QSAC Blog

Transit Benefits, Discovery at the Museum, Tax Forms & More...

2015-01-28T15:00:00.000-05:00

QSAC EMPLOYEE NEWSLETTER - January 28, 2015

Use Your Transit Benefits to Save Big on Your Metrocard

As you may know, the MTA has agreed on a fare increase on MetroCards. As of March 22nd, single rides go from $2.50 to $2.75, unlimited weekly MetroCards go from $30 to $31, and unlimited monthly MetroCards go from $112 to $116.50. There's never been a better time to take full advantage of your transit benefits to purchase your MetroCards TAX FREE. This benefit is also available for LIRR, NJ Transit, Metro North, and many other major forms of New York City transit. By doing so, your monthly fare goes from $116.50 to approximately $88.

To get yourself signed up to have your transportation fees taken out of your paycheck each week and placed on a Benny Card for you to purchase your transportation fares tax free, employees must fill out the form by CLICKING HERE and submit tohrbenefits@qsac.com.

*Also, if you’re already signed up to purchase transportation fare based on the old MTA fare prices, you will need to update your transit deductions to reflect the new prices before March 15th. You can do that by filling out the form HERE.

If you have any questions, contact hrbenefits@qsac.com

Loved Ones on the Autism Spectrum Can Now Discover Something Exciting at the Museum of Natural History

The American Museum of Natural History is proud to introduce The Discovery Squad, a unique tour program designed for families affected by autism spectrum disorders. The program was developed in collaboration with the Seaver Autism Center at the Icahn School of Medicine at Mount Sinai.

On selected Saturday mornings, children on the autism spectrum ages 5–14, accompanied by an adult, can attend a 40-minute tour lead by specially trained Museum tour guides, then spend some time exploring the Discovery Room before the Museum opens to the public.

For more information on dates and prices, CLICK HERE

Use the Tax Form That's Right for You

This tax filing season, get things off to a good start. Make it easy on yourself and let the software you use to e-file select the right form for you. Filing electronically is the easiest way to file a complete and accurate return. The software asks questions that guide you, minimizes errors and helps you get the tax credits and deductions that you are entitled to claim. Brand-name software’s also free when you use IRS Free File on IRS.gov.

For more information, CLICK HERE.

QSAC Provides Assistance for Life's Problems Outside the Office

From time to time, we may find ourselves confronted with confusing and uncomfortable situations. These could be anything from financial problems, marital issues, substance abuse, or even emotional problems. QSAC is pleased to announce the implementation of a new Employee Assistance Program (EAP). QSAC has retained the services of Health Management Systems of America (HMSA) that will confidentially help employees deal with a wide range of personal problems.

If you find yourself facing any personal issues such as marital, family, alcoholism, drug abuse, financial or psychological, confidential help is just a phone call away. Professional counselors are available at HMSA 24-hours a day and can be reached by calling 1-800-767-5320.

For more information on these services, CLICK HERE, search Google Drive for EAP, or visit www.my-life-resource.com. Username: hmsa (lower case) Password: myresource (one word).

Get Your Tickets While You Still Can! Autism Awareness Day & QSAC's Car Raffle Tickets Still Available!

Tickets are still available for two of QSAC’s amazing fundraising events: Autism Awareness Day at Citi Field and QSAC’s Annual Car Raffle! Get your tickets now and support these wonderful causes.

Car Raffle

Our 2015 Car Raffle is a little different this year -- We will be auctioning off a three year lease for a Nissan Altima, VW Jetta, Mazda 3, or Subara Impreza, or the winner may choose to take $7500 cash. Tickets are $10 each, 3 for $20, 8 for $50, or 20 for $100 (making them just $5 each). The winner will be chosen at QSAC's Gala on June 16th. Any staff selling $500 worth of tickets will receive a free ticket to QSAC's gala ($400 value). For more information or to purchase or sell tickets, go towww.qsac.com/2015raffle.

Autism Awareness Day

We are excited to have the first rows of the field level Big Apple section available for purchase at a discounted rate. Tickets are first come - first served and going fast! Tickets are discounted at $30 each and will be seated within row 1 or 2 of section 140, 141, or 142.. For more information or to purchase tickets, go to www.qsac.com/aaday

Broadway Day Hab Takes a Trip to the Met

Recently, a group from the Broadway Day Hab decided to take a recreation trip to the Metropolitan Museum of Art. The participants at the Broadway Day Hab are in the process of learning how to travel by using public transportation. Before leaving, the group met and planned their trip by reviewing the MTA subway map.

After locating the starting location and the destination on the map, we set out on our journey. When we arrived at the Met, the group took a look at the Egyptian exhibit where they checked out sarcophagi and hieroglyphs. Next, they traveled to the Asian art wing where they saw Asian statues and hung out in the Chinese Garden Court. Lastly, the group went to the American wing where they admired paintings of George Washington. Afterward, we enjoyed lunch in Manhattan. Needless to say, we had a great day exploring the city.

Computer Issues? Need Support? QSAC has an electronic work order system for computer related issues. Send an email totechsupport@qsac.com and a work order will be generated. You and the I.T. Team will then have a record of your request as well as the repair details! Work orders can be opened for any computer related issues, salesforce issues, printing issues or just general questions.

Get Your Pay Quicker

Sign up for direct deposit or a CashZone payroll card. Click here for direct deposit and cash card authorization forms. For full cash card details, click here .

Looking for Additional Hours?

QSAC employees can work extra hours doing Comm Hab and/or Respite. Make an impact in the lives of those we serve by working as a Habilitation Specialist or Respite Worker in our In-Home Comm Hab and Respite Programs providing 1:1 instruction to our clients. Schedules are available with 3-4 hours shifts, primarily evenings and weekends.

To view an up-to-date list of which slots are open, click here. Email any questions or comments to iamavailable@qsac.com or call(718) 728-8476 extensions 1257, 1260, or 1274.

Securing Your Paid Time Off

QSCA's PTO system is no longer able to accept non-QSAC or non-Gmail email addresses. If you are currently using a non-Gmail address such as AOL or Yahoo to submit requests to QSAC, please set up a free personal Gmail account by going to www.gmail.com.

You must notify HR of your new email address by completing a Personal Information Update. Once you've notified HR, your email address and username to log into Salesforce will be updated by the next business day. You can use your previous username until then. Your password will remain the same.

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A New Perspective

2013-12-19T11:31:00.003-05:00

This is a wonderful holiday read. Enjoy!

Happy Holidays!

Taken from www.autismafter16.com, written by Liane Kupferberg Carter.

Silence is Golden

Every year at Thanksgiving, there comes a moment after dinner when I need to escape.

I should say up front that Thanksgiving is my favorite holiday. I revel in it. But no matter how much fun we are having, no matter how full my heart is with good will and satisfaction and joy, I reach a point when everything becomes too much. An aural assault. I feel an overpowering urge to step outside into the November night air.

Each year I make the same excuse to myself –I just need to shake out the crumbs from the tablecloth—and step onto the front porch. The blast of cold air on my face is bracing. Reviving. Sound falls away and the world goes silent.

This year, as I took in great gulps of wintry cold air, it struck me: This is how Mickey must feel, when he reaches the tipping point of sensory overload and says, “I’ve had enough.”

When Mickey was 8 and Jonathan 13, we flew to Arizona for our niece’s bat mitzvah. Mickey fidgeted but managed to sit through the religious service, even singing along to familiar songs. At the end of the ceremony, we moved across the hall into the banquet room. We slammed up against a wall of thrumming music and flashing lights. Mickey flung himself to the floor and clutched his hands over his ears. People stared. Then they stepped over him.

Embarrassed, I tried to coax him up. He wouldn’t budge. “This isn’t going to work,” my husband Marc said. “I’ll go back to the hotel with him.”

“But your family is all here, I don’t want you to miss out,” I said. “You and Jonathan should stay. I’ll take Mickey back.”

We returned to our spacious, serene suite. I called room service and ordered Mickey’s favorite meal: a burger and fries. After dinner he played with his Game Boy. I read a novel. We were both perfectly happy. The truth? I don’t like loud parties either.

Having a child with these sensitivities opened a window into myself. I always hated crowded rooms. Strobe lights. Roller coasters. I thought it was a character flaw. I didn’t realize it was just the way I was wired.

