Reliability of the SKILLS Language Index

By Marlena N. Smith

A recent study conducted by CARD research and Development faculty found the Shaping Knowledge though Individualized Life Learning Systems (SKILLS) Language Index to have strong reliability. While early intensive behavioral intervention (EIBI) is a highly supported treatment for children with autism spectrum disorders (ASD), treatment content can differ across EIBI programs. Furthermore, assessment tools designed to identify individualized content for EIBI programs are limited, and none have undergone psychometric evaluation. The purpose of this study was to evaluate the reliability of the SKILLS Language Index.

The SKILLS Index is a comprehensive assessment instrument developed to identify appropriate treatment content for EIBI programs. While the SKILLS Index covers all areas of human functioning, this study focused specifically on the SKILLS Language Index. To learn more about SKILLS and the SKILLS Index visit www.skillsforautism.com.

This study evaluated the reliability of the SKILLS Language Index. Reliability measures an instrument’s ability to replicate results over time (test-retest reliability) or between raters (inter-rater reliability). Participants included 66 children who were randomly selected from a pool of over 1000 children with ASD. Two therapists completed the SKILLS Language Index for each participant within a one week period. Additionally, one therapist completed the SKILLS Language Index twice within a one month period.

The SKILLS Language Index was found to have excellent internal consistency, test-retest reliability, and inter-rater reliability. Furthermore, the SKILLS Language Index is the first assessment directly linked to an ABA curriculum for children with ASD to receive psychometric research. While this study found the SKILLS Language Index to have strong reliability, further research is needed to evaluate the reliability of the other domains within the SKILLS Index in addition to the validity of the entire instrument.

The CARD research team would like to thank the more than 100 therapists that assisted with the study, and particularly Catherine Peters for her help coordinating the project.

References

Dixon, D. R., Tarbox, J., Najdowski, A. C., Wilke, A. E., & Granpeesheh, D. (in press). A
comprehensive evaluation of language for early behavioral intervention programs: The reliability
of the SKILLS Language Index. Research in Autism Spectrum Disorders.
doi:10.1016/j.rasd.2010.06.016

The use of Citalopram in Children with Autism Spectrum Disorders

By Marlena N. Smith

In a recent study, King et al. did not find citalopram to be effective in improving repetitive behavior in children with autism spectrum disorders (ASD). Children with ASD are commonly prescribed selective serotonin reuptake inhibitors; however, research investigating the use of this medication in children with ASD is limited. King et al. set out to investigate the effectiveness of citalopram in treating repetitive behavior in children with ASD as compared to placebo.

Participants included 149 individuals with ASD, ages 5 to 17 years. The participants were randomly selected to receive either citalopram or placebo for the duration of 12 weeks. Treatment effectiveness was evaluated via measures of positive response, repetitive behavior, and negative effects.

Results revealed no significant differences between citalopram and placebo in measures of positive response and repetitive behavior. On the other hand, citalopram was significantly more likely to have negative effects including:

• Greater energy level
• Impulsive behavior
• Reduced concentration
• Hyperactivity
• Stereotyped behavior
• Diarrhea
• Insomnia
• Dry or itchy skin

Citalopram was not found to improve repetitive behavior in children with ASD. These findings do not support the use of citalopram in children with ASD. Further research regarding the use of citalopram and other selective serotonin reuptake inhibitors in children with ASD is warranted.

References

King, B. H., Hollander, E., Sikich, L., McCracken, J. T., Scahill, L., Bregman, J. D.,… Ritz, L. (2009). Lack of efficacy of citalopram in children with autism spectrum disorders and high levels of repetitive behavior: Citalopram ineffective in children with autism. Archives of General Psychiatry, 66, 583-590.

CARD Publishes a Second Research Study on the Effectiveness of Hyperbaric Oxygen Therapy for Children with Autism Spectrum Disorders

By Marlena N. Smith

A recent study conducted by CARD research and development faculty in collaboration with the Thoughtful House Center for Children found hyperbaric oxygen therapy (HBOT) to have no effect on the behavior of children with autism spectrum disorders (ASD). Over recent years HBOT has become an increasingly popular treatment for children with ASD; however, the research evaluating its effectiveness is limited. The purpose of this study was to investigate the effect of HBOT on the behavior of children with ASD.

Sixteen participants with ASD, ages 3 to 9 years, completed the study. Participants received 40 HBOT sessions delivering 24% oxygen at 1.3 atmospheres of pressure, an HBOT dosing regimen that is commonly practiced in the community. Treatment effectiveness was evaluated using a multiple baseline across participants design, via direct observation of the participants’ adaptive behavior, stereotypy, challenging behavior, toy contact, and physical activity.

