{"id":7415,"date":"2019-04-14T00:28:38","date_gmt":"2019-04-13T22:28:38","guid":{"rendered":"https:\/\/www.melodycenter.de\/aba-vb\/article\/"},"modified":"2025-04-18T14:58:57","modified_gmt":"2025-04-18T12:58:57","slug":"article","status":"publish","type":"page","link":"https:\/\/www.melodycenter.de\/en\/aba-vb\/article\/","title":{"rendered":"Article"},"content":{"rendered":"<p>[et_pb_section fb_built=\u201c1\u201d admin_label=\u201cStudie 1\u201d module_id=\u201cstudie_1\u201d _builder_version=\u201c4.16\u201d background_color=\u201c#e89700\u201d parallax=\u201con\u201d parallax_method=\u201coff\u201d custom_padding=\u201c51.1562px|0px|40px|0px|false|false\u201d top_divider_style=\u201cramp2\u201d top_divider_color=\u201c#0972c3\u201d da_disable_devices=\u201coff|off|off\u201d global_colors_info=\u201d{}\u201d da_is_popup=\u201coff\u201d da_exit_intent=\u201coff\u201d da_has_close=\u201con\u201d da_alt_close=\u201coff\u201d da_dark_close=\u201coff\u201d da_not_modal=\u201con\u201d da_is_singular=\u201coff\u201d da_with_loader=\u201coff\u201d da_has_shadow=\u201con\u201d][et_pb_row custom_padding_last_edited=\u201con|phone\u201d admin_label=\u201crow\u201d module_class=\u201cheader_gap\u201d _builder_version=\u201c4.16\u201d background_size=\u201cinitial\u201d background_position=\u201ctop_left\u201d background_repeat=\u201crepeat\u201d custom_margin_tablet=\u201d-40px||\u201d custom_margin_phone=\u201c20px||29px\u201d custom_margin_last_edited=\u201con|desktop\u201d custom_padding=\u201c10px||51px|||\u201d custom_padding_tablet=\u201d\u201d custom_padding_phone=\u201c0px||0px\u201d global_colors_info=\u201d{}\u201d][et_pb_column type=\u201c4_4\u201d _builder_version=\u201c4.16\u201d custom_padding=\u201d|||\u201d global_colors_info=\u201d{}\u201d custom_padding__hover=\u201d|||\u201d][et_pb_blurb use_icon=\u201con\u201d font_icon=\u201cr||divi||400\u201d icon_color=\u201d#ffffff\u201d icon_placement=\u201cleft\u201d image_icon_width=\u201c31px\u201d content_max_width=\u201c1100px\u201d _builder_version=\u201c4.16\u201d header_level=\u201ch1\u201d header_font=\u201d|700|||||||\u201d header_text_align=\u201cleft\u201d header_text_color=\u201d#ffffff\u201d header_font_size=\u201c56px\u201d body_font=\u201d|700|||||||\u201d body_text_color=\u201d#ffffff\u201d body_font_size=\u201c30px\u201d transform_origin=\u201d-50%|50%\u201d text_orientation=\u201ccenter\u201d background_layout=\u201cdark\u201d custom_margin=\u201d|470px||\u201d custom_margin_tablet=\u201c30px|0px|0px|-2px\u201d custom_margin_phone=\u201d|0px||-10px\u201d custom_margin_last_edited=\u201con|tablet\u201d custom_padding=\u201d|||||\u201d custom_padding_tablet=\u201d||10px|\u201d custom_padding_phone=\u201d||20px\u201d custom_padding_last_edited=\u201con|tablet\u201d header_font_size_tablet=\u201d\u201d header_font_size_phone=\u201c56px\u201d header_font_size_last_edited=\u201con|phone\u201d body_font_size_tablet=\u201d\u201d body_font_size_phone=\u201c22px\u201d body_font_size_last_edited=\u201con|phone\u201d icon_font_size=\u201c31px\u201d global_colors_info=\u201d{}\u201d icon_color__hover_enabled=\u201con\u201d icon_color__hover=\u201d#ffffff\u201d]<\/p>\n<p style=\"text-align: left;\">Articles on <span class=\"caps\">ABA<\/span>\/<span class=\"caps\">VB<\/span><\/p>\n<p>[\/et_pb_blurb][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=\u201c4.16\u201d custom_padding=\u201c0|0px|0|0px|false|false\u201d global_colors_info=\u201d{}\u201d][et_pb_column type=\u201c4_4\u201d _builder_version=\u201c4.16\u201d custom_padding=\u201d|||\u201d global_colors_info=\u201d{}\u201d custom_padding__hover=\u201d|||\u201d][et_pb_toggle title=\u201cSucceeding in College with <span class=\"caps\">ADHD<\/span>: Key Tools and Stra\u00adte\u00adgies for Success\u201d open_toggle_text_color=\u201c#000000\u201d open_toggle_background_color=\u201crgba(255,255,255,0.7)\u201d closed_toggle_text_color=\u201d#ffffff\u201d closed_toggle_background_color=\u201c#0c71c3\u201d icon_color=\u201d#ffffff\u201d open_icon_color=\u201d#ffffff\u201d module_id=\u201copen_article_ADHDTools\u201d module_class=\u201cjump\u201d _builder_version=\u201c4.27.4\u201d title_text_color=\u201d#ffffff\u201d title_font=\u201d|700|||||||\u201d title_font_size=\u201c20px\u201d title_line_height=\u201c1.1em\u201d body_font=\u201d||||||||\u201d body_text_align=\u201cleft\u201d body_text_color=\u201c#000000\u201d custom_margin=\u201c30px||||false|false\u201d custom_padding_tablet=\u201d\u201d custom_padding_phone=\u201c10px||10px\u201d custom_padding_last_edited=\u201con|phone\u201d hover_enabled=\u201c0\u201d title_font_size_tablet=\u201c15px\u201d title_font_size_phone=\u201c14px\u201d title_font_size_last_edited=\u201con|phone\u201d body_font_size_tablet=\u201d\u201d body_font_size_phone=\u201c14px\u201d body_font_size_last_edited=\u201con|phone\u201d custom_css_before=\u201ccontent:%22%22;||display:block;||height:140px; \/* fixed header height*\/||margin:-140px 0&nbsp;0; \/* nega\u00adtive fixed header height *\/\u201d border_width_all=\u201c2px\u201d border_color_all=\u201c#e02b20\u201d icon_color__hover=\u201d\u201d icon_color__hover_enabled=\u201con\u201d global_colors_info=\u201d{}\u201d open_icon_color__hover_enabled=\u201con\u201d open_icon_color__hover=\u201d#ffffff\u201d sticky_enabled=\u201c0\u201d]<\/p>\n<p><span>Those conside\u00adring their job and educa\u00adtion options have a&nbsp;lot of choices as we enter 2025. Those choo\u00adsing to continue their educa\u00adtion journey by ente\u00adring college face a&nbsp;new set of educa\u00adtional and social chal\u00adlenges. For those pursuing college among the esti\u00admated 7&nbsp;million people in America diagnosed with atten\u00adtion deficit hyperac\u00adti\u00advity disorder (<span class=\"caps\">ADHD<\/span>), accor\u00adding to the Center for Disease Control (<span class=\"caps\">CDC<\/span>), those chal\u00adlenges are twofold.&nbsp;<\/span><\/p>\n<p><span>If you\u2019re worried about how to handle the new chal\u00adlenges that may arrive with college, there are a&nbsp;lot of tools, stra\u00adte\u00adgies, and options to help students with <span class=\"caps\">ADHD<\/span> cope and thrive in their college career. First, it\u2019s important to get a&nbsp;good idea of some hurdles that can come up in higher educa\u00adtion if you have&nbsp;<span class=\"caps\">ADHD<\/span>.<\/span><\/p>\n<h1><span>Potential challenges to expect if you have <span class=\"caps\">ADHD<\/span><\/span><span>&nbsp;<\/span><\/h1>\n<p><span>Most people going into college with <span class=\"caps\">ADHD<\/span> were aware of their diagnosis and lear\u00adning needs in high school or well before. They expe\u00adri\u00adenced <span class=\"caps\">ADHD<\/span> chal\u00adlenges in their educa\u00adtional career prior to college, and any coping skills learned then were prac\u00adticed in the more struc\u00adtured envi\u00adron\u00adment of life with care\u00adgi\u00advers at home and teachers in a&nbsp;tradi\u00adtional school setting. In college, many of those chal\u00adlenges are compounded by having those struc\u00adtures torn away, and the student with <span class=\"caps\">ADHD<\/span> is faced with the chall\u00adenge of mana\u00adging their symptoms on their own and living in a&nbsp;more self-directed way than they are perhaps used to. On top of this, there is an added social aspect that you may not have had at school previously, with many having to start over in crea\u00adting their commu\u00adnity in the new higher educa\u00adtion envi\u00adron\u00adment. Here are a&nbsp;few more chal\u00adlen\u00adging areas someone ente\u00adring college with <span class=\"caps\">ADHD<\/span> might&nbsp;face.<\/span><\/p>\n<h2><span>Managing focus <\/span><\/h2>\n<p><span>Two of the major chal\u00adlenges that come with <span class=\"caps\">ADHD<\/span> are focus and execu\u00adtive dysfunc\u00adtion. In fact, one of the defi\u00adning charac\u00adte\u00adristics of <span class=\"caps\">ADHD<\/span> is the diffi\u00adculty focu\u00adsing, which <a href=\"https:\/\/www.verywellmind.com\/the-relationship-between-dopamine-and-adhd-5267960\">science suggests is linked to the neuro\u00adtrans\u00admitter dopa\u00admine<\/a> and dysfunc\u00adtion in dopamine\u2019s produc\u00adtion and trans\u00admis\u00adsion in the brain. Dopa\u00admine can affect lear\u00adning, moti\u00adva\u00adtion, atten\u00adtion, and impulse control, all of which are areas of chall\u00adenge for those with <span class=\"caps\">ADHD<\/span>. Having so many classes to focus on as well as having to focus enough in class and during study to pass exams and projects can be espe\u00adci\u00adally&nbsp;hard.&nbsp;<\/span><\/p>\n<h2><span>Loss of support and routine&nbsp;<\/span><\/h2>\n<p><span>Routine and support aren\u2019t built into the daily sche\u00addule anymore. Parents aren\u2019t around to keep students in check, and classes are no longer so regi\u00admented within a&nbsp;set period of time throug\u00adhout the day. Execu\u00adtive func\u00adtion is needed to juggle so many diffe\u00adrent moving parts on your own, an area where many with <span class=\"caps\">ADHD<\/span> struggle. <a href=\"https:\/\/my.clevelandclinic.org\/health\/articles\/executive-function\">Execu\u00adtive func\u00adtion<\/a> is the set of skills used to manage daily tasks and is marked by skills in working memory, cogni\u00adtive flexi\u00adbi\u00adlity, and impulse control. Execu\u00adtive dysfunc\u00adtion is any diffi\u00adculty in deve\u00adlo\u00adping or prac\u00adti\u00adcing these skills.<\/span><\/p>\n<h2><span>Managing your time and workload<\/span><\/h2>\n<p><span>Because you don\u2019t have a&nbsp;built-in routine anymore, execu\u00adtive dysfunc\u00adtion can increase at this time. This can affect ever\u00ady\u00adthing, inclu\u00adding mana\u00adging your sche\u00addule and ability to get work done on time. Classes are not always back-to-back anymore. You may have to make sure you watch your time and keep a&nbsp;close eye on what class is coming in 3&nbsp;hours. There are often more projects and assign\u00adments to manage, and teachers won\u2019t hold students\u2019 hands with remin\u00adders. This can be chal\u00adlen\u00adging if you struggle with&nbsp;<span class=\"caps\">ADHD<\/span>.<\/span><\/p>\n<h2><span>Managing social life<\/span><\/h2>\n<p><span>Again, because of execu\u00adtive dysfunc\u00adtion, it can be diffi\u00adcult to gain and then main\u00adtain friend\u00adships in college. In high school, you may have attended school with people you knew for years. Plus, you knew who would be in your class and in your day because ever\u00adyone is in the same buil\u00adding at the same set time. It is all planned. Not so with college, where it can take effort to see friends regu\u00adlarly, depen\u00adding on your class sche\u00addule and how big the campus is.<\/span><\/p>\n<h2><span>Mental Health<\/span><\/h2>\n<p><span>Those with <span class=\"caps\">ADHD<\/span> have an <a href=\"https:\/\/www.cdc.gov\/adhd\/about\/other-concerns-and-conditions.html\">increased suscep\u00adti\u00adbi\u00adlity to other mental health chal\u00adlenges<\/a>, like anxiety and depres\u00adsion. This increased suscep\u00adti\u00adbi\u00adlity mixed with poten\u00adtial diffi\u00adculty in mana\u00adging social life in college and over\u00adsti\u00admu\u00adla\u00adtion and over\u00adload from an increased workload and need to manage your own sche\u00addule can further increase the likeli\u00adhood of deve\u00adlo\u00adping an addi\u00adtional mental health challenge.&nbsp;<\/span><\/p>\n<h1><span>Tips and strategies for success<\/span><\/h1>\n<h2><span>Seek professional intervention<\/span><\/h2>\n<p><span>If you have <span class=\"caps\">ADHD<\/span>, it can be helpful to talk with your primary care provider to explore your options for things like medi\u00adca\u00adtion or other inter\u00adven\u00adtions to help manage symptoms. You can go a&nbsp;step further and pursue work with a&nbsp;<a href=\"https:\/\/onlinemftprograms.com\/cacrep-accredited-counseling-programs\/mental-health-counseling\/\">mental health coun\u00adselor<\/a>, who can help you develop and prac\u00adtice skills for incre\u00adasing execu\u00adtive func\u00adtion and find stra\u00adte\u00adgies that work for you and your <span class=\"caps\">ADHD<\/span>. They can also help you work through stress and other emotions or mental health chal\u00adlenges that might arise on your college journey. You can check out certi\u00adfied thera\u00adpists who specia\u00adlize in <span class=\"caps\">ADHD<\/span> <a href=\"https:\/\/www.psychologytoday.com\/us\">here<\/a>.<\/span><\/p>\n<h2><span>Get some exercise<\/span><\/h2>\n<p><span>Exer\u00adcise might surprise you. Science has found that <a href=\"https:\/\/www.healthline.com\/health\/fitness\/adhd-and-exercise#exercise-and-adhd\">exer\u00adcise can increase dopa\u00admine and nore\u00adpi\u00adne\u00adphrine<\/a>, neuro\u00adtrans\u00admit\u00adters which help regu\u00adlate the atten\u00adtion system. Done over time, exer\u00adcise can help increase the base\u00adline for both of these neuro\u00adtrans\u00admit\u00adters, helping you manage your <span class=\"caps\">ADHD<\/span> symptoms more easily. Exer\u00adcise also helps regu\u00adlate mood, increase execu\u00adtive func\u00adtion, promote brain plas\u00adti\u00adcity, and it can become a&nbsp;part of a&nbsp;routine which you can fall back on when you feel overwhelmed.&nbsp;<\/span><\/p>\n<h2><span>Get enough sleep<\/span><\/h2>\n<p><span>Those who have strug\u00adgled with getting good sleep know that getting enough of it is a&nbsp;game changer for all people. However, for someone with <span class=\"caps\">ADHD<\/span>, not getting enough sleep can make symptoms worse. <a href=\"https:\/\/www.mswguide.org\/blog\/sleep-hygiene-the-irregular-schedule-of-a-student\">Poor sleep<\/a> contri\u00adbutes to emotional distur\u00adbance, problems in long and short-term memory, atten\u00adtion and focus distur\u00adbances, and impul\u00adsi\u00advity, which can become two-fold with <span class=\"caps\">ADHD<\/span>. To help manage these symptoms and make sure you\u2019re opera\u00adting at your best, develop a&nbsp;healthy sleep routine. A&nbsp;few ways to help yourself include:<\/span><\/p>\n<ul>\n<li><span> <\/span><span>Choose a&nbsp;time to stop drin\u00adking caffeine in the day. For example, if you know drin\u00adking coffee after 5&nbsp;p.m. makes it harder to sleep later, plan to have your last cup earlier in the day and switch to decaf for the evening.<\/span><\/li>\n<li><span> <\/span><span>Exer\u00adcise also helps with regu\u00adla\u00adting&nbsp;sleep.<\/span><\/li>\n<li><span> <\/span><span>Create a&nbsp;routine for sleep. Work to go to bed and wake up at the same time every&nbsp;day.<\/span><\/li>\n<li><span> <\/span><span>Take a&nbsp;warm bath or create another calming ritual before bed.<\/span><\/li>\n<li><span> <\/span><span>Leave acti\u00advi\u00adties that cause hyper\u00adfocus or hyper\u00adfix\u00ada\u00adtion for earlier in the day and opt for acti\u00advi\u00adties that are less stimu\u00adla\u00adting at&nbsp;night.<\/span><\/li>\n<\/ul>\n<h2><span>Consider using lists and timers<\/span><\/h2>\n<p><span>To help manage your time and your workload, find a&nbsp;listing and orga\u00adniza\u00adtion system that works for you. That might look like buying a&nbsp;planner, keeping a&nbsp;note\u00adbook on hand, or putting ever\u00ady\u00adthing in your phone calendar or notes&nbsp;app.&nbsp;<\/span><\/p>\n<p><span>Whatever method you choose to&nbsp;manage your sche\u00addule and workload, consider jotting down a&nbsp;list at the begin\u00adning of the day or any time you feel over\u00adwhelmed. Not only can this help you stay on task throug\u00adhout the day and get done what you need to get done, it can satisfy a&nbsp;quick dopa\u00admine rush to cross some\u00adthing off when you\u2019ve completed it.&nbsp;<\/span><\/p>\n<p><span>Timers can also be effec\u00adtive for focus. When you know you need to work on some\u00adthing, set a&nbsp;timer for a&nbsp;reasonable length of time, and commit to working on the assign\u00adment. When the timer goes off, take a&nbsp;break. These lengths of time can be as short as you need, and they can become longer as you become more used to the process.<\/span><\/p>\n<h2><span>Take advantage of your school\u2019s resources<\/span><\/h2>\n<p><span>Many people don\u2019t realize that their school may have resources speci\u00adfi\u00adcally desi\u00adgned to help those with lear\u00adning disa\u00adbi\u00adli\u00adties, <span class=\"caps\">ADHD<\/span>, and other concerns. For example, many univer\u00adsi\u00adties have students desi\u00adgnated as note takers for a&nbsp;class. At the end of the class, they copy their notes for other students who struggle with focus or listening to access later. Consider seeking out a&nbsp;tutor, reques\u00adting extra time to complete an exam or an exten\u00adsion when writing a&nbsp;paper. Talk to your profes\u00adsors about chan\u00adging seating to accom\u00admo\u00addate focus chal\u00adlenges, or ask if recor\u00addings of the lectures are available. These are just a&nbsp;few examples of accom\u00admo\u00adda\u00adtions that are available at college. Don\u2019t be afraid to ask. Profes\u00adsors and admi\u00adnis\u00adtra\u00adtors want you to succeed.<\/span><\/p>\n<h2><span>Eat a&nbsp;healthy diet<\/span><\/h2>\n<p><span>While rese\u00adarch is mixed on the effec\u00adti\u00adve\u00adness of an \u201c<span class=\"caps\">ADHD<\/span> diet,\u201d main\u00adtai\u00adning a&nbsp;healthy life\u00adstyle can help regu\u00adlate <span class=\"caps\">ADHD<\/span> and mental health symptoms, which can trigger each other. Eating a&nbsp;healthy diet is part of a&nbsp;healthy life\u00adstyle, so aim to eat nutri\u00adtious, balanced meals. Avoi\u00adding too much sugar and caffeine can also be helpful for mana\u00adging <span class=\"caps\">ADHD<\/span> symptoms as well, espe\u00adci\u00adally if you already take <span class=\"caps\">ADHD<\/span> medication.<\/span><\/p>\n<h2><span>Establish a&nbsp;routine<\/span><\/h2>\n<p><span>As mentioned above, crea\u00adting your own daily routine can help keep you on track throug\u00adhout the day and get work done even if you\u2019re strugg\u00adling with <span class=\"caps\">ADHD<\/span> symptoms. You will also be more likely to have less trouble with focus, for example, if you have a&nbsp;regu\u00adlarly set time and place where you study or work on assign\u00adments. Your routine can help give back some struc\u00adture that is lost when leaving high school.