The Nashville walk has already raised over $76,000 for Autism Speaks and we’re sure the weekend will bring even more donations.  We’ll be sure to post up a review of the day and some pictures on Monday.  If you’re in the Nashville area with nothing to do this Saturday morning (9/10/11), consider attending — it’s a family fun event and looks like the weather will be great!

Here’s the official information page: http://www.walknowforautismspeaks.org/faf/home/default.asp?ievent=463129

We hope to see many of our TN-based therapists, educators and parents there!
-Ryan

It’s Autism Awareness Month.  One Cenla mother is making it her mission to kick, punch and chop away at the effects of the disease.

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She jumpstarted an autistic karate class.  News Channel Five’s, Brooke Buford, has the story.

5-year old, Will Neely, isn’t setting out to become a black belt.

He’s one of five autistic karate kids at a class at Global Fitness, a class his mother, Brandie, helped jumpstart with Brian Neal, an area karate instructor.

“We tried it one day and I told him, I knew he would be honest with me and tell me, look Will can’t handle this, if that were the truth,” said Neely. “And, he’s worked with them and it’s turned out great.”

Story from KALB News Channel 5 in Alexandria, LA – Read Full Story Here (with videos)

What are some ways you’ve seen sports or activities benefit those on the Autism spectrum?

View the worldwide outreach effort at: http://www.worldautismawarenessday.org

Please join us in this effort by leaving a comment with your story, discussing/reposting on Twitter or Facebook, or simply learning more about this prevalent topic.

I just reviewed the following article by Sallie Bernard which gives her thoughts on a recent conference on autism. The debate over genetic and/or environmental causes of autism rages on….Esther Hess, Ph.D.

Click here to read the article: “Feeling exposed? Insights from a new meeting on environmental impacts in autism“ by Sallie Bernard, Autism Speaks’ Board Member, co-founder and Executive Director of Safe Minds

Given the historic inattention of the scientific establishment to the environmental contributions to autism, it was nice to see a day-long conference on the topic held this week by a major research center. “Exploring the Environmental Causes of Autism and Learning Disabilities” was put together by the Children’s Center for Environmental Health at the Mount Sinai School of Medicine in New York City. The center is run by Dr. Phil Landrigan, who has been a prominent researcher on the harmful effects of environmental toxicants for decades. He told the incredible story of the harms of lead exposure on children’s cognition and behavior, and how the successful effort to remove leaded gasoline from the market in the 1970s resulted in rising IQ scores and economic gain to the country. I hope this same massive effort will be applied to autism and the chemicals which underlie the increase in its prevalence.

Also of note was the presence at the meeting of Linda Birnbaum. Dr. Birnbaum is the director of the National Institute of Environmental Health Sciences (NIEHS) which holds the autism/environment portfolio at NIH. The Mt. Sinai meeting follows on a workshop held at NIEHS several months ago which explored the role of the environment in autism. Large scientific initiatives in the field fall to the NIH, so without its support, gains will be painfully slow. Hopefully Dr. Birnbaum’s personal involvement signals a heightened interest at NIEHS to look at autism. Although Dr. Birnbaum stated at the conference that her institute spends $30 million on children’s environmental health, at a Senate hearing earlier this year, it was shown that just $8 million of this is for autism specifically.

A few interesting bits of information came out of the conference. One was the definition of “environment” that the insiders use. It covers synthetic chemicals like pesticides, flame retardants and plasticizers; heavy metals like arsenic, lead and mercury; combustion and industrial by-products; diet and nutrients; medications, medical interventions, and substance abuse; infections; the microbiome; heat and radiation; and lifestyle factors. Some may be harmful; others protective. They may operate before conception, during pregnancy or in early life, and some may alter gene expression through epigenetic modifications to chemicals surrounding our genes. Craig Newshaffer, who runs the EARLI study to look at environmental factors among younger autism siblings, referred to the concept of the “exposome”, that is, everything we are exposed to and its effects on health. Dr. Birnbaum’ made the point that health does not equal medicine, and prevention through reduction in chemical exposures is of equal importance to health. Colleen Boyle from the CDC stated that the next prevalence report will be issued in April 2011. We will see if the 1 in 110 number from last year’s report has changed. New research from Korea was unable to confirm increased risk of autism due to parental age or low birth weight, which have been identified as risk factors in Western studies.

