All About Autism

Recently, I gave a presentation to our board of directors on our Adult Basic Education (ABE) program. The board was so interested in learning about the program that I wanted to share with my readers, as well! As the only special needs program of its kind in Pennsylvania, our ABE program offers essential and basic skill development for adults 18 and older with intellectual challenges and learning disabilities. Because the program is grant funded through the PA Department of Education, students are able to attend at no cost to them.

Personally, I believe that what makes the program so successful is its individualized approach to meeting each student’s vocational, social, professional and/or educational goals. After enrolling, teachers and coordinators in ABE work with a student to provide orientation, counseling and assessment services that help determine the appropriate level and type of instruction that will most benefit the student. The math and reading curriculums used in the classroom offer a variety of levels to not only begin at the right level but also to help the student continue to develop his or her skills.

This includes a literacy program, which focuses on helping students learn to read. Additionally, ABE helps adult learners become more successful in the workplace by collaborating with job trainers and supervisors.

The classroom is run as a centers-based environment; teachers set up “centers” around the classroom, each one focusing on a different component of that day’s lesson. For example, on a “Reading day” the centers might be: fluency, comprehension, spelling, technology, and a reading skill. This one-on-one learning helps to ensure that the student is fully successful.

Technology is also widely used in lessons via online educational programs as well as iPads, which help to expand and maintain educational skills.

When it fits in with a lesson unit, ABE will frequently ask members of the community to come in and present an informal lesson on the subject. Visitors have included a local weather forecaster presenting on weather and seasons, and a credit union representative discussing budget and finance.

Meet the Students!

Walter

Walter is in his early 80s and originally from Mississippi. When he first came to the ABE program in June 2015, he was lacking any type of formal education. He enrolled because he wanted to be able to write his granddaughter a letter.  Using ABE’s assessment tools they determined he was at a Fluency level 3.5 and a Comprehension level 3. By June 2017, Walter had risen to a Fluency  level 4.5 and a Comprehension level 7!! Walter not only achieved his goal of writing his granddaughter a letter, but also got his first cell phone, learned how to use a calculator and a computer, and successfully completed the softball umpire exam and his umpire registration!

Chris

Chris, who is in his early 20s, became part of the ABE program during the 2015-2016 school year. At that time, he had a comprehension level 4; in a little over a year, Chris was learning at comprehension level 6! Not only did Chris make significant academic gains he has also joined the work force and is now an employee of Giant Eagle.

The Annie E. Casey recently published its 2017 Kids Count Data Book, an annual review of how America’s children and families are faring across the United States. The study uses four indicators, economic wellbeing, education, health, and family/community, to measure the status of a child’s overall wellbeing. The results are a state-by-state report and ranking.

I, of course, was mostly interested in Pennsylvania and our ranking. Overall, we rank better than the nation in the metrics of economic wellbeing, including children who live in poverty, children who live in a household with a high housing cost burden, and number of teens who are not in school nor are working. We are also at or below the national averages that measure health; which includes the number of children without health insurance and child/teen deaths.

Although we remain below the national averages for both education and family/community, our rank has declined (albeit slightly). All in all, Pennsylvania is ranked as 18^th out of 50 states.

Top 5 ranked:

1. New Hampshire
2. Massachusetts
3. Vermont
4. Minnesota
5. Iowa

Bottom 5 ranked:

46. Arizona
47. Nevada
48. Louisiana
49. New Mexico
50. Mississippi

Obviously there are distinct regional patterns that emerge from the state rankings. Northeastern states compose half of the top ten, while states in the south east, south west, and Appalachian have the bottom rankings. Perhaps one of the most important correlations in mapping this out is that these low ranking areas are also where states have the lowest household income.

Intrigued by these statistics, I dug around for some numbers for Erie. I was shocked by my findings, to say the least. According to the most recent statistics available, the city of Erie’s poverty rate for children was 38.2% – for children younger than 5, a staggering 46.7% live in poverty.

The Casey foundation suggests a strong push towards eradicating child poverty, stating: While all indicators are important, the child poverty rate demands immediate action given the role that economic hardship plays in nearly every other indicator.”