<\/span><\/p>\n<h2><span>Avoid online classes<\/span><\/h2>\n<p><span>While <a href=\"https:\/\/abamastersprograms.org\/online-aba-programs-no-gre\/\">online classes<\/a> can be conve\u00adnient, they can make focus and under\u00adstan\u00adding and retai\u00adning course content chal\u00adlen\u00adging for those with <span class=\"caps\">ADHD<\/span>. When possible, attend classes in-person rather than online to decrease chances of being distracted and make the professor more acces\u00adsible for asking for accom\u00admo\u00adda\u00adtions or&nbsp;help.<\/span><\/p>\n<h1><span>More tips for students<\/span><\/h1>\n<ul>\n<li><span> <\/span><span>Use a&nbsp;highlighter<\/span><\/li>\n<li><span> <\/span><span>It\u2019s ok to doodle in class if this helps you listen<\/span><\/li>\n<li><span> <\/span><span>Taking notes can help keep you on track even if the notes don\u2019t make sense&nbsp;later<\/span><\/li>\n<li><span> <\/span><span>Study stan\u00adding&nbsp;up<\/span><\/li>\n<li><span> <\/span><span>Use a&nbsp;high\u00adlighter to help you as you&nbsp;read<\/span><\/li>\n<li><span> <\/span><span>Use the audio version of the book if you&nbsp;can<\/span><\/li>\n<li><span> <\/span><span>Use music to measure time instead of a&nbsp;timer (for example, after 3&nbsp;songs, take a&nbsp;break)<\/span><\/li>\n<li><span> <\/span><span>Get your things ready the night before<\/span><\/li>\n<li><span> <\/span><span>Create a&nbsp;list for the next day and leave it some\u00adwhere you will see&nbsp;it<\/span><\/li>\n<li><span> <\/span><span>Make plans with others to study to keep you accountable<\/span><\/li>\n<li><span> <\/span><span>Consider getting an <a href=\"https:\/\/addca.com\/adhd-coach-directory\/\"><span class=\"caps\">ADHD<\/span> coach<\/a><\/span><\/li>\n<li><span> <\/span><span>If you take medi\u00adca\u00adtion, put a&nbsp;timer in your phone to take them on&nbsp;time<\/span><\/li>\n<li><span> <\/span><span>Reach out to friends that you do have for support<\/span><\/li>\n<li><span> <\/span><span>Keep stress down with yoga, a&nbsp;walk, coffee with a&nbsp;friend, or other inter\u00adven\u00adtion that feels&nbsp;good<\/span><\/li>\n<li><span> <\/span><span>Join a&nbsp;club to connect with others<\/span><\/li>\n<li><span> <\/span><span>Keep in touch with your current friends<\/span><\/li>\n<li><span> <\/span><span>Don\u2019t give up and remember that it is always ok to ask for&nbsp;help!<\/span><\/li>\n<\/ul>\n<p><span>Remember, you\u2019re not alone. For many, this is the first time they have been away from home or on their own when it comes to mana\u00adging their own time. While not ever\u00adyone is dealing with <span class=\"caps\">ADHD<\/span>, <a href=\"https:\/\/www.cdc.gov\/adhd\/data\/index.html\">there are many who are.<\/a> Because of this, colleges and univer\u00adsi\u00adties are more neuro\u00addi\u00adver\u00adgent friendly than ever, so whether you are on your college journey already or about to embark on it, there is help along the&nbsp;way.<\/span><\/p>\n<h1><span>Additional resources<\/span><\/h1>\n<ul>\n<li><span> <\/span><span><a href=\"https:\/\/www.additudemag.com\/\">ADDi\u00adtude<\/a>: Online maga\u00adzine for those with <span class=\"caps\">ADHD<\/span> and parents of kids with&nbsp;<span class=\"caps\">ADHD<\/span>.<\/span><\/li>\n<\/ul>\n<ul>\n<li><span> <\/span><span><a href=\"https:\/\/www.mindmeister.com\/\">Mind\u00adMeister<\/a>: An online tool for visually brain\u00adstor\u00adming and orga\u00adni\u00adzing&nbsp;ideas.<\/span><\/li>\n<\/ul>\n<ul>\n<li><span> <\/span><span><a href=\"https:\/\/www.studygs.net\/\">StudyGS<\/a>: A&nbsp;resource for study stra\u00adte\u00adgies and college guidance.<\/span><\/li>\n<\/ul>\n<ul>\n<li><span> <\/span><span><a href=\"https:\/\/thearc.org\/\">TheArc<\/a>: An advo\u00adcate group for those living with intellec\u00adtual and deve\u00adlo\u00adp\u00admental disabilities.<\/span><\/li>\n<\/ul>\n<ul>\n<li><span> <\/span><span><a href=\"https:\/\/quizlet.com\/\">Quizlet<\/a>: For flash\u00adcards and studying help.<\/span><\/li>\n<\/ul>\n<ul>\n<li><span> <\/span><span><a href=\"https:\/\/www.dreamcollegedisability.org\/learn-about-us.html\"><span class=\"caps\">DREAM<\/span><\/a>: An orga\u00adniza\u00adtion that places chap\u00adters at univer\u00adsi\u00adties around the country and is run by students. Its aim is to get resources and commu\u00adnity to students with disa\u00adbi\u00adli\u00adties of all&nbsp;types.<\/span><\/li>\n<\/ul>\n<ul>\n<li><span> <\/span><span><a href=\"https:\/\/hemingwayapp.com\/\">Hemingway App<\/a>: A&nbsp;free appli\u00adca\u00adtion to help check your writing.<\/span><\/li>\n<\/ul>\n<ul>\n<li><span> <\/span><span><a href=\"https:\/\/chadd.org\/about\/\">Chadd<\/a>: An advo\u00adcacy group provi\u00adding educa\u00adtion and outreach to those with <span class=\"caps\">ADHD<\/span> and their families.<\/span><\/li>\n<\/ul>\n<ul>\n<li><span> <\/span><span><a href=\"https:\/\/play.google.com\/store\/apps\/details?id=com.alt.goodmorning&amp;pli=1\">Routi\u00adnery<\/a>: A&nbsp;free app to help track and develop habits<\/span><\/li>\n<\/ul>\n<ul>\n<li><span><a href=\"https:\/\/www.reddit.com\/r\/ADHD\/\">Reddit\u2019s <span class=\"caps\">ADHD<\/span> Commu\u00adnity (r\/<span class=\"caps\">ADHD<\/span>)<\/a><\/span><\/li>\n<\/ul>\n<p><span><br>To the original article: <\/span><span><a href=\"https:\/\/abamastersprograms.org\/thriving-in-college-with-adhd\/\" target=\"_blank\" rel=\"noopener\">https:\/\/\u200babamas\u200bters\u200bpro\u200bgrams\u200b.org\/\u200bt\u200bh\u200br\u200bi\u200bv\u200bi\u200bn\u200bg\u200b-\u200bi\u200bn\u200b-\u200bc\u200bo\u200bl\u200bl\u200be\u200bg\u200be\u200b-\u200bw\u200bi\u200bt\u200bh\u200b-\u200ba\u200bd\u200bhd\/<\/a><\/span><\/p>\n<p><a href=\"\/wp-content\/uploads\/Artikel\/ADHD_Essential_Tools_Strategies_ENG.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><span>Down\u00adload the article<br><\/span><img decoding=\"async\" src=\"https:\/\/www.melodycenter.de\/wp-content\/uploads\/2019\/03\/PDF_Symbol_small.png\" alt=\"PDF Download\"><\/a><\/p>\n<p>[\/et_pb_toggle][et_pb_toggle title=\u201cA Perspec\u00adtive on Today\u2019s <span class=\"caps\">ABA<\/span> from Dr. Greg Hanley\u201d open_toggle_text_color=\u201c#000000\u201d open_toggle_background_color=\u201crgba(255,255,255,0.7)\u201d closed_toggle_text_color=\u201d#ffffff\u201d closed_toggle_background_color=\u201c#0c71c3\u201d icon_color=\u201d#ffffff\u201d open_icon_color=\u201d#ffffff\u201d module_id=\u201copen_article_ABAperspective\u201d module_class=\u201cjump\u201d _builder_version=\u201c4.27.4\u201d title_text_color=\u201d#ffffff\u201d title_font=\u201d|700|||||||\u201d title_font_size=\u201c20px\u201d title_line_height=\u201c1.1em\u201d body_font=\u201d||||||||\u201d body_text_align=\u201cleft\u201d body_text_color=\u201c#000000\u201d custom_margin=\u201c30px||||false|false\u201d custom_padding_tablet=\u201d\u201d custom_padding_phone=\u201c10px||10px\u201d custom_padding_last_edited=\u201con|phone\u201d hover_enabled=\u201c0\u201d title_font_size_tablet=\u201c15px\u201d title_font_size_phone=\u201c14px\u201d title_font_size_last_edited=\u201con|phone\u201d body_font_size_tablet=\u201d\u201d body_font_size_phone=\u201c14px\u201d body_font_size_last_edited=\u201con|phone\u201d custom_css_before=\u201ccontent:%22%22;||display:block;||height:140px; \/* fixed header height*\/||margin:-140px 0&nbsp;0; \/* nega\u00adtive fixed header height *\/\u201d border_width_all=\u201c2px\u201d border_color_all=\u201c#e02b20\u201d icon_color__hover=\u201d\u201d icon_color__hover_enabled=\u201con\u201d global_colors_info=\u201d{}\u201d open_icon_color__hover_enabled=\u201con\u201d open_icon_color__hover=\u201d#ffffff\u201d sticky_enabled=\u201c0\u201d]<\/p>\n<p><a href=\"https:\/\/practicalfunctionalassessment.com\/2020\/06\/04\/a-perspective-on-todays-aba-by-dr-greg-hanley\/\" target=\"_blank\" rel=\"noopener noreferrer\">To the original article by&nbsp;Dr. Greg Hanley,&nbsp;June 4,&nbsp;2020<\/a><\/p>\n<p><strong>This is today\u2019s <span class=\"caps\">ABA<\/span> when starting therapy with an autistic person,&nbsp;espe\u00adci\u00adally one who routi\u00adnely engages in problem behavior.&nbsp;<\/strong><\/p>\n<p>Today\u2019s <span class=\"caps\">ABA<\/span> (applied beha\u00advior analysis) is about conti\u00adnu\u00adally lear\u00adning about the predil\u00adec\u00adtions of the autistic person being served so that preferred lear\u00adning contexts can be deve\u00adloped en route to deve\u00adlo\u00adping skills that can be appre\u00adciated by the autistic person as well as others. What follows is a&nbsp;guide for those imple\u00admen\u00adting today\u2019s <span class=\"caps\">ABA<\/span> but written for those who are curious about what today\u2019s <span class=\"caps\">ABA<\/span> involves.<\/p>\n<p><strong>Learn by listening.<\/strong><\/p>\n<p>Ask the autistic person and\/or ask people who know and love the autistic person about what he\/she\/they loves and hates. Be sure to review the love, aver\u00adsion, and indif\u00adfe\u00adrence towards acti\u00advi\u00adties, objects, furni\u00adture, contexts, and espe\u00adci\u00adally social inter\u00adac\u00adtions. Ask that person about the autistic person\u2019s voice. How do they routi\u00adnely commu\u00adni\u00adcate? And, espe\u00adci\u00adally, what are they commu\u00adni\u00adca\u00adting with their problem beha\u00advior? In other words, today\u2019s <span class=\"caps\">ABA<\/span> starts with asking ques\u00adtions, listening, and lear\u00adning about the autistic person by people who know and love the autistic person.<\/p>\n<p><strong>Learn by crea\u00adting&nbsp;joy.&nbsp;<\/strong><\/p>\n<p>From that conver\u00adsa\u00adtion, put toge\u00adther a&nbsp;context in which the autistic person will be happy, relaxed, and engaged, one in which they will feel safe and in control. Enrich this space with all of the objects and acti\u00advi\u00adties that they love. Don\u2019t be stingy with the stuff\u2013more is better. Be sure to include all the things that they have lost in the past because they could not handle their removal or because they engaged with them in unique, stig\u00adma\u00adtizing, or disrup\u00adtive&nbsp;ways.<\/p>\n<p>Do not rest\u00adrict in any way their freedom to do or move. Keep the door open. Follow their lead, physi\u00adcally and conver\u00adsa\u00adtio\u00adnally. Let the autistic person bring other mate\u00adrials to this context, remove mate\u00adrials in this context, repo\u00adsi\u00adtion objects and people in this context, and essen\u00adti\u00adally rede\u00adsign it with either their actions or&nbsp;words.<\/p>\n<p>Be sure to create clear signals of your submis\u00adsion (i.e., remove all signals of dominance\u2014hovering too close or stan\u00adding above them). During this time, avoid all acts of redi\u00adrec\u00adtion, promp\u00adting, teaching, ques\u00adtio\u00adning, and language expan\u00adsion. Be 100% available to the autistic person but do not add your \u201ctwo-cents\u201d to the situa\u00adtion unless asked. Reserve even praise unless the autistic person initiates by sharing what they are doing or just did with you and you are authen\u00adti\u00adcally impressed. Do not super\u00advise the expe\u00adri\u00adence; share in it without taking it over in any&nbsp;way.<\/p>\n<p>Respond to all attempts to communicate\u2013this will happen the sooner you stop trying to lead the situa\u00adtion. Help them, for instance, not when they struggle, but when they indi\u00adcate they would like assis\u00adtance. Be earnest in your attempts to help even when you are not sure how to do so. Do not let any beha\u00advior towards you be ignored; react to their beha\u00advior in normal ways, just do not attempt inspire the next interaction\u2014let them&nbsp;lead.<\/p>\n<p>Continue revi\u00adsing the context and your manner of inter\u00adac\u00adtion until the autistic person does not want to be anywhere but there. Let them \u201cvote with their feet.\u201d Besides being digni\u00adfying and avoi\u00adding regrettable physical manage\u00adment, allo\u00adwing them to leave the space provides good infor\u00adma\u00adtion. Leaving means some\u00adthing important is missing or some\u00adthing aver\u00adsive is present. Keep working on buil\u00adding and refi\u00adning the context until the autistic person is happy, relaxed, and engaged for an extended period. Reco\u00adgnize that happy, relaxed, and engaged looks very diffe\u00adrent for diffe\u00adrent autistic persons, which is why it is essen\u00adtial that someone who knows and loves the autistic person is present at this and the next step of the process.<\/p>\n<p>In sum, teach the autistic person that you know them, you see them, you hear them, and you are there for them. This is the first and crucial step in today\u2019s <span class=\"caps\">ABA<\/span>.<\/p>\n<p><strong>Learn by empowering.<\/strong><\/p>\n<p>After you are confi\u00addent that you can create a&nbsp;safe and enga\u00adging context and there is zero proba\u00adbi\u00adlity of any severe problem beha\u00advior in this context, it is time to empower the autistic person further and estab\u00adlish trust between you and the autistic person. It starts by clearly signaling that the prevai\u00adling condi\u00adtions are about to change, and for the worse, but be clear and kind about it. Through normal actions and words, make it clear to the autistic person that you would like them to stop what they are doing, set aside their mate\u00adrials, move in a&nbsp;diffe\u00adrent direc\u00adtion, inhibit any self-stimu\u00adla\u00adtory beha\u00advior, and tran\u00adsi\u00adtion to an area in which deve\u00adlo\u00adp\u00admen\u00adtally appro\u00adpriate instruction\/expectations will commence. Be sure this area of high expec\u00adta\u00adtions is set aside to some extent and popu\u00adlated with all the chal\u00adlen\u00adging acti\u00advi\u00adties and expec\u00adta\u00adtions reported by those who know and love this autistic person as important for his\/her\/their development.<\/p>\n<p>If the autistic person shows any explicit sign of distress, discom\u00adfort, or protest in the form of either minor or severe problem beha\u00advior while tran\u00adsi\u00adtio\u00adning from essen\u00adti\u00adally&nbsp;<em>their way<\/em>&nbsp;to&nbsp;<em>your way<\/em>, acknow\u00adledge it imme\u00addia\u00adtely and relent. Let the autistic person return to their way and resume follo\u00adwing their lead until he\/she\/they gets back to their version of happy, relaxed, and engaged for a&nbsp;short period.<\/p>\n<p>Repeat this process until it is obvious that the autistic person is empowered and under\u00adstands that they do not need to comply against their will and they do not need to esca\u00adlate to escape or avoid the things they don\u2019t want or obtain the things they do want. Teach them that you see them, hear them, and under\u00adstand them even more now, despite the some\u00adtimes lack of precision or general accep\u00adta\u00adbi\u00adlity of their commu\u00adni\u00adca\u00adtion.&nbsp;Teach them to trust you.&nbsp;In this period, be clear, be alert, be quick, and be consis\u00adtent. From this reset\u00adting of the rela\u00adti\u00adonship, you will even\u00adtually restore balance and be able rein\u00adtro\u00adduce the ambi\u00adguity and chal\u00adlenges of life without problem beha\u00advior returning.<\/p>\n<p><strong>Learn while teaching.<\/strong><\/p>\n<p>The path to a&nbsp;joyous life\u00adstyle for fami\u00adlies with autistic persons is paved with skills. The big pavers are play\/leisure skills, commu\u00adni\u00adca\u00adtion, tole\u00adra\u00adtion, and coope\u00adra\u00adtion. Once these are set, the bran\u00adching paths are endless. Today\u2019s <span class=\"caps\">ABA<\/span> process conti\u00adnues by repla\u00adcing the beha\u00advior reve\u00adaled in the empower\u00adment phase with an easier one that will be better received by others. The process involves gradu\u00adally intro\u00addu\u00adcing ambi\u00adguity as to whether the new commu\u00adni\u00adca\u00adtion skill will work and by stret\u00adching the periods of coope\u00adra\u00adtion. The pace and aims of this treat\u00adment process are conti\u00adnu\u00adally informed by feed\u00adback provided by the autistic person, both in terms of what they say and do. Gone are the days of working through problem beha\u00advior and nega\u00adtive emotional responses\u2014those are indic\u00adtors that the treat\u00adment process needs to be adjusted, and not at the team meeting, but at that moment.<\/p>\n<p>This treat\u00adment process is one in which the starting point is a&nbsp;happy, relaxed, and engaged autistic person. The themes of I&nbsp;see you, I&nbsp;hear you, I&nbsp;under\u00adstand you, and I&nbsp;am here for you persist throug\u00adhout the entire process. It bears repea\u00adting that there is no obli\u00adga\u00adtion to teach while children are upset in any way or under any duress. Hasty efforts at promo\u00adting compli\u00adance or deter\u00admi\u00adning the deve\u00adlo\u00adp\u00admental status of an autistic person are not cham\u00adpioned in this process. That which is cham\u00adpioned is estab\u00adli\u00adshing trust, enga\u00adge\u00adment, authen\u00adti\u00adcity, and agency. Coope\u00adra\u00adtion in shared expe\u00adri\u00adences follows. Acknow\u00adledged in this process is that skills will be learned both during therapist\u2011, teacher\u2011, and parent-led times as well as during times in which the autistic person is leading. Also reco\u00adgnized is the under\u00adstan\u00adding that deve\u00adlo\u00adp\u00admental assess\u00adment is best under\u00adtaken once trust and persis\u00adtence in diffi\u00adcult tasks has been established.