Simplify the World - National Autism Network

advertisement
Marion Blank, Ph.D.
Columbia University
msb5@columbia.edu
Suzanne Goh, M.D.
Pediatric Neurology
Therapeutics
sgoh@gohmd.com
Website
www.spectacularbond.com
Susan Deland
delands@optonline.net
Email
info@spectacularbond.com
OVERVIEW
creating the social and behavioral
foundation for learning
Dr. Marion Blank
the neuroscience behind
Spectacular Bond
Dr. Suzanne Goh
a family’s experience
Susan Deland
The Starting Point
in contrast to the common focus on what the
child needs to learn, our starting point is
seeing the world through the
child’s eyes
 the “everyday world” is not getting in –
WHY?
The Child’s View
via reports
via observations
the child finds the world to be
overwhelming, confusing, &
painful
 Much of that pain and confusion is
caused by the very stimulation that NT
children find appealing and irresistible –
the social realm.
The Social World
newborn is primed to
attend to, focus on,
and interact with the
adult
one-day-old infant
with her mother
Diane Deland age 2
(prior to starting the Spectacular Bond program)
Implications
The social world is the basis for communication.
Communication is the basis of all interaction,
including INTERVENTION.
When a child avoids the social world, adult-directed
teaching will rarely, if ever, be truly effective.
The “accommodations” made for children are often
counterproductive.
The First Element
Simplify the World
simplifying the world is the opposite of
providing stimulation
key points for the two worlds:
the non-social world
the social world
Simplification is not Enough
well-established defenses are in play
child will not readily give them up
one key defense is “stimming”
 keeps the outside world from intruding
 provides stimulation
Comment from a “Nonverbal”
Teenager with ASD
“I treat stims like a welcomed
friend….I am so needy to escape
reality and stims take me to
another world.” (Ido in Autismland)
The Second Element
Self Control of Stimming and Other
Unproductive Behaviors
(in the presence of adults)
The Third Element
Managing Meltdowns
temper tantrums
overloads
The Fourth Element
Sitting Quietly
Key Elements
 focus is on developing inhibition and inner
calm
 all are done at home – prior to moving to the
outside world
 goal is 10 to 15 minutes of carefully
structured, effective interaction every hour
(child is “free” the rest of the time)
 child’s room becomes a “haven”
OVERVIEW
creating the social and behavioral
foundation for learning
Dr. Marion Blank
the neuroscience behind
Spectacular Bond
Dr. Suzanne Goh
a family’s experience
Susan Deland
The Neuroscience Behind
Spectacular Bond
Knowledge about how the brain works
has not been factored into most
intervention programs
Yet, all intervention programs represent
efforts to reshape brain networks
The Brain in Autism CAN
Change
• With early intervention, electrical
patterns of brain activity begin to
resemble that of neurotypical children*
Before these changes can take place,
children need to be receptive to
intervention
*Dawson, G. et al. (2012) “Early behavioral intervention is associated with
normalized brain activity in young children with autism.” Journal of the
American Academy of Child and Adolescent Psychiatry. 51(11):1150–1159.
The Effects of “Training” on
Brain Networks
If unproductive behaviors aren’t addressed in
a treatment program
 stronger neural networks are created in areas of
the brain that should NOT be growing
 new, productive patterns can’t be established
How to Reshape Neural
Networks
Change is possible if we
 Diminish those repetitive behaviors that are
working against positive brain growth
 Expand neural networks for the skills that will allow
the children to live full and productive lives
Calm the Brain before
Stimulating It
Reduce the stressful stimulation that the
child must face
Simplify the child’s world
Intervention Must Begin in the
Social Domain
 Social brain is intimately tied to emotional centers
of the brain that control feelings of fear and
anxiety
The “Social Brain”
 Amygdala
 Prefrontal cortices
 Temporal cortices
OVERVIEW
creating the social and behavioral
foundation for learning
Dr. Marion Blank
the neuroscience behind
Spectacular Bond
Dr. Suzanne Goh
a family’s experience
Susan Deland
Diane Deland – a case study
 Diagnosed at 3 years of
age, Diane began the
Spectacular Bond
program right away.
 We will see the program
in action in her particular
case.
Element 1 – simplify the world
 changing the physical
and interpersonal
environment
 Diane would no longer
eat meals in the
playroom
Element 2 – build self control
targeting unproductive
behaviors
Diane would stop
running and shrieking
in our playroom. She
would stop pulling
clothes out of drawers.
Element 3 – manage
meltdowns
 distinguishing between
tantrums and overloads
 bypassing rewards
 learning to say “not now”
 Diane would get the
things she desired, but at
the times that we
decided, not at her
request
Element 4 – sit quietly
 calming the mind
 reshaping my relationship
with Diane
 Diane would sit quietly
with her hands on her lap
for a short period of time
Element 5 – organize the day
Creating a clear plan for
how each day would be
structured
There would be time for
adult-led exchange, childled exchange, minimal
exchange, and no
exchange.
Element 6 – simple actions
 Teaching her to follow
simple commands under
an adult’s direction
 Diane would imitate
simple actions with me or
Dr. Blank
Marion Blank, Ph.D.
Columbia University
msb5@columbia.edu
Suzanne Goh, M.D.
Pediatric Neurology
Therapeutics
sgoh@gohmd.com
Website
www.spectacularbond.com
Susan Deland
delands@optonline.net
Email
info@spectacularbond.com
Download