learned behaviors and /or brain physiology or chemistry dysfunction. In these cases, Applied Behavior Analysis integrated with psychotropic medications has proven beneficial for many autistic individuals.

Maladaptive behaviors may be maintained by any number of variables such as a medical condition, idiosyncratic condition or lack of verbal communication in non-verbal individuals and / or neurological or psychiatric disorders. If the function is deemed, by the person’s interaction with the environment, such as to escape from or avoid a noisy room or attention-seeking, it would be understandable to develop an intervention accordingly. However, if an autistic individual engages in self-injurious behavior as a result of a sinus infection, dental problem, pain or a bodily discomfort, using a behavioral intervention or psychotropic medications intervention to address the problematic behavior, would be ineffective and unethical.

In a research that took a sample of Medicaid enrolled individuals with autism, 56% used at least 1 psychotropic medication, 20% of whom were prescribed 3 medications concurrently.Neuroleptic medications were the most common psychotropicclass (31%), followed by antidepressants (25%) and stimulants(22%) (Mandell, et al. 2008); 11.5% anti-epileptic drugs and 12.5% antihypertensive drugs (e.g. alpha or beta blockers) (Aman, et al. 2004).

In summary, Applied Behavior Analysis and psychotropic medications (e.g. Risperdal, Haldol) are empirically validated treatments for reducing problem behaviors in individuals with autism. Additionally, ABA research methods could be used to study drug effects (Behavioral-Pharmacology) (Weeden, 2009; Durand, 2005, Mace, et al., 2001). However, it is imperative to have in consideration several aspects before determining that a combined treatment is warranted: 1) a rigorous functional behavioral analysis; 2) consistency in the implementation of the behavioral intervention is needed. 3) a carefully selection of the psychotropic medication and dosage to target specific symptoms and / or comorbid conditions (e.g. some autistic individuals may develop drug or dose intolerance, or they may have a pre existing condition such as Fragile X, Epilepsy or Tuberous Sclerosis) and 4) the development of a comprehensive treatment plan (Efron et al., 2003). These dimensions are very important to guarantee the effectiveness of an integrated treatment plan.

BGC Partners Names QSAC Beneficiary of 9/11 Charity Day Event

September 3, 2009 2:31 pm Published by
BGC Partners Inc., a major inter-dealer broker named for B. Gerald Cantor, the founder of Cantor Fitzgerald, has selected QSAC as one of a dozen New York-based nonprofit organizations to benefit from its annual Charity Day on September 11, 2009. Since the first Charity Day in 2004, BGC has raised over $20 million, contributing their entire trading commissions for that day to more than one hundred charitable organizations throughout the world.

Mark Webster, Executive Managing Director and General Manager for the Americas at BGC commented: “We are thrilled to have QSAC back for BGC’s fifth annual Charity Day. By raising the profile of autism and providing comprehensive support and services to autistic children and their families, QSAC is encouraging and making a vast difference in the lives of many.”

On Charity Day, celebrities representing the charities help raise funds by assisting professional brokers with trades of financial products to BGC’s institutional clients. This year, Didi Conn, actress and comedienne, Peter X. Kelly, extraordinary chef and winner of the Iron Chef, and Mets’ Ed Kranepool, 1965 All Stars and 1969 World Champion, will serve as QSAC’s ambassadors.

According to Gary A. Maffei, Executive Director of QSAC, “to be a beneficiary of Charity Day is a tremendous opportunity for us to generate funds which could not have come at a better time given the state of today’s economy. We are grateful to BGC – being selected for the second consecutive year is both an honor and a vote of confidence for the work that QSAC does.

ABOUT US

QSAC is a New York City and Long Island based nonprofit that supports children and adults with autism, together with their families, in achieving greater independence, realizing their future potential, and contributing to their communities in a meaningful way by offering person-centered services.

QSAC pursues this mission through direct services that provide a supportive and individualized setting for children and adults with autism to improve their communication, socialization, academic, and functional skills.