<\/p>\n<p>Today\u2019s <span class=\"caps\">ABA<\/span> is trauma-informed. It is to be assumed that any person in the care of a&nbsp;beha\u00advior analyst for problem beha\u00advior has expe\u00adri\u00adenced multiple adverse events, with many excee\u00adding the criteria for acknow\u00adled\u00adging that trauma has been expe\u00adri\u00adenced. By lear\u00adning through listening; by enri\u00adching thera\u00adpeutic contexts; by buil\u00adding and main\u00adtai\u00adning trust; by follo\u00adwing one\u2019s lead; by relying on perso\u00adna\u00adlized contexts in which people are happy, relaxed, and engaged; by listening to commu\u00adni\u00adca\u00adtion bids; by not working people through noncom\u00adpli\u00adance or emotional duress; by allo\u00adwing people to walk away; by making decis\u00adions based on perfor\u00admance; and by teaching from joy; today\u2019s <span class=\"caps\">ABA<\/span> is trauma-informed.<\/p>\n<p><strong>Final Reflec\u00adtions<\/strong><\/p>\n<p>Our world, our country, and yes, our little field of <span class=\"caps\">ABA<\/span> are at all at their own cross\u00adroads. The time to recon\u00adsider the status quo is now, whether it be as mundane as how to work in an office and socia\u00adlize in restau\u00adrants or as profound as dismant\u00adling systemic racism. Our issues in <span class=\"caps\">ABA<\/span> are some\u00adwhere in between but I&nbsp;daresay that our issues share chal\u00adlenges asso\u00adciated with getting back to work in the midst of the coro\u00adna\u00advirus and addres\u00adsing inju\u00ads\u00adtices for people of color, espe\u00adci\u00adally black people in America.&nbsp;Let\u2019s learn from others, espe\u00adci\u00adally those expert in public health policy, human rights, and criminal justice as we make our way. But let us not wait any longer to get on the right side of history.<\/p>\n<p>Ours is not to domi\u00adnate but to de-esca\u00adlate or better yet prevent escala\u00adtion in the first place. Ours is not to coerce (thank you Murray Sidman!) but to listen, learn, guide, and coach. Ours is not to redi\u00adrect, restrain, or merely manage and modify. Ours is to under\u00adstand, share, and shape. Ours is to prio\u00adri\u00adtize safety, rapport, and the tele\u00advi\u00adsi\u00adbi\u00adlity of what we do above all else. We have proven that meaningful outcomes can follow when we prio\u00adri\u00adtize these things (see&nbsp;<a href=\"https:\/\/www.practicalfunctionalassessment.com\/\" target=\"_blank\" rel=\"noopener noreferrer\">www\u200b.prac\u200bti\u200bcal\u200bfunc\u200btion\u200bal\u200bas\u200bsess\u200bment\u200b.com<\/a>).<\/p>\n<p>To those who do not know this as <span class=\"caps\">ABA<\/span> or who down\u00adright despise <span class=\"caps\">ABA<\/span>: I&nbsp;hear you and I&nbsp;under\u00adstand where the confu\u00adsion or hatred comes from. I&nbsp;acknow\u00adledge that our field has been asso\u00adciated with wrongs on its journey of helping autistic people and members of under\u00adserved popu\u00adla\u00adtions (i.e., those with intellec\u00adtual disa\u00adbi\u00adli\u00adties). Our coll\u00adec\u00adtive attempts at helping are better now than they were, and both rese\u00adarch and prac\u00adtice reveal to me that beha\u00advior analysts doing better is conti\u00adnuing. I&nbsp;also reco\u00adgnize that impro\u00adve\u00adment is not inevi\u00adtable just because we embrace a&nbsp;form of scien\u00adtific method. Values-based move\u00adments have been displaced from <span class=\"caps\">ABA<\/span> in the name of science for as long as <span class=\"caps\">ABA<\/span> has been in exis\u00adtence. This is a&nbsp;sad and uncom\u00adfor\u00adtable truth, but one within our power to address if we listen to the voices of dissent that have been margi\u00adna\u00adlized for too&nbsp;long.<\/p>\n<p><span class=\"caps\">ABA<\/span> has the poten\u00adtial to inflict trauma, and it has the poten\u00adtial to alle\u00adviate trauma. I&nbsp;don\u2019t want to wait for some horrific inci\u00addent being recorded for funda\u00admental change to take place. I&nbsp;have been attemp\u00adting to correct my mistakes and improve the way I&nbsp;do <span class=\"caps\">ABA<\/span> through rese\u00adarch, authentic prac\u00adtice, consul\u00adting, and espe\u00adci\u00adally listening to other voices outside my choir for many years. I&nbsp;won\u2019t make excuses for my beha\u00advior or that of other BCBAs. I&nbsp;simply apolo\u00adgize. I&nbsp;apolo\u00adgize for not doing more, saying more, pushing more, or disrupting more. Consider this a&nbsp;step in the direc\u00adtion towards self-aware\u00adness, impro\u00adve\u00adment, trans\u00adpa\u00adrency, accoun\u00adta\u00adbi\u00adlity, and an obvious commit\u00adment to protec\u00adting the rights of those we serve. I&nbsp;hope you will join me on this quicke\u00adning walk towards a&nbsp;more perfect <span class=\"caps\">ABA<\/span> to help fami\u00adlies of autistic persons whose lives are nega\u00adtively impacted by problem behavior.<\/p>\n<p><em>* Thanks to Dr. Anthony Cammil\u00adleri for his sugges\u00adtions and encou\u00adra\u00adge\u00adment with respect to this&nbsp;paper.<\/em><\/p>\n<p>[\/et_pb_toggle][et_pb_toggle title=\u201cProtecting children from sexual abuse\u201d open_toggle_text_color=\u201c#000000\u201d open_toggle_background_color=\u201crgba(255,255,255,0.7)\u201d closed_toggle_text_color=\u201d#ffffff\u201d closed_toggle_background_color=\u201c#0c71c3\u201d icon_color=\u201d#ffffff\u201d open_icon_color=\u201d#ffffff\u201d module_id=\u201copen_article_abuse\u201d module_class=\u201cjump\u201d _builder_version=\u201c4.16\u201d title_text_color=\u201d#ffffff\u201d title_font=\u201d|700|||||||\u201d title_font_size=\u201c20px\u201d title_line_height=\u201c1.1em\u201d body_font=\u201d||||||||\u201d body_text_align=\u201cleft\u201d body_text_color=\u201c#000000\u201d custom_padding_tablet=\u201d\u201d custom_padding_phone=\u201c10px||10px\u201d custom_padding_last_edited=\u201con|phone\u201d title_font_size_tablet=\u201c15px\u201d title_font_size_phone=\u201c14px\u201d title_font_size_last_edited=\u201con|phone\u201d body_font_size_tablet=\u201d\u201d body_font_size_phone=\u201c14px\u201d body_font_size_last_edited=\u201con|phone\u201d custom_css_before=\u201ccontent:%22%22;||display:block;||height:140px; \/* fixed header height*\/||margin:-140px 0&nbsp;0; \/* nega\u00adtive fixed header height *\/\u201d border_width_all=\u201c2px\u201d border_color_all=\u201c#e02b20\u201d icon_color__hover=\u201d\u201d icon_color__hover_enabled=\u201con\u201d global_colors_info=\u201d{}\u201d open_icon_color__hover_enabled=\u201con\u201d open_icon_color__hover=\u201d#ffffff\u201d]<\/p>\n<p>Most children will enjoy a&nbsp;happy child\u00adhood, full of love, support and oppor\u00adtu\u00adni\u00adties for growth. Rela\u00adti\u00adonships with parents, siblings, the extended family and friends will help them develop neces\u00adsary social skills to fulfill their need to be included in the commu\u00adnity and excel with others.<\/p>\n<p>Unfort\u00adu\u00adna\u00adtely, a&nbsp;few children will be exposed to nega\u00adtive rela\u00adti\u00adonships, some of which can be extre\u00admely harmful. This docu\u00adment aims to increase aware\u00adness of sexu\u00adally abusive rela\u00adtions and guide parents and profes\u00adsio\u00adnals on how to create safe envi\u00adron\u00adments for children to grow and interact safely.<\/p>\n<p><strong>Key Facts:<\/strong><\/p>\n<ul>\n<li><span>Some forms of sexual abuse include having inter\u00adcourse with a&nbsp;child, touching a&nbsp;child\u2019s geni\u00adtals for sexual plea\u00adsure or produ\u00adcing porno\u00adgra\u00adphic images of children.<\/span><\/li>\n<li><span>1 in every 10 minors will suffer sexual abuse by the age of&nbsp;18.<\/span><\/li>\n<li><span>About 93% of victims suffer sexual abuse by someone known to them or their family.<\/span><\/li>\n<li><span>About 82% of victims below the age of 18 are&nbsp;girls.<\/span><\/li>\n<li><span>In 88% of sexual abuse cases, the perpe\u00adtrator is&nbsp;male.<\/span><\/li>\n<li><span>Appro\u00adxi\u00adm\u00adately one third of perpe\u00adtra\u00adtors is an older child. In the remai\u00adning cases, the perpe\u00adtrator is an&nbsp;adult.<\/span><\/li>\n<li><span>Children with disa\u00adbi\u00adli\u00adties and younger children who cannot yet commu\u00adni\u00adcate with others are parti\u00adcu\u00adlarly vulnerable.<\/span><\/li>\n<li><span>Remember that if abuse occurs, the perpe\u00adtrator is to blame and not the child or yourself.<\/span><\/li>\n<\/ul>\n<p><strong>Guide\u00adlines:<\/strong><\/p>\n<ul>\n<li><span>Sexual abuse is <strong>preven\u00adtable<\/strong> by crea\u00adting safe spaces and know\u00adled\u00adgeable adults and by encou\u00adra\u00adging children to&nbsp;talk.<\/span><\/li>\n<li><span>Ensure profes\u00adsio\u00adnals and parents are aware of <strong>guide\u00adlines<\/strong> for safe\u00adguar\u00adding children from sexual abuse.&nbsp;<\/span><\/li>\n<li><span>Adopt an <strong>open door policy<\/strong> for class\u00adrooms, therapy rooms and leisure activities.<\/span><\/li>\n<li><span>Observe physical signs or changes in beha\u00advior or mood during daily routines that could indi\u00adcate ongoing distress (e.g., marks around private parts, complains about pain, reduced appe\u00adtite, disturbed slee\u00adping pattern, unex\u00adplained nervous\u00adness or crying, disturbed toile\u00adting habits, etc.).<\/span><\/li>\n<li><span>Notice if your child seems to know or describes <strong>things that you would not expect them to know<\/strong> accor\u00adding to their age and deve\u00adlo\u00adp\u00admental stage (e.g., a&nbsp;pre-school child describing sexual acts).<\/span><\/li>\n<li><span>Teach your child what kind of <strong>beha\u00advior<\/strong> is <strong>accep\u00adtable<\/strong> <strong>by others<\/strong> and how to <strong>calmly say \u201cNo\u201d<\/strong>. For example, tell them who can see their private body parts (e.g., doctors) and instruct them to say \u201cNo\u201d to anyone else trying to touch them or asking them to touch their own body&nbsp;parts.<\/span><\/li>\n<li><strong><span>Children with disa\u00adbi\u00adli\u00adties<\/span><\/strong><span> are parti\u00adcu\u00adlarly <strong>vulnerable<\/strong> and should be educated on <strong>healthy social rela\u00adti\u00adonships<\/strong> and <strong>sexua\u00adlity<\/strong>. This includes trai\u00adning on <strong>basic life skills<\/strong> that increase their <strong>inde\u00adpen\u00addence<\/strong>, such as toile\u00adting, dres\u00adsing, bathing, naming body parts inclu\u00adding geni\u00adtals, etc. This will reduce the amount of high risk situa\u00adtions they are exposed at and increase their ability to commu\u00adni\u00adcate any concerns to&nbsp;you.<\/span><\/li>\n<li><span>When\u00adever there is <strong>one-to-one teaching<\/strong> involved in a&nbsp;setting, home, school or acti\u00advity clubs, we should have <strong>safe\u00adguar\u00adding measures<\/strong> in place. Espe\u00adci\u00adally high risk situa\u00adtions, such as toilet, dres\u00adsing, swim\u00adming and similar should involve <strong>two adults<\/strong> at all times. If staff resour\u00adcing is an issue and you cannot have two adults present, <strong>adopt alter\u00adna\u00adtive measures<\/strong>: offer trai\u00adning, issue guide\u00adlines for children safe\u00adguar\u00adding, check adults\u2019 criminal back\u00adground and profes\u00adsional refe\u00adrences, conduct frequent random checks and super\u00advi\u00adsion of acti\u00advi\u00adties, adopt one-way mirrors in one-to-one work rooms, film sessions.<\/span><\/li>\n<li><span>Parents should be <strong>allowed to watch educa\u00adtional<\/strong> sessions frequently and when\u00adever this is not possible, alter\u00adna\u00adtive means of trai\u00adning them and protec\u00adting children should be in place (e.g., film videos that can later on be examined toge\u00adther with parents).<\/span><\/li>\n<li><span>Teach children to say \u201cNo\u201d in a&nbsp;calm way and <strong>respect their wishes<\/strong>. Children should be able to <strong>make choices<\/strong> that are propor\u00adtio\u00adnate to their deve\u00adlo\u00adp\u00admental level and in their own benefit. For example, they should be able to choose not to kiss or hug a&nbsp;rela\u00adtive and shake hands instead. Keep expec\u00adta\u00adtions for achie\u00adve\u00adment and main\u00adtain a&nbsp;struc\u00adture that helps kids to develop auto\u00adno\u00admously but keep these expec\u00adta\u00adtions in a&nbsp;balance with indi\u00advi\u00addual auto\u00adnomy and the fact that children have chan\u00adging needs and the right to choose. Educa\u00adtors should not expect or teach full compli\u00adance to any child; they should instead seek to develop every child\u2019s full poten\u00adtial by <strong>respec\u00adting their prefe\u00adrences and adop\u00adting evidence-based prac\u00adtices<\/strong>. Read the bene\u00adfits of offe\u00adring choice at <a href=\"https:\/\/link.springer.com\/article\/10.1007\/s40489-018-00154-7\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/link.springer.com\/article\/10.1007\/s40489-018\u201300154\u20117<\/a><\/span><\/li>\n<li><strong><span>Risk assess\u00adments<\/span><\/strong><span> should be conducted by schools and after\u00adschool clubs (or parents, when profes\u00adsio\u00adnals are employed at home) and children safe\u00adguar\u00adding measures should be put in place. Ask your child\u2019s school about such guide\u00adlines and if they do not have a&nbsp;policy, share the present docu\u00adment with&nbsp;them.<\/span><\/li>\n<\/ul>\n<p><strong>Resources:<\/strong><\/p>\n<ul>\n<li><span>Chicago Children\u2019s Advo\u00adcacy Center <a href=\"https:\/\/www.chicagocac.org\/resources\/sexual-abuse-resources\/preventing-sexual-abuse\/\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/\u200bwww\u200b.chica\u200bgocac\u200b.org\/\u200br\u200be\u200bs\u200bo\u200bu\u200br\u200bc\u200be\u200bs\u200b\/\u200bs\u200be\u200bx\u200bu\u200ba\u200bl\u200b-\u200ba\u200bb\u200bu\u200bs\u200be\u200b-\u200br\u200be\u200bs\u200bo\u200bu\u200br\u200bc\u200be\u200bs\u200b\/\u200bp\u200br\u200be\u200bv\u200be\u200bn\u200bt\u200bi\u200bn\u200bg\u200b-\u200bs\u200be\u200bx\u200bu\u200ba\u200bl\u200b-\u200ba\u200bb\u200bu\u200bse\/<\/a><\/span><\/li>\n<li><span>Child Mind Insti\u00adtute <a href=\"https:\/\/childmind.org\/article\/10-ways-to-teach-your-child-the-skills-to-prevent-sexual-abuse\/\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/\u200bchild\u200bmind\u200b.org\/\u200ba\u200br\u200bt\u200bi\u200bc\u200bl\u200be\u200b\/\u200b1\u200b0\u200b-\u200bw\u200ba\u200by\u200bs\u200b-\u200bt\u200bo\u200b-\u200bt\u200be\u200ba\u200bc\u200bh\u200b-\u200by\u200bo\u200bu\u200br\u200b-\u200bc\u200bh\u200bi\u200bl\u200bd\u200b-\u200bt\u200bh\u200be\u200b-\u200bs\u200bk\u200bi\u200bl\u200bl\u200bs\u200b-\u200bt\u200bo\u200b-\u200bp\u200br\u200be\u200bv\u200be\u200bn\u200bt\u200b-\u200bs\u200be\u200bx\u200bu\u200ba\u200bl\u200b-\u200ba\u200bb\u200bu\u200bse\/<\/a><\/span><\/li>\n<li><span>Dark\u00adness to Light <a href=\"https:\/\/www.d2l.org\/the-issue\/statistics\/\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/\u200bwww\u200b.d2l\u200b.org\/\u200bt\u200bh\u200be\u200b-\u200bi\u200bs\u200bs\u200bu\u200be\u200b\/\u200bs\u200bt\u200ba\u200bt\u200bi\u200bs\u200bt\u200bi\u200bcs\/<\/a><\/span><\/li>\n<li><span>National Society for the Preven\u00adtion of Cruelty to Children <a href=\"https:\/\/www.nspcc.org.uk\/preventing-abuse\/child-abuse-and-neglect\/child-sexual-abuse\/?utm_source=meganav&amp;utm_medium=&amp;utm_campaign=\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/\u200bwww\u200b.nspcc\u200b.org\u200b.uk\/\u200bp\u200br\u200be\u200bv\u200be\u200bn\u200bt\u200bi\u200bn\u200bg\u200b-\u200ba\u200bb\u200bu\u200bs\u200be\u200b\/\u200bc\u200bh\u200bi\u200bl\u200bd\u200b-\u200ba\u200bb\u200bu\u200bs\u200be\u200b-\u200ba\u200bn\u200bd\u200b-\u200bn\u200be\u200bg\u200bl\u200be\u200bc\u200bt\u200b\/\u200bc\u200bh\u200bi\u200bl\u200bd\u200b-\u200bs\u200be\u200bx\u200bu\u200ba\u200bl\u200b-\u200ba\u200bb\u200bu\u200bs\u200be\u200b\/\u200b?\u200bu\u200bt\u200bm\u200b_\u200bs\u200bo\u200bu\u200br\u200bc\u200be\u200b=\u200bm\u200be\u200bg\u200ba\u200bn\u200ba\u200bv\u200b<span class=\"amp\">&amp;<\/span>\u200bu\u200bt\u200bm\u200b_\u200bm\u200be\u200bd\u200bi\u200bu\u200bm\u200b=\u200b<span class=\"amp\">&amp;<\/span>\u200bu\u200bt\u200bm\u200b_\u200bc\u200ba\u200bm\u200bp\u200ba\u200bign=<\/a><\/span><\/li>\n<li><span>Stop It Now! <a href=\"https:\/\/www.stopitnow.org\/sites\/default\/files\/documents\/files\/prevent_child_sexual_abuse.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/\u200bwww\u200b.stopitnow\u200b.org\/\u200bs\u200bi\u200bt\u200be\u200bs\u200b\/\u200bd\u200be\u200bf\u200ba\u200bu\u200bl\u200bt\u200b\/\u200bf\u200bi\u200bl\u200be\u200bs\u200b\/\u200bd\u200bo\u200bc\u200bu\u200bm\u200be\u200bn\u200bt\u200bs\u200b\/\u200bf\u200bi\u200bl\u200be\u200bs\u200b\/\u200bp\u200br\u200be\u200bv\u200be\u200bn\u200bt\u200b_\u200bc\u200bh\u200bi\u200bl\u200bd\u200b_\u200bs\u200be\u200bx\u200bu\u200ba\u200bl\u200b_\u200ba\u200bb\u200bu\u200bs\u200be\u200b.\u200bpdf<\/a><\/span><\/li>\n<li><span>The National Center for Victims of Crime <a href=\"https:\/\/victimsofcrime.org\/media\/reporting-on-child-sexual-abuse\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/\u200bvictim\u200bsof\u200bcrime\u200b.org\/\u200bm\u200be\u200bd\u200bi\u200ba\u200b\/\u200br\u200be\u200bp\u200bo\u200br\u200bt\u200bi\u200bn\u200bg\u200b-\u200bo\u200bn\u200b-\u200bc\u200bh\u200bi\u200bl\u200bd\u200b-\u200bs\u200be\u200bx\u200bu\u200ba\u200bl\u200b-\u200ba\u200bb\u200buse<\/a><\/span><\/li>\n<li><span><span class=\"caps\">RAINN<\/span> (Rape, Abuse <span class=\"amp\">&amp;<\/span>&nbsp;Incest National Network) <a href=\"https:\/\/www.rainn.org\/statistics\/children-and-teens\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/\u200bwww\u200b.rainn\u200b.org\/\u200bs\u200bt\u200ba\u200bt\u200bi\u200bs\u200bt\u200bi\u200bc\u200bs\u200b\/\u200bc\u200bh\u200bi\u200bl\u200bd\u200br\u200be\u200bn\u200b-\u200ba\u200bn\u200bd\u200b-\u200bt\u200be\u200bens<\/a><\/span><\/li>\n<\/ul>\n<p><a href=\"\/wp-content\/uploads\/Artikel\/Protecting_children_from%20_sexual_abuse.