The most informative talk was by Dr. Irva Hertz-Picciotto from UC-Davis. She explained how changes in diagnosis do not account for most of the increase in autism rates, and how recent research by their group on mercury and flame retardant blood levels do not address whether these substances are causative for autism because the blood samples were taken years after the autism diagnosis. A paper out this week from UC-Davis found that proximity to traffic air pollution during pregnancy almost doubles the risk of autism. Another paper just accepted by a journal has found higher antibodies to cerebellar tissue in children with autism relative to controls, highlighting the immune component in autism.

Other than these interesting items, the conference covered minimal new ground as far as the science goes. Rather, the points of the meeting seemed to be to make the case that environmental factors research in autism must now be considered mainstream science and to showcase the work being done or about to be done to investigate the issue. Dr. Landrigan made the case for an environmental role by noting that the rate of autism has increased too much to be solely genetic, and that at most, genetics alone will end up explaining 40% of autism cases with the likely percentage much lower.



February is the month when many of us celebrate the possibilities of romance with Valentine’s Day. It comes as no surprise then that our older adolescent and young adult population with developmental delays such as Asperger’s Disorder has similar yearnings as they begin to become aware of the need for companionship. The question is how do you clinically support this hormonal need and simultaneously encourage developmental growth?

Asperger’s Disorder is what many developmental experts believe to be the highest form of functioning within the autism spectrum and is characterized by the severe inability of the impacted individual to comprehend social nuances while at the same time having the capacity for great academic intelligence. Older teenagers and young adults with Asperger’s Disorder need more support than their neuro-typically developing peers, because despite potentially brilliant I.Q.’s often their chronological age does not match their developmental age.

DIR/Floortime is an affect driven, developmental/relational approach towards the treatment of Asperger’s Disorder and takes into consideration an individual’s developmental age (the D of DIR), underlying individual neurological differences that might be impeding development (the I of this treatment model) and the individual’s relationship with the world and how to use that relationship (the R of DIR) to move that individual forward. The basic tenant of Floortime is to ‘follow the lead’ of the individual that you are working with (their area of initial interest and motivation) and then expand on that interest.

As mentioned, many older teens and young adults appear much younger in both their overall appearance and behavior (D). They characteristically are challenged in regard to good hygiene because of underlying sensory regulatory issues (I). Adolescents with developmental delays can be tactilely defensive and reluctant to wash their bodies, shampoo their hair, use deodorant/cologne and/or shave on a regular basis. While these individuals may not necessarily be bothered by their bodily odors, using Floortime (i.e., his/her motivation to date) can be an impetus for emphasizing the  importance of keeping oneself clean and neat and how by doing so you will make a good impression (R).

Keeping in mind individual neurological differences, clinicians working with this population can offer additional support, by helping to create visual schedules that can be placed in the bathroom that chart how often this individual needs to take care of his/her personal needs. Many teens and young adults with developmental delays are visual learners and get very organized once they have a clearer ‘map’ of social expectations.

Dating and safe sex practices can be addressed through role- play and concrete visual demonstrations. Working with your impacted teen/young adult, you can create a step by step guide for the date, giving an opportunity to practice and improve on issues such as appropriate boundaries, limiting perseverative talk and learning how to share in mutual interests thus expanding on what are typically very limited social skills. The advantage of practicing with a supportive clinician is that the information you will share, will in all likelihood be far more appropriate and accurate then the direction that might be received from watching over sexualized sitcoms or dramas on TV. You might also want to guide the direction of the date by suggesting a Floortime strategy of using the individual’s interest as a theme. For example, if your client likes animals, suggest that a great date can be done by escorting someone to the zoo. Likewise, if someone is interested intensely in trains there are many cities which have wonderful museums with permanent locomotive exhibits.

Undoubtedly, there will be many bumps and bruises along the social journey of our older teens and young adults with developmental challenges. While we certainly can’t nor should we even try to protect from all of life’s hard knocks, it’s actually o.k. to offer some Floortime tips as a steadying hand along the way.