Just the way he is wired.

“I’ve had enough.” He says it adamantly, often while the rest of us are still having fun. For years, I cajoled. Reasoned. Even bribed him. I wanted him to sit longer at religious services. Stay later at the party. Last through the movie.

Did I have my own agenda? Was it more about my desires than his? Or am I beating myself up too much? Mickey has always resisted anything unfamiliar, whether tasting a vegetable or trying an art class. I believe it’s my job as his parent to expose him to as many new experiences as I can. I want to open the richness of the world to him. When is it okay to push? How hard? When to pull back? It’s an intricate dance.

It has taken me a long time to understand that he doesn’t mean to be difficult or self-absorbed. He is simply advocating for what he needs. Just as I need my moments of respite and retreat, Mickey does too.

Which is a good thing. A marvelous thing, in fact.

Standing there Thanksgiving night, inhaling the cold, restorative air, I shook out more than tablecloth crumbs.

Parenting Your Child with Autism during the Holidays

2013-12-13T10:20:00.000-05:00

The holiday season is magical for some, but can be hectic for a family with an autistic child. Christmas, Hanukkah, Kwanzaa – whatever you celebrate, there is a lot to take in when you have a child on the spectrum. Lights, crowds, traffic, visitors, waiting in line, etc. can be particularly overwhelming, especially to children. This time of year brings the entire family out of their usual routine, and exposes them to people and places they may not be familiar with. This can create a host of problems, including increased stress levels for all involved.

Social requirements such as relatives wanting a hug and kiss, or extended holiday dinners with strange food and a lot of noise can be overwhelming for your child. Your child may not understand personal space or safety, and may run around the house or try to play with something breakable. If your child cannot communicate what he/she wants, tantrums might ensue. Relatives may think that the child is misbehaving, and may try to discipline the child, not realizing that the child really can’t help it, and that discipline is not helpful when it comes to sensory overload and high anxiety.

Now is a good time to take a deep breath and make some very specific plans that will help you get through this period. What can you do? With some preparation, planning, and information sharing, the holidays can be less stressful and more enjoyable. Here are some tips on how to prepare your friends and relatives, whom you will be visiting the next few weeks.

Like any behavior we are trying to increase, behaviors we want to see during the holidays need to be practiced and reinforced. Creating similar situations to holiday events, where your child can be reinforced, is a good start. For example, you can place a wrapped gift in front of your child and prompt him/her to wait or keep his/her hands down, and reinforce this behavior. You can reinforce your child for keeping ornaments on the tree. At the beginning of the holidays, establish these types of clear “holiday rules.” These rules tell your child about your expectations and should be positive. Use “do” statements rather than “don’t statements.” For example, “Hands down.” rather than “No, stop touching.”

Remember your child’s needs. Try not to have unrealistic expectations for your child when visitors or relatives are over. A little advanced preparation can lessen your child’s anxiety. You can help your child by trying to keep his/her usual routines, such as mealtimes and bedtimes. If you are at a relative’s house, ask if there is a quiet room where your child can retreat for a time to escape the commotion and noise.

You can also prepare by thinking of the holidays in terms of a series of activities that occur before, during, and after a certain time. Examples include cleaning the house, getting decorations out, taking photos, shopping, buying a tree, starting school vacation, taking decorations down, and writing thank you notes. Providing information in a way that your child understands is essential. For instance, mark special days on the calendar. Use picture symbols to support routines and aid in communication. Use social stories – these personalized stories can be used to incorporate what will be happening in the days ahead. Include photos of who he/she will be seeing, or the house decorated during last year’s holiday season. Play some of the music he/she may be hearing during this time of year. Some other behaviors you can work on to prepare your child are practicing unwrapping presents. Wrap a bunch of boxes up with favorite treats inside, and have him/her open them. Practice a handshake. Practice tolerating sitting at table.

Also, where will you be spending the holidays? Call or email your extended family or friends in advance, and let them know what your plans are, and what you need from them. Make decisions based on what is truly best for your child. Who will be there? Do all of the people in attendance know your child? Does everyone know what Autism Spectrum Disorder is? Are they comfortable and familiar with your child's special needs? Cover all your bases beforehand by writing a group email or letter to those who will be in attendance. Let them know the things that your child is uncomfortable with, but also the things they are particularly fond of.

Remember, it’s up to you. With a little advanced planning, the holiday season can be enjoyable for you and your child.

written by QSAC Director of Training, Anne Denning, MA, BCBA

Some considerations when working on improving communication deficit

2013-11-18T12:45:00.001-05:00

Children and adults diagnosed with Autism Spectrum Disorder have persistent deficits in social communication and social interaction across multiple contexts as one of the symptoms. This impairment is usually manifested in lack of social-emotional reciprocity, poor integration of verbal and nonverbal communication and difficulties adjusting behavior to suit various social contexts. Delays in communication usually vary in severity ranging from monotone speech about preferred topic to a total absence of verbal communication. Often individuals with ASD do not effectively perform the single most important task of communication and language, and that is expressing their wants and needs (i.e. making requests, exhibiting mands) and, as a result, they have very little control over what happens to them in their daily lives.

Further, multiple researches has shown that communication impairment is correlated with an increased risk of challenging behavior and reduced opportunities for community involvement and therefore it is understandable why a huge amount of intervention research has focused on developing successful procedures for improving communication skills of individuals with ASD.

In most cases, the traditional developmental model of language represents the basis for teaching communication and language skills, however in this model, the primary unit of communication and language is the word and words, signs, pictures, or symbols are taught without much regard to the circumstances present during instruction. For example, some expressive language is taught as "labels" (“car”, “table”, “spoon”), some as "answers to questions or responses to statements" (“more”, “fine”, “please”, “hello, my name is___ “) and some as "generalized requests" (“eat”, “drink”, and “break”). For children and adults with ASD, the words, signs, or pictures they learn in one circumstance, don’t tend to occur in other circumstances without additional instruction. In many cases, this result in little to no expressive language or communication responses that are useful or important to the person, in other words, the person does not learn how to make specific requests (i.e. “no mands”).

Very often, this also results in problem behaviors. Individuals begin to communicate by screaming, dropping to the floor, hitting, spitting, kicking, biting, etc. and, if these behaviors result in what the individual wants, even intermittently, these same behaviors function as either specific or generalized requests (“problem mands”) and tend to occur again and again...Then, usually a clinician is asked to conduct a functional assessment in order to develop a plan to reduce the frequency of the problem behaviors and replace these behaviors with more appropriate alternatives. Often, these "replacement" behaviors are either a limited array of receptive skills (following directions or completing assigned tasks) or "generalized requests" for attention, escape, or access to categories of preferred items and activities (i.e. eat, drink, play, more, please, etc.)

When the only "replacement" behaviors are receptive skills, we are teaching poor speakers to be better listeners and when the "replacement" behaviors are generalized requests, we are teaching poor speakers to be non-specific speakers.

Neither is adequate...

Ideal practice should include teaching individuals to make specific requests (SPECIFIC MANDS) and expanded array of receptive skills (following directions, completing assigned tasks, waiting, sharing, and accepting no) (GENERALIZED COMPLIANCE).

In other words we should be teaching poor speakers to be effective, specific speakers who have more control over what happens in their daily lives while also teaching them to be good listeners in a wide variety of commonly occurring situations. Under these circumstances we could expect to see that when individuals have more control and power over what happens in their daily lives they tend to exhibit far lower rate of problem behavior.

Nevena Savic, MA

Autism: The Nature vs. Nurture Debate

2013-10-28T07:45:00.001-04:00

At the 17^th Conference on “Advances in Autism” held October 2013 at the Icahn School of Medicine at Mount Sinai Hospital, Dr. Buxbaum and Dr. Reichenberg outlined the argument that autism is a behavioral defined complex neurodevelopmental disorder resulting from the combination of genetic and environmental factors. The critical issues discussed were: to what extent is autism genetic, what is the role of the environmental risk factors for autism, and to what degree can autism be due to the interactions between genes and environmental factors? How genetic factors compare to non-genetic factors?

