Pasadena Child Development Associates, Inc.
Pasadena Child Development Associates, Inc.
Articles
It is great to see new toys or ways of encouraging my son to develop new skills.
Autism - National Institute of Health Public Access Author Manuscript
Autism spectrum disorders are characterised by severe deficits in socialisation, communication, and repetitive or unusual behaviours. Increases over time in the frequency of these disorders (to present rates of about 60 cases per 10,000 children) might be attributable to factors such as new administrative classifications, policy and practice changes, and increased awareness. Surveillance and screening strategies for early identification could enable early treatment and improved outcomes. Autism spectrum disorders are highly genetic and multifactorial, with many risk factors acting together. Genes that affect synaptic maturation are implicated, resulting in neurobiological theories focusing on connectivity and neural effects of gene expression. Several treatments might address core and comorbid symptoms. However, not all treatments have been adequately studied. Improved strategies for early identification with phenotypic characteristics and biological markers (eg, electrophysiological changes) might hopefully improve effectiveness of treatment. Further knowledge about early identification, neurobiology of autism, effective treatments, and the effect of this disorder on families is needed.
Click here for the complete article: Levy-Autism.pdf (Adobe Acrobat PDF)
What is the DIR®/FloortimeTM Model?
The Developmental, Individual Difference, Relationship-based (DIR®/FloortimeTM) Model is a framework that helps clinicians, parents and educators conduct a comprehensive assessment and develop an intervention program tailored to the unique challenges and strengths of children with Autism Spectrum Disorders (ASD) and other developmental challenges. The objectives of the DIR®/FloortimeTM Model are to build healthy foundations for social, emotional, and intellectual capacities.
- The D (Developmental) part of the Model describes the building blocks of this foundation. This includes helping children to develop capacities to attend and remain calm and regulated, engage and relate to others, initiate and respond to all types of communication beginning with emotional and social affect based gestures, engage in shared social problem-solving and intentional behavior involving a continuous flow of interactions in a row, use ideas to communicate needs and think and play creatively, and build bridges between ideas in logical ways which lead to higher level capacities to think in multicausal, grey area and reflective ways. These developmental capacities are essential for spontaneous and empathic relationships as well as the mastery of academic skills.
Click here for the complete article: What_is_DIR-2008.doc (Word Doc),
What_is_DIR-2008.pdf (Adobe Acrobat PDF)
Helping Children Master New Experiences:
DIR® Applied to Increasing Flexibility Around Eating
One of the most difficult challenges for parents and therapists is to help children become more flexible eaters. This happens particularly when the children are rigid, stubborn, and narrow in their choices. It is often due to sensory processing differences, where particular tastes and smells may be aversive and lots of controlling behavior has developed to minimize surprises.
The strategy, which is based on the DIR® model, involves harnessing the child's initiative and problem-solving and, if possible, verbal or symbolic mastery. This is done in the context of pleasurable, regulating experiences and the gradual modulation of sensory overreactivity in areas of taste and smell. The strategy involves first establishing shared attention and engagement with the child through Floortime play and then in eating contexts. A critical step is to reduce any anxiety from a history of power struggles around eating and replace it with calm, regulating experiences. Again, this begins simply with regular Floortime sessions where a child is tuned into at his functional level in terms of his sensory profile, with nurturing and follow the child's interest-type interactions. As one takes this now soothing, regulating, pleasurable relationship to the eating situation, one is likely to see increased anxieties and negative behaviors. It’s therefore important, once having established pleasurable, soothing interactions in play, to establish this around eating as well. Therefore, begin with foods the child enjoys and tolerates well and don’t try to introduce new foods or stretch the child’s capacities at the outset.
