The Pseudoscientific Phenom—Facilitated Communication—Makes a Comeback

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Correction: A previous version of this blog inaccurately suggested faculty in the Communication Sciences and Disorders Department at Syracuse University promoted facilitated communication. The Institute of Communication and Inclusion is housed in the School of Education at Syracuse and is not associated with the Communication Sciences and Disorders Department.

In the early 1990s, professionals who served children with autism and other developmental disabilities were swept up by a breakthrough method known as facilitated communication (FC). The method included a “facilitator” who provided physical support at the finger, hand, wrist and/or arm of a child who was believed to be typing his or her thoughts. The method allegedly “unlocked” these children from the prison of an unresponsive body to reveal average and sometimes superior intelligence, advanced literacy skills and profound insight about their experiences.

Although no validating evidence was available, popular media latched onto the story and FC fervently spread throughout the country. When researchers investigated claims made about FC, they discovered facilitators subconsciously authoring the messages and concluded FC was fake. For the most part, FC was widely dismissed by the professional communities and became a history lesson on the dangers of credulity, pseudoscience and the importance of evidence-based treatment.

However, beliefs about FC’s demise are premature.

Facilitated communication remains at the fringes of special education and related professions. The primary advocacy has come from faculty affiliated with the Institute of Communication and Inclusion at Syracuse University. A confluence of recent events reinvigorated the method, which is increasingly touted as “a form of augmentative and alternative communication.” Despite overwhelming scientific consensus that the client isn’t totally controlling the message, the method recently underwent a strategic rebranding and is now called “supported typing” or “rapid prompting method.”

Several indicators suggest FC is not just poised for a comeback, but that it’s already begun. A number of credible organizations lend FC unwarranted legitimacy, including the University of New Hampshire Institute on Disability/Center Excellence in DisabilityUniversity of Northern Iowa, Massachusetts Department of Elementary and Secondary Education, and Vermont Department of Disabilities.

Supporters in academia publish articles in peer-reviewed journals that portray FC in positive light, albeit without demonstrations of its efficacy. Indeed, the method is regaining popularity and school districts are beginning to adopt it for their students with autism.

Facilitated communication—known for being the quintessential pseudoscientific fad in developmental disabilities—is infamous for the number of unsubstantiated charges of sexual abuse made by users. In late 2014, the Wendrow family, whose story was featured on 20/20, was awarded nearly $7 million for wrongful prosecution after sexual abuse allegations were made via FC. Former Rutgers University Philosophy Department Chair and leading FC proponent Anna Stubblefield, who claimed any criticism about FC constituted hate speech, was recently charged with multiple accounts of aggravated  sexual assault after she allegedly acted as a facilitator to obtain consent for sex from a man with a severe disability and communication impairment. Stubblefield pleaded not guilty and her trial is set for August 2015.

The method also appears to have played a role in the murder of a child with autism. In November 2014, wealthy businesswoman Gigi Jordan was convicted of murdering her 8-year-old son. Jordan’s defense centered on her claim that she committed a mercy killing after her son allegedly requested via FC they both commit suicide.

Professionals responsible for teaching communication skills to children, youth and adults with autism and other developmental disabilities should take stock when examining claims of hidden communication skills, sudden breakthroughs and inspiring anecdotes that are incongruous with generally accepted research. Evidence-based interventions and treatments do exist to support acquisition of communication and other skills for these learners, though progress often is painstakingly slow. FC and its variants remain illegitimate and ultimately usurp the voices of individuals with communication impairments.

If those teaching individuals with autism and other developmental disabilities to communicate adhere to evidence-based approaches, they better serve their clients, prevent harm, and halt the proliferation of pseudoscience in autism.

Editor’s Note: Jason Travers will be speaking at the upcoming Schools Conference in Phoenix, July 10-12.  His presentation, Get the Message? The Communicative Nature of Inappropriate Behavior in Learners With ASD, will also be featured at Convention in October. See the full schedule for Schools, which is co-located with the Health Care & Business Institute.