In this study, HBOT was not found to have a positive or negative effect on the participants’ behavior. These findings replicate those of an earlier study by CARD researchers on HBOT, which used a randomized placebo-controlled design, and which was conducted in a different state. Particularly when both studies are considered together, the findings do not support the use of HBOT for the treatment of ASD. While HBOT may be effective if delivered at a different dosing regimen than the one evaluated in this study, parents are not recommended to invest in this treatment until more favorable results are shown in the context of controlled research.

References

Jepson, B., Granpeesheh, D., Tarbox, J., Olive, M. L., Stott, C., Braud, S.,… Allen, M. S. (in press). Controlled evaluation of the effects of hyperbaric oxygen therapy on the behavior of 16 children with autism spectrum disorders. Journal of Autism and Developmental Disorders.

Hollywood’s Hottest Reality Stars Unite with the Center for Autism and Related Disorders for an Autism Awareness Day July 25th in Woodland Hills, CA.

“CLICK IMAGE TO ENLARGE”

Woodland Hills, CA – July 25, 2010 The Center for Autism and Related Disorders, Inc. (CARD), considered the world’s largest organization effectively treating children with autism, will host Ride and Style Family Festival – an Autism Awareness Day event - in Woodland Hills, CA on Sunday, July 25, 2010. The festival will be held from 11am – 6pm at 208555 Ventura Blvd, in Woodland Hills, California.

Hollywood reality stars Dean McDermott of “Tori and Dean: Home Sweet Hollywood”, Grant Reynolds of “Househusbands of Hollywood”, and Racecar Driver / Model Ashley van Dyke will join world – renowned autism expert Dr. Doreen Granpeesheh on the stage as co-hosts of the Ride and Style Family Festival. Celebrity Stylist Allen Edwards, best known for creating Farrah Fawcett’s signature hairstyle, will conduct a “Cutting for Autism” cut-a-thon as part of the festival.

According to the Center for Disease Control and Prevention, one in 110 children in America, is diagnosed with autism. Autism is more prevalent than AIDS, pediatric cancer and diabetes combined.

“With statistics like that, many people in the Los Angeles community know someone with a child with autism,” says CARD Founder, Dr. Doreen Granpeesheh, who has a record of recovering children from autism. “We want to bring awareness to the issue of autism, share valuable resources, and show community appreciation with this fun filled family day.”

The Ride and Style Family Festival will also feature live performances by some of LA’s hottest performers and musicians, including Zac Poor, Zoe Myers, Arrest My Sister, Odori 73 International Hip Hop Dance Crew, and Latin Jam. The festival will also offer top of the line, exotic cars; custom motorbikes, food concessions, vendors, and carnival games. Proceeds from the Ride and Style Family Festival will go to Autism Care and Treatment (ACT Today!) a non profit organization that provides grants for therapy, biomedical treatments, social skills groups and more to children with autism whose families can not afford these necessary tools.

The CARD co-hosted Autism Awareness Day event is one of 20 celebrations hosted by the Center for Autism and Related Disorders, this year, to recognize its 20 years of leading the way in the successful treatment of autism. For more information about Ride and Style Family Festival, visit: www.rideandstyleforautism.net.

The Center for Autism and Related Disorders to Host a Free Family Festival in San Diego, August 07th

“CLICK IMAGE TO ENLARGE”

The Center for Autism and Related Disorders, Inc. (CARD), considered the world’s largest organization effectively treating children with autism, will host a CARD Family Festival on Saturday, August 07th. The event will be held from 10am – 2pm at Kearny Mesa Park, located at 3170 Armstrong Street in San Diego, California.

According to the Center for Disease Control and Prevention, one in 110 children in America, is diagnosed with autism. Autism is more prevalent than AIDS, pediatric cancer and diabetes combined.

“With statistics like that, many people in the San Diego community know someone with a child with autism,” says CARD San Diego Managing Supervisor Theresa Contreras, MA, BCBA. “We want to bring awareness to the issue of autism, share valuable resources, and show community appreciation with this fun filled family festival.

The free CARD Family Festival is open to the entire San Diego community, and will feature live performances by San Diego dance groups “Jr. Crew” and “Arms Wide Open”, carnival games, resource booths, food, music and raffle prizes. All proceeds of the raffle will benefit Autism Care and Treatment (ACT Today!), a non profit organization that provides grants for therapy, biomedical treatment, social skills groups, and helmets for children with autism whose families can not afford the necessary tools for their child to reach their highest potential.

The CARD Family Festival is one of 20 celebrations hosted by the Center for Autism and Related Disorders, this year, to recognize its 20 years of leading the way in the successful treatment of autism.

Identifying Preferred Reinforcers for Persons with Autism Spectrum Disorders

By Marlena N. Smith

In a recent review, Weeden and Poling explored the procedures used to identify preferred reinforcers in studies delivering reinforcement to teach skills to persons with autism spectrum disorders (ASD). Reinforcement is an important element of behavioral intervention for ASD. Moreover, the identification of preferred reinforcers is crucial to the effectiveness of treatment.