Certainly, Erie’s numbers reflect the need to make this a priority as well. With the mayoral race this November, I plan on contacting the candidates to urge them to speak out about their plans to eliminate poverty in our community. Regardless of where you live, this is a serious issue that demands national attention. In past blogs, I’ve talked about how by investing in our children today we are investing in our country’s future – lower poverty rates are directly linked to decreased health and criminal justice expenditures and increased economic output. Working together, we can change the outlook for America’s children.

Recently, Ryan and I had plans to fly to Chicago for my nephew’s wedding. I was concerned because Ryan had not flown in 15 years. How would he do? The long security lines, loud noises, tight spaces, and of course, the inability to leave on time… all of this had me worried, to say the least. Fortunately, he did great! He watched out the window the entire time we were in the air. However, I know air travel is problematic for many families.

I recently came across an article regarding how airports are making travel easier for autistic passengers. Sensory rooms and the ability to get on the plane last are great additions to airports and their practices. I learned that the ARC, an international group representing people with intellectual disabilities, have been working with airports around the globe to make air travel easier for these individuals. Chicago, Atlanta, Shannon, Vancouver, and LaGuardia are just a few of the airports that now offer these opportunities. At the Atlanta airport, Delta even has mock flights so passengers may simulate the experience to help them prepare. There is even an event called “Wings for Autism,” which works with airports, airlines, and transportation security administration to allow planes to taxi with participants with special needs on-board. Why is this important? Being prepared and familiar with the setting is key for individuals with special needs to having an easier travel experience.

I’d encourage you to investigate if there is a “Wings for Autism” chapter in your community and/or work with your local ARC chapter to help ease air travel. I’m going to write to our local airport municipal authority, as well as the airlines that service Erie, to see what we can do to bring these same services to our community. Why don’t you do the same?

PS – now that I know Ryan can fly, who knows what our next destination might be!!

As school starts to let out, I’m sure many of you are considering how the transition from school to summer will go. This can be a challenging time for some families – it was certainly a challenge for Ryan and I! What I learned over the years was that structure is essential and a day full of planned activities was best. To facilitate this, we would look at the calendar at the beginning of the summer and count the number of days for summer vacation. Then, we would add our activities to each day. This way, Ryan could look ahead and see what day he was going to be golfing, or going to the amusement park, or just beaching it on Lake Erie. Having a schedule helped to reduce his anxiety about what he would do the following day and reassured him that he would be having lots of fun throughout his summer vacation!

Some other tips I would recommend to help make the transition an easy one:

• Include lots of physical activity. Students get weary by the end of the school year from sitting at a desk day in and day out. Help them to release all their bottled up energy by playing outside, jogging, or engaging in team sports. Plus, it’s good for their health! We are so fortunate to have Presque Isle State Park so close to us. Nature walks, swimming, and pontoon boats are just a few of the “free” activities to enjoy.
• Communicate by talking about the changes that will be occurring soon and even consider starting a countdown to the first day of summer. The more time you give your child to prepare, the easier the transition can be. Likewise, as August neared I reached out to the school to schedule a time for Ryan to visit, meet his new teachers and see his new classroom. Giving him time to prepare and reminding him that the change was coming ensured a smoother start to the new school year.
• Although Ryan didn’t participate in any of the traditional summer camps, today there are so many more opportunities to consider. The best way to find out what’s available is get on the internet and google summer camp options in your area.

If you are looking for some additional fun ideas, two GREAT websites to take a look at are:

https://www.autismspeaks.org/blog/2015/06/11/10-fun-summer-diy-sensory-games-kids

http://www.friendshipcircle.org/blog/2012/06/20/82-summer-activities-for-families-with-special-needs/

In this graduation season, there will be many commencement speeches made around the world. I always find this time particularly uplifting – a call to look to the future, to work hard for your dreams, and to never stop trying to achieve them. Recently, a friend sent me the transcript of Emory College’s keynote address, given by renowned epidemiologist William Foege. I was so moved by it that I wanted to share a briefer version of his incredible insights with you.

~Maureen

“Lessons I am Still Desperately Trying to Learn”

Chapter 1: Obituaries

Every day we edit our obituaries. It’s not until you get older that you realize how good a life has been. Consciously, edit your obituary each day so you may realize that sooner; edit with care and gusto.

Chapter 2: Life Plans

50 years ago, everyone’s advice was to develop a life plan. Times have changed. My advice? Avoid a life plan. You enter a world of infinite possibilities, confusing ideas and continuous changes. A life plan will only limit your future.