Jason C. Travers, PhD, is an assistant professor of special education at the University of or Kansas. He earned his PhD at the University of Nevada, Las Vegas, while working as a special educator of students with autism in the nation’s fifth-largest school district. He investigates the racial disparity in the administrative prevalence of autism as well as the efficacy of technology for preventing inappropriate behavior while supporting academic, social and communication skills of students with autism. A board-certified behavior analyst, he teaches graduate courses in applied behavior analysis, evidence-based instructional strategies for learners with autism, and issues in special education. jason.travers@ku.edu

 

Apraxia Awareness Day: 10 Tips on Giving Kids With CAS a Voice

May 14 marks the third annual Apraxia Awareness Day, a movement headed by the Childhood Apraxia of Speech Association of North America (CASANA). The association’s motto—”Every Child Deserves a Voice”—entreats industry pros to correctly identify and treat kids with apraxia who may not develop intelligible speech. This is why apraxia awareness day is so important.

When I wrote the 10 Early Signs and Symptoms of Childhood Apraxia of Speech, many SLPs voiced their concern about how CAS is supposed to be a rare disorder and they are seeing over-diagnosis. Their concerns are valid. Current data, according to the ASHA portal, state that CAS occurs in every one to two children per 1,000. Over-diagnosis is a problem precipitated by factors that include:

  • Lack of clear and consistent diagnostic guidelines.
  • Lack of adequately validated diagnostic tools.
  • Professionals other than SLPs (pediatricians, neurologists) diagnosing CAS.
  • SLPs inadequately trained in diagnosis and treatment.

Over-diagnosis can cause families undue emotional stress and financial hardship. It also might divert important resources from those children who most need them.

According to research, children with CAS also often go undiagnosed if they truly DO have it! Differential diagnosis is critical with this disorder. Children not identified with CAS may struggle their entire lives and quite possibly not achieve intelligible speech without early and appropriate intervention. Consider that last line again: Without proper diagnosis and treatment, children with CAS may NOT achieve intelligible speech. This is what’s at stake!

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Apraxia awareness is crucial for professionals and families, so every child who has CAS gets the services he or she needs and deserves, regardless of how “rare” the disorder.

These children and parents rely on SLPs to be their heroes. So please, take time today—or soon—to learn more about childhood apraxia of speech. And if you suspect CAS in a client or student:

  • Seek out resources.
  • Attend a conference.
  • Listen in to a webinar.
  • Talk to and consult with your colleagues.
  • Wear blue and speak up for those who don’t yet have a voice.
  • Above all, be part of the solution.

These children and families are counting on you.

Having trouble getting reimbursed for CAS treatment? Read advice on making successful appeals.

And more resources to learn more about childhood apraxia of speech:

 

Laura Smith, MA, CCC-SLP, is a school-based and private clinician in the Denver metro area specializing in childhood apraxia of speech. She’s CASANA-certified for advanced training and clinical expertise in Childhood Apraxia of Speech and often speaks at conferences and consults for school districts or other professionals. Like her on Facebook, follow her on Pinterest, or visit her website at SLPMommyofApraxia.comlauraslpmommy@gmail.com

Tots as Young as 2 Use Tablets, and Parents Are Worried, ASHA Survey Finds

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A new ASHA survey of U.S. parents finds significant percentages reporting technology use by very young children. Additionally, more than half of the parents surveyed report feeling concern that technology use could negatively affect their young children’s ability to communicate.

Conducted this past March, the survey polled 1,000 parents of children ages 0 to 8. Its release occurs during May Is Better Hearing and Speech Month, a time for ASHA and its members to raise awareness of speech, language and hearing disorders—and spotlight the importance of communication health.

Although the fact that most children use “smart” technology today may not be surprising, just how early it begins may be. The survey results show that more than two-thirds of the respondents say their 2-year-olds are using tablets, more than half say they use smart phones, and one in four indicate their 2-year-olds are using some form of technology at the dinner table. All of this raises questions about how this tech use will affect children’s communication development.