Dr. Buxbaum stated that at this point we know three things about autism: a) Autism Spectrum Disorder (ASD) is defined by, “deficits in social interaction and the social use of language and presence of stereotypical mannerism”; b) ASD is highly genetic and the heritability has been estimated in 80-90%; and c) the genetic architecture of ASD includes many rare genetic variants with major effect in chromosome abnormalities.

In the human genomics, scientists have identified a large number of genetic variations associated with autism. According to Rosenberg and colleagues (2009) monozygotic twins have higher concordance rates than dizygotic twins. The concordance rates among monozygotic twins (MZ) for Autistic Disorder are estimated at approximately 77% to 86%, and for dizygotic twins (DZ) at about 40% to 50%. (The California Autism Twins Study (CATS), Hallmayer et al., 2011). The risk for siblings of individuals with autism is 2% to 8%, and rises to 12% to 20% if we also take into consideration siblings showing impairment in one or two symptom domains of autism. In support of this notion, the concordance rates for autism reach up to 90% in monozygotic twins and 10% in dizygotic twins (Rutter, 2000; Folstein and Rosen-Sheidley, 2001; Veenstra-Vanderweele et al., 2003; Won, et al. 2013).

Genetic factors might be mainly responsible for the occurrence of autism; however they are not solely responsible in all cases. There is some combination of autism-related genes and /or specific environmental factors that might act as triggers for the development of autism. The role of environmental factors in autism is somewhat a neglected area of research. One of the challenges is to understand the relationship between genetic variations and phenotype, since identical variations have been associated with autism and schizophrenia (Chaste & Leboyer 2012). Other unresolved issues are the two major hypotheses of the sex ratio (sex chromosomes and the role of hormonal influences in utero in the etiology of autism), where autism is more prevalent in males than females. Moreover, the overlap in which 65% to 75% of individuals with autistic disorder have an intellectual disability, is not clear. Two hypotheses have been proposed: individuals with autism and intellectual disabilities share common genetic bases, and the intellectual disability unmasks the limitation in the individual’s capacity for social reciprocity (Chaste & Leboyer, 2012). There is evidence that epigenetic dysregulation may be implicated in autism, such can be seen in the several syndromes associated with autism that are caused by mutations in genes. Epigenetics is defined as the non-permanent heritable changes that alter expression of genes without affecting primary DNA sequence itself, which considers the role of environment in this modulation of gene expression. Research data suggest that many environmental risk factors are interrelated and their identification and comparison might disclose a common scheme in autistic disorder (Grabrucker, 2012).

Furthermore, according to Lehti and colleagues (2013), environmental factors in connection with gene-environment interactions may influence the risk of autism. There are several potential environmental risk factors associated with autism such as advanced parental age (father >40 and mother >35), obstetric complications, viral or bacterial infection (influenza, rubella, and cytomegalovirus infections), disruption in the immune system, zinc homeostasis, dietary factors, lack of vitamin D, and being a second-generation immigrant (Grabrucker, 2012). Several studies conducted in Europe have shown that immigrants born outside Europe have an increased risk of having a child with autism. For instance, in Finland, children have an increased risk of autism if their mother or both parents are immigrants. The main prenatal and perinatal factors are maternal gestational diabetes, maternal bleeding and maternal medication. Exposure to certain medications during pregnancy, such as Selective Serotonin Reuptake Inhibitors (SSRI), use of valproate, as well as organophosphate insecticide, has shown to increase the risk of autism, especially if contact occurred during the first trimester (Schendel, 2013; Gardener, et al. 2009; Landrigan, 2010). These risk factors might cause brain morphological abnormalities, including altered cerebellar structures and reduced number of cranial motor neurons (Rodier et al., 1997; Ingram et al., 2000, Blattner, 1974; Grabrucker, 2012). The hypothesis of the MMR vaccine (measles, mumps, rubella) has been rejected for lack of scientific evidence of a causal relationship between thimerosal-containing vaccines and autism (Madsen, et al. 2002).

The appearance of a connection between autism-associated genes and environmental risk factors suggests that more studies concerning gene-environmental risk factors and multigenerational studies (autism across generations) are needed; these should also bring together analytic epidemiology, behavioral genetics and molecular epigenetic to continue solving the puzzle of the etiology of Autism Spectrum Disorder (ASD).

Tips for a Safe and Enjoyable Halloween

2013-10-22T16:01:00.000-04:00

The Long Island Sibling Support Group hosted their annual Halloween Party. Before the fun commenced, group leaders reviewed some Halloween etiquette with siblings, as to ensure a safe and fun Halloween. We shared tips and practiced some fun activities for enjoying Halloween. The Long Island Parent and Sibling Group runs twice a month at our Long Island site in Baldwin.

It is free for parents and siblings of children diagnosed with autism. Click here for more information and to view the schedule.

Here are some of our Halloween ideas...

Costumes:

Wear costumes that can be seen.
Bring a flashlight, glow stick, or reflective tape to place on your costume
Make sure that you and your sibling can see with your mask on!

Make sure you and your sibling do not trip over your costume.
Practice putting on your costume. (New things can sometimes be scary for your brother or sister.)

Trick or Treat!

Practice what to say and do when you go out Trick or Treating.
Remind your sibling that you knock on someone's door or ring their bell and say "Trick or Treat!"
Practice holding your treat bag up to the door.
Use this time to teach your sibling to have manners.

List examples of Halloween etiquette:

1.____________________________________

2.____________________________________

3.____________________________________

NYS Child Care Educational Incentive Program for Preschool and School-Age Providers

2013-10-18T14:51:00.000-04:00

The Educational Incentive Program (EIP) is a scholarship program which helps teaching staff pay for training and educational activities with the intent to build their knowledge, skills and competencies and improve the quality of care. You can apply for an EIP scholarship if you are currently caring for children as a: - classroom staff in a licensed child care center (QSAC EI and Preschool) - classroom staff in a registered school-age program - direct supervisor of any of the child care staff listed above EIP scholarships fund non-credit bearing training, college tuition and mandatory college fees, training and assessment fees associated with certain credential or certificate programs. All courses taken as part of an early childhood or related degree program are eligible for scholarship. Eligibility is based on your: - Employment - Income - Education/coursework To apply for an EIP scholarship or find more information about the program, please visit www.ecetp.pdp.albany.edu.

Guest Blogger Lea Passione: QSAC Program Participant

2013-10-01T15:45:00.001-04:00

Lea Passione currently receives MSC and Community Habilitation from QSAC. I personally worked with Lea and am so proud and excited that she is able to share this article she composed.

Conversations Event with Sebastian Arcelus

By: Lea Passione

As a saying goes “expect the unexpected”, I guess it worked true to its word. I found an article on one of my favorite websites Broadwayworld.com and it had details on an event at the Baruch Performing Arts center which was jointly presented by the SAG (Screen Actors Guild) Foundation in partnership with Broadway World called Conversations Event with Sebastian Arcelus. It was hosted by Richard Ridge who hosts on Broadwayworld.com Backstage with Richard Ridge.

· About Sebastian Arcelus

Sebastian Arcelus graduated from Williams College with a degree in Political Science before becoming an actor. He made his Broadway debut as a swing (a swing is an offstage cast member that covers several parts in the ensemble of a Broadway musical as well in some cases also covering leads) in the Tony Award winning musical RENT before being promoted to the lead role of rocker Roger Davis. In 2005, Arcelus originated the role of Jan in the short lived Beach Boys Musical, Good Vibrations. He later played the role of Fiyero in the national tour of the hit musical Wicked, a role he reprised on Broadway opposite his wife, actress Stephanie J. Block. Arcelus was also the first replacement for the role of Bob Gaudio in the Tony Award winning musical Jersey Boys. He also originated the role of Buddy the Elf in Elf the Musical. His Off-Broadway credits include Happiness (Lincoln Center Theater) and The Blue Flower as Franz. He has done voice work for TV shows such as “The Winx Club”, “Yu-Gi-Oh” and “Go Diego Go!” Arcelus is also appears in the movie “The Last Day of August” in which he not only he stars in the film, he produces it. He can be currently seen on the Netflix show “House of Cards” as Lucas Goodwin (season 2 is coming soon) and will be returning to Broadway as Jake Brigance (a role he played at Arena Stages) in “A Time to Kill” on opening October 20th at the John Golden Theatre. As you can plainly see, Sebastian is one of my favorite actors or I would not know all this minutiae about him.