Chapter 3: Instead of a life plan, develop a life philosophy

And then you will have tools to evaluate every fork in the road. What is truly important to you?

Chapter 4: Integrate your world of knowledge

Become globalists, concentrated on the needs of the group rather than your own needs. Be good ancestors – remember the children of the future have given you’re their proxy and are asking for you to make good decisions. Because each of us can do so little, it’s important we do our part. It may be a little contribution, but we each have to make that contribution.

Chapter 5: Actively seek mentors

Identify people who have the traits, ideas, and philosophies you want and get their help, always asking “how best to live?” Borrow their wisdom. I’m in my eighties, and I still seek mentors. Many of them much younger than me.

Chapter 6: The world is expanding

For all the problems of the world, I tell you there has never been a better time to be alive and enjoy that. An example: you have been exposed to as much knowledge in one year of college as Aristotle was in his entire lifetime.

Chapter 7: Seek equity

I avoided dying of tuberculosis, food poisoning, toxic water because of a government and much more – not because I deserved it but because of a coalition of government, religious institutions, and public and private groups all conspiring to help me, born in this country. And your story is the same. So what can we do? Seek equity and justice so others can tell that story someday.

Chapter 8: Seek serendipity

We often think of serendipity as a random good fortune, but the original story tells about three men, finding small clues that other people missed, figured out where the lost camel of Serendip (now Sri Lanka) was. We are told this can be learned by living in the moment and looking for connections. Thoreau said: “It’s not what you look at that matters, it’s what you see.”

Chapter 9: Civilization

We like to feel we are civilized, but how do we measure that? All usual measures (science, wealth, education) fail, except one. How people treat each other. Kindness is the measure of a civilized person, of a civilized university, of a civilized state. It is the measure of a civilized nation. How you treat people is the healing force in the world.

And finally, Chapter 10: Finding our way home

In the book “Cutting for Stone,” there is an unforgettable line, and may this phrase stick with you forever: “Home is not where you are from. Home is where you are needed.”

As I congratulate you on what you have done, I also hope we all find our way home.

Read the full transcript here.

Congratulations to all of the 2017 graduates!!

Last night was a momentous evening at the Barber National Institute! We celebrated the 2016 graduation with over 70 preschool, elementary, and high school students. Each of our students comes to the stage and receives their diploma. A representative from the local school district presents their official diploma to the high school graduates. We close the program with our school song, which was written by one of our teachers (Julie) and her husband Chris, members of the band Tennessee Back Porch when Dr. Gertrude Barber passed away. It has been sung at every graduation since! There were only a few dry eyes in our crowd of 400 family members and friends of our graduates!

Celebrate What’s Different, By Chris & Julie Moore

There’s a light on the shore of Lake Erie

Through the fog of ignorance it shines

Where a future awaits every child

Yours and mine, yours and mine

Building on the dream of Gertrude Barber

That for everyone there is a place

Knowing the light is always there to guide us

On our way, on our way

And we’ll celebrate what’s different

Knowing we’re all the same

The dream of school and family has come true

You will learn from me, and I will learn from you

And we’ll spread the light to others every day

And the Barber National Institute’s the way

Certainly, no one would argue that a healthy lifestyle is an important goal for all individuals, both young and old. This National Physical Fitness & Sports Month is a great time to renew your commitment to a healthy, active lifestyle. Children with special needs in particular benefit from having a healthy influence in all aspects of their life: social, physical, and mental. The participation of children with disabilities in sports and recreational activities promotes inclusion, minimizes negative behavioral incidents, optimizes physical functioning, and enhances overall well-being. Despite these benefits, children with disabilities are more restricted in their participation, have lower levels of fitness, and have higher levels of obesity than their peers without disabilities.

Four years ago, I came across an article that mentioned a program aimed at teaching adults with disabilities how to ride a bicycle. I was unaware that many adults with disabilities were never presented with the opportunity to learn this skill many of us take for granted as children.

Thus, “Learn to Ride” Bike Camp was born. This Barber National Institute camp is a four-week program designed to help children develop skills to ride bicycles independently. Bike Camp is open to any youngster in the community who is able to pedal but who has not been successful riding without training wheels.