Some findings from the survey:

  • 55 percent of parents have some degree of concern that misuse of technology may be harming their children’s hearing, and 52 percent have concerns about speech and language skills.
  • 52 percent  say they are concerned that technology negatively affects the quality of their conversations with their children; 54 percent say they are concerned that they have fewer conversations with their children than they would like to because of technology.
  • Parents recognize the potential hearing hazards of personal audio devices: 72 percent agree that loud noise from technology may lead to hearing loss in their children.
  • 24 percent of 2-year-olds use technology at the dinner table. By age 8, that percentage nearly doubles to 45 percent.
  • By age 6, 44 percent of kids would rather play a game on a technology device than read a book or be read to. By age 8, a majority would prefer that technology be present when spending time with a family member or friend.
  • More than half of parents say they use technology to keep kids ages 0 to 3 entertained; nearly 50 percent of parents of children age 8 report they often rely on technology to prevent behavior problems and tantrums.

These results present an opportunity to deliver communication health messages nationally and in our circles of influences and local communities. Earlier this month, ASHA shared the survey results with media around the country via a satellite media tour, and will continue to spread the word this month through social media. ASHA also has created new resources with a technology theme for its Identify the Signs public education campaign.

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Visit www.asha.org/bhsm to find resources you can use to reach out to the media and public in your community. There you will also find the full survey results.

Looking beyond Better Hearing and Speech Month, the summer presents an ideal time to continue to push out these messages. For instance, 55 percent of parents polled in the survey said their children age 8 or younger use technology during car trips. Members could present this statistic and note that this is an ideal time for a family to put the tech devices away and focus on communicating.

We hope members will find such information compelling and useful for building awareness of communication health; speech, language and hearing disorders; and the professionals—certified audiologists and speech-language pathologists—who are best educated and trained to address them.

 

Judith L. Page, PhD, CCC-SLP, is ASHA 2015 president. She served as program director for Communication Sciences and Disorders at the University of Kentucky for 17 years and as chair of the Department of Rehabilitation Sciences for 10 years. judith.page@uky.edu

When Patients Won’t Practice

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You give 100 percent in each session, but end up repeating last week’s activities because your patient didn’t practice. Who’s at fault?

We all tend to get complacent with the materials and techniques we use. Thankfully, we also take CEU courses to keep ideas and implementations fresh. But what if you try everything in your bag of tricks and your patient still doesn’t improve?

I discussed this exact issue with two of my patients recently. Each one had a different situation, but both were making limited progress. “John,” for example, sought treatment with the hope that others would stop complaining about his voice quality. He says he stopped doing the diaphragmatic breathing exercises I assigned, because his voice wasn’t any better. I replied that it takes more than a week of doing only breathing exercises to make improvement. Breathing is just the first component of coordinating a new voice.

He and I talked about the real reason he was here. I discovered that although he felt his voice sounded disordered, it was really only affecting those around him. It really didn’t bother him that others thought his voice was annoying, so he decided not to continue sessions. Fair enough.

“Sara’s” case was different. She and I worked together for several weeks and ended up going through almost the same session each time. She reported practicing, but I didn’t see evidence of that in her productions. Frustrations arose and she felt like she was getting nowhere.

In our most recent session, we talked at length about life and the projected outcomes of her condition. Her voice issues affect her life, which upsets her. This emotional roadblock gets in the way of her dedicating time to practice outside the treatment room. She also feels guilt and blames herself for the issue, even though it’s not at all her fault. She realizes that these feelings are holding her back, so she’s taking time off from sessions and coming back when she’s ready to commit.

We should try to build up patients when they come to us feeling down on themselves. That might be tricky, however, because we also point out their mistakes in order to correct them. Sometimes sharing personal experiences as encouragement helps. It’s never a bad idea to refer clients to a therapist or counselor as supplemental treatment—it’s even in our code of ethics and scope of practice.

I do this occasionally when sessions frequently turn into “therapy.” If I think a patient would benefit from talking through issues with a trained professional, I always refer out. That way when the patient comes to our sessions, we focus on the voice disorder and I know the other issues are being addressed.

If your patient isn’t practicing, it’s time to find out why. Is it motivation? Is it you? Do your best to figure out what else the patient needs from you to be successful, and offer many options. Sometimes all you have to do is ask.