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Down\u00adload the article as <span class=\"caps\">PDF<\/span><strong><span><br> <\/span><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.melodycenter.de\/wp-content\/uploads\/2019\/03\/PDF_Symbol_small.png\" alt=\"PDF download\" width=\"65\" height=\"80\">&nbsp;<\/strong><\/a><\/p>\n<p><strong>Created by Dr Kate\u00adrina Dounavi<\/strong><\/p>\n<p>Psycho\u00adlo\u00adgist (EuroPsy), Beha\u00advior Analyst (<span class=\"caps\">BCBA<\/span>\u2011D)<\/p>\n<p style=\"text-align: left;\">[\/et_pb_toggle][et_pb_toggle title=\u201cApplied Beha\u00advior analysis: The scien\u00adtific base of an incre\u00adasingly popular inter\u00adven\u00adtion for children with autism\u201d open_toggle_text_color=\u201c#000000\u201d open_toggle_background_color=\u201crgba(255,255,255,0.7)\u201d closed_toggle_text_color=\u201d#ffffff\u201d closed_toggle_background_color=\u201c#0c71c3\u201d icon_color=\u201d#ffffff\u201d open_icon_color=\u201d#ffffff\u201d _builder_version=\u201c4.16\u201d title_text_color=\u201d#ffffff\u201d title_font=\u201d|700|||||||\u201d title_font_size=\u201c20px\u201d title_line_height=\u201c1.1em\u201d body_font=\u201d||||||||\u201d body_text_align=\u201cleft\u201d body_text_color=\u201c#000000\u201d custom_padding_tablet=\u201d\u201d custom_padding_phone=\u201c10px||10px\u201d custom_padding_last_edited=\u201con|phone\u201d title_font_size_tablet=\u201c15px\u201d title_font_size_phone=\u201c14px\u201d title_font_size_last_edited=\u201con|phone\u201d body_font_size_tablet=\u201d\u201d body_font_size_phone=\u201c14px\u201d body_font_size_last_edited=\u201con|phone\u201d border_width_all=\u201c2px\u201d border_color_all=\u201c#e02b20\u201d icon_color__hover=\u201d\u201d icon_color__hover_enabled=\u201con\u201d global_colors_info=\u201d{}\u201d open_icon_color__hover_enabled=\u201con\u201d open_icon_color__hover=\u201d#ffffff\u201d]<\/p>\n<p style=\"text-align: left;\"><a href=\"\/wp-content\/uploads\/Artikel\/Wissenschaftlich_erprobte_lernpsychologisch_fundierte_ABA-basierte_Behandlungen.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-size: 16px;\">Down\u00adload the article as <span class=\"caps\">PDF<\/span><br> <\/span><img decoding=\"async\" src=\"https:\/\/www.melodycenter.de\/wp-content\/uploads\/2019\/03\/PDF_Symbol_small.png\" alt=\"PDF download\" style=\"width: 69px; height: 84px;\"><br> <\/a><\/p>\n<p>[\/et_pb_toggle][et_pb_toggle title=\u201cTowards true multi\u00addi\u00adsci\u00adpli\u00adna\u00adrity\u201d open_toggle_text_color=\u201c#000000\u201d open_toggle_background_color=\u201crgba(255,255,255,0.7)\u201d closed_toggle_text_color=\u201d#ffffff\u201d closed_toggle_background_color=\u201c#0c71c3\u201d icon_color=\u201d#ffffff\u201d open_icon_color=\u201d#ffffff\u201d _builder_version=\u201c4.16\u201d title_text_color=\u201d#ffffff\u201d title_font=\u201d|700|||||||\u201d title_font_size=\u201c20px\u201d body_font=\u201d||||||||\u201d body_text_align=\u201cleft\u201d body_text_color=\u201c#000000\u201d custom_padding_tablet=\u201d\u201d custom_padding_phone=\u201c10px||10px\u201d custom_padding_last_edited=\u201con|phone\u201d title_font_size_tablet=\u201c15px\u201d title_font_size_phone=\u201c14px\u201d title_font_size_last_edited=\u201con|phone\u201d body_font_size_tablet=\u201d\u201d body_font_size_phone=\u201c14px\u201d body_font_size_last_edited=\u201con|phone\u201d border_width_all=\u201c2px\u201d border_color_all=\u201c#e02b20\u201d icon_color__hover=\u201d\u201d icon_color__hover_enabled=\u201con\u201d global_colors_info=\u201d{}\u201d open_icon_color__hover_enabled=\u201con\u201d open_icon_color__hover=\u201d#ffffff\u201d]<\/p>\n<p>3 November 2014<\/p>\n<p>Kate\u00adrina Dounavi explains how beha\u00adviour analysis can feed multi\u00addi\u00adsci\u00adpli\u00adnary&nbsp;work.<\/p>\n<p style=\"text-align: justify;\">Multi\u00addi\u00adsci\u00adpli\u00adna\u00adrity is regarded as a&nbsp;crucial part of educa\u00adtional (and clinical) assess\u00adment and inter\u00adven\u00adtion. But colla\u00adbo\u00adra\u00adtive work by cross-disci\u00adpli\u00adnary teams calls for a&nbsp;solid scien\u00adtific base which permits mutual under\u00adstan\u00adding, concep\u00adtual cohe\u00adrence, and consis\u00adtent appli\u00adca\u00adtions and evalua\u00adtions of outcomes. Without this common ground, profes\u00adsio\u00adnals coming from diffe\u00adrent back\u00adgrounds might end up adop\u00adting a&nbsp;mixture of conflic\u00adting and inco\u00adherent approa\u00adches which are coun\u00adter\u00adpro\u00adduc\u00adtive for those they are trying to help. The evidence from condi\u00adtions such as Autism Spec\u00adtrum Disorder (<span class=\"caps\">ASD<\/span>) and other special educa\u00adtional needs suggests that most, if not all, effec\u00adtive inter\u00adven\u00adtions are beha\u00advioural in nature. This leads us to think that Applied Beha\u00adviour Analysis (<span class=\"caps\">ABA<\/span>), the applied branch of the science of beha\u00adviour analysis, may well serve as the solid basis required for produc\u00adtive cross-disci\u00adpline work that enhances students\u2019 learning.<\/p>\n<p style=\"text-align: justify;\"><span class=\"caps\">ABA<\/span>\u2019s metho\u00addo\u00adlogy is diffe\u00adrent from tradi\u00adtional approa\u00adches in that it empha\u00adsises data-based decision making. It makes use of opera\u00adtional defi\u00adni\u00adtions of target beha\u00adviours; the break-up of complex skills into teachable units; objec\u00adtive measures of progress; and the imple\u00admen\u00adta\u00adtion of scien\u00adtific prin\u00adci\u00adples and methods in teaching. These include rein\u00adforce\u00adment, shaping and promp\u00adting. Promp\u00adting is the process of encou\u00adra\u00adging desired beha\u00adviours. Rein\u00adforce\u00adment is the rewar\u00adding of these beha\u00adviours. shaping involves working gradu\u00adally towards a&nbsp;desired beha\u00adviour in small steps that converge upon the target. Profes\u00adsio\u00adnals trained in <span class=\"caps\">ABA<\/span>, whatever their area of exper\u00adtise, share the same code of ethics and a&nbsp;focus on evidence-based proce\u00addures. These corner\u00adstones in the prac\u00adtice of beha\u00adviour analysts \u2013 be they psycho\u00adlo\u00adgists, medical doctors, teachers, speech and language patho\u00adlo\u00adgists or allied-health profes\u00adsio\u00adnals \u2013 allow them to colla\u00adbo\u00adrate effi\u00adci\u00adently, and to bring in their special exper\u00adtise while follo\u00adwing a&nbsp;common scien\u00adtific route. In ABA-based educa\u00adtional programmes for students with <span class=\"caps\">ASD<\/span>, a&nbsp;team of ABA-trained profes\u00adsio\u00adnals would gather before the inter\u00adven\u00adtion starts and assess the student\u2019s needs in diffe\u00adrent deve\u00adlo\u00adp\u00admental areas. These might include academic, social, commu\u00adni\u00adca\u00adtion or motor skills. This assess\u00adment would be the base\u00adline against which the student\u2019s progress would be measured, and diffe\u00adrent profes\u00adsio\u00adnals would contri\u00adbute accor\u00adding to their exper\u00adtise. Occu\u00adpa\u00adtional thera\u00adpists, for instance, would provide the list of fine and gross skills to assess, accor\u00adding to the student\u2019s age. An indi\u00advi\u00addua\u00adlised educa\u00adtional curri\u00adculum would then be set for the student, incor\u00adpo\u00adra\u00adting teaching methods driven from the science, as well as indi\u00adca\u00adtions of how to break down skills into smaller teachable units and how to monitor progress. Again, diffe\u00adrent profes\u00adsio\u00adnals would set the targets and methods for diffe\u00adrent&nbsp;areas.<\/p>\n<p style=\"text-align: justify;\">Conti\u00adnuous measu\u00adre\u00adment of the student\u2019s progress by all profes\u00adsio\u00adnals would provide the basis for main\u00adtai\u00adning teaching proce\u00addures that work, and chan\u00adging or substi\u00adtu\u00adting the ones that do not seem to yield the best outcomes. To illus\u00adtrate how this might work, let\u2019s take a&nbsp;student who is curr\u00adently recei\u00adving ABA-based one-to-one instruc\u00adtion at home and atten\u00adding a&nbsp;main\u00adstream school with an ABA-trained shadow teacher. At the begin\u00adning of the academic year, all profes\u00adsio\u00adnals involved in the student\u2019s educa\u00adtion would meet with parents to discuss the lear\u00adning goals for the upco\u00adming year and decide on the most appro\u00adpriate teaching proce\u00addures to achieve them. For instance, if the student needed to learn how to respond to the teacher\u2019s ques\u00adtions on specific content, the follo\u00adwing stra\u00adtegy might be adopted: the one-to-one tutor would teach the mate\u00adrial at home and record progress. The shadow teacher would provide prompts for the student to raise her hand at appro\u00adpriate times in class. And the teacher would make sure that there were oppor\u00adtu\u00adni\u00adties for praise and other forms of rein\u00adforce\u00adment for correct responses.<\/p>\n<p>All the profes\u00adsio\u00adnals involved would gather data on whether the student incre\u00adasingly parti\u00adci\u00adpated in class. They would adapt their processes if the outcomes were not as posi\u00adtive as expected.<\/p>\n<p style=\"text-align: justify;\">It is clear that cross-disci\u00adpli\u00adnary work is possible and can prove very fruitful when teaching indi\u00advi\u00adduals with a&nbsp;variety of needs. For it to work effec\u00adtively, however, consis\u00adtent scien\u00adtific accoun\u00adta\u00adbi\u00adlity needs to underpin all strands. The science of <span class=\"caps\">ABA<\/span> has a&nbsp;long-stan\u00adding history of achie\u00adving this level of accoun\u00adta\u00adbi\u00adlity, and we recom\u00admend that more profes\u00adsio\u00adnals be trained in&nbsp;it.<\/p>\n<p><a href=\"http:\/\/magiko-sympan.gr\/\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Kate\u00adrina Dounavi<\/a>, <span class=\"caps\">BCBA<\/span>\u2011D (Board Certi\u00adfied Beha\u00advior Analyst-Doctoral), is a&nbsp;lecturer in the School of Educa\u00adtion and Deputy Director of the <a href=\"http:\/\/www.qub.ac.uk\/research-centres\/CentreforBehaviourAnalysis\/\/\" target=\"_blank\" rel=\"noopener noreferrer\">Centre for Beha\u00adviour Analysis<\/a> at Queen\u2019s Univer\u00adsity Belfast.<\/p>\n<p>Link to the original article: <a href=\"https:\/\/cerp.aqa.org.uk\/perspectives\/towards-true-multidisciplinarity\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/\u200bcerp\u200b.aqa\u200b.org\u200b.uk<\/a><\/p>\n<p>Many thanks to Anja Chlis\u00adtalla for trans\u00adla\u00adting the article Into German.<\/p>\n<p>Refe\u00adrences:<br> Dillen\u00adburger, K., R\u00f6tt\u00adgers, H. R., Dounavi, K., Sparkman, C., Keenan, M., Thyer, B., et al. (2014). Multi\u00addi\u00adsci\u00adpli\u00adnary Team\u00adwork in Autism: Can One Size Fit All? The Austra\u00adlian Educa\u00adtional and Deve\u00adlo\u00adp\u00admental Psycho\u00adlo\u00adgist, 1\u201316. 10.1017\/edp.2014.13<\/p>\n<p style=\"text-align: left;\">\n<\/p><p>[\/et_pb_toggle][et_pb_toggle title=\u201cDown Syndrome and Autistic Spec\u00adtrum Disorder: A&nbsp;look at what we know\u201d open_toggle_text_color=\u201c#000000\u201d open_toggle_background_color=\u201crgba(255,255,255,0.7)\u201d closed_toggle_text_color=\u201d#ffffff\u201d closed_toggle_background_color=\u201c#0c71c3\u201d icon_color=\u201d#ffffff\u201d open_icon_color=\u201d#ffffff\u201d _builder_version=\u201c4.16\u201d title_text_color=\u201d#ffffff\u201d title_font=\u201d|700|||||||\u201d title_font_size=\u201c20px\u201d body_font=\u201d||||||||\u201d body_text_align=\u201cleft\u201d body_text_color=\u201c#000000\u201d custom_padding_tablet=\u201d\u201d custom_padding_phone=\u201c10px||10px\u201d custom_padding_last_edited=\u201con|phone\u201d title_font_size_tablet=\u201c15px\u201d title_font_size_phone=\u201c14px\u201d title_font_size_last_edited=\u201con|phone\u201d body_font_size_tablet=\u201d\u201d body_font_size_phone=\u201c14px\u201d body_font_size_last_edited=\u201con|phone\u201d border_width_all=\u201c2px\u201d border_color_all=\u201c#e02b20\u201d icon_color__hover=\u201d\u201d icon_color__hover_enabled=\u201con\u201d inline_fonts=\u201cVerdana\u201d global_colors_info=\u201d{}\u201d open_icon_color__hover_enabled=\u201con\u201d open_icon_color__hover=\u201d#ffffff\u201d]<\/p>\n<p><b>By George T. Capone, M.D.<\/b><span> <\/span><\/p>\n<p><\/p>\n<p><i>This paper was written for the Down\u2019s Syndrome Asso\u00adcia\u00adtion news\u00adletter and is repro\u00adduced here with the permis\u00adsion of the author and the <span class=\"caps\">DSA<\/span><\/i><span> <\/span><\/p>\n<p style=\"text-align: justify;\"><span>During the past 10 years, I\u2019ve evaluated hundreds of children with Down syndrome, each one with their own strengths and weak\u00adne\u00adsses, and certainly their own perso\u00adna\u00adlity. I&nbsp;don\u2019t think I\u2019ve met a&nbsp;parent who does not care deeply for their child at the clinic. Their love and dedi\u00adca\u00adtion is obvious. But some of the fami\u00adlies stand out in my mind. Some\u00adtimes parents bring their child with Down Syndrome to the clinic \u2014 not always for the first time \u2014 and they are deeply distraught about a&nbsp;change in their child\u2019s beha\u00adviour or deve\u00adlo\u00adp\u00adment. Some\u00adtimes they describe situa\u00adtions and isolated concerns that worry them such as their child has stopped lear\u00adning new signs or using speech. He is happy playing by himself, seeming to need no one else to make the odd game (shaking a&nbsp;toy, lining things up) he is playing fun. When they call to him, he doesn\u2019t look at them. Maybe he isn\u2019t hearing well? He will only eat 3&nbsp;or 4&nbsp;foods. The sugges\u00adtion of a&nbsp;new food, or even an old favou\u00adrite, brings about a&nbsp;tantrum like no other. He is constantly starting at the lights and ceiling fans. Not just while they pass by, but obses\u00adsi\u00advely. Getting him to stop staring at the lights is some\u00adtimes diffi\u00adcult and may result in a&nbsp;scene. He requires a&nbsp;certain order to things. Moving a&nbsp;chair to another spot in the room upsets him until it is returned to its usual&nbsp;spot.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><span>Some fami\u00adlies do their own rese\u00adarch and mention they think their child may have autistic spec\u00adtrum disorder (<span class=\"caps\">ASD<\/span>) along with Down Syndrome. Others have no idea what may be happe\u00adning. They do know it isn\u2019t good and they want answers now. This article is for fami\u00adlies in situa\u00adtions like this and other, similar ones. If your child has been dually-diagnosed with Down Syndrome and Autistic Spec\u00adtrum Disorder (<span class=\"caps\">DS-ASD<\/span>) or if you believe your child may have <span class=\"caps\">ASD<\/span>, you will learn a&nbsp;little more about what that means, what we are lear\u00adning through data coll\u00adec\u00adtion, and insights to the evalua\u00adtion process.<\/span><span style=\"font-size: 16px;\"> <\/span><\/p>\n<p style=\"text-align: justify;\"><span>There is little written in the form of rese\u00adarch or commen\u00adtary about <span class=\"caps\">DS-ASD<\/span>. In fact, until recently it was commonly believed that the two condi\u00adtions could not exist toge\u00adther. Parents were told their child had Down Syndrome with a&nbsp;severe to profound impair\u00adment without further inves\u00adti\u00adga\u00adtion or inter\u00adven\u00adtion into a&nbsp;diagno\u00adstic cause. Today, the medical profes\u00adsion reco\u00adg\u00adnises that people with Down Syndrome may also have a&nbsp;psych\u00adia\u00adtric \u2011related diagnosis such as <span class=\"caps\">ASD<\/span> or Obses\u00adsive Compul\u00adsive Disorder (<span class=\"caps\">OCD<\/span>). Because this philo\u00adsophy is rela\u00adtively new to medical and educa\u00adtional profes\u00adsio\u00adnals, there is little known about children and adults with <span class=\"caps\">DS-ASD<\/span> medi\u00adcally or educationally.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><span>Over the past six years we have gathered data and studied <span class=\"caps\">DS-ASD<\/span> at Kennedy Krieger Insti\u00adtute. We have coll\u00adected and analysed data from clinical medical evalua\u00adtions, psycho\u00adlo\u00adgical and beha\u00advioural testing, and <span class=\"caps\">MRI<\/span> scans of the brain. We now follow a&nbsp;cohort of appro\u00adxi\u00adm\u00adately 30 children with <span class=\"caps\">DS-ASD<\/span> through the Down Syndrome Clinic, possibly the largest group of children with <span class=\"caps\">DS-ASD<\/span> that has been gathered.&nbsp;<\/span><\/p>\n<p><\/p>\n<h3><strong><span style=\"font-family: Verdana;\">What Should I&nbsp;Look For?<\/span><\/strong><\/h3>\n<p style=\"text-align: justify;\"><b><i>Signs and Symptoms<\/i><\/b><br> As parents, it is common, if not expected, for you to worry at times about your child\u2019s deve\u00adlo\u00adp\u00adment. It is also common to hear only part of the criteria for a&nbsp;parti\u00adcular label. This is espe\u00adci\u00adally true when it comes to <span class=\"caps\">DS-ASD<\/span> because there is little infor\u00adma\u00adtion available on the topic. This can be espe\u00adci\u00adally trou\u00adble\u00adsome if your child suddenly picks up a&nbsp;new habit you asso\u00adciate with <span class=\"caps\">ASD<\/span> such as inces\u00adsantly shaking toys. The children we have seen at Kennedy Kreiger Insti\u00adtute who have <span class=\"caps\">DS-ASD<\/span> present symptoms in several diffe\u00adrent ways, which we have sepa\u00adrated into two general groups:<\/p>\n<p><b><i>Group One<\/i><\/b><br> Children in this first group appear to display \u201catypical\u201d beha\u00adviours early. During infancy or toddler years you may&nbsp;see:<\/p>\n<ul>\n<li>repe\u00adti\u00adtive motor beha\u00adviours (fingers in mouth, hand flapping),<\/li>\n<li>fasci\u00adna\u00adtion with and staring at lights, ceiling fans, or fingers,<\/li>\n<li>extreme food refusal,<\/li>\n<li>repe\u00adti\u00adtive language problems (poor under\u00adstan\u00adding and use of gestures) possibly giving the appearance that the child does not hear,&nbsp;and<\/li>\n<li>spoken language may be highly repe\u00adti\u00adtive or absent.<\/li>\n<\/ul>\n<p>Along with these beha\u00adviours, other medical condi\u00adtions may also be present inclu\u00adding seizures, dysfunc\u00adtional swallow, nystagmus (a constant move\u00adment of the eyes), or severe hypo\u00adtonia (low muscle tone) with a&nbsp;delay in motor skills.