Written by Esther B. Hess, Ph.D.
Summit Professional Education Instructor – View Upcoming DIR/Floortime Seminars

Share Your Thoughts

• Have you implemented DIR/Floortime in your practice?
• What have been some results, difficulties or other thoughts related to DIR/Floortime you could share?

New problems are being met by new therapies.  Drugs have long been used for unmanageable behaviors, but now with increased applicability of behavioral methods, many parents are seeing rising utility with alternative and nonpharmacological approaches.

MRI studies have long shown that the autistic brain has a very small corpus collusum.  The corpus collusum is responsible for cross-talk, or communication in the brain.  Hence, the autistic brain is not wired to communicate within itself.

Several new therapies seek to do just that.  The Sensory Learning Program unites three modalities (auditory, visual, and vestibular) into a single 30-day intervention to improve perception, understanding and learning.  During these 30 days children receive two 30-minute sessions involving intense sensory experiences where they simultaneously receive visual, auditory, and vestibular stimulation.  After the initial 12 days in the sensory learning center, this student returns home with a portable light instrument to continue the program for 18 more days.  The brain, now receiving overwhelming sensory data, is forced to cope with such data neurologically.  It is believed new neural pathways are being engaged so that children can integrate the sensory experiences.  In autistic children, this has improved their ability to “connect” to other human beings as shown by increased eye contact and an approachable personality.  Some children with Asperger’s and developmental delays are now able to better process verbal information, therefore improving their speech.  Long-term research is still outstanding on the Sensory Learning Program, but it appears to be an alternative method worth investigating.

Jeff Strong and Beth Kaplan established the REI Institute after over a decade of research into using musical rhythms in therapy to practice.  Their Rhythmic Entrainment Intervention has been used successfully now by hundreds of speech and occupational therapists, with not only autistic children but those with language and communication delays, hyperactivity, self-stimulatory behaviors and oppositional behaviors.

Strong’s therapy is also based on the principle that auditory stimulation will improve and influence brain wave patterns.  Strong bases his therapy on ancient approaches that emphasize rhythm-healing, including drumming patterns that influence the internal rhythmic patterns of the individual.  It is well known that autism and ADHD are related to deficits in self-regulation with the individual’s self-control.  Strong’s therapy improves internal specific rhythms, which are then used to modulate emotion and nervous system function.

This “healing music” is easy to use and only includes listening to a CD one-half hour a day for ten weeks.  Strong is continuing with objective scientific research.  Scientifically controlled pilot studies are already showing the following effects in autistic populations:  calming, reduction of self-stimulatory behaviors, reduced aggression and improved eye contact.

Social skills training is the principal means by which high-functioning autistic or Asperger’s children are remediated.  The ILAUGH model of social cognition, established by Marcia Garcia Winner, objectively teaches the Asperger’s student how to talk more appropriately about their favorite topic of interest.  It emphasizes subtle body language.  ILAUGH teaches how to listen with “one’s eyes.”  Hence, the student is taught joint attention along with the ability to follow increasingly complex cues that eventually lead to improved body language.  Latter sessions emphasize the teaching of abstract inferential language comprehension.  ILAUGH can be taught by its main curriculum book or “thinking” worksheets.  In other words, it can be taught in the school system just as one teaches math in a math class.

This exciting approach is already helping Asperger’s children get out of their world of self-absorption and preoccupations.  With better social skills, Asperger’s children are finding themselves better accepted by peers and more appropriate for job placement.

Research is underway for all of these alternative therapies.  Thousands of parents, as well as forward-thinking speech and occupational therapists, have begun to take notice.  Contrary to her pharmacological approach, these therapies have curative, not palliative effects.  The future of autism treatment has now broadened.

Gary M. Eisenberg, Ph.D.
Clinical Psychologist
Summit Instructor

Share Your Thoughts

• Have you had any experience with the Sensory Learning Program, REI or ILAUGH?
• What are you thoughts on these three alternative therapies?

Here are a few links for reference:

• DSM V Website
• Psych.org Article
• WrongPlanet.net Article
• PsychCentral.com Article: A look at the DSM V draft