 

 

Kristie Knickerbocker, MS, CCC-SLP, is a speech-language pathologist and singing voice specialist in Fort Worth, Texas. She provides voice, swallowing and speech-language treatment in her private practice, a tempo Voice Center, LLC, and lectures on the singing voice to area choirs and students. She is an affiliate of ASHA Special Interest Group 3, Voice and Voice Disorders. Knickerbocker blogs on her website at www.atempovoicecenter.com. Follow her on Twitter @atempovoice or like her on Facebook at www.facebook.com/atempovoicecenter.

 

Collaboration Corner: Knowing the Big Picture and Little Details of Autism

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As Autism Awareness month wraps up, I thought I‘d share my learning moments from working 15-plus years with my students on the spectrum, their families and my dedicated co-workers who support them:

  • Autism is a spectrum. There’s not a cure or a fix, but there are evidence-based interventions and nuances for each child that will help him or her succeed. My job (and yours) is to recognize those little details and shine a light on them.
  • I’ve developed a super appreciation for things that spin, shake, light up and squish. I also appreciate when these features suddenly become appalling and over-stimulating.
  • Sometimes the best way to get a child’s attention is to speak just above a whisper or not talk at all. Less is more and often things don’t just sound loud, they feel loud to a person with autism.
  • Sand and water play are seriously awesome.
  • Regardless of where a child is on the spectrum, you can find an activity that feels like fun and learning at the same time.
  • Candy doesn’t always taste or feel good, but hot sauce tastes delicious on French fries.
  • Take the short and long view on augmentative and alternative communication. Work on the here and now to make your clients efficient communicators, then model your expectations to bring them to the next level. Make them life-long communicators.
  • Students and families will show you when they are ready—ready to try something new, ready to accept who they are. You just have to listen, be patient and push. But not too hard.
  • Finally, having co-workers who are cued in and can step in and help at a moment’s notice is invaluable and—when in action—nothing less than a work of art.

What lessons have you learned from working with clients on the spectrum?

 

Kerry Davis EdD, CCC-SLP, is a speech-language pathologist in the Boston area, working with children who have significant communication challenges. She conducts trainings and workshops, and serves as a volunteer clinician and consultant for Step by Step Guyana, a school for children with autism in South America. The opinions expressed in this blog are her own, and not those of her employer. kerrydav@gmail.com

 

 

 

 

Social Mediating: Using Telepractice for Clients With Autism

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I think most of us agree that technology changes our social interactions. The daily flurry of “tweets,” “likes” and “snaps” can make us feel more engaged with our world than ever. At the same time, we probably feel isolated sitting next to a person who has their face buried in a smartphone.

So what does a highly technological exchange like telepractice mean for individuals with autism spectrum disorder (ASD) who typically require social interaction guidance and have restricted behaviors?

The core characteristics of ASD include “deficits in social communication and social interaction and the presence of restricted, repetitive behaviors.” As a result, people with ASD struggle with a variety of behaviors like joint attention, verbal and nonverbal communication, restricted interests and routines, and high sensitivity to sensory input. That’s a wide range of things to cover in treatment.

In addition, speech-language pathologists use many different treatment methods with these clients. The National Professional Development Center identified 27 evidence-based interventions for ASD. Some of these approaches require physical assistance. Others focus on a client’s environment. Treatment might also target subtle skills such as interpreting a partner’s eye gaze and tone of voice.

The remote nature of telepractice versus the “hands-on” nature of some tools means that SLPs must evaluate each client’s needs, treatments already in use, and ways to modify treatments for telepractice, and look at options better suited for telepractice. Be aware and ready for potential obstacles—how to address eye contact when you’re using a webcam, for instance, or if the equipment accurately conveys subtle changes in body language and tone of voice—ahead of time.

However, there are also advantages.  Telepractice interaction may be less overwhelming to a client with ASD, for example, or using technology may hold his interest more so than an in-person session.


April is Autism Awareness Month and our entire April issue focuses on related issues.


Obviously, autism and its treatments require flexibility. Fortunately, telepractice offers just that. Researchers at the University of Pittsburgh outlined various technologies and clinical applications for telerehabilitation. These include more-direct “teletherapy,” to less-direct “teleconsultation,” “telecoaching,” and “teleplay.”