<\/p>\n<p style=\"text-align: justify;\">If your child with Down Syndrome is young, you may see only one or a&nbsp;few of the beha\u00adviours listed above. This does not mean your child will neces\u00ads\u00ada\u00adrily progress to have autistic spec\u00adtrum disorder. It does mean that they should be moni\u00adtored closely and may benefit from recei\u00adving diffe\u00adrent inter\u00adven\u00adtion services (such as sensory inte\u00adgra\u00adtion) and teaching stra\u00adte\u00adgies (such as visual commu\u00adni\u00adca\u00adtion stra\u00adte\u00adgies or discrete trial teaching) to promote learning.<\/p>\n<p style=\"text-align: justify;\"><b><i>Group Two<\/i><\/b><br> A&nbsp;second group of children are usually older. This group of children expe\u00adri\u00adence a&nbsp;dramatic loss (or plateauing) in their acqui\u00adsi\u00adtion and use of language and social-atten\u00adding skills. This deve\u00adlo\u00adp\u00admental regres\u00adsion may be followed by exces\u00adsive irri\u00adta\u00adbi\u00adlity, anxiety, and the onset of repe\u00adti\u00adtive beha\u00adviours. This situa\u00adtion is most often reported by parents to occur follo\u00adwing an other\u00adwise \u201ctypical\u201d course of early deve\u00adlo\u00adp\u00adment for a&nbsp;child with Down Syndrome. Accor\u00adding to parents, this regres\u00adsion most often occurs between ages three to seven years. The medical concerns and stra\u00adte\u00adgies for these two groups may be diffe\u00adrent. There is not enough infor\u00adma\u00adtion available to know at this time. However, regard\u00adless of how or when <span class=\"caps\">ASD<\/span> is first disco\u00advered, children with <span class=\"caps\">DS-ASD<\/span> have similar educa\u00adtional and beha\u00advioural needs once they are identified.<\/p>\n<p style=\"text-align: justify;\"><b><i>Signs and Symptoms Vary<\/i><\/b><br> Although we are docu\u00admen\u00adting some simi\u00adla\u00adri\u00adties in the way <span class=\"caps\">DS-ASD<\/span> pres\u00adents, autism is what is considered a&nbsp;spec\u00adtrum disorder. This means every child with <span class=\"caps\">DS-ASD<\/span> will be diffe\u00adrent in one way or another. Some will have speech, some will not. Some will rely heavily on routine and order, and others will be more easy-going. Combined with the wide range of abili\u00adties seen in Down Syndrome alone, it can feel mysti\u00adfying. It is easier if you have an under\u00adstan\u00adding of <span class=\"caps\">ASD<\/span> disor\u00adders sepa\u00adrate from Down Syndrome.<\/p>\n<p style=\"text-align: justify;\">Autism, autistic-like condi\u00adtion, autistic spec\u00adtrum disorder (<span class=\"caps\">ASD<\/span>), and perva\u00adsive deve\u00adlo\u00adp\u00admental disorder (<span class=\"caps\">PDD<\/span>) are terms that mean the same thing, more or less. They all refer to a&nbsp;neuro\u00adbe\u00adha\u00advioural syndrome diagnosed by the appearance of specific symptoms and deve\u00adlo\u00adp\u00admental delays early in life. These symptoms result from an under\u00adlying disorder of the brain, which may have multiple causes, inclu\u00adding Down Syndrome. At this time, there is some disagree\u00adment in the medical commu\u00adnity regar\u00adding the specific evalua\u00adtions neces\u00adsary to iden\u00adtify the syndrome or the degree to which certain \u201ccore-features\u201d must be present to estab\u00adlish the diagnosis of <span class=\"caps\">ASD<\/span> in a&nbsp;child with Down Syndrome. Unfort\u00adu\u00adna\u00adtely, the lack of specific diagno\u00adstic tests creates considerable confu\u00adsion for profes\u00adsio\u00adnals, parents, and others trying to under\u00adstand the child and develop an optimal medical care and effec\u00adtive educa\u00adtional programme.<\/p>\n<p>There is general agree\u00adment&nbsp;that:<\/p>\n<ul>\n<li>Autism is a&nbsp;spec\u00adtrum disorder: it may be mild or severe.<\/li>\n<li>Many of the symptoms overlap with other condi\u00adtions such as obses\u00adsive-compul\u00adsive disorder (<span class=\"caps\">OCD<\/span>) or atten\u00adtion deficit hyperac\u00adti\u00advity disorder (<span class=\"caps\">ADHD<\/span>).<\/li>\n<li><span class=\"caps\">ASD<\/span> is a&nbsp;deve\u00adlo\u00adp\u00admental diagnosis. Expres\u00adsion of the syndrome varies with a&nbsp;child\u2019s age and deve\u00adlo\u00adp\u00admental level.<\/li>\n<li>Autism can co-exist with condi\u00adtions such as lear\u00adning disa\u00adbi\u00adlity, seizure disorder or Down Syndrome.<\/li>\n<li>Autism is a&nbsp;life-long condition.<\/li>\n<\/ul>\n<p>The most commonly described areas of concern for children with <span class=\"caps\">ASD<\/span> include:<\/p>\n<ul>\n<li>Commu\u00adni\u00adca\u00adtion (using and under\u00adstan\u00adding spoken words or&nbsp;signs),<\/li>\n<li>Social skills (rela\u00adting to people and social circumstances),<\/li>\n<li>Repe\u00adti\u00adtive body move\u00adments or beha\u00adviour patterns.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Of course there is incon\u00adsis\u00adtency in any of these areas in all children, espe\u00adci\u00adally during early child\u00adhood. Children who have <span class=\"caps\">ASD<\/span> may or may not exhibit all of these charac\u00adte\u00adristics at any one time nor will they consis\u00adt\u00adently demons\u00adtrate their abili\u00adties across similar circum\u00ads\u00adtances. Some of the variable charac\u00adte\u00adristics of <span class=\"caps\">ASD<\/span> we have commonly observed in children with <span class=\"caps\">DS-ASD<\/span> include:<\/p>\n<ul>\n<li>Unusual response to sensa\u00adtions (espe\u00adci\u00adally sounds, lights, touch or&nbsp;pain),<\/li>\n<li>Food refusal (preferred textures or tastes),<\/li>\n<li>Unusual play with toys and other objects,<\/li>\n<li>Diffi\u00adculty with changes in routine or fami\u00adliar surroundings,<\/li>\n<li>Little or no meaningful communication,<\/li>\n<li>Disrup\u00adtive beha\u00adviours (aggres\u00adsion, thro\u00adwing tantrums, or extreme non-compliance),<\/li>\n<li>Hyperac\u00adti\u00advity, short atten\u00adtion, and impulsiveness,<\/li>\n<li>Self-inju\u00adrious beha\u00adviour (skin picking, head hitting or banging, eye-poking, or biting),<\/li>\n<li>Sleep distur\u00adbances, and<\/li>\n<li>History of deve\u00adlo\u00adp\u00admental regres\u00adsion (esp. language and social skills).<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Some\u00adtimes these charac\u00adte\u00adristics are seen in other child\u00adhood disor\u00adders such as atten\u00adtion deficit hyperac\u00adti\u00advity disorder or obses\u00adsive compul\u00adsive disorder. Some\u00adtimes <span class=\"caps\">ASD<\/span> is over\u00adlooked or considered inap\u00adpro\u00adpriate for a&nbsp;child with Down Syndrome due to cogni\u00adtive impair\u00adment. For instance, if a&nbsp;child has a&nbsp;high degree of hyperac\u00adti\u00advity and impul\u00adsi\u00adve\u00adness only the diagnosis of <span class=\"caps\">ADHD<\/span> may be considered. Children with many repe\u00adti\u00adtive beha\u00adviours may only be regarded as having stereo\u00adtypy move\u00adment disorder (<span class=\"caps\">SMD<\/span>), which is common in indi\u00advi\u00adduals with severe cogni\u00adtive impairments.<\/p>\n<p style=\"text-align: justify;\">Most parents agree that severe beha\u00adviour problems are usually not easily fixed. Finding solu\u00adtions for beha\u00advioural concerns is one reason fami\u00adlies seek help from physi\u00adcians and beha\u00adviour specia\u00adlists. Compared to other groups of children with cogni\u00adtive impair\u00adment, those with Down Syndrome, as a&nbsp;group, are less likely to have beha\u00advioural or psych\u00adia\u00adtric disor\u00adders. When they do, it is some\u00adtimes referred to as having a \u201cdual diagnosis\u201d. It is important for profes\u00adsio\u00adnals to consider the possi\u00adbi\u00adlity of a&nbsp;dual diagnosis (Down Syndrome with a&nbsp;psych\u00adia\u00adtric condi\u00adtion such as <span class=\"caps\">ASD<\/span> or <span class=\"caps\">OCD<\/span>) because:<\/p>\n<ul>\n<li>It may be respon\u00adsive to medi\u00adca\u00adtion or beha\u00advioural treat\u00adments, and<\/li>\n<li>A formal diagnosis may entitle the child to more specia\u00adlised and effec\u00adtive educa\u00adtional and inter\u00adven\u00adtion services.<\/li>\n<\/ul>\n<p>If you think your child may have <span class=\"caps\">ASD<\/span>, share this before or during your evalua\u00adtion. Don\u2019t wait to see what might happen.<\/p>\n<p style=\"text-align: justify;\"><b><i>Inci\u00addence<\/i><\/b><br> Esti\u00admating the preva\u00adlence or occur\u00adrence of <span class=\"caps\">ASD<\/span> among children and adults with Down Syndrome is diffi\u00adcult. This is partly due to disagree\u00adment about diagno\u00adstic criteria and incom\u00adplete docu\u00admen\u00adta\u00adtion of cases over the years. Curr\u00adently, esti\u00admates vary between 1&nbsp;and 10%. I&nbsp;believe that 5\u20137% is a&nbsp;more accu\u00adrate esti\u00admate. This is substan\u00adti\u00adally higher than is seen in the general popu\u00adla\u00adtion (.04%). and less than other groups of children with lear\u00adning disa\u00adbi\u00adli\u00adties (20%). Appar\u00adently, the occur\u00adrence of trisomy 21 lowers the thres\u00adhold for the emer\u00adgence of <span class=\"caps\">ASD<\/span> in some children. This may be due to other genetic or other biolo\u00adgical influences on brain development.<\/p>\n<p style=\"text-align: justify;\">A review of the lite\u00adra\u00adture on this subject since 1979 reveals 36 reports of <span class=\"caps\">DS-ASD<\/span> (24 children and 12 adults). Of the 31 cases that include gender, an asto\u00adnis\u00adhing 28 indi\u00advi\u00adduals were males. The male-to-female ratio is much higher than the ratio seen for autism in the general popu\u00adla\u00adtion. Addi\u00adtio\u00adnally, in reports that include cogni\u00adtive level, most children tested were in the severe range of cogni\u00adtive impair\u00adment. Gene\u00adrally, the cause of <span class=\"caps\">ASD<\/span> is poorly unders\u00adtood, whether or not it is asso\u00adciated with Down Syndrome. There are some medical condi\u00adtions in which <span class=\"caps\">ASD<\/span> is more common such as Fragile\u2011X syndrome, other chro\u00admo\u00adsome anoma\u00adlies, seizure disorder, and pre-natal or peri\u00adnatal viral infec\u00adtions. Down Syndrome should be included in this list of condi\u00adtions. The impact of a&nbsp;pre-exis\u00adting medical condi\u00adtion such as Down Syndrome on the deve\u00adlo\u00adping brain is probably a&nbsp;critical factor in the emer\u00adgence of <span class=\"caps\">ASD<\/span> disorder in a&nbsp;child.<\/p>\n<p style=\"text-align: justify;\"><b><i>Brain Deve\u00adlo\u00adp\u00adment and <span class=\"caps\">ASD<\/span><\/i><\/b><br> The deve\u00adlo\u00adp\u00adment of the brain and how it func\u00adtions is diffe\u00adrent in some way in children with <span class=\"caps\">DS-ASD<\/span> than their peers with Down Syndrome. Charac\u00adte\u00adri\u00adsing and recor\u00adding these diffe\u00adrences in brain deve\u00adlo\u00adp\u00adment through detailed evalua\u00adtion of the situa\u00adtion will provide a&nbsp;better under\u00adstan\u00adding of the situa\u00adtion and possible treat\u00adments for children with <span class=\"caps\">DS-ASD<\/span>.<\/p>\n<p>A detailed analysis of the brain performed at autopsy or with magnetic reso\u00adnance imaging <span class=\"caps\">MRI<\/span> in children with autism shows invol\u00advement of several diffe\u00adrent regions of the&nbsp;brain:<\/p>\n<ul>\n<li>The limbic system, which is important for regu\u00adla\u00adting emotional response, mood and memory,<\/li>\n<li>The temporal lobes, which are important for hearing and normal proces\u00adsing of sounds,<\/li>\n<li>The cere\u00adbellum, which co-ordi\u00adnates motor move\u00adments and some cogni\u00adtive opera\u00adtions, and<\/li>\n<li>The corpus callosum, which connects the two hemi\u00adspheres of the cortex together.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">At Kennedy Krieger Insti\u00adtute, we have conducted <span class=\"caps\">MRI<\/span> studies of 25 children with <span class=\"caps\">DS-ASD<\/span>. The preli\u00admi\u00adnary results support the notion that the cere\u00adbellum and corpus callosum is diffe\u00adrent in appearance in these children compared to those without Down Syndrome alone. We are presently evalua\u00adting other areas of the brain, inclu\u00adding the limbic system and all major cortical subre\u00adgions, to look for addi\u00adtional markers that will distin\u00adguish children with <span class=\"caps\">DS-ASD<\/span> from their peers with Down Syndrome alone.<\/p>\n<p><\/p>\n<p style=\"text-align: justify;\"><b><i>Brain Chemistry and <span class=\"caps\">ASD<\/span><\/i><\/b><br> The neuro\u00adche\u00admistry (chemistry of the brain) of autism is far from clear and very likely involves several diffe\u00adrent chemical systems of the brain. This infor\u00adma\u00adtion provides the basis for medi\u00adca\u00adtion trials to impact the way the brain works in order to elicit a&nbsp;change in beha\u00adviour. An analysis of neuro\u00adche\u00admistry in children with <span class=\"caps\">ASD<\/span> alone has consis\u00adt\u00adently iden\u00adti\u00adfied invol\u00advement of at least two systems.<\/p>\n<ul>\n<li>Dopa\u00admine: regu\u00adlates move\u00adment, posture, atten\u00adtion, and reward beha\u00adviours; and<\/li>\n<li>Sero\u00adtonin: regu\u00adlates mood, aggres\u00adsion, sleep, and feeding behaviours.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Addi\u00adtio\u00adnally, opiates, which regu\u00adlate mood, reward, responses to stress, and percep\u00adtion of pain, may also be involved in some children. Detailed studies of brain chemistry in children with <span class=\"caps\">DS-ASD<\/span> have not yet been done. However, our clinical expe\u00adri\u00adence in using medi\u00adca\u00adtions that modu\u00adlate dopa\u00admine, sero\u00adtonin or both systems has been favourable in some children with <span class=\"caps\">DS-ASD<\/span>.<\/p>\n<p><\/p>\n<h3><strong>How Do I&nbsp;Find Out?<\/strong><\/h3>\n<p style=\"text-align: justify;\"><b><i>Obtai\u00adning an Evalua\u00adtion<\/i><\/b><br> If you suspect your child with Down Syndrome has some of the charac\u00adte\u00adristics of <span class=\"caps\">ASD<\/span> or any other condi\u00adtion quali\u00adfying as a&nbsp;dual diagnosis, it is important for him to be seen by someone with suffi\u00adcient expe\u00adri\u00adence evalua\u00adting children with cogni\u00adtive impair\u00adment \u2014 ideally Down Syndrome in parti\u00adcular. Some of the same symptoms which occur in <span class=\"caps\">DS-ASD<\/span> are also seen in stereo\u00adtypy move\u00adment disorder, major depres\u00adsion, post-trau\u00admatic stress disorder, acute adjus\u00adt\u00adment reac\u00adtions, obses\u00adsive-compul\u00adsive disorder, anxiety disorder, or when children are exposed to extre\u00admely stressful and chaotic events or environments.<\/p>\n<p style=\"text-align: justify;\">Some\u00adtimes when children with Down Syndrome are expe\u00adri\u00aden\u00adcing medical problems that are hidden \u2014 such as earache, headache, tooth\u00adache, sinu\u00ads\u00aditis, gastritis, ulcer, pelvic pain, glau\u00adcoma, and so on \u2014 the situa\u00adtion results in beha\u00adviours that may appear \u201cautistic-like\u201d such as self-injury, irri\u00adta\u00adbi\u00adlity, or aggres\u00adsive beha\u00adviours. A&nbsp;compre\u00adhen\u00adsive medical history and physical exami\u00adna\u00adtion is manda\u00adtory to rule out other reasons for the beha\u00adviour. When co- opera\u00adtions is elusive, seda\u00adtion or anaes\u00adthesia may be required. If so, use this \u201canaes\u00adthesia time\u201d effec\u00adtively by sche\u00addu\u00adling as many specialty exami\u00adna\u00adtions as are feasible at one session. In addi\u00adtion to the medical assess\u00adment, you will be asked to help complete a&nbsp;check\u00adlist to deter\u00admine whether or not your child has <span class=\"caps\">ASD<\/span>. I&nbsp;use the Autism Beha\u00adviour Check\u00adlist (<span class=\"caps\">ABC<\/span>). But there are others that are also used such as the Child\u00adhood Autism Rating Scale (<span class=\"caps\">CARS<\/span>) and the Gilliam Autism Rating Scale (<span class=\"caps\">GARS<\/span>). Each of these is completed either in an inter\u00adview with parents or done by parents before coming to the appoint\u00adment. They are then scored and considered along with clinical obser\u00adva\u00adtion to deter\u00admine if your child has&nbsp;<span class=\"caps\">ASD<\/span>.<\/p>\n<p><\/p>\n<p><b>Obsta\u00adcles to Diagno\u00adsing <span class=\"caps\">DS-ASD<\/span><\/b><\/p>\n<p><i><span class=\"dquo\">\u201c<\/span>If it looks like a&nbsp;duck, and it quacks like a&nbsp;duck\u2026 guess&nbsp;what?\u201d<\/i><\/p>\n<p>Parents some\u00adtimes face unneces\u00adsary obsta\u00adcles in seeking help for their children. Parents have shared several reasons demons\u00adt\u00adra\u00adting this. Some of the more common include:<\/p>\n<p style=\"text-align: justify;\"><b>Failure to Reco\u00adg\u00adnise the Dual Diagnosis<\/b><br> <i>Problem:<\/i>Failure to reco\u00adg\u00adnise the dual diagnosis except in the most severe cases.<br> <i>Result:<\/i> This is frus\u00adt\u00adra\u00adting for ever\u00adyone who is actively seeking solu\u00adtions for a&nbsp;child. If you are in this situa\u00adtion and feel that your concerns are not taken seriously, keep trying. The best advice is to trust your gut feeling regar\u00adding your child. Even\u00adtually you will find someone willing to look at all the possi\u00adbi\u00adli\u00adties with&nbsp;you.<\/p>\n<p style=\"text-align: justify;\"><b>Lack of Accep\u00adtance by Profes\u00adsio\u00adnals<\/b><br> <i>Problem:<\/i> There is some\u00adtimes a&nbsp;lack of accep\u00adtance by profes\u00adsio\u00adnals that <span class=\"caps\">ASD<\/span> can co-exist in a&nbsp;child with Down Syndrome who has cogni\u00adtive impair\u00adment. They may feel an addi\u00adtional label is not neces\u00adsary or accu\u00adrate. Parents may be told \u201cThis is part of \u2018low func\u00adtio\u00adning\u2019 Downs Syndrome.