Going into our fourth consecutive summer, it has been wonderful to see such tremendous results. Nearly all students who participate in our bike camp are able to ride their bikes independently by the end of the four weeks – those that do not have still made remarkable progress towards reaching that objective.

Not in the Erie area? This blog post from 2015 does a wonderful job of sharing some pointers for teaching your child how to learn to ride a bike:http://www.huffingtonpost.ca/joanne-giacomini/special-needs-bike_b_8312246.html

Interested in starting your own “Learn to Ride” bike camp? Contact me for tips and plans on how!

In honor of National Mental Health Awareness Month, I asked Rochelle Von Hof, Ph.D., Director of Clinical Programming and Services at the Barber National Institute, to say a few words about her experiences in this vast and ever-changing field. 

~ Maureen

Dr. Rochelle Von Hof

Hello!  Let me take a minute to introduce myself.  My name is Dr. Rochelle Von Hof.  I am the Director of Clinical Services and Programming at the Barber National Institute.  I have been with the Institute since March 2011; however, I have been in the mental health field since 2004.  I have a passion for working with children, adolescents and families who have experienced trauma or have relational issues.  When I started my journey into mental health I had no idea that it would lead me into this direction.  Originally, when I started my career I thought I was going to be a teacher for special education.  Boy did that change!

When I first entered the field it seemed that anyone could get services and have these services for almost any length of time.  This is one of the biggest changes that I have seen in the field.  In the current world, it seems that it is difficult to get children approved for services.  I often hear of children being denied services or only getting part of their services approved.  This is something that I think is frightening due to the potential impact on the child’s recovery and overall wellbeing.  I feel that if a child is prescribed services by a psychologist or psychiatrist it is something that should be honored.

Outside of payment and authorization for services, one of the most positive growths I have seen in this field is the improvement of delivery of quality services and the view on trauma.  There has been a large focus on quality improvement initiatives and quality checks being conducted.  This is something that has grown since I began the field.  It is really nice to see that our auditors want to see that children and families in services are improving and that the clinician is clearly documenting this.  Quality is another passion of mine because I believe it is a quality service that drives an agency to be successful.  I believe that every individual being served should receive the same quality treatment no matter who the individual’s therapist is.

The view towards individuals who have been traumatized has also improved.  In some agencies they treat everyone as if they have experienced a traumatic event.  Other agencies, such as Barber National Institute, have become Certified Trauma Informed Learning Communities.  This is a movement to spread the word about trauma throughout the agency, to educate staff and clients about trauma, and to increase safety awareness.  Additionally there are evidence based models of treatment, such as Trauma Focused Cognitive Behavior Therapy (TF-CBT) and Eye Movement Desensitization Reprocessing (EMDR), empirically proven to help children, adolescents and adults recover from the traumatic event.

As the mental health community grows I would like to see more funding available for the children’s services.  I believe that the split between funding for adults and children is 80/20.  It would be nice to see the split in funding be closer to equal amongst the two populations.  If children have a better chance of getting services early in life than maybe they will not need as many services or intensive services later in life.

At the Barber National Institute we offer a variety of mental health services to children and families.  These services include Early Intervention, Behavioral Health Rehabilitation Services (BHRS), Family Based Mental Health, Acute Partial Hospitalization Program, Blended Case Management, and the Outpatient Clinic.  For adults the mental health services offered include Adult Behavior Specialists, Blended Case Management, Adult Partial Hospitalization Program, and the Outpatient Clinic.  All of our therapists are highly skilled and trained in a variety of backgrounds.  Our clinical therapists receive monthly trauma training and consultation from a local trauma specialist.  The therapists also receive training in family therapy.  Additional trainings are offered to the clinicians throughout the year as well.

It is important to seek mental health help if you feel that you are struggling with anxiety, depression, or even a recent change in your life.  Feel free to reach out to the Barber National Institute for an appointment or to help answer any questions you may have.

Dr. Von Hof joined the Barber National Institute in 2011 as a mobile therapist and behavior specialist, and also served as program director of the family based mental health program. Dr. Von Hof was awarded a doctoral degree in psychology from Walden University in January of 2017. Her dissertation focused on the effects of childhood trauma on family dynamics. A graduate of Mercyhurst University, where she received bachelor’s and master’s degrees, Von Hof completed additional training in family therapy, trauma focused cognitive behavior therapy and Parent Child Interaction Therapy (PCIT.)  She has extensive experience relating to the treatment of trauma and other mental health issues.