You can use some techniques—like social narratives, technology-aided instruction and video modeling—through telepractice without many extra steps. Interventions including peer-mediated instruction, parent-implemented intervention and pivotal response training already require indirect approaches, so modifying them for telelpractice won’t take much more effort than applying them for a specific client in face-to-face sessions.

Emerging research in telepractice treatment for ASD clients already shows success in both direct and indirect interactions. One case study gives positive results for two clients with ASD. One subject received services through “active consult,” in which a student clinician was coached  and monitored by a remote supervising clinician using Bluetooth technology. The other client received telepractice services and responded more favorably to those than he did to onsite intervention.

Another study compared traditional onsite intervention to a hybrid model of direct onsite and indirect telecoaching services. They found that gains made through traditional therapy could be maintained as well or better in a model that also incorporated telepractice.

We still have a lot to learn about how to use telepractice to serve clients with ASD. However, developing evidence reinforces something we know from other settings: We are most successful when we analyze and individualize our services to fit a specific client.

 

Nate Cornish, MS, CCC-SLP, is a bilingual (English/Spanish) clinician and clinical director for VocoVision and Bilingual Therapies.  He is the professional development manager for ASHA Special Interest Group 18, Telepractice; a member of ASHA’s Multicultural Issues Board; and a past president and vice president of ASHA’s Hispanic Caucus. Cornish provides clinical support to monolingual and bilingual telepractitioners around the country. He also organizes and presents at various continuing education events, including an annual symposium on bilingualism.  

nate.cornish@vocovision.com.

Maximize Treatment Minutes by Assigning Homework

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A recently published article in Frontiers of Neuroscience supports what we as clinicians know: The more time clients spend on meaningful treatment tasks, the better their outcomes.

Yet there are only so many hours in the work day, so many sessions that insurance covers and only so many minutes of treatment we can give. So how do we get around these limitations? Give your clients homework.

The article mentioned above states that patients who do exercises at home in addition to their weekly sessions improve significantly more than patients who only attend sessions. But how do we find time to create, assign and track homework in the midst of packed schedules, IEP meetings and productivity expectations?

A go-to for SLPs are worksheets and activities like those found in the Workbook of Activities for Language or Cognition and Handbook of Exercises for Language Processing series. Many SLPs also develop their own activities or assignments that they write or print for clients. These paper-based exercises are free and individualized, plus they cover any range of skills from visuospatial reasoning to word-finding.

In addition, the increasing availability of technology offers several online-based options. The app featured in the study referenced above (Constant Therapy, free for clinicians) allows SLPs to assign a variety of language or cognitive homework tasks for clients to do throughout the week on their iPads, Androids or Kindles. Plus, clinicians and patients see all of the progress tracked by the app.

There are also several other apps that help patients work on specific skills. For instance, growing numbers of interactive, pediatric-oriented games allow parents to play with their children to practice treatment skills. (I like the Bag Game from all4mychild, for example.) There are also apps aimed specifically at adults, such as those from Lingraphica, Tactus, and Virtual Speech’s new, adult-oriented series of apps (like Verbal Reasoning). There are even apps that are built into many tablets and smartphones—calendars and alarm systems—that we can use with our clients to practice executive function skills independently and functionally.

The practice of assigning homework allows the clinician to more effectively manage our time and also has a great advantage of engaging patients in their own treatment programs. Today’s technology also allows clinicians to monitor clients’ compliance while empowering them to take responsibility for their improvement.

In today’s fast-paced, schedule-packed world, we must maximize our time and that of our patients! Try out a new homework option today—then share it with a clinician friend to help them save some time, too.