I have never listened to a conversation event nor did I ever attend one. As I said before, Sebastian is one of my favorite performers having seen him perform in the role of Fiyero twice, two concerts (both with his wife who is also a favorite of mine), and as Buddy the elf. Plus it’s always interesting to hear an actor talk about their experiences and what made them get into the business of acting. I have met him at times at the stage door and he is just a sweet down to earth guy. I always love hearing actors do these interviews because you get to know the person apart from the performer and hopefully learn something from them. Plus I have met the interviewer Richard Ridge a few times at his website’s booth at the Broadway Flea Market (an annual charity event that takes place at the end of September). He did a very good job with this interview, making it not only informative but also extremely entertaining.

Would I go to another one of these events? Yes I would. A bonus treat was getting to say “Hi” to Richard and then shaking Sebastian’s hand. Of course not a word came out of my mouth as I was just in total amazement of the guy. Another bonus treat took place once my mom and I got outside the theater. She said we should take pictures of the auditorium exterior to remember the day. I took the ponytail out and turn back to take the picture, but from the corner of my eyes I saw someone running towards me. I heard in a very familiar voice “Did you get it?” I turn around and lo behold Sebastian Arcelus’ wife Stephanie J. Block, a fabulous theater actress (who remembers me from a couple of shows and events) was standing behind me giving me and my mom a big surprise by wanting to be in the picture. I was hugging her in the picture. What a great opportunity for a memorable photo. These actors are so talented but still so humble. I had a really great time. Keep these 2 actors names in mind when choosing the next play you are going to see: Stephanie J. Block and Sebastian Arcelus. You won’t regret it.

Lea's mom Terry, Sebastian Arcelus and Lea

Turning over a new Leaf at the QSAC Preschool - PBIS comes to Preschool

2013-09-30T11:13:00.000-04:00

During the long cold days of winter, the clinical team at the QSAC Preschool came to a consensus. We wanted to build a stronger foundation in which to develop stronger behavior analytic teaching practices for the 2013-14 school year. During the winter and spring we toiled, scouring and discussing best practice literature, ultimately deciding that PBIS ( Positive Behavioral Intervention and Supports) fit perfectly into our behavior analytic program. In September, we launched a campaign called "Turning Over a New Leaf". Because we pride ourselves in our use of behavior analysis system wide, subscribing to the tenets of PBIS would only serve to highlight this. We are teaching our staff that what we do daily promotes several ideals; the effective and accurate implementation of instructional and behavioral practices and interventions. We are confident that this will only make our program better.

While we are not stating we are a PBIS program, by incorporating these practices we think we can strengthening our teaching. The four integrated elements found in a PBIS program are already aligned with our school practices:

• the use of data for decision making
• measurable outcomes supported and evaluated by data
• practices with evidence that these outcomes are achievable and
• systems that efficiently and effectively support implementation of these practices

PBIS is guided by 6 principals, 2 of which are arranging the environment to prevent the development and occurrence of problem behavior while teaching and encouraging prosocial skills and behaviors. With all of this as our framework we adopted 3 tenets for preschool conduct: Be safe, Be responsible and Be Kind. Each classroom then created a matrix of how each of these should look in the classroom, the hallway, the gym and the bathroom.

By doing this everyone knew what being safe, kind and responsible would look like. We could now look for both staff and student behaviors to be reinforced. Although still in its infancy we have heard teaching staff tact that what they were doing was "being responsible"or "kind". The data will tell us if "Turning over a New leaf" has lead to an decrease in inappropriate student behavior and an increase in prosocial behaviors. Stay tuned for updates!

Gina Feliciano, PhD, SAS, BCBA-D, Preschool Director

Advocates for Children & QSAC Offer Free Workshop on Autism

2013-09-26T15:20:00.002-04:00

QSAC and Advocates for Children are collaborating on a free workshop for parents regarding autism. The workshop will be offered on Thursday, November 21 from 6pm to 8pm at Advocates for Children of New York's offices in Manhattan (151 West 30th Street). Parents can register online at http://www.eventbrite.com/event/8179568309/eac2.

NEWS! - Welcome to Life Skills Training - Cooking School

2013-07-29T10:32:00.001-04:00

Did you check out our picture collage above? QSAC's Residential Adult Clinical Department is proud to announce that we are currently conducting Life Skills Training Series in our Floral Park office. The training series consists of several modules that include Cooking School, Exercise and Coping Skills Training, Money Management class and Travel Training. Cooking school is a first module that recently started. It is a project that has been developed to help participants learn about cooking and the benefits of eating a variety of foods. The project is divided into 7 workshops that are designed to be practical and enjoyable, while teaching individuals important food related messages and skills.

Seven workshops are designed in such way that each workshop is based around a different dish for a meal occasion, e.g. Super smoothie, Healthy salad, Fabulous fruit salad, etc. In each workshop a small group of participants develop knowledge and skills based around that dish. Participants are introduced to the recipe, list of ingredients, necessary utensils and equipment, specific safety precautions, and steps they need to follow to complete preparing a dish. A group instructor engages participants in discussion by using colorful educative visual tools, and by providing them with support and guidance while they have the hands-on experience.

Nevena Savic, MA

Repetitive Self-injurious behaviors (RSIBs) and Autism

2013-07-08T08:19:00.002-04:00

Repetitive/compulsive self-injurious behaviors (RSIBs), also known as Body-Focused Repetitive Behaviors (BFRBs), has been defined as a behavior or a group of behaviors, which are destructive or cause physical harm in terms of tissue damage. These non-functional behaviors toward the body are typically repetitive or rhythmic, and constant (Roberts, et al. 2013, Tureck, et al. 2013, Matson & Turygin 2012). According to Davies and Oliver’s study (2013), repetitive self-injurious behaviors and aggressive behaviors are the most prevalent challenging behaviors among individuals with intellectual disabilities (especially those who score in the severe to profound range), Fragile X and Autism Spectrum Disorder (ASD), and individuals with deficits in receptive and or expressive communication.

Repetitive/compulsive self-injurious behavior (RSIB) is a chronic disorder that often begins in early childhood. Some studies have identified a likelihood of increase in the prevalence of self-injurious behaviors with increased age and co-morbid diagnoses. Autism constitutes a high risk factor for repetitive self-injurious behaviors, which is unclear. The prevalence of SIB has been estimated in 30-50% of individuals with autism and 97% of individuals with SIB displayed concomitantly some forms of stereotyped motor behaviors (Baghdadli, et. al 2003, Gal et. al, 2009). The topography of the behaviors varies from mild self-harm to severe forms involving permanent and even life-threatening tissue damage (Wolff, et. al 2013).

According to Devine and Symons (2013), the literature concerning self-injurious behaviors is frequently confused between etiology and treatment efficacy. The best comprehensive way to understand repetitive self-injurious behavior is by assuming RSIB has a multitude of “environment-brain-behavior relationships.” Multiple vulnerability factors may be involved in repetitive self-injurious behavior (RSIB) such as deficits in emotional processing information, pain sensitivity, stereotypy behavior, anxiety symptoms, lack of communication skills and institutionalization. Several studies have associated repetitive/compulsive self-injurious behaviors with biological and genetic risk factors such as developmental age, clinical condition, sensory impairment, Lesch-Nyhan, Prader-Willi, Smith-Magenis, Fragile X, and Cornelia de Lange.

Frequently, repetitive self-injurious behaviors can cause tissue damage. However, knowledge about the sensory and nociceptive neurobiological basis is very limited. Symons and colleagues (2011) suggest that chronic SIB and altered pain experiences are also associated with a wide spectrum of neurological, psychiatric, and developmental disorders. There is evidence that pain pathways and pain amplification mechanisms may be altered, which might contribute to self-injurious behavior. However, more studies are necessary to evaluate the relationship between pain and self-injurious behavior (Peebles, 2012).

From the functional analysis point of view, the repetitive self-injurious behavior (RSIB) is usually present when an individual desires to escape a situation, avoid unpleasant activities, obtain tangible items or for attention. However, for a number of people with autism, social contingency relationships (reinforcement mechanisms) seem to not apply or are difficult to establish, making it difficult to design effective behavioral intervention.