\u201d Today we know that this is not right. Children with <span class=\"caps\">DS-ASD<\/span> are clearly distin\u00adgu\u00adis\u00adhable from children with Down Syndrome alone or those who have Down Syndrome and severe cogni\u00adtive impair\u00adment when stan\u00addar\u00addised diagno\u00adstic assess\u00adment tools such as the <span class=\"caps\">ABC<\/span> are used.<br> <i>Resultat:<\/i>Parents become frus\u00adtrated and may give up trying to obtain more specific medical treat\u00adment or beha\u00advioural intervention.<\/p>\n<p style=\"text-align: justify;\"><b>Confu\u00adsion in Parents<\/b><br> Problem: Lack of accep\u00adtance, under\u00adstan\u00adding, aware\u00adness, or agree\u00adment on the part of parents or other family members, parti\u00adcu\u00adlarly of very young children, about what\u2019s happe\u00adning. Initial reac\u00adtions by fami\u00adlies and parents vary consider\u00adably from, \u201cThis too shall pass\u201d to \u201cWhy isn\u2019t he doing as much as other kids with <span class=\"caps\">DS<\/span>?\u201d<br> <i>Result:<\/i> Parents in this situa\u00adtion may find them\u00adselves at odds with each other about the signi\u00adfi\u00adcance of their child\u2019s beha\u00adviour and what to do about it. As a&nbsp;result, marriages are stressed, paren\u00adting rela\u00adti\u00adonships with other children are strained, and life is tough altog\u00ade\u00adther. Unfort\u00adu\u00adna\u00adtely, I&nbsp;have found that parents in this situa\u00adtion almost univer\u00adsally with\u00addraw from local Down Syndrome support groups or other groups that may provide support. There are a&nbsp;variety of reasons for this inclu\u00adding \u201cthe topics discussed don\u2019t apply to my child\u201d, \u201cIt\u2019s just too hard to see all those children doing so much more than my child\u201d, and \u201cI feel like people think I\u2019m a&nbsp;bad parent because of my daugh\u00adter\u2019s beha\u00adviour.\u201d Ideally someone in the parent group would reco\u00adg\u00adnise this when it is happe\u00adning and offer addi\u00adtional support instead of watching them with\u00addraw. What is worri\u00adsome is that the very parents who are most in need of support and assis\u00adtance cannot or do not receive it within the context of their local parent group. In fact, there may not be another parent in the group with a&nbsp;child who is similar because <span class=\"caps\">DS-ASD<\/span> is uncommon and not easily shared. It is critical that parents have an oppor\u00adtu\u00adnity to meet and learn from other parents whose children also have <span class=\"caps\">DS-ASD<\/span>. Despite the under\u00adlying medical condi\u00adtion (trisomy 21), the neuro\u00adbe\u00adha\u00advioural syndrome of <span class=\"caps\">ASD<\/span> may mean that a&nbsp;support group for fami\u00adlies of children with autism will be helpful as well. However, because of the lack of accep\u00adtance or know\u00adledge about the dual diagnosis, these support groups can be equally daunting.<\/p>\n<p><\/p>\n<h3><strong>What Does it&nbsp;Mean?<\/strong><\/h3>\n<p style=\"text-align: justify;\"><b><i>Beha\u00advioural Findings<\/i><\/b><br> Obtai\u00adning a&nbsp;diagnosis of <span class=\"caps\">DS-ASD<\/span> is rarely helpful in under\u00adstan\u00adding how <span class=\"caps\">ASD<\/span> affects your child. It is compli\u00adcated by the lack of infor\u00adma\u00adtion available, making it diffi\u00adcult to discern appro\u00adpriate medical and educa\u00adtional options. To deter\u00admine what beha\u00adviors are most common in <span class=\"caps\">DS-ASD<\/span> we are conduc\u00adting case-control studies which randomly match (for gender and age) a&nbsp;child with <span class=\"caps\">DS-ASD<\/span> with a&nbsp;child who has Down Syndrome without <span class=\"caps\">ASD<\/span>. These compa\u00adri\u00adsons are based on the infor\u00adma\u00adtion obtained from the <span class=\"caps\">ABC<\/span> toge\u00adther with a&nbsp;detailed deve\u00adlo\u00adp\u00admental history and beha\u00advioural obser\u00adva\u00adtion. Through this process we have been able to deter\u00admine the follo\u00adwing:<br> Children with <span class=\"caps\">DS-ASD<\/span> were more likely to&nbsp;have:<\/p>\n<ul>\n<li>History of deve\u00adlo\u00adp\u00admental regres\u00adsion inclu\u00adding loss of language and social skills,<\/li>\n<li>Poor commu\u00adni\u00adca\u00adtion skills (many children had no meaningful speech or signing),<\/li>\n<li>Self-inju\u00adrious and disrup\u00adtive beha\u00adviours (such as skin picking, biting, and head hitting or banging),<\/li>\n<li>Repe\u00adti\u00adtive motor beha\u00adviours (such as grin\u00adding teeth, hand flap\u00adping, and rocking),<\/li>\n<li>Unusual voca\u00adli\u00adsa\u00adtions (such as grun\u00adting, humming, and throaty noises),<\/li>\n<li>Unusual sensory respon\u00adsi\u00adve\u00adness (such as spin\u00adning, staring at lights, or sensi\u00adti\u00advity to certain sounds),<\/li>\n<li>Feeding problems (such as food refusal or strong prefe\u00adrence for specific textures), and<\/li>\n<li>Increased anxiety, irri\u00adta\u00adbi\u00adlity, diffi\u00adculty with tran\u00adsi\u00adtions, hyperac\u00adti\u00advity, atten\u00adtion problems, and signi\u00adfi\u00adcant sleep disturbances.<\/li>\n<\/ul>\n<p>Other obser\u00adva\u00adtions include:<\/p>\n<ul>\n<li>Children with <span class=\"caps\">DS-ASD<\/span> scored signi\u00adfi\u00adcantly higher than their peers with Down Syndrome alone on all five subscales of the <span class=\"caps\">ABC<\/span>: sensory func\u00adtion, social rela\u00adting, body and object use, language use, and social skills.<\/li>\n<li>Children with <span class=\"caps\">DS-ASD<\/span> show less impair\u00adment in social rela\u00adted\u00adness than those with <span class=\"caps\">ASD<\/span>&nbsp;only.<\/li>\n<li>Children with <span class=\"caps\">DS-ASD<\/span> show more preoc\u00adcu\u00adpa\u00adtion with body move\u00adment and object use than children with <span class=\"caps\">ASD<\/span>&nbsp;alone.<\/li>\n<li>Children with <span class=\"caps\">DS-ASD<\/span> scored higher on all five subscales of the <span class=\"caps\">ABC<\/span> than children with severe cogni\u00adtive impair\u00adment&nbsp;alone.<\/li>\n<li>Among children with Down Syndrome only, even those with severe cogni\u00adtive impair\u00adment do not always meet the criteria for&nbsp;<span class=\"caps\">ASD<\/span>.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">The conclu\u00adsion I&nbsp;draw from this data is children with <span class=\"caps\">DS-ASD<\/span> are clearly distin\u00adgu\u00adis\u00adhable from both \u201ctypical\u201d children with Down Syndrome and those with severe cogni\u00adtive impair\u00adment (inclu\u00adding children with Down Syndrome). Thus, it is probably incor\u00adrect to suggest autistic-like beha\u00adviours are enti\u00adrely due to lower cogni\u00adtive func\u00adtion. However, the fact that autistic features and lower cogni\u00adtion are asso\u00adciated indi\u00adcates there is some shared determinant(s) that is common to both features (<span class=\"caps\">ASD<\/span> and lower cogni\u00adtion) of the condition.<\/p>\n<p style=\"text-align: justify;\"><b><i>Asso\u00adciated Medical Condi\u00adtions<\/i><\/b><br> There are ques\u00adtions about the possi\u00adbi\u00adlity of simi\u00adla\u00adri\u00adties in the variety of medical condi\u00adtions asso\u00adciated with Down Syndrome in general in children with <span class=\"caps\">DS-ASD<\/span>. To deter\u00admine this we used the same matching scheme as described above. It is important to point out the number of matched pairs curr\u00adently in our study is quite small and, as a&nbsp;result, some of these findings may not hold up as we examine more children.<\/p>\n<p>Children with <span class=\"caps\">DS-ASD<\/span> were <i>more likely<\/i> to&nbsp;have:<\/p>\n<ul>\n<li>Conge\u00adnital heart disease and anato\u00admical <span class=\"caps\">GI<\/span> tract anomalies,<\/li>\n<li>Neuro\u00adlo\u00adgical findings, (i.e. seizures, dysfunc\u00adtional swallow, severe hypo\u00adtonia and motor&nbsp;delay),<\/li>\n<li>Ophthal\u00admo\u00adlogic problems,<\/li>\n<li>Respi\u00adra\u00adtory problems (i.e. Pneu\u00admonia and sleep apnoea), and<\/li>\n<li>Increased total number of medical conditions.<\/li>\n<\/ul>\n<h3><strong>What Now?<\/strong><\/h3>\n<p style=\"text-align: justify;\">After the Evalua\u00adtion<br> If you child has <span class=\"caps\">DS-ASD<\/span>, obtai\u00adning a&nbsp;diagnosis or label may be a&nbsp;relief of sorts. The addi\u00adtion of <span class=\"caps\">ASD<\/span> brings new ques\u00adtions. From a&nbsp;medical perspec\u00adtive it is important to consider use of medi\u00adca\u00adtion, parti\u00adcu\u00adlarly in older children, for specific beha\u00adviours. This is espe\u00adci\u00adally true if these beha\u00adviours inter\u00adfere with lear\u00adning or socia\u00adli\u00adsa\u00adtion. While there is no cure or remar\u00adkably effec\u00adtive treat\u00adment for Down Syndrome and autistic spec\u00adtrum, certain \u201ctarget beha\u00adviours\u201d may be respon\u00adsive to medi\u00adca\u00adtion. Some of these beha\u00adviours include:<\/p>\n<ul type=\"circle\">\n<ul type=\"circle\">\n<li>Hyperac\u00adti\u00advity and poor attention,<\/li>\n<li>Irri\u00adta\u00adbi\u00adlity and anxiety,<\/li>\n<li>Sleep distur\u00adbance,<\/li>\n<li>Explo\u00adsive beha\u00adviours resul\u00adting in aggression\/disruption (can some\u00adtimes be reduced), and<\/li>\n<li>Self-injury (can some\u00adtimes be reduced).<\/li>\n<\/ul>\n<\/ul>\n<p style=\"text-align: justify;\">As you continue to take care of your child, make a&nbsp;point to take care of yourself and your family \u2014 in that order. You have a&nbsp;life and a&nbsp;family to consider. Reco\u00adg\u00adnise that there is only so much time, energy and resources that you can put into this \u201cproject\u201d. Of course there will be cycles, of good time and bad, but if you can\u2019t find some way to renew your emotional spirit, the \u201cburn-out\u201d is inevi\u00adtable. There is a&nbsp;higher rate of anxiety, sleep problems, lack of energy, depres\u00adsion, and failed or strugg\u00adling marriages under these circum\u00ads\u00adtances. Learn to reco\u00adg\u00adnise your own diffi\u00adcul\u00adties and be honest with yourself and your spouse about the need for help. Coun\u00adsel\u00adling and medi\u00adca\u00adtion may go a&nbsp;long way in helping you to be at your best for ever\u00adyo\u00adne\u2019s&nbsp;sake.<\/p>\n<p><strong><\/strong><\/p>\n<h3><strong><span size=\"3\">Conclusion<\/span><\/strong><\/h3>\n<p style=\"text-align: justify;\"><span>Clearly there is a&nbsp;great deal to be learned about children with Down Syndrome who are dually diagnosed with autism spec\u00adtrum disorder. In the mean\u00adtime, it is essen\u00adtial for parents to educate them\u00adselves and others about this condi\u00adtion. Fami\u00adlies must work on buil\u00adding a&nbsp;team of health-care profes\u00adsio\u00adnals, thera\u00adpists and educa\u00adtors who are inte\u00adrested in working with their child to promote the best possible outcome. Rese\u00adarch efforts must move beyond mere descrip\u00adtion to address causa\u00adtion, early iden\u00adti\u00adfi\u00adca\u00adtion, and natural history. Specific markers in the deve\u00adlo\u00adp\u00adment of the brain which can distin\u00adguish <span class=\"caps\">DS-ASD<\/span> from \u201ctypical\u201d Down Syndrome and \u201ctypical autism\u201d need to be sought; and the possible bene\u00adfits of various treat\u00adments need ot be more carefully docu\u00admented. Reali\u00adsing these goals will take a&nbsp;very long time to accom\u00adplish and must be approa\u00adched with a&nbsp;spirit of support, co-opera\u00adtion, and caring both for indi\u00advi\u00addual children and the larger commu\u00adnity of children with <span class=\"caps\">DS-ASD<\/span>.&nbsp;<\/span><\/p>\n<p>Thank You for appro\u00adving to trans\u00adlate this Article and publish it on our Website to George T&nbsp;Capone, <span class=\"caps\">MD<\/span>. George T&nbsp;Capone, <span class=\"caps\">MD<\/span>, is the Director of the Down Syndrome Clinic and Atten\u00adding Physi\u00adcian on the Neuro\u00adbe\u00adha\u00advi\u00adoral Unit at Kennedy Krieger Insti\u00adtute in Balti\u00admore, Maryland.<\/p>\n<p>Read and down\u00adload the Original Version in <span class=\"caps\">ENG<\/span> here:<br> <i>http:\/\/\u200bwww\u200b.dsmig\u200b.org\u200b.uk\/\u200bl\u200bi\u200bb\u200br\u200ba\u200br\u200by\u200b\/\u200ba\u200br\u200bt\u200bi\u200bc\u200bl\u200be\u200bs\u200b\/\u200bc\u200ba\u200bp\u200bo\u200bn\u200be\u200b-\u200ba\u200bu\u200bt\u200bi\u200bs\u200bt\u200bi\u200bc\u200b-\u200bs\u200bp\u200be\u200bc\u200bt\u200br\u200bu\u200bm\u200b-\u200bd\u200bi\u200bs\u200bo\u200br\u200bd\u200be\u200br\u200b.\u200bpdf<\/i><\/p>\n<p>Refe\u00adrences: <strong><br> <\/strong><\/p>\n<ul type=\"decimal\">\n<ul type=\"decimal\">\n<li>Kent, L., J., Paul, M., and Sharp, M. \u201cComor\u00adbi\u00addity of Autistic Spec\u00adtrum Disor\u00adders in Children with Down Syndrome.\u201d Deve\u00adlo\u00adp\u00admental<span> <\/span><i>Medi\u00adcine and Child Neuro\u00adlogy<\/i>41:154\u2013158 (1999).<\/li>\n<li>Howlin, P., Wing, L., and Gould, J. \u201cThe Reco\u00adgni\u00adtion of Autism in Children with Down Syndrome: Impli\u00adca\u00adtions for Inter\u00adven\u00adtion and Some Specu\u00adla\u00adtions About Patho\u00adlogy.\u201d<span style=\"font-size: 16px;\"> <\/span><i style=\"font-size: 16px;\">Deve\u00adlo\u00adp\u00admental Medi\u00adcine and Child Neuro\u00adlogy<\/i><span style=\"font-size: 16px;\"> <\/span><span style=\"font-size: 16px;\">37:406\u2013414 (1995).<\/span><\/li>\n<li>Ghaziuddin, M., Tsai L., and Ghaziuddin, N. \u201cAutism in Down- Syndrome: Presen\u00adta\u00adtion and Diagnosis\u201d<span style=\"font-size: 16px;\"> <\/span><i style=\"font-size: 16px;\">Journal of Intellec\u00adtual Disa\u00adbi\u00adlity Rese\u00adarch<\/i><span style=\"font-size: 16px;\"> <\/span><span style=\"font-size: 16px;\">36:449\u2013456 (1992).<\/span><\/li>\n<li>Rapin, I., \u201cAutism.\u201d<span style=\"font-size: 16px;\"> <\/span><i style=\"font-size: 16px;\">New England Journal of Medi\u00adcine<\/i><span style=\"font-size: 16px;\"> <\/span><span style=\"font-size: 16px;\">33(2): 97\u2013104 (1997).<\/span><\/li>\n<li>Camp\u00adbell, M., Scho\u00adpler, E., Cueva, J., and Hallin, A. \u201cTreat\u00adment of Autistic Disorder.\u201d<span style=\"font-size: 16px;\"> <\/span><i style=\"font-size: 16px;\">Journal of the American Academy of Child and Adole\u00ads\u00adcent Psych\u00adiatry <\/i><span style=\"font-size: 16px;\">35(2): 134\u2013143 (1996).<\/span><\/li>\n<li>Rogers, S. \u201cNeuro\u00adpsy\u00adcho\u00adlogy of Autism in Young Children and Its Impli\u00adca\u00adtions for Early Inter\u00adven\u00adtion.\u201d<span style=\"font-size: 16px;\"> <\/span><i style=\"font-size: 16px;\">Mental Retar\u00adda\u00adtion and Deve\u00adlo\u00adp\u00adment Disa\u00adbi\u00adli\u00adties Rese\u00adarch Reviews<\/i><span style=\"font-size: 16px;\"> <\/span><span style=\"font-size: 16px;\">4: 104\u2013112 (1998).<\/span><\/li>\n<li>Forness, S. and Kavale, K. \u201cAutistic Children in School: The Role of the Pedia\u00adtri\u00adcian.\u201d<span style=\"font-size: 16px;\"> <\/span><i style=\"font-size: 16px;\">Pedia\u00adtric Annals<\/i><span style=\"font-size: 16px;\"> <\/span><span style=\"font-size: 16px;\">13(4):319\u2013328 (1984).<\/span><\/li>\n<\/ul>\n<\/ul>\n<p>Thank You for Trans\u00adla\u00adting this Article to Miriam Zoller.<span> <\/span><\/p>\n<p style=\"text-align: left;\"><a href=\"\/wp-content\/uploads\/Artikel\/Down-Syndrom_und_autistische_Spektrumsstoerung.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-size: 16px;\">You can down\u00adload the Trans\u00adla\u00adtion of this Article here<br> <\/span><img decoding=\"async\" src=\"https:\/\/www.melodycenter.de\/wp-content\/uploads\/2019\/03\/PDF_Symbol_small.png\" alt=\"PDF download\" style=\"width: 69px; height: 84px;\"><br> <\/a><\/p>\n<p>[\/et_pb_toggle][et_pb_toggle title=\u201cTeach me how to talk: 10 tips for teaching language to children with autism\u201d open_toggle_text_color=\u201c#000000\u201d open_toggle_background_color=\u201crgba(255,255,255,0.7)\u201d closed_toggle_text_color=\u201d#ffffff\u201d closed_toggle_background_color=\u201c#0c71c3\u201d icon_color=\u201d#ffffff\u201d open_icon_color=\u201d#ffffff\u201d _builder_version=\u201c4.16\u201d title_text_color=\u201d#ffffff\u201d title_font=\u201d|700|||||||\u201d title_font_size=\u201c20px\u201d body_font=\u201d||||||||\u201d body_text_align=\u201cleft\u201d body_text_color=\u201c#000000\u201d custom_padding_tablet=\u201d\u201d custom_padding_phone=\u201c10px||10px\u201d custom_padding_last_edited=\u201con|phone\u201d title_font_size_tablet=\u201c15px\u201d title_font_size_phone=\u201c14px\u201d title_font_size_last_edited=\u201con|phone\u201d body_font_size_tablet=\u201d\u201d body_font_size_phone=\u201c14px\u201d body_font_size_last_edited=\u201con|phone\u201d border_width_all=\u201c2px\u201d border_color_all=\u201c#e02b20\u201d icon_color__hover=\u201d\u201d icon_color__hover_enabled=\u201con\u201d global_colors_info=\u201d{}\u201d open_icon_color__hover_enabled=\u201con\u201d open_icon_color__hover=\u201d#ffffff\u201d]<\/p>\n<p><span>1. Moti\u00adva\u00adtion: Iden\u00adtify rein\u00adforcers, i.e., the student\u2019s prefe\u00adrences, and make sure these vary as often as possible.<\/span><\/p>\n<p><span>2. Create oppor\u00adtu\u00adni\u00adties for the students to ask for access to things or acti\u00advi\u00adties they like, make comm\u00adents, respond to other people\u2019s questions.<\/span><\/p>\n<p><span>3. Use a&nbsp;variety of ante\u00adce\u00addent stimuli (e.g., pictures, objects, ques\u00adtions) so that the acquired skills are func\u00adtional and easily generalised.<\/span><\/p>\n<p><span>4. Carefully assess the condi\u00adtions under which the child uses language, so that you can iden\u00adtify where intense teaching is required and which are the next targets to work&nbsp;on.