 

Jordyn Sims, MS, CCC-SLP, is a speech-language pathologist working in the Boston area. She is an affiliate of ASHA Special Interest Groups 1, Language Learning and Education; 2, Neurophysiology and Neurogenic Speech and Language Disorders; and 15, Gerontology.  Sims has experience with adults and pediatrics and is a clinical consultant for Constant Therapy. jordyn.sims@gmail.com 

Dental Distress: Helping Children with Autism Successfully Navigate a Trip to the Dentist

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Do you like listening to podcasts while you commute, run errands or work around the house? Now you can catch up on your audiology or speech-language pathology tips and tricks while you listen. ASHA has produced more than 30 podcasts on topics ranging from “Untreated Hearing Loss in Older Americans” to “Building Language and Literacy Skills During the Lazy Days of Summer.”

Listen to the latest episode on helping kids with autism handle a trip to the dentist then check out the entire archive of podcasts.

 

Podcast: Episode 32
Almost half of parents of children with autism spectrum disorder describe their child’s dental health as fair or poor, according to a study in the journal Pediatric Dentistry. Considering that one in 68 children in the U.S. has autism, this is a sizable issue. Trisha Self, an associate professor and speech-language pathologist at Wichita State University, discusses an innovative pilot program, featured in The ASHA Leader, designed to help children with autism successfully complete a trip to the dentist. Collaborator Kelly Anderson and Lisa Cicchetti, the mother of one of the program participants, also share their insights.

Read the transcript.

 

Trisha Self, PhD, CCC-SLP, is an associate professor in the Department of Communication Sciences and Disorders at Wichita State University and coordinator of the school’s Community Partners: Autism Interdisciplinary Diagnostic Team. She is an affiliate of ASHA Special Interest Groups 1, Language Learning and Education; and 10, Issues in Higher Education.
Trisha.Self@wichita.edu 

 

 

10 Early Signs and Symptoms of Childhood Apraxia of Speech

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I was a practicing speech-language pathologist for five years before my daughter was born. I worked primarily at the elementary and middle-school levels. I took professional development workshops on childhood apraxia of speech (CAS) and treated it successfully in three kiddos from my caseload. Perhaps that’s why I was bewildered, angry and utterly devastated when I missed those very signs in my own child.

I hadn’t yet worked in early intervention, so I missed what seem like obvious signs to me now that I specialize in the disorder. I urge all SLPs to learn more about CAS, because the disorder requires a specialized approach different from other commonly used treatments for speech and language delays.

In addition, ASHA denotes that the qualified professional to diagnose CAS is an SLP with specialized knowledge in motor learning theory and skills with differential diagnosis in childhood motor speech disorder, not a neurologist or other medical practitioner. It’s important to know the signs, but also to refer your client to a qualified SLP for differential diagnosis if you suspect childhood apraxia of speech.

Here are 10 early signs and symptoms of childhood apraxia of speech:

  • Limited babbling, or variation within babbling
  • Limited phonetic diversity
  • Inconsistent errors
  • Increased errors or difficulty with longer or more complex syllable and word shapes
  • Omissions, particularly in word initial syllable shapes
  • Vowel errors/distortions
  • Excessive, equal stress
  • Loss of previously produced words
  • More difficulty with volitional versus automatic speech responses
  • Predominant use of simple syllable shapes

Other non-speech “soft signs” that may be present include:

  • Impaired volitional oral movements (oral apraxia)
    • Difficulty with volitional “smiling” “kissing” “puckering”
  • Delays with fine/gross motor skills
  • Feeding difficulties that include choking and/or poor manipulation of food
  • General awkwardness or clumsiness

These are early signs, but many overlap with other phonologic and language delays, so it’s important to keep in mind that differential diagnosis is critical, as over-diagnosis of CAS remains problematic. It’s still a relatively rare disorder; however, there are resources that can help if you suspect it.

You can tap the below resources to learn more about childhood apraxia of speech.

 

Laura Smith, MA, CCC-SLP, is a school-based and private clinician in the Denver metro area specializing in childhood apraxia of speech. She’s CASANA-certified for advanced training and clinical expertise in Childhood Apraxia of Speech and often speaks at conferences and consults for school districts or other professionals. Like her on Facebook, follow her on Pinterest, or visit her website at SLPMommyofApraxia.comlauraslpmommy@gmail.com

 

 

 

 

 

Interprofessional Pre-screening Shortens the Wait for Autism Diagnoses

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Editor’s Note: In recognition of Autism Awareness Month, we have several posts addressing autism-related issues throughout April. The screening program described here is one of several ASD initiatives at Wichita State University; another that eases children’s visits to the dentist is explored in this month’s April ASHA Leader issue.