Mood dysregulation (anxiety, depression, eating, and substance-related disorders) may be a risk factor as well as the relationship between emotion-regulation strategies (acceptance, avoidance, problem solving, reappraisal, rumination, and suppression) promoting repetitive self-injurious behaviors (RSIBs). According to Divine and Symons publication (2013), “abnormal basal activity and responsiveness of the limbic-hypothalamus-pituitary-adrenal (LHPA) axis” may be a common characteristic among many self-injurious behaviors. It has been reported that 50% of individuals with autism experience anxiety symptoms. According to the emotion regulation model, the behavior occurs as a response to the identification of emotional experiences (Roberts et al., 2013). Roberts and colleagues (2013) suggest that the individual seeks relief from or to alleviate negative emotions, which in turn reinforces and perpetuates the repetitive self-injurious behaviors. Therefore, given an individual’s inability to cope with the emotional state or to control the impulse, it is assumed that the repetitive self-injurious behavior is negatively reinforced because it provides an escape from undesired emotions or difficult events. Often individuals with repetitive self-injurious behaviors (RSIBs) may suffer from anxiety and mood dysregulation (Teng et al. 2004).

Currently, there is no proven effective pharmacological treatment for repetitive self-injurious behaviors. The data from Naltrexone studies (an opioid antagonist) to sensory aspects of repetitive self-injurious behaviors has been mixed. In a research study, Fontenot and colleagues (2009) compared Fluoxetine and Venlafaxine. Fluoxetine (Prozac) was most effective in reducing self-injurious behaviors than Venlafaxine (Effexor). In an animal model study, Calcium Channels Blockers such as Nifedipine (Procardia) suppressed the self-injurious behaviors. Anti-convulsive medications such as divalproex sodium (Depakote), Levetiracetam (Keppra), Topiramate (Topamax) and Zonisamide (Zonegran) (Deriaz, 2012, Triba, 2012) have shown some efficacy in reducing self-injurious behaviors. More studies are needed to understand the etiology, underlying pain, and sensory expression, as well as the role of co-morbid medical/psychiatric diagnoses and risk factors, to develop an effective treatment approach.

Brain differences found in children with autism

2013-07-01T18:12:00.000-04:00

A recent study published in the online issue of JAMA Psychiatry found that children with autism may have stronger functional connectivity between certain areas of the brain networks than typically developing children. Researchers observed dense interconnections within the salience network of the brain, which predicted autism classification in 83% of the sample as well as symptom severity, denser connectivity was exhibited in children with more severe restricted and repetitive behaviors.

New Partnership will Train Future Educators for Children with Autism - QSAC’s Preschool and Queens College Sign Partnership Agreement

2013-06-13T11:18:00.001-04:00

Queens, N.Y., June 13, 2013 – Quality Services for the Autism Community’s (QSAC) Preschool in Douglaston and Queens College have forged an agreement that will support a collaborative partnership to enhance the behavior analytic training of students enrolled at the college. Students participating in the program are enrolled in Queens College’s Psychology Ph.D. program and Applied Behavior Analysis Master’s degree program.

The College’s program will provide CUNY students with relevant mentored clinical and research opportunities to supplement the graduate program experiences. Specifically, the program will draw on QSAC’s more than 35 years of experience in serving the autism community as well as the organization’s staff including Gina Feliciano, Ph.D., BCBA-D, SAS, the Director of the QSAC Preschool.

The Preschool will benefit from this partnership by having teaching assistants who are pursuing at least a Master’s degree and are funded by an outside entity. With their onsite work at QSAC, not only will students in the preschool and QSAC staff benefit by the field of Applied Behavior Analysis will as well. As QSAC moves forward in our mission to provide the best evidenced based services for the people we serve, it is important that QSAC be a part of the research efforts. This new relationship with Queens College will aid in increasing QSAC’s visibility with regards to Applied Behavior Analysis as well as its long history of providing quality services for the autism community.

The QSAC Preschool is a center-based program which provides children between the ages of three and five with an appropriate education in the least restrictive environment. The preschool is a full day, 12-month program with a continuum of class size ratios from small classes to less restrictive classrooms, which are led by New York State Certified Special Education Teachers. All classroom instruction at the preschool is implemented according to the principles of Applied Behavior Analysis.

This new partnership between the QSAC Preschool and Queens College is a testament to QSAC’s longstanding commitment to supporting new professionals entering the field. Throughout its history, QSAC has trained a number of leaders serving children and adults with autism. Regarding the new partnership, QSAC’s Deputy Executive Director who is an alumna of Queens College, Lisa Veglia said, “We are very excited about this new partnership. Our close relationship with Queens College goes back many years, so this agreement will allow us to work even more closely together as we train the next generation of professionals serving children with autism.”

ABOUT QSAC

Quality Services for the Autism Community is dedicated to providing meaningful educational, residential, habilitation, and support services for children with autism and their families. Today, QSAC serves more than 5,000 people per year throughout New York City and Long Island. Visit QSAC online at www.qsac.com.

Raphael Miranda, NBC4 Meteorologist, to Emcee Gala for Quality Services for the Autism Community’s 35th Anniversary

2013-06-12T09:37:00.000-04:00

Raphael Miranda, an Emmy Award winning meteorologist for NBC4’s “Weekend Today in New York,” will serve as the emcee for Quality Services for the Autism Community’s (QSAC) upcoming gala taking place on Tuesday, June 18 in New York City. The annual gala raises funds to support direct services for children and adults with autism through New York City and Long Island.

In addition to serving on the “Weekend Today in New York” on-air team, Mr. Miranda is also a weather producer for NBC4’s various newscasts. Since joining WNBC in 2007, Miranda has appeared on News 12 Westchester, NBC Weatherplus, Early Today, and on MSNBC and CNBC World.

In 2011, Miranda won an Emmy Award for weather coverage of Hurricane Irene. He is a member of the American Meteorological Society (AMS) and holds the National Weather Association (NWA) Seal of Approval. He is a member of the National Lesbian and Gay Journalists Association and the National Association of Hispanic Journalists.

As emcee, Raphael will help to inaugurate QSAC’s 35th year of service to the autism community of New York City and Long Island. Since 1978, QSAC has been providing quality services for children and adults with autism and their families. Today, QSAC serves 5,000 people each year through its educational, residential, habilitation, and support programs.

This year’s gala will be held at Guastavino’s on Manhattan’s East Side under the 59th Street Bridge. The gala will honor the Barr-Knight family with the Humanitarians of the Year Award, Danielle Guarino with the Philanthropic Leadership Award, and PIMCO with the organization’s Corporate Leadership Award.

Grant Will Help Families Navigate Services for Children with Autism

2013-05-23T14:15:00.003-04:00

$145,000 Challenge Grant Will Help Families Navigate Services for Children with Autism

Grant Marks Largest Foundation Gift Ever Made to QSAC

New York, N.Y., May 23, 2013 – Quality Services for the Autism Community (QSAC) and the New York Center for Autism Charter School (NYCACS), as a sub-grantee, have received a challenge grant for $145,000 from The Heckscher Foundation for Children in support of its “Pathways for the Future” initiative. This collaboration will provide families throughout the region with access to meaningful support for navigating key transition points throughout the life of a child with autism.

The $145,000 grant from The Heckscher Foundation for Children is a matching grant in that it will need to be matched with new donations from the community over the two years. In essence, any donation over the next two years will be doubled with the support from the Heckscher Foundation.

The Pathways program is an educational initiative for parents and providers on transition periods during the life of child with autism and the various programs children are eligible for. The project will also incorporate a one-on-one component regarding support and advocacy on behalf of parents seeking services for their children with autism, so as to assist with program eligibility and linkage to services.

These workshops and conferences will be tailored so as to address key transition points in the life of a child with autism. Specifically, those transition periods are (1) diagnosis, (2) early intervention, (3) preschool, (4) school, and (5) adulthood. This resource will help to inform families about existing public and private programs that their children may qualify for as well as link them to concrete services when possible.

All of the programs offered through this initiative will be free for the family members of children and adults with autism. In the coming weeks, the date and location of AUTISM 2014 will be announced. The annual conference will be open to family members, educators, professionals, and other individuals interested in learning more about services for people with autism and their families as well as the various processes involved with obtaining eligibility for services. .