Click here for the complete article: Greenspan-Eating.pdf (Adobe Acrobat PDF)
Social Skills Group Training using a Developmental Approach
Evidence Based Practice
Dr. Diane Cullinane
- Diplomat, American Board of Pediatrics
- Diplomat in Developmental-Behavioral Pediatrics
- Diplomat in Neurodevelopmental Disabilities
- Faculty, Interdisciplinary Council on Development and Learning Disorders
The development of social skills, specifically skills in relating to peers, is an important capacity that provides the foundations for life long success. Challenges in the development of social skills impact individual happiness and family function for many children with developmental disabilities, especially those with autism. Indeed, deficits in social behaviors are a major component of the diagnostic criteria for autism. In a survey done at Tri-counties Regional center, parents of children with autism reported that social skills were their number one concern. A study of children with ASD in elementary school showed that children with autism were less accepted and had fewer reciprocal friendships than matched peers at each grade level, and that the deficits increased with advancing age. A detailed review of the theoretical understanding and approaches to social skills intervention is available in the report of The Committee on Educational Interventions for Children with Autism by the National Research Council (NRC). They note: "Interaction with peers is another dimension of children’s social development that becomes increasingly important for children..."
Click here for the complete article:
Social-Skills-Training-Developmental-Approach.doc (Word Doc),
Social-Skills-Training-Developmental-Approach.pdf (Adobe Acrobat PDF)
Evidence Base for the DIR®/Floortime Approach
Due to the recent budget cuts in California, the 'evidence' to justify public funding for DIR®/FT programs is currently under scrutiny by regional centers in California. This article attempts to summarize the most current research evidence pertaining to the DIR®/FT approach, which will not only provide sufficient basis for a determination that DIR®/FT is evidence-based but will also present an historical view that shows that the field of intervention for children with PDD is shifting from more behavioral approaches towards more developmental models overall.
From Trailer bill: "Evidence-based practice" means a decision making process which integrates the best available scientifically rigorous research, clinical expertise, and individual's characteristics. Evidence-based practice is an approach to treatment rather than a specific treatment. Evidence-based practice promotes the collection, interpretation, integration, and continuous evaluation of valid, important, and applicable individual- or family-reported, clinically-observed, and research-supported evidence. The best available evidence, matched to infant or toddler circumstances and preferences, is applied to ensure the quality of clinical judgments and facilitates the most cost-effective care.
Click for the complete article: Evidence_Base_for_the_DIR-2-2011.doc (Word Doc),
Evidence_Base_for_the_DIR-2-2011.pdf (Adobe Acrobat PDF)
Evidence-based Practice and Practice-based Evidence
"Evidence-based" has become the gold standard for determining funding. The terms evidence based medicine, treatment, guidelines, practice, models, etc are often used interchangeably. The distinctions are particularly important for the care of children with disabilities and complex medical conditions. Evidence based treatments refer to specific treatments which have been studied on specific and limited populations. These types of treatments are more amenable to study and validation because they limit variables, such as a single diagnosis, and use more easily measured outcomes. Affect, initiative, creativity, warmth, and reciprocity in complex dynamic systems are less often measured. For children with complex conditions, EBTs must be integrated into EB practice. Sackett1 defined evidence based medicine as "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients."
Click here for the complete article:Evidence-based_Practice.doc (Word Doc), Evidence-based_Practice.pdf (Adobe Acrobat PDF)
What is DIR®/Floortime and Why is it "Best Clinical Practice"?
The Developmental, Individual Difference, Relationship based approach to helping children with special needs, known as DIR®, was described by Dr. Stanley Greenspan and Serena Wieder beginning in the 1980s. This approach is the culmination of years of observation and study of infants and children, done by many outstanding researchers since the 1950s. Dr. Greenspan and Serena Wieder brought together the knowledge from developmental studies, and mental health research, and recognized the critical importance of relationships and affect to learning. DIR®/Floortime is a framework for understanding child development, a philosophy that emphasizes the critical importance of relationships and affect, and a set of treatment strategies built upon those principles. DIR® is a broad and comprehensive approach which encompasses all disciplines that work with children.