Ninety-seven research studies, published between 2005 and 2009, were reviewed. All studies involved the use of reinforcement to teach skills to individuals with ASD.

While all the studies reported the use of reinforcement, only 32 described the procedures used to identify preferred reinforcers. Procedures commonly reported in the studies, descending from most frequently used, include:

1. Interviewing an individual close to the participant, such as a parent, caregiver, or teacher
2. Asking the participant
3. Observing the participant
4. Administering preference assessments to the participant

All the studies found positive reinforcement to be effective in teaching skills to persons with ASD; however, the majority of the studies did not report the procedures used to identify reinforcers. Therefore, clinicians and researchers can not accurately replicate these studies. Weeden and Poling stress the importance of reporting procedures used to identify reinforcers in research studies involving persons with ASD.

References

Weeden, M., & Poling, A. (in press). Identifying reinforcers in skill acquisition studies involving participants with autism: Procedures reported from 2005 to 2009. Research in Autism Spectrum Disorders. doi:10.1016/j.rasd.2010.05.004

Teaching Children with Autism Spectrum Disorders to Ride a Bike

Liliane Savard, a physical therapist, has taught many children with autism spectrum disorders (ASD) to ride bicycles despite their potentially low muscle tone and poor motor planning. Savard’s methods are described in the recent Parenting Autism blog post: Get Out Your Bike--It is Summer!. Savard’s preliminary training steps include:

1) Finding a teaching bicycle
2) Wearing a helmet
3) Teaching with positive energy
4) Finding an appropriate training area
5) Eliminating distractions
6) Determining verbal cues to use with the child (i.e., pedal faster, glide, etc.)

Savard’s training procedures involve teaching children to:

1) Glide (push off the ground with both feet)
2) Scooter (keep dominate foot on the petal while using the other foot to push off)
3) Pedal

Children should be provided ample time to practice each step before moving on to the next.

This training method may be effective in teaching children with ASD to ride a bike. Research investigating the success of this training method is warranted. For a more detailed description of Savard’s methods visit: http://parenting-autism.org/2/post/2010/06/get-out-your-bike-it-is-summer.html.

Behavioral Professionals Learn New Skills with CARD CE

The Center for Autism and Related Disorders, Inc. (CARD) is proud to be an approved continuing education (ACE) provider of Type 2 continuing education hours for BCBA and BCaBA certificate holders. All programs offered by CARD CE are also approved for credit by the CA Board of Behavioral Science (PCE 4737) for continuing education for MFTs and LCSWs.

The CARD CE online programs are designed to provide you with the opportunity for professional growth and refinement. CARD CE offers behavioral health practitioners the ability to earn Continuing Education hours from the comfort, privacy and convenience of home or office through our web-based programs, which includes live web-based PowerPoint presentations and teleconferencing, recorded presentations and article reviews.

Benefits of CARD CE...
• Live, BCBA certified CARD instructors
• From the convenience of your home or office
• Variety of CE formats
• Interact with professionals from all over the world

Register NOW for the next two classes - July 10th and 22nd.

http://www.centerforautism.com/cardce/live-presentations.asp

click images to register.

Melatonin and Children with Autism Spectrum Disorders

By Marlena N. Smith

In a recent study, Wright et al. found melatonin to significantly improve sleep in children with autism spectrum disorders (ASD). Children with ASD often experience sleep problems. Several causes for sleep problems in children with ASD have been speculated, including insufficient levels of the sleep hormone melatonin. The purpose of this study was to evaluate the effectiveness of melatonin in improving sleep in children with ASD as compared to placebo.

Seventeen participants with ASD, ages 4-16 years, completed the study. All participants experienced severe sleep problems and showed no response to behavioral intervention. The participants were randomly selected to receive melatonin or placebo for the duration of three months. Later, those who previously received melatonin were subsequently given placebo, and vice versa, for an additional three months. The treatment’s effectiveness was evaluated via sleep diaries, where in parents recorded the participants’ sleep patterns on a daily basis.

The study found that, compared to placebo, melatonin:

• Decreased sleep latency (the time it takes to fall asleep after bedtime)
• Increased total sleep time
• Showed no effect on the number of awakenings during the night

The results suggest that melatonin is effective in improving sleep in children with ASD. These findings are relevant to both the wellbeing of children with ASD and their parents; oftentimes when a child loses sleep, the parents do as well. Further research evaluating the use of melatonin in treating sleep problems in children with ASD is warranted.

References

Wright, B., Sims, D., Smart, S., Alwazeer, A., Alderson-Day, B., Allgar, V.,… Miles, J. (2010). Melatonin versus placebo in children with autism spectrum conditions and severe sleep problems not amenable to behaviour management strategies: A randomised controlled crossover trial. Journal of Autism and Developmental Disorders. doi:1007/s10803-010-1036-5