QSAC’s Executive Director, Gary Maffei said, “The timing of this grant and initiative are critical in that it will coincide with the forthcoming changes associated with the funding of services for people with developmental disabilities. This generous grant from The Heckscher Foundation for Children will ensure that we are well-prepared to assist families as they seek to obtain much-needed services and programs for their loved ones under the current system as well as the future processes.”

This grants marks the largest foundation gift ever to QSAC. If you would like to learn more about the Pathways program or if you are interested in making a donation toward the match campaign, please contact Joseph Amodeo, Director of Development, at jamodeo@qsac.com or (212) 244-5560, ext. 2016.

ABOUT QSAC

Quality Services for the Autism Community is dedicated to providing meaningful educational, residential, habilitation, and support services for children with autism and their families. Today, QSAC serves more than 5,000 people per year throughout New York City and Long Island. Visit QSAC online at www.qsac.com.

ABOUT THE HECKSCHER FOUNDATION FOR CHILDREN

The Heckscher Foundation was founded in 1921 to promote the welfare of children in New York and elsewhere throughout the United States. Today, it provides grants to youth-serving organizations in the fields of education, family services, child welfare, health, arts and recreation.

In-Home Services

2013-05-10T13:30:00.000-04:00

“Comm Hab”, “Respite”, “Family Support”, “Parent Training”…..In-home services for families who have a child with Autism Spectrum Disorders (ASD) can go by many names. This range of services and supports often means the difference between a family staying intact or coming apart at the seams. Jimmy’s in-home worker spent months building rapport, gradually coaxed him out of his room to play, and is now able to go with him to leave the house for necessary medical appointments. Elena’s worker helps her find places to visit in the city and together they plan how they will get there. And QSAC Respite providers enable parents to attend family events, to accompany siblings to school events, or simply to relax in another part of their home, knowing their loved one with ASD is in capable and caring hands.

There is strong research supporting in-home services. Parents who receive more social supports are better able to manage their child’s challenging behavior (Michelson, et al., Clinical Child and Family Psychology Review, v16 n1 p18-34 Mar 2013; Boyd, Focus on ASD Other Developmental Disabilities, Winter 2002 vol. 17 no. 4, 208-215), have better overall interactions with their children (Koegel, Bimbela, and Schreibman, 1996, Journal of ASD and Developmental Disabilities Volume 26 (3)), and see more skill gains in their children.

There are several aspects of in-home services that are distinctive. First, the relationship between families and in-home staff can be very close. Many times in-home workers stay with a particular family for many years, building a warm and caring relationship. In-home workers often have more interactions and more personal interactions with family members than might be possible in other education and social service settings. This presents advantages for both staff members and families. An easy and close relationship allows in-home staff members to see the daily impact of their work, and how their effort helps the family they’re working with. Families have a comfortable connection to someone who can provide the information and help that meets their individual needs.

Another unique aspect of providing services in family homes is that the focus is on the exact skills that the child or adult will use at home and in the community. In-home staff members have the opportunity to work on skills that have a direct impact on the day-to-day life of an adult or child with ASD and his or her family. In-home supports also use the instructions that the child or adult will hear every day. For families and consumers, this focus leads to greater independence at home and in the community and access to a wider range of family and community activities. Instruction in homes and communities also provides opportunities for children and adults with ASD to generalize skills that were learned in school or at Day Hab.

Finally, teaching at home or in the community allows both families and staff members to use the natural supports available to the child or adult with ASD. Siblings, parents, other family members, neighbors, store owners, and others in the community can be peer models, social interaction partners, and natural reinforcers for new skills. This provides tremendous benefit to the family and consumer who gain support for new skills and gain skills that they can use right away. Using natural supports benefits the in-home workers as well. Using the other people in a child or adult’s life can make a teaching interaction rich and fun.

In home services, whether they are Respite, Community Habilitation, or another form of family and parent support, provide essential benefits for families and expand consumer skills. Working in homes and communities can create close staff-family relationships, lets staff work on functional skills, and makes use of the wide range of natural supports available to children, adults, and families. In-home services are an integral and important part of many consumers’ overall supports.

By Susan G. Izeman, Phd, BCBA-D

Sue Izeman is QSAC's Director of Family Services. This department provides in-home Respite and Community Habilitation services throughout New York City and Nassau County.

Sexuality education for students with autism spectrum disorders

2013-05-06T13:24:00.000-04:00

Individuals with autism spectrum disorders (ASD) demonstrate the same needs for relationships as most of us do. Unfortunately, a deficit in social skills can make relationship building a challenge for the individual with ASD. Social skills training does not often target the skills required for adult relationships. These topics may get placed on the back burner, and/or are not addressed at all. There exists a hidden curriculum within adult relationships, and one such topic includes sex education. Individuals with ASD experience the same bodily changes as their typically developing peers. The topic of sex education is an uncomfortable topic for many families, but one that requires attention. Individuals with ASD usually require instruction and support in order to develop appropriate sexual behavior. We are currently faced with a lack of research concerning sex education within the ASD population.

The following is a two part blog written by Dr. Peter F. Gerhardt, Ph. D. for the Sage Colleges Achieve Ideas. Dr. Gerhardt discusses the definition of sexuality, its history, as well as guidelines and considerations for the instruction of sexuality. Dr. Gerhardt is a leading expert in the field of autism and issues such as sex education.

By Dr. Peter F. Gerhardt, Ph. D.

Sexuality education for students with autism spectrum disorders, Part I

Although generally difficult to talk about in an open and honest manner, sex and sexuality are central to understanding ourselves. Comprehensive sexuality instruction focuses primarily on who the individual is as a sexual being and what that may mean in his or her life. Sexuality education involves instruction beyond just basic facts and knowledge and includes issues such as personal safety, individual values, gender-role identification, physical maturation and an understanding of the complex social dimension of sexuality and sexual behavior. Therefore, sexuality education should be considered an integral element of education for learners with an autism spectrum disorder (ASD), assuming that the goal is for them to be a safe, competent and confident adults.

Definition of sexuality
Human sexuality presents us with very complex subject. As defined by the World Health Organization (2004), sexuality is:

a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behavior, practices, roles and relationships. Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, ethical, legal, historical, religious and spiritual factors. (p. 2)

Similarly complex is the process of sexual development, which has been described as a “multidimensional process intimately liked to the basic human needs of being liked and accepted, displaying and receiving affection, feeling valued and attractive and sharing thoughts and feelings” (Murphy & Elias, 2006, p. 398). What both of these definitions boils down to is that sexuality is simply part of being human. Avoidance of any discussion of sexuality and/or sexuality instruction as it pertains to learners with ASD constitutes, in effect, a tacit denial of their humanity which, I think we all agree, is unacceptable.

History
For much of our history the very concept of individuals with any disability label being viewed as sexual beings was, by and large, anathema to the thinking of the time. Up until fairly recently, the predominant method of addressing sexuality in learners with developmental disabilities was denial and suppression (Watson, Venema, Molloy & Reich, 2002). Not surprisingly, neither approach was effective. Learners with ASD are, by definition, sexual beings, and to deny them that status is to deny them appropriate access to a critical part of their life, their status as an adult and their ability to be safe from harm.

Components of sexuality education
Sexuality education actually starts very early in life (differences between boys and girls; using the boys room or girls room, etc.) and continues well into adulthood (dating, marriage and parenting). Comprehensive sexuality education consists of instruction in three distinct (yet interrelated) content areas:

1) Basic facts/accurate information
2) Individual values and
3) Social relationships.

Effective sexuality education for learners with ASD can be complicated by the language/communication problems and social deficits associated with the disorder. And while sexual feelings and interest may be high, a primary information source available to neurotypical teens, (i.e., other teens), is often not available to learners on the spectrum (Volkmar & Wiesner, 2003). This often results in a situation where information is not taught in school, not addressed by family and not provided by friends resulting in little, if any, appropriate skill development. But make no mistake: teens will encounter information about sex as part of daily life, whether it’s from the media, overhearing locker room talk, watching the physical actions of couples at school or in the community or being the subject of insensitive, sexually-oriented teasing by others.