&nbsp;<\/span><\/p>\n<p><span>5. Iden\u00adtify which are the verbal or non-verbal pre-requi\u00adsite skills that should be taught first in order to faci\u00adli\u00adtate later teaching of more complex verbal skills.<\/span><\/p>\n<p><span>6. Select and teach the use of alter\u00adna\u00adtive commu\u00adni\u00adca\u00adtion forms (e.g., sign language, picture-based commu\u00adni\u00adca\u00adtion systems, text-based commu\u00adni\u00adca\u00adtion systems, use of voice-output digital devices) only when a&nbsp;signi\u00adfi\u00adcant delay in teaching speech is fore\u00adseen and in combi\u00adna\u00adtion with teaching this. We should not forget that students will be included in an envi\u00adron\u00adment where the majo\u00adrity of people around them use speech as the main means of commu\u00adni\u00adca\u00adtion, so our target is that our students can also acquire it. However, since the ability of our student to commu\u00adni\u00adcate with others is of crucial importance inde\u00adpendently of the used commu\u00adni\u00adca\u00adtion form, when the use of Augmen\u00adta\u00adtive and Alter\u00adna\u00adtive Commu\u00adni\u00adca\u00adtion (<span class=\"caps\">AAC<\/span>) forms is deemed neces\u00adsary, we should carefully assess which methods would better suit our students in their environment.&nbsp;<\/span><\/p>\n<p><span>7. We conti\u00adnuously record data on the student\u2019s progress on all verbal and non-verbal skills we have set, so that we can at any given moment assess which teaching methods are effec\u00adtive and which need to be modified.&nbsp;<\/span><\/p>\n<p><span>8. We carefully plan for the gene\u00adra\u00adli\u00adsa\u00adtion of mastered skills with other people (e.g., other adults, class\u00admates) and in diffe\u00adrent settings (e.g., play\u00adground, home, school).<\/span><\/p>\n<p><span>9. We teach complex verbal skills to students who are at an advanced deve\u00adlo\u00adp\u00admental level by follo\u00adwing the beha\u00adviour-analytic methods that have proven to be effec\u00adtive in nume\u00adrous studies. We do not forget that <span class=\"caps\">ABA<\/span> is an applied science, thus it is effec\u00adtive with indi\u00advi\u00adduals of any age that need to learn new skills, inde\u00adpendently of whether these are basic skills (e.g., children using single words to ask for things) or complex (e.g., secon\u00addary school student respon\u00adding compre\u00adhen\u00adsion ques\u00adtions on a&nbsp;text and reci\u00adting history).&nbsp;<\/span><\/p>\n<p><span>10. Finally, we do not forget that many academic skills (e.g., reading, writing, mathe\u00adma\u00adtical calcu\u00adla\u00adtions) are also verbal skills or their progress depends on the progress of verbal skills! Ther\u00ade\u00adfore, in order to teach them we use the same evidence-based tech\u00adni\u00adques and a&nbsp;similar manner of analysis as we do for teaching language\/verbal behaviour.<\/span><\/p>\n<p><a href=\"http:\/\/magiko-sympan.gr\/blog\/teach-me-how-to-talk-10-tips-for-teaching-language-to-children-with-autism\/\">Dr. Kate\u00adrina Dounavi<span> <\/span><\/a><\/p>\n<p>[\/et_pb_toggle][et_pb_toggle title=\u201cBehavioral and skill-based early inter\u00adven\u00adtion in children with autism\u201d open_toggle_text_color=\u201c#000000\u201d open_toggle_background_color=\u201crgba(255,255,255,0.7)\u201d closed_toggle_text_color=\u201d#ffffff\u201d closed_toggle_background_color=\u201c#0c71c3\u201d icon_color=\u201d#ffffff\u201d open_icon_color=\u201d#ffffff\u201d _builder_version=\u201c4.16\u201d title_text_color=\u201d#ffffff\u201d title_font=\u201d|700|||||||\u201d title_font_size=\u201c20px\u201d body_font=\u201d||||||||\u201d body_text_align=\u201cleft\u201d body_text_color=\u201c#000000\u201d custom_padding_tablet=\u201d\u201d custom_padding_phone=\u201c10px||10px\u201d custom_padding_last_edited=\u201con|phone\u201d title_font_size_tablet=\u201c15px\u201d title_font_size_phone=\u201c14px\u201d title_font_size_last_edited=\u201con|phone\u201d body_font_size_tablet=\u201d\u201d body_font_size_phone=\u201c14px\u201d body_font_size_last_edited=\u201con|phone\u201d border_width_all=\u201c2px\u201d border_color_all=\u201c#e02b20\u201d icon_color__hover=\u201d\u201d icon_color__hover_enabled=\u201con\u201d inline_fonts=\u201cVerdana\u201d global_colors_info=\u201d{}\u201d open_icon_color__hover_enabled=\u201con\u201d open_icon_color__hover=\u201d#ffffff\u201d]<\/p>\n<p><b><span class=\"caps\">HTA<\/span> report | Summary<\/b><span> <\/span><br> <u><b><\/b><\/u><span><b>Wein\u00admann S, Schwarz\u00adbach C, Bege\u00admann M, Roll S, Vauth C, Willich <span class=\"caps\">SN<\/span>, Greiner W:<\/b> <\/span><\/p>\n<p style=\"text-align: justify;\"><b>Intro\u00adduc\u00adtion<\/b><span> <\/span><br> <span>Autistic syndromes include early child\u00adhood autism (kanner syndrome), Asper\u00adger\u2019s syndrome and atypical autism forms or non-speci\u00adfied profound deve\u00adlo\u00adp\u00admental disor\u00adders. In autistic syndromes, there are impairm\u00adents (1) of commu\u00adni\u00adca\u00adtion and (2) of social inter\u00adac\u00adtion. Further\u00admore (3) the children exhibit stereo\u00adty\u00adpical, repe\u00adti\u00adtive beha\u00advior to varying degrees and have certain special inte\u00adrests. <\/span><br> <span>In recent years, epide\u00admio\u00adlo\u00adgical studies have shown an increase in the preva\u00adlence rate. So far, it has been unclear whether this increase can be explained mainly by diffe\u00adrences in study metho\u00addo\u00adlogy or actually reflects an epide\u00admio\u00adlo\u00adgi\u00adcally more frequent occur\u00adrence. People with autistic syndromes need support and care over a&nbsp;longer period of time, as well as often throug\u00adhout life. Children or adole\u00ads\u00adcents with autism attend all available types of kinder\u00adgarten and school, using special forms of instruc\u00adtion in small groups to meet the special needs of children. However, the promo\u00adtion and inte\u00adgra\u00adtion of the affected children, which is fair to the syndrome, has so far been poorly imple\u00admented in Germany. Adults with autism are cared for by diffe\u00adrent insti\u00adtu\u00adtions and social services in Germany, with very few attuned to their specific problems. <\/span><br> <span>Both drug and non-medi are trea\u00adting methods for autism. Some medi\u00adca\u00adtions can alter certain aspects of beha\u00advior, affects or acti\u00advity levels. Evidence of an impro\u00adve\u00adment in the overall course of drug inter\u00adven\u00adtion does not yet exist, so the main inter\u00adven\u00adtions are non-drug in nature and to the promo\u00adtion of deve\u00adlo\u00adp\u00adment, the influence of beha\u00adviour and the promo\u00adtion of beha\u00adviour. Family and social ties. There are now a&nbsp;variety of psycho\u00adso\u00adcial inter\u00adven\u00adtions. Most are based on lear\u00adning theory and beha\u00advioural therapy concepts and take into account the parti\u00adcular impairm\u00adents in percep\u00adtion, emotional responses, social inter\u00adac\u00adtions and commu\u00adni\u00adca\u00adtion patterns. <\/span><br> <span>However, the syste\u00admatic appli\u00adca\u00adtion and evalua\u00adtion of such models in Germany is now more of an excep\u00adtion. Since the publi\u00adca\u00adtion of studies in which a&nbsp;signi\u00adfi\u00adcant propor\u00adtion of children have under\u00adgone an intel\u00adli\u00adgence level in the normal area, which is mostly deve\u00adloped in the United States of America (<span class=\"caps\">USA<\/span>), even alters and an admis\u00adsion to a&nbsp;normal school achieved, high expec\u00adta\u00adtions. However, the early studies were criti\u00adcised due to metho\u00addo\u00adlo\u00adgical defi\u00adci\u00aden\u00adcies and selec\u00adtion effects, so that the analysis of recent studies has to provide guidance on which early inter\u00adven\u00adtions should also be encou\u00adraged in Germany and which inter\u00adven\u00adtion compon\u00adents contri\u00adbute to efficacy.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><b>Ques\u00adtions<\/b><span> <\/span><br> <span>The evalua\u00adtion of early inter\u00adven\u00adtion programmes is a&nbsp;major chall\u00adenge due to the nature of the disrup\u00adtion and metho\u00addo\u00adlo\u00adgical problems. There are curr\u00adently no uniform stan\u00addards for asses\u00adsing the effec\u00adti\u00adve\u00adness of early inter\u00adven\u00adtions in autism. Results para\u00adme\u00adters in studies on autistic syndromes are intended to include core areas of autism (such as deve\u00adlo\u00adp\u00admental steps, commu\u00adni\u00adca\u00adtive skills, social inter\u00adac\u00adtions, lingu\u00adi\u00adstic skills, repe\u00adti\u00adtive beha\u00adviors), special beha\u00advi\u00adoral problems (such as sleep distur\u00adbances and aggres\u00adsion), intel\u00adli\u00adgence and quality of life, but also objec\u00adtive para\u00adme\u00adters such as school admis\u00adsion or the need to take home. This health tech\u00adnoloy assess\u00adment (<span class=\"caps\">HTA<\/span>) report examines the ques\u00adtion of how the health effec\u00adti\u00adve\u00adness and safety of beha\u00advi\u00adoral or prefa\u00adbric-based early inter\u00adven\u00adtions in autistic syndromes with each other and compared to a&nbsp;stan\u00addard treat\u00adment. It also examines whether there is evidence of parti\u00adcular factors for effec\u00adti\u00adve\u00adness, such as the type and inten\u00adsity of treat\u00adment. <\/span><br> <span>For the economic part, the ques\u00adtion is based on the cost-effec\u00adti\u00adve\u00adness of the various beha\u00advi\u00adoral And ready-based inter\u00adven\u00adtions and the costs of such care. It is also to be examined whether, on the basis of ethical and legal conside\u00adra\u00adtions, conclu\u00adsions can be drawn about the appli\u00adca\u00adtion of the inter\u00adven\u00adtions under conside\u00adra\u00adtion in those with autistic syndrome in practice.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><b>Methods<\/b><span> <\/span><br> <span>The rele\u00advant lite\u00adra\u00adture is iden\u00adti\u00adfied by a&nbsp;syste\u00admatic elec\u00adtronic lite\u00adra\u00adture search, a&nbsp;hand search and the cover letter of rele\u00advant insti\u00adtu\u00adtions. This survey does not claim to be exhaus\u00adtive. <\/span><br> <span>From 2000 onwards, controlled studies published in German or English will include children up to the age of 12 who have a&nbsp;diagnosis from the autism spec\u00adtrum. Diagno\u00adstic and statis\u00adtical manual of mental disor\u00adders (<span class=\"caps\">DSM<\/span>) or inter\u00adna\u00adtional clas\u00adsi\u00adfi\u00adca\u00adtion of dise\u00adases (<span class=\"caps\">ICD<\/span>). The inter\u00adven\u00adtions reviewed are beha\u00advi\u00adoral or prefa\u00adbric-based inter\u00adven\u00adtions desi\u00adgned speci\u00adfi\u00adcally for children with autism. Beha\u00advioural or prefa\u00adbric-based inter\u00adven\u00adtion is defined here as an inter\u00adven\u00adtion aimed at impro\u00adving beha\u00adviour and\/or the func\u00adtional skills or deve\u00adlo\u00adp\u00adment process of children, and beha\u00advi\u00adoral therapy stra\u00adte\u00adgies or a&nbsp;trai\u00adning of specific skills. The minimum number of study parti\u00adci\u00adpants must be ten per inter\u00adven\u00adtion group. Only studies with a&nbsp;survey of outcomes (treat\u00adment results) of at least six months after the start of the inter\u00adven\u00adtion are taken into account. There are no rest\u00adric\u00adtions on the endpoints under inves\u00adti\u00adga\u00adtion. The selec\u00adtion of the studies is carried out inde\u00adpendently by two scien\u00adtists, taking into account the pre-defined inclu\u00adsion and exclu\u00adsion criteria.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><b>Results<\/b><span> <\/span><br> <span>Based on the defined search terms and she search carried out, after the exclu\u00adsion of dupli\u00adcate studies, 2,281 Hits will be paid for medical rese\u00adarch (inclu\u00adding 999 hits for clinical primary studies, 1,252 hits for clinical syste\u00admatic reviews, and meta-analyses and 30 hits for <span class=\"caps\">HTA<\/span> reports), 235 health economic and 135 hits for ethische\/rechtliche\/social aspects iden\u00adti\u00adfied. After revie\u00adwing the abstracts, 102 clinical and 52 economic texts are ordered as full texts. In the end, 15 publi\u00adca\u00adtions of clinical primary studies, eight syste\u00admatic reviews and an economic publi\u00adca\u00adtion meet the pre-defined inclu\u00adsion criteria. Three treat\u00adment guide\u00adlines citing early inter\u00adven\u00adtions in children with autism are reported. <\/span><br> <span>The 15 iden\u00adti\u00adfied publi\u00adca\u00adtions of clinical primary studies are based on 14 studies, inclu\u00adding eight rando\u00admised controlled trials (<span class=\"caps\">RCT<\/span>) and six non-rando\u00admised controlled trials. Six studies were conducted in the <span class=\"caps\">US<\/span>, five studies in the <span class=\"caps\">UK<\/span> and one each in Israel, Australia and Norway, none in Germany. <\/span><br> <span>Most studies evaluate inten\u00adsive early inter\u00adven\u00adtions based on the model of Lovaas (Early Inten\u00adsive beha\u00advioural Treat\u00adment (<span class=\"caps\">EIBT<\/span>), Applied beha\u00advioural analysis (<span class=\"caps\">ABA<\/span>)). Some studies evaluate other inter\u00adven\u00adtions that were partly prag\u00admatic and partly follow a&nbsp;parti\u00adcular model (specific parental trai\u00adning, respon\u00adsive educa\u00adtion and prelin\u00adgu\u00adi\u00adstic milieu teaching (<span class=\"caps\">RPMT<\/span>), joint atten\u00adtion (<span class=\"caps\">YES<\/span>), symbolic gaming (<span class=\"caps\">SP<\/span>) and Picture exch\u00adange commu\u00adni\u00adca\u00adtion system (<span class=\"caps\">PECS<\/span>)). The inter\u00adven\u00adtions studied, as well as the compa\u00adra\u00adtive inter\u00adven\u00adtions (partly routine treat\u00adment, so-called eclectic treat\u00adment from mixed elements, waiting list, lower frequency treat\u00adment or other specific treat\u00adment concept) were very much diffe\u00adrent. <\/span><br> <span>Based on the evaluated syste\u00admatic reviews and the evaluated primary studies, beha\u00advi\u00adoral analy\u00adtical inter\u00adven\u00adtions based on the Lovaas model can continue to be considered the best empi\u00adri\u00adcally targeted early inter\u00adven\u00adtions in children with autism be viewed. In most studies, the subgroup of children with initi\u00adally higher intel\u00adli\u00adgence quoti\u00adents (<span class=\"caps\">IQ<\/span>) had better treat\u00adment outcomes than the group with lower <span class=\"caps\">IQ<\/span>. Overall, the effect strengths depended heavily on the type of routine treat\u00adment. The studies suggest that preschoo\u00adlers with autism are impro\u00adving in cogni\u00adtive and func\u00adtional areas through beha\u00advioural inter\u00adven\u00adtions with a&nbsp;minimum inten\u00adsity of 20 hours per week (expres\u00adsive language, language compre\u00adhen\u00adsion and commu\u00adni\u00adca\u00adtion) be able to reach. The core symptoms of autism ther\u00ade\u00adfore appear to be quite acces\u00adsible to early treat\u00adment. However, it remains unclear what minimum inten\u00adsity is neces\u00adsary and which impact compon\u00adents are respon\u00adsible for the results. Moreover, there is no solid direct evidence of a&nbsp;supe\u00adrio\u00adrity of an early start to inter\u00adven\u00adtion. Based on the selected studies, no solid state\u00adments can be made on the effects of parent, hospital or centre-based programs based on the Lovaas model. <\/span><br> <span>There is no high-quality evidence for other compre\u00adhen\u00adsive early inter\u00adven\u00adtions in children with autism. There is also little evidence for the <span class=\"caps\">PECS<\/span> and <span class=\"caps\">RPMT<\/span>, which are basi\u00adcally not compre\u00adhen\u00adsive early inter\u00adven\u00adtions but theory-led addi\u00adtional inter\u00adven\u00adtions, that the bene\u00adfits observed in the studies in social commu\u00adni\u00adca\u00adtion and language Can be trans\u00adferred to the ever\u00adyday life of the children. <\/span><br> <span>The publi\u00adca\u00adtion iden\u00adti\u00adfied and included in the economic sub-sector is not metho\u00addi\u00adcally and thema\u00adti\u00adcally suitable for even begin\u00adning to answer the cost-effec\u00adti\u00adve\u00adness or cost effects of early inter\u00adven\u00adtions in autism. This study lists costs for an early inter\u00adven\u00adtion programme (here based on the Lovaas model) between <span class=\"caps\">GBP<\/span> 15,000 and <span class=\"caps\">GBP<\/span> 30,000. The refe\u00adrence date of this data is not clear. The costs are still not linked to effi\u00adci\u00adency measures, so no state\u00adment can be made about the effi\u00adci\u00adency of the funds used. A&nbsp;descrip\u00adtive publi\u00adca\u00adtion also takes a&nbsp;very brief look at the cost of imple\u00admen\u00adting beha\u00advi\u00adoral early inter\u00adven\u00adtion programmes. It states that this can exceed $60,000. Valide state\u00adments for the German supply context are not possible. <\/span><br> <span>No publi\u00adca\u00adtions are iden\u00adti\u00adfied regar\u00adding legal, ethical and social issues. The finan\u00adcial situa\u00adtion of those affected and fami\u00adlies is improved by the care deve\u00adlo\u00adp\u00adment act (Pf-WG). Other legal issues rela\u00adting to autism arise, for example, in connec\u00adtion with the rest\u00adric\u00adtion of decision-making or consent, problems of busi\u00adness capa\u00adcity or legal repre\u00adsen\u00adta\u00adtion of the persons concerned. Care is also rele\u00advant from an ethical point of view, with pati\u00adents being cared for in the majo\u00adrity in the home envi\u00adron\u00adment, with carers often survived by the autistic indi\u00advi\u00adduals. Equal care and c<\/span><span>are in Germany are also important ques\u00adtions, espe\u00adci\u00adally against the back\u00adground of care in the home environment.