I recently had the opportunity to attend the conference “Treating OCD in the Autism Community,” sponsored by the Obsessive-Compulsive Foundation of Western Pennsylvania (OCDFWPA) and Autism Connections of PA. Going into the conference, my driving questions were: “How does OCD look in a person with autism? How do you differentiate the repetitive behaviors which we find in autism from OCD?”

As it turns out, this really was one of the major thrusts of the conference. I learned that in OCD, one has recurrent and persistent thoughts that are intrusive and unwanted. Often, the focus of these thoughts and behaviors centers on the themes of contamination, harm, hoarding, counting, and/or doubt. A person with an OCD wants to stop these thoughts from occurring and is significantly distressed about his/her inability to control these symptoms.

While the person with autism spectrum disorder often insist on sameness, adherence to routines, has highly restricted interests and focuses his thoughts and behaviors on repeating things and engaging in repetitive behaviors, in contrast to a person with OCD, a person with ASD is not bothered by his thoughts and behaviors, may not want to stop the thoughts, and may likely enjoy his specialized interests. With OCD, symptoms can wax and wane and the focus of the OCD can change over time. In persons with ASD, symptoms are typically recognized before 24 months of age, but may look differently at different stages of life. 

Ryan began exhibiting repetitive behaviors when he was only one year old. He thoroughly enjoyed opening and closing doors, whether it was the microwave, a cupboard door, or closet doors. I thought this was rather odd, but at the time I did not make the connection to autism. Another repetitive behavior he had very early on was an interest in walking the stairs. When we would go to my brother’s or sister’s houses, he would repeatedly walk up and down the stairs. I attributed this to the fact that stairs were a novelty to him, since we had no stairs in our home. Around the time Ryan was 18 months old, I began putting the pieces of the puzzle together and realized that I was seeing more than just a repetitive behavior. It was at this time that my brother, pediatric neurologist Joe Barber, completed an evaluation and gave Ryan the diagnosis of ASD.

Over the years, Ryan has always had some repetitive behaviors that, for him, are calming and reduce anxiety. What I learned at the conference was that these behaviors that I see are not OCD-related, but in fact another symptom of autism.

The OCDFWPA has a wealth of resources on their website, which I encourage you to review: http://www.ocfwpa.org/resources1.html.

I hope you all have a wonderful Mother’s Day this weekend!

Scientists and researchers are constantly uncovering more information related to autism, offering insights into the origins, possible causes and even at times potential cures. I come across dozens of articles on a weekly basis, some of which seem more important than others. I thought I would share on a monthly basis stories that caught my eye.

~ Maureen

Tracing autism’s trajectories could help explain its diversity

There is enormous variability in the developmental trajectories of children with autism, which shows how little we know about a child’s future at the time of diagnosis. Much of this uncertainty stems from how we study autism. Currently, the trend is to group children together based on features they share at a given point in time, and then assume that children within a particular group will share a similar developmental path. But children develop at different rates, and their individual developmental paths are rarely linear. In this new research article, scientists propose the term ‘chronogeneity’ to describe the heterogeneity of autism features over time.

Read the full article here.

Study Looks At How Autism Impacts Parents

Moms and dads of kids with autism spend less time together than couples with typically-developing children, new research suggests, but that doesn’t mean they don’t support one another. In a study looking at the day-to-day experiences of parents of kids on the spectrum, researchers found that such couples spend an average of 21 fewer minutes per day together.

Read the full article here.

Social-Emotional Skills in Early Childhood Support Workforce Success

Across the country, business executives have observed that too many employees and job applicants lack the “social-emotional skills” necessary to succeed on the job. This has consequences for the capability of businesses to compete in the global economy. Businesses need employees who can communicate well with coworkers or customers, collaborate to solve problems, and persevere to overcome challenges. The truth is, the foundation for these skills is laid in a child’s earliest years, as much of a child’s brain architecture is developed during the first five years of life. This directly impacts the development of the social and emotional capabilities that support long-term success in school and the workforce. In a recent Zogby Survey of 300 business decision-makers, 92% agreed that early childhood experiences affect the development of social-emotional skills later in life.

Read the full article here.

Tune in next month for an update on autism research!