In light of the social challenges experienced by even the brightest learner with ASD, direct training and education about sexual issues needs to be provided, commensurate with each individual’s receptive and expressive abilities. This direct social skills instruction should be two-pronged: on one hand discussing the complexities of relationship building and on the other hand more concrete discrimination training as to who can, and who cannot, help in the bathroom, with menstrual care, at the doctor’s office, etc.

References
Murphy, N.A. & Elias, E.R. (2006). Sexuality of children and adolescents with developmental disabilities. Pediatrics, 118 (1), 398-403.

Volkmar, F.R. & Wiesner, L.A. (2003). Healthcare for children on the autism spectrum: A guide to medical, nutritional and behavioral issues. Bethesda, MD: Woodbine House.

Watson, S., Venema, T., Molloy, W. & Reich, M. (2002). Sexual rights and individuals who have a developmental disability. In D. Griffiths, D. Richards, P. Fedoroff & S. Watson (Eds.). Ethical Dilemmas: Sexuality and Developmental Disability. Kingston, NY: NADD Press.

World Health Organization (2004). What constitutes sexual health?Progress in Reproductive Health Research, 64, Accessed on line (8/15/06) at http://www.who.int/reproductive-health/hrp/progress/67.pdf

Sexuality education for students with autism spectrum disorders, Part II

In general, there are three basic goals for sexuality instruction – sharing basic facts/accurate information; developing individual values and teaching appropriate social relationship skills – and these should form the structure of any program for learners with autism spectrum disorders (ASD). Age and functioning level will affect how information is shared, but adults should use care not to restrict education because of their own preconceived notions about what these learners ‘need’ or ‘want.’ Other guidelines include:

· Think ahead and be proactive. Waiting until something inappropriate happens is not an option. For example, training in appropriate menstrual care should start prior to onset of a young woman’s first period if it is to be most effective (and potentially, less challenging).

· Start when children are young. Don’t make the mistake of waiting until the individual expresses interest in sex for education to begin. Teaching children about personal safety issues such as good touch/bad touch, consent and personal boundaries should start at an early age.

· Be concrete and factual in presenting information, but also calm and supportive in all your interactions. References to the “birds and bees” as an introduction to sex or comparisons of the vulva to “petals on a flower” will, in all likelihood, be misunderstood. Much of the information is factual, based on biology. Use visuals whenever possible.

· Break larger areas of information into smaller, more manageable blocks (task analyze). For some individuals discussing the biological underpinnings of pregnancy may be quite appropriate while for another a more simplistic explanation may be sufficient.

· Always remember that sexual behavior is social behavior and, therefore, the social dimension of sexuality needs to be addressed when and wherever appropriate. “Hidden rules” regarding sexual behavior are pervasive. Masturbation, not often thought of as having a social component, does indeed, and it includes such social rules as 1) don’t masturbate in front of others, 2) your bedroom is the appropriate place for masturbation and 3) close the door to your bedroom if you want to masturbate, etc.

· Keep in mind that sexuality education needs to be consistent, and the skills learned may need to be monitored to make certain they are retained. Once a young woman learns who can/cannot help her with menstrual care, the hope is that this skill is rarely practiced in real life. It may have to be revisited at different times across her life to assure maintenance of these very important skills.

Sexuality education with learners with ASD is often regarded as a “problem because it is not an issue, or is an issue because it is seen as a problem” (Koller, 2000, p. 126). In practice this means we generally ignore sexuality as it pertains to learners with ASD until it becomes a problem, at which point we generally regard it as big problem. A more appropriate and, ideally, more effective approach is to address sexuality as just another, albeit complex, instructional focus, the teaching of which allows learners to be safer, more independent and more integrated into their own communities, resulting in a more positive quality of life. As noted by Koller (2000), the question no longer can be if sexuality education should be provided, but rather how it will be offered.

References
Koller, R., (2000). Sexuality and adolescents with autism. Sexuality and Disability, 18, (125-135).

Sobsey, D. (1994). Violence and Abuse in the Lives of Persons with Disabilities: The End of Silent Acceptance? Baltimore: Paul H. Brookes Publishing.

Posted by Rocio E. Chavez, MA, MSEd, BCBA

Attack [Guest Blog]

2013-04-22T14:51:00.000-04:00

by Jeff Stimpson, QSAC Parent

I’m coming from the kitchen and just trying to balance a bowl of soup when I hear Ned’s shattering “Ow!” What’s happened now? “He bit Ned!” Jill says as I round the corner. Jill is my wife. Ned is my 12-year-old son, typically developing. "He" is Alex, my 14-year-old son with autism.

Ned’s head is in Jill’s lap, and I see the shaking shoulders that I have seen way too often. We all see it – except Alex, who charges his little brother. He plunges toward Ned with his forearm to his teeth. Then Alex sinks his teeth down on Ned's arm. I grab Alex’s arm and waist and his neck and arms in what my brother Lee in his martial arts period used to call “a full nelson”. I have my older son who has autism in a full nelson.

“Alex stop this. Stop this or you could wind up in some place where they’re not this nice to you and you will have a problem!” Think I like saying this to my son? I manhandle Alex over by the door – what the hell else am I supposed to do? – and he collapses to the floor, screeching. He wraps his arm around my legs and bites my legs. It’s not right that Alex is biting me. “Alex, you have to calm down...” He deflates at my feet and wraps his arms around my leg and sinks his mouth toward my legs where I feel the what he’s always saved for his own forearm but on this night went into Ned and soon after into my leg. (“Did he break the skin?” Aunt Julie will ask the next day. “No, of course not.” Of course not.)

“Jill,” I say, “I need you to stay home tomorrow. I know Jill can’t: Her boss is tough and anyway I don’t mean it. What I mean, as I’ll assure her later, is that saying it meant something to me.

I get Alex to the couch; he plunges toward Ned again. We didn’t go through the last 14 years to wind up like this. “Alex, leave your brother alone. Get a grip on yourself-” I take his chin (look at the beard he refuses to shave!) and try to turn it toward my face. This always worked when he was a little boy, when all he did was bolt from our apartment and from restaurants. “Alex, get a grip on yourself or you’re going to have to go somewhere where they won’t be so nice to you.”

I don’t know what I mean by this; it seems to make Ned cry harder in Jill's lap. This moment peters out as Alex starts asking, “What’s wrong? What’s wrong?’ He slaps his own face. "

"Alex looks like’s about to cry," says Ned. (And Alex does, adding, “Sorry. Sorry.”) “I know what to do,” Ned announces. “Just let me go to my computer.” Ned plays Minecraft on his computer. “I’m building solar panels,” Ned says. “Just let me go do that.”

Jill and I sit at the dining room table and discuss eventualities. “Let’s get through this,” I tell her. I settle Alex down in his bed. Sometimes I listen to music on my iPod or play “Angry Birds” on his iPod while he goes to sleep. Not tonight. I stare at him as he falls asleep, then I come out to the table where Jill is sitting and staring at words of her own she’s written on her computer.

The rims of her eyes are red. I tell her we’ll get through this. “That’s not what I’m crying about,” she says.

Jeff Stimpson

Jeff Stimpson lives in New York with his wife Jill and two sons. He is the author of Alex: The Fathering of a Preemie and Alex the Boy: Episodes From a Family’s Life With Autism (both available on Amazon). He maintains a blog about his family at jeffslife.tripod.com/alextheboy, and is a frequent contributor to various sites and publications on special-needs parenting, such as Autism-Asperger’s Digest, Autism Spectrum News, the Lostandtired blog, The Autism Society news blog, and An Anthology of Disability Literature (available on Amazon). He can also be found on LinkedIn and on Twitter @Jeffslife.

Procedures For Self-Stimulatory Behavior Reduction

2013-04-12T12:30:00.001-04:00

It is known that many behavior problems in individuals with Autism and developmental disabilities are maintained by social reinforcement, positive and negative (provided by other people), however some behaviors persist in the absence of social contingencies and appear to be maintained by sensory stimulation that is directly produced by the person. Examples of such behavior include repetitive and rhythmic actions (such as rocking, flapping hands, twirling objects), certain destructive behaviors (such as tearing clothes) and some forms of self-injurious behavior, (such as hand mouthing or head banging). Usually these behavior responses are called ‘stereotypy,’ ‘self-stimulation,’ and ‘ritualistic behavior.’