 

Recently, I became passionate about expediting identification and diagnosis for young children who show signs and symptoms of autism spectrum disorder (ASD). This desire was fueled by a research project I conducted with Douglas F. Parham and Jagadeesh Rajagopalan; the results revealed that pediatricians and family physicians have not been screening young children for ASD as recommended by the American Academy of Pediatrics (regularly conducting ASD-specific screenings for children two times prior to their second birthday) in Kansas, Iowa and Oklahoma.

Based on these results, I determined that one way I could help advance the identification of these young children would be to develop an authentic interprofessional education opportunity for students in the allied-health and education programs at my university: Wichita State University in Kansas. In the spring of 2012, WSU students, faculty and community professionals agreed to form the Wichita State University-Community Partners: Autism Interdisciplinary Diagnostic Team (AIDT).

The team aims to:

  1. Educate undergraduate and graduate students to better recognize the characteristics of ASD and to be able to participate in screening, assessment and referral of children who demonstrate early signs.
  2. Provide a highly needed service to children and families throughout south-central Kansas.

Since the initiation of this team, faculty, clinical educators and students from eight departments—communication sciences and disorders (audiology and speech-language pathology), early childhood unified special education, clinical psychology, physical therapy, dental hygiene, physician assistant, nursing and public health—have participated. Additionally, the University of Kansas School of Medicine–Wichita (represented by a developmental pediatrician and an advanced practice registered nurse) has been a valued partner and referral source.

Faculty and clinical educators recruit and select students to participate in our screening program. Student participants must enroll in a field-based experience and/or an appropriate class within their respective programs. All stakeholders then do a one-day training prior to the start of each semester on identifying the characteristics of ASD, to screen, to participate in the assessment process and to identify appropriate referrals for children and families. The educators agree to participate in at least four diagnostic sessions each semester, ensuring that students from various professions have multiple opportunities to work together, while observing interprofessional collaboration among university and community professionals.

The partnering developmental pediatrician and the advanced practice registered nurse refer children and families to the screening program based on the “red flag” characteristics parents report on the pediatrician’s developmental history form. The program’s coordinator (that’s me) contacts the family via phone to gather additional developmental information, and then the team meets to discuss that information and other relevant documents.

The team conducts the evaluation over two days. The first day, we assess the child’s communication, play and cognitive abilities, using selected tools and strategies based on the child’s strengths and needs. The second day, we administer the Autism Diagnostic Observation Schedule-2 and the Childhood Autism Rating Scale-Second Edition, Standard Version, to provide the developmental pediatrician with diagnosis-relevant information. We also conduct hearing, motor and oral health screenings. The team then meets to discuss the aggregated assessment results, which, in addition to appropriate recommendations and resources, are shared with the family.

We schedule an appointment for the child and family with the developmental pediatrician approximately one week following our assessment. Someone from our team accompanies the family to the appointment to act as a liaison and assist with the examination.

Since the introduction of the AIDT, 133 students, clinical educators, faculty and community professionals across 10 disciplines have come together via this individualized education program field-based experience. Our students and professionals have assessed 24 young children who present with characteristics of ASD, and approximately 85 percent of these children have received a confirming medical diagnosis.

Participants and families alike gain from this experience. Students learn from, with and among others who are committed to interprofessional practice. Families voice their appreciation for receiving diagnostic information from multiple disciplines all at once, so they don’t have to run from place to place to receive it.

Mostly, they value how quickly the AIDT’s work enables them to get their child needed help.

 

Trisha Self, PhD, CCC-SLP, is an associate professor in the Department of Communication Sciences and Disorders at Wichita State University and coordinator of the school’s Community Partners: Autism Interdisciplinary Diagnostic Team. She is an affiliate of ASHA Special Interest Groups 1, Language Learning and Education; and 10, Issues in Higher Education.
Trisha.Self@wichita.edu