Click here for the complete article: What_is_DIR.doc (Word Doc),
What_is_DIR.pdf (Adobe Acrobat PDF)
Mandating Autism Policy - A Closer Look at the Evidence - April 2009
A Fact Sheet for Law Makers, Parents and Health Professionals
... Informed decision-making requires a thorough review of existing research. Are claims and assertions that support one method of intervention, ABA, founded on solid, unbiased science and evidence-based research? This fact sheet reviews up to date research and autism literature to address this and other related questions. Included in the research are recent systematic reviews that provide meta-analysis of studies from the last 30 years. Systematic reviews and meta-analysis are considered the highest level of evidence among evidence based clinical guidelines.
Click here for the complete article: Autism_A-closer-look.doc (Word Doc), Autism_A-closer-look.pdf ( PDF)
DIR/Floortime and Autism Spectrum Disorders Overview
and Summary of Scientific and Public Support
... The objectives of the DIR/Floortime Model are to build the healthy foundations necessary for a child to develop social, emotional, and intellectual capacities. As stressed in the general literature that promotes healthy emotional and social development, two of the key elements to building these foundations are: spontaneous communication between children and their caregivers and nurturing relationships, that promote joyful and pleasant engagement. These two elements are basic components of the DIR/Floortime Model. Importantly, the National Research Council of the National Academy of Sciences, in their 2001 landmark report, Educating Children with Autism, called for tailoring the treatment approach to unique features of the individual child and recommended to give priority to interventions that promote functional, spontaneous communication...
Click here for the complete article:
DIR-Floortime_Overview-and-Summary.doc (Word Doc), DIR-Floortime_Overview-and-Summary.pdf ( PDF)
CDC/ICDL Collaborative Report - November 2006
Centers for Disease Control and Prevention (CDC) and the Interdisciplinary Council on Developmental and Learning Disorders (ICDL) Collaboration Report on a Framework for Early Identification and Preventive Intervention of Emotional and Developmental Challenges
Click for an Adobe Acrobat PDF version of the complete article: CDC-ICDLCollaborationReport.pdf
Articles by Barry M. Prizant, Ph.D., CCC-SLP
About the Author
Dr. Barry Prizant is the Director of Childhood Communication Services and an adjunct professor in the Center for the Study of Human Development, Brown University. Barry has more than 35 years of experience as a researcher and international consultant to children and adults with ASD. He has published more than 90 articles and chapters on childhood communication disorders and has given more than 500 seminars and workshops at national and international conferences. He also serves on the Editorial Boards of six scholarly journals. Barry is a co-author of the SCERTS Model (Prizant, Wetherby, Rubin, Laurent & Rydell, 2006 - www.SCERTS.com). In 2005, Barry received the Princeton University-Eden Foundation Career Award "for improving the quality of life for individuals with autism".
Click on the links below to access the articles.
- Finding Balance
- On Recovery
- Parent-Professional Relationships:
It's a Matter of Trust
- Treatment Options and Parent Choice:
An Individualized Approach to Intervention
- Treatment Options and Parent Choice:
Is ABA the Only Way?
- The Use and Misuse of Evidence-based Practice:
Implications for Persons with ADS
Raising Baby: What You Need to Know - Published Summer 2000
Bookstore shelves are crammed with titles purporting
to help you make your baby smarter, happier, healthier, stronger, better-behaved and
everything else you can imagine, in what I call a shopping-cart approach to infant development. But experts are now beginning to look more broadly, in an integrated fashion, at the first few months of a baby's life. And so should you.
Psychological theorists are moving away from focusing on single areas such as physical development, genetic inheritance, cognitive skills or emotional attachment, which give at best a limited view of how babies develop. Instead, they are attempting to synthesize and integrate all the separate pieces of the infant-development puzzle. The results so far have been enlightening, and are beginning to suggest new ways of parenting.
The most important part of the emerging revelations is that the key to stimulating emotional and intellectual growth in your child is your own behavior -- what you do, what you don't do, how you scold, how you reward and how you show affection. If the baby's brain is the hardware, then you, the parents, provide the software. When you understand the hardware (your baby's brain), you will be better able to design the software (your own behavior) to promote baby's well-being...
Click for an Adobe Acrobat PDF version of the complete article: Raising-Baby_What-You-Need-to-Know.pdf