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><b>Discus\u00adsion<\/b><span> <\/span><br> <span>There are few metho\u00addi\u00adcally appro\u00adpriate studies to assess the effec\u00adti\u00adve\u00adness of early inter\u00adven\u00adtions in children with autism. Most studies are compa\u00adra\u00adtively short and partly do not have a&nbsp;linked result rating. In many cases, compli\u00adance with the thera\u00adpeutic rules (manual fide\u00adlity) has not been levied. Although mostly stan\u00addar\u00addized result para\u00adme\u00adters were used, the Wechsler intel\u00adli\u00adgence scales used to measure <span class=\"caps\">IQ<\/span> are only parti\u00adally suitable because they are unde\u00adre\u00adsti\u00admated by the intel\u00adli\u00adgence in the affected ones. Children can lead. <\/span><br> <span>The lack of high-quality compa\u00adra\u00adtive studies does not allow a&nbsp;solid answer to the ques\u00adtion of which early inter\u00adven\u00adtion is most effec\u00adtive in which children with autism. Overall, it can be deter\u00admined that inten\u00adsive, beha\u00advi\u00adoral programs appear most effec\u00adtive under the Lovaas model. This is espe\u00adci\u00adally true when they are performed clinic-based. Parental trai\u00adning is better than routine treat\u00adment in which a&nbsp;mixture of therapy-elements is used in terms of impro\u00adving commu\u00adni\u00adca\u00adtion. For both clinical and health economic studies, the problem of insuf\u00adfi\u00adcient gene\u00adra\u00adliza\u00adbi\u00adlity of the study results is in the German supply context. The clinical studies show that effect strengths depend heavily on the type of control inter\u00adven\u00adtion. Ther\u00ade\u00adfore, other studies, which are carried out in the German or a&nbsp;compa\u00adrable health system, are parti\u00adcu\u00adlarly desi\u00adrable. <\/span><br> <span>There is clear evidence that parental invol\u00advement in inter\u00adven\u00adtion programmes is very important. Ideally, parents should be trained as co-thera\u00adpists and master the tech\u00adni\u00adques. However, early inter\u00adven\u00adtion programmes should also meet the needs of fami\u00adlies and must be adapted accor\u00addingly. <\/span><br> <span>Early inter\u00adven\u00adtion programmes appear most successful when they support fami\u00adlies and aim to provide them with skills in dealing with the children involved. For the children, inter\u00adac\u00adtions with their peers seem to be of great importance. Only then can a&nbsp;gene\u00adra\u00adli\u00adsa\u00adtion of the skills learned during specific beha\u00advi\u00adoral inter\u00adven\u00adtions be achieved in child\u00adren\u2019s ever\u00adyday lives and in daily routines. Like\u00adwise, typical autistic beha\u00adviors seem to dimi\u00adnish. <\/span><br> <span>Early inter\u00adven\u00adtions in children with autism should target specific core areas (such as joint atten\u00adtion, certain lingu\u00adi\u00adstic skills, imita\u00adtion, social inter\u00adac\u00adtion). The simul\u00adta\u00adneous compre\u00adhen\u00adsive conside\u00adra\u00adtion of all areas of life seems less sensible. A&nbsp;mana\u00adlized treat\u00adment model seems to have advan\u00adtages over a&nbsp;mix of many indi\u00advi\u00addual compon\u00adents. However, the proce\u00addure should in any case be indi\u00advi\u00addua\u00adlised and leave enough room for modi\u00adfi\u00adca\u00adtions. <\/span><br> <span>The economic studies are not metho\u00addi\u00adcally and thema\u00adti\u00adcally suitable for answe\u00adring the ques\u00adtions raised.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><b>Conclu\u00adsion<\/b><span> <\/span><br> <span>Based on the current study situa\u00adtion, there is insuf\u00adfi\u00adcient evidence for none of the early beha\u00advi\u00adoral inter\u00adven\u00adtions studied in children with autism. The studies and reviews evaluated in this report suggest that preschoo\u00adlers with autism can achieve impro\u00adve\u00adments in cogni\u00adtive and func\u00adtional areas through beha\u00advi\u00adoral inter\u00adven\u00adtions with a&nbsp;minimum inten\u00adsity of 20 hours per week. There is so far no evidence that a&nbsp;substan\u00adtial propor\u00adtion of children can achieve a&nbsp;complete norma\u00adli\u00adsa\u00adtion of deve\u00adlo\u00adp\u00adment. In the studies with the best treat\u00adment results, a&nbsp;signi\u00adfi\u00adcant acce\u00adle\u00adra\u00adtion of the rate of deve\u00adlo\u00adp\u00adment was achieved in up to half of the children, so that these children are close to the normal values for age-appro\u00adpriate children or quite within the normal range. In other studies, however, only slight impro\u00adve\u00adments compared to routine treat\u00adment could be shown. The core symptoms of autism ther\u00ade\u00adfore appear to be quite acces\u00adsible to early treat\u00adment. Most of the evidence is available for the <span class=\"caps\">ABA<\/span>. However, the lower the inten\u00adsity of treat\u00adment, the lower the effects. However, a&nbsp;minimum of required or meaningful treat\u00adment inten\u00adsity cannot be speci\u00adfied. No valid infor\u00adma\u00adtion can be provided on the cost and cost-effec\u00adti\u00adve\u00adness of inten\u00adsive early inter\u00adven\u00adtions in children with autism.&nbsp;<\/span><\/p>\n<p>We would like to thank the German agency for Health Tech\u00adno\u00adlogy Assessment\/<span class=\"caps\">DAHTA<\/span> German agency for <span class=\"caps\">HTA<\/span> DIMDI-German Insti\u00adtute for medical docu\u00admen\u00adta\u00adtion and infor\u00adma\u00adtion for the permis\u00adsion to put this article on our website.<\/p>\n<p>[\/et_pb_toggle][et_pb_toggle title=\u201cM.I.N.D. Insti\u00adtute scien\u00adtists find important clues regar\u00adding lear\u00adning defi\u00adcits in children with autism\u201d open_toggle_text_color=\u201c#000000\u201d open_toggle_background_color=\u201crgba(255,255,255,0.7)\u201d closed_toggle_text_color=\u201d#ffffff\u201d closed_toggle_background_color=\u201c#0c71c3\u201d icon_color=\u201d#ffffff\u201d open_icon_color=\u201d#ffffff\u201d module_id=\u201c<span class=\"caps\">MIND<\/span>\u201d _builder_version=\u201c4.16\u201d title_text_color=\u201d#ffffff\u201d title_font=\u201d|700|||||||\u201d title_font_size=\u201c20px\u201d body_font=\u201d||||||||\u201d body_text_align=\u201cleft\u201d body_text_color=\u201c#000000\u201d custom_padding_tablet=\u201d\u201d custom_padding_phone=\u201c10px||10px\u201d custom_padding_last_edited=\u201con|phone\u201d title_font_size_tablet=\u201c15px\u201d title_font_size_phone=\u201c14px\u201d title_font_size_last_edited=\u201con|phone\u201d body_font_size_tablet=\u201d\u201d body_font_size_phone=\u201c14px\u201d body_font_size_last_edited=\u201con|phone\u201d border_width_all=\u201c2px\u201d border_color_all=\u201c#e02b20\u201d icon_color__hover=\u201d\u201d icon_color__hover_enabled=\u201con\u201d inline_fonts=\u201cVerdana\u201d global_colors_info=\u201d{}\u201d open_icon_color__hover_enabled=\u201con\u201d open_icon_color__hover=\u201d#ffffff\u201d]<\/p>\n<p><b>Highly tech\u00adno\u00adlogy eye-tracking head\u00adgear shows that autistic children look less at the face of the teaching person compared to normally deve\u00adlo\u00adping children.<\/b><span> <\/span><\/p>\n<p><b>October 7, 2008<\/b><span> <\/span><\/p>\n<p style=\"text-align: justify;\"><b>(<span class=\"caps\">SACRAMENTO<\/span>, Cali\u00adfornia, <span class=\"caps\">USA<\/span>)<\/b><span> <\/span><span>A&nbsp;study by scien\u00adtists at the <span class=\"caps\">UC<\/span> Davis M.I.N.D. Insti\u00adtute has found an important clue as to why children from the autistic spec\u00adtrum have diffi\u00adculty imita\u00adting other people. They spend less time watching the face of the indi\u00advi\u00adduals who are delaying new skills.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><span>This study was conducted using high-tech\u00adno\u00adlogy eye-tracking head equip\u00adment and soft\u00adware that accu\u00adra\u00adtely measured what a&nbsp;child was looking at during a&nbsp;lear\u00adning exer\u00adcise. The rese\u00adar\u00adchers deployed an actor to demons\u00adtrate a&nbsp;task on the computer screen.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><span><span class=\"dquo\">\u201c<\/span>We found that the children with autism were focused on the acti\u00advi\u00adties of the lead person and that they were much less likely than normally deve\u00adlo\u00adping children to look at the protes\u00adter\u2019s face,\u201d said Giacomo Vivanti, a&nbsp;scien\u00adtist accor\u00adding to the doctoral thesis at the M.I.N.D. Insti\u00adtute and the leading author. \u201cThe normally deve\u00adlo\u00adping children may have looked at the face of the precurtain in order to obtain infor\u00adma\u00adtion about what to do or how to do this appro\u00adpria\u00adtely; children with autism are less likely to seek this infor\u00adma\u00adtion. This is an important finding because children with autism struggle to learn from others. Part of the solu\u00adtion may lie here as to why this is so,\u201d says Vivanti.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><span><span class=\"dquo\">\u201c<\/span>Imita\u00adtion plays an important role in how children learn, but also how indi\u00advi\u00adduals interact soci\u00adally,\u201d says M.I.N.D. Insti\u00adtute scien\u00adtist and lead study author Sally J. Rogers. She has studied impair\u00adment in imita\u00adtion for more than 20 years. \u201cThis is a&nbsp;charac\u00adte\u00adristic that we see as early as how it is possible to estab\u00adlish the diagnosis of autism; and it\u2019s one of the features that\u2019s also present in slightly impaired adults,\u201d Rogers says.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><span>Limited imita\u00adtion leads to addi\u00adtional impairm\u00adents in the sharing of feelings, in the imagi\u00adnary play, in prag\u00admatic commu\u00adni\u00adca\u00adtion and in the under\u00adstan\u00adding of emotional states of other persons. For years, scien\u00adtists thought children with autism and similar disor\u00adders had diffi\u00adculty lear\u00adning through imita\u00adtion because they had a&nbsp;lack of motor skills, or because they paid no atten\u00adtion to the exer\u00adcise being performed. This current study excludes this hypothesis.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><span><span class=\"dquo\">\u201c<\/span>We now under\u00adstand more about how the defi\u00adcits in imita\u00adtion come about; and we may ther\u00ade\u00adfore, after addi\u00adtional rese\u00adarch, also address them in such a&nbsp;way that children with autism can be helped to develop a&nbsp;more natural reper\u00adtoire of beha\u00adviors, \u201creports Rogers, a&nbsp;rese\u00adar\u00adcher at <span class=\"caps\">UC<\/span> Davis and professor of psycha\u00adtrics. And beha\u00advi\u00adoral sciences.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><span>In this latest study, published on the internet in June and will appear in the Journal of Expe\u00adri\u00admental Child Psycho\u00adlogy in November; 18 children aged 8\u201315 with high-unctio\u00adning autism were carefully matched with 13 normally deve\u00adlo\u00adping children. While wearing the special eye-tracking head set, the children were shown video clips that were between 7\u201319 seconds long. After watching the clips, the children made up the performed move\u00adments. The findings confirmed previous rese\u00adarch that children with autism have diffi\u00adculty with imita\u00adtion exer\u00adcises compared to the age-deve\u00adlo\u00adping children. But it also became clear that children with autism, as well as other children, paid atten\u00adtion to the acti\u00advi\u00adties demons\u00adtrated. This excluded the hypo\u00adthesis of lack of atten\u00adtion in rela\u00adtion to tasks. \u201cThis finding is parti\u00adcu\u00adlarly important,\u201d Rogers says. \u201cNow we can exclude this variable. We know that the children are looking at the&nbsp;tasks.\u201d&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><span>Rese\u00adar\u00adchers have also found that successfully performing tasks of children with autism increased when the time they had to look at them increased; However, this was not related to the basic skills in motor skills; This ruled out the possi\u00adbi\u00adlity that a&nbsp;defi\u00adci\u00adency in motor dexterity could cause the effects in imitation.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><span>Finally, the study showed that both groups of children turned their atten\u00adtion from acti\u00advity to the precursout, however, the children with autism made this much less common.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><span>Accor\u00adding to Rogers, these findings suggest that imita\u00adtion is not just a&nbsp;repeat of an act, but the under\u00adstan\u00adding of the occa\u00adsion for that activity.&nbsp;<\/span><\/p>\n<p><span><span class=\"dquo\">\u201c<\/span>This infor\u00adma\u00adtion is conveyed through our face,\u201d she explains.&nbsp;<\/span><\/p>\n<p style=\"text-align: left;\"><span>Rogers and Vivanti will continue to try to under\u00adstand how this diffe\u00adrence in looking at faces affects more clut\u00adtered lear\u00adning and understanding.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><span><span class=\"dquo\">\u201c<\/span>We\u2019re looking at how children look at feelings and inten\u00adtions trans\u00admitted through the premier\u2019s face. And we also look at how informing the faces by looking or not looking affects the under\u00adstan\u00adding and imita\u00adtion of the observed actions,\u201d Vivanti says.&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><span>Based on these studies, Vivanti and Rogers hope they can one day develop studies desi\u00adgned to show whether or not looking in faces is an important part of the copycat process. \u201cIt could be that people with autism might be better at reco\u00adgni\u00adzing feelings, they might start to mimic their role models quite natu\u00adrally, as other indi\u00advi\u00adduals do,\u201d Rogers says. \u201d If it\u2019s a&nbsp;matter of how to under\u00adstand the infor\u00adma\u00adtion from the face, then it provides you with a&nbsp;goal for intervention.&nbsp;\u201d&nbsp;<\/span><\/p>\n<p style=\"text-align: justify;\"><span>The <span class=\"caps\">UC<\/span> Davis M.I.N.D. Insti\u00adtute, in Sacra\u00admento, Calif., was founded in 1998 as a&nbsp;unique inter\u00addi\u00adsci\u00adpli\u00adnary rese\u00adarch center where parents, commu\u00adnity boards, scien\u00adtists, doctors and volun\u00adteers work toge\u00adther to address autism and others Neuro\u00adde\u00adve\u00adlo\u00adp\u00admental disorders.&nbsp;<\/span><\/p>\n<p><span>More infor\u00adma\u00adtion about the insti\u00adtute can be found on the Internet:<\/span> <a href=\"http:\/\/www.ucdmc.ucdavis.edu\/mindinstitute\/\" target=\"new\" rel=\"noopener noreferrer\">www\u200b.ucdmc\u200b.ucdavis\u200b.edu\/\u200bm\u200bi\u200bn\u200bd\u200bi\u200bn\u200bs\u200bt\u200bi\u200bt\u200bu\u200bte\/<\/a> <span>. <\/span><\/p>\n<p><span>Thank You for Allo\u00adwing this Article to be trans\u00adlated and published to: Phyllis Brown, Senior Public Infor\u00adma\u00adtion Officer, <span class=\"caps\">UC<\/span> Davis M.I.N.D. 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height: 84px;\"><br> <\/a><\/p>\n<p>[\/et_pb_toggle][et_pb_toggle title=\u201cChallenging beha\u00advior and effec\u00adtive inter\u00adven\u00adtions\u201d open_toggle_text_color=\u201c#000000\u201d open_toggle_background_color=\u201crgba(255,255,255,0.7)\u201d closed_toggle_text_color=\u201d#ffffff\u201d closed_toggle_background_color=\u201c#0c71c3\u201d icon_color=\u201d#ffffff\u201d open_icon_color=\u201d#ffffff\u201d _builder_version=\u201c4.16\u201d title_text_color=\u201d#ffffff\u201d title_font=\u201d|700|||||||\u201d title_font_size=\u201c20px\u201d body_font=\u201d||||||||\u201d body_text_align=\u201cleft\u201d body_text_color=\u201c#000000\u201d custom_padding_tablet=\u201d\u201d custom_padding_phone=\u201c10px||10px\u201d custom_padding_last_edited=\u201con|phone\u201d title_font_size_tablet=\u201c15px\u201d title_font_size_phone=\u201c14px\u201d title_font_size_last_edited=\u201con|phone\u201d body_font_size_tablet=\u201d\u201d body_font_size_phone=\u201c14px\u201d body_font_size_last_edited=\u201con|phone\u201d border_width_all=\u201c2px\u201d border_color_all=\u201c#e02b20\u201d icon_color__hover=\u201d\u201d icon_color__hover_enabled=\u201con\u201d inline_fonts=\u201cVerdana\u201d global_colors_info=\u201d{}\u201d open_icon_color__hover_enabled=\u201con\u201d open_icon_color__hover=\u201d#ffffff\u201d]<\/p>\n<p style=\"text-align: left;\"><a href=\"\/wp-content\/uploads\/Artikel\/Challenging_behaviors_and%20effective_intervention-K.Dounavi.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-size: 16px;\">Down\u00adload the article as <span class=\"caps\">PDF<\/span><br> <\/span><img decoding=\"async\" src=\"https:\/\/www.melodycenter.de\/wp-content\/uploads\/2019\/03\/PDF_Symbol_small.png\" alt=\"PDF download\" style=\"width: 69px; 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Those choo\u00adsing to continue their educa\u00adtion journey by ente\u00adring college face a&nbsp;new set of educa\u00adtional and social chal\u00adlenges. For those pursuing college among the esti\u00admated 7&nbsp;million people in America diagnosed with atten\u00adtion deficit hyperac\u00adti\u00advity disorder&nbsp;[\u2026]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":7357,"menu_order":4,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","wp_typography_post_enhancements_disabled":false,"footnotes":""},"difl_page_category":[],"class_list":["post-7415","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Articles about autismus \u2013 Melody Learning Center ABA\/VB<\/title>\n<meta name=\"description\" content=\"Articles about autism ABA\/VB of the Melody Learning Centers: protecting children from sexual abuse, Applied Behavior analysis\" \/>\n<meta name=\"robots\" content=\"index, follow, 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