Several interventions have been developed as treatment options for behavior maintained by automatic positive reinforcement.

One intervention frequently reported in the literature is sensory extinction (EXT). Sensory extinction involves elimination or attenuation of stimulation produced by a behavior, while still permitting responding to occur (for instance carpeting a table top in order to attenuate sound, effectively reduces an individual’s object twirling on the table, placing vibrators on the back of the person's hands reduces finger and arm flapping, padding devices reduces some forms of SIB). EXT procedure actually includes manipulation of the physical environment and although it has been shown to be effective it does not directly establish alternative forms of appropriate behavior.

Another procedure for behavior maintained by automatic reinforcement is differential reinforcement, which is usually implemented in either differential reinforcement of other behavior (DRO) or differential reinforcement of alternative behavior (DRA)contingencies. For example, stereotypy can be reduced by delivering praise and food contingent on the completion of intervals during which inappropriate behavior did not occur (DRO), or by having a therapist provide social reinforcement contingent on object manipulation (DRA). One possible explanation for the limited effectiveness of DRO and DRA procedures with individuals who engage in stereotypic behavior is that stimulation produced by the behavior is continuously available and other reinforcers cannot compete with that, unless they are extremely potent or if little effort is required to obtain them.

One of the most effective interventions include noncontingent reinforcement (NCR) or often called environmental enrichment. Several research showed that the use of NCR decreases variety of stereotypic behavior problems when individuals were given free (noncontingent) access to leisure items or when object manipulation was provided within an alternative activities. In some studies it has also been shown that NCR is more potent than EXT. The main advantage of NCR over both EXT and differential reinforcement is that, when reinforcement is delivered in the form of noncontingent access to leisure (manipulable) materials, behavior is suppressed in the absence of a programmed contingency. Additionally, NCR generally does not produce extinction bursts, does not require the use of potentially restrictive devices, and eliminates deprivation that may occur when an individual fails to meet criterion for reinforcement in a differential reinforcement contingency. Also, in cases when the alternative activity requires some form of object manipulation, NCR may strengthen and maintain appropriate behavior.

Overall the success of this treatment is dependent on selecting stimuli that provide sensory stimulation that matches the reinforcing qualities of the automatically maintained behavior.

Nevena Savic, MA

ASAT: The Association for Science in Autism Treatment

2013-04-05T16:42:00.001-04:00

by Anya Kurtz Silver, QSAC Assistant Director of Adult Behavior Services

ASAT is a not-for-profit organization of parents and professionals committed to improving the education, treatment, and care of individuals with autism. Since autism spectrum disorders were first identified, there has been a long history of failed treatments and fads, imposed on vulnerable individuals as well as on their families. From the scandal of the “refrigerator mother” theory, to the ongoing parade of “miracle cures” and “magical breakthroughs,” history has been dominated by improbable theories about causation and treatments.

In March 2013, the CDC (Centers of Disease Control) reported that the prevalence of autism is 1 in 50 school age children. Unfortunately, countless families spend thousands of dollars on unproven or harmful treatments for their child with autism, wasting both valuable time and money that could otherwise be directed toward effective intervention.

ASAT's core mission is to disseminate accurate information about autism treatments, to empower families to identify and choose the most effective, scientifically-validated intervention for their children. All families should have timely access to clear, accurate and science-based information about autism and treatments. This information will help these families distinguish between the fads and “miracle cures” that have plagued autism intervention for decades, and effective science-based intervention.

ASAT also works on educating the public about effective autism treatment through proactive contact with the media. There is a media watch committee whose sole responsibility is to respond to inaccurate information or proposed treatments described by the media and to support accurate media depictions of empirically–sound interventions for individuals with autism spectrum disorders.

ASAT has achieved some notable accomplishments this year, including the development of a formal externship program, an increase in the use of social media to reach the public, and a focus on an international presence for ASAT. Please check out the ASAT website to find out more. And be sure to sign up for the newsletter!

You can also friend us on Facebook!

http://www.facebook.com/ASATonline

DECANTING AN IRREVOCABLE TRUST

2013-03-26T08:52:00.001-04:00

by Andrew M. Cohen, Esq.

In previous articles, I have written about the importance of a Supplemental Needs Trust and, more specifically, how it enables a person with a disability to have money and assets accumulated for him/her (typically managed by a family member or friend) without affecting or jeopardizing eligibility for means based public benefits such as SSI and Medicaid.

An all too common scenario arises when a relative (typically a grandparent) – with the best of intentions to aid a family member with special needs – establishes an Irrevocable Trust which would be considered a resource for the disabled beneficiary and thus preclude that person from receiving public benefits. An Irrevocable Trust is, by its terms, typically unable to be altered, modified or changed.

In 2011, New York’s “decanting” statute was expanded and, as a result, provides a welcome relief for the scenario described. Decanting is defined as pouring or transferring from one vessel to another. This process is most commonly associated with wine, where the liquid is moved from its original bottle to another vessel, to allow it to aerate or breathe. Under New York’s decanting law, when the right facts and circumstances are presented, a Trustee of an Irrevocable Trust is permitted to take the assets from the original trust and move them to a new trust with new provisions to meet the needs of the beneficiary.

In the case scenario above, the “grandparent” trust would be invaded and the assets moved to the new or “appointed” trust which complies with New York’s Supplemental Needs Trust Law (EPTL 7-1.12). As a result of decanting the prior trust, a disabled individual who would have been barred from Medicaid and its wide range of services and programs due to financial constraints resulting from the terms of the original trust, would now qualify for the much needed benefits. Once decanting has been completed, the corpus of the new trust would be able to provide the disabled individual with goods and services not covered by the government – such as clothing, furniture, electronics, etc. – to further enhance the quality of his/her life while remaining eligible for public benefits.

Under the decanting law, certain procedural safeguards (notice provisions) must be met. Further, a Trustee who seeks to use this recently created power must be cautious of some unanticipated tax ramifications of modifying the original trust.

The New York decanting statute has become a model law for several states and provides a broad and flexible platform to remedy a circumstance that could otherwise have a significant and detrimental effect on a disabled individual.

Andrew M. Cohen, Esq. is the principal of the Law Offices of Andrew M. Cohen. The firm concentrates in the areas of Trusts & Estates, Guardianships, Elder Law and Estate Planning, with an emphasis on planning for special needs families and disabled persons. Mr. Cohen has a Juris Doctorate and an L.L.M. in Taxation. The firm’s offices are located in Garden City and mid-town Manhattan and can be reached at (516)-877-0595 or www.amcohenlaw.com.

1 in 50 Children has Autism

2013-03-25T15:57:00.000-04:00

In March 2013, the Centers for Disease Control and Prevention (CDC) announced that autism diagnosis rates were now one in fifty school-aged children based on a new study conducted by the CDC. The CDC’s full report is available online at http://go.qsac.com/cdc2013.

Commenting on the new statistics, Gary Maffei, QSAC’s Executive Director said, “These statistics demonstrate the importance of providing person-centered services for children and adults with autism. QSAC remains steadfast in its commitment to ensuring that all children have access to meaningful programs and services.”

Antecedent-Based Intervention to Reduce Challenging Behaviors

2013-03-18T08:15:00.002-04:00

Behavioral intervention specialists have been using functional behavior assessment (FBA) to identify the consequences that maintaining challenging behaviors and modify them to encourage appropriate behaviors (“consequence-based intervention.”) The role of the consequences to increase appropriate behaviors and decrease maladaptive behaviors has been widely demonstrated in the literature (Iwata, et.al, 1994; Paclawskyj, et.al 2000).

New attention is being focused also on the influence of antecedent variables (“antecedent-based intervention”) on severe problematic behaviors (e.g. self-injurious behaviors, physical aggression, property destruction, and elopement) (Lennox, et, al, 1988). According to Iwata (1997), the antecedent variables may include processes as discrimination, deprivation and satiation, emotional state, and aversive stimulation. “Antecedent-based interventions,” in contrast to “consequence-based intervention,” use a series of techniques, which are implemented before the occurrence of challenging behaviors to reduce the probability of these behaviors. (Luiselli, 2006). These interventions have been associated with reductions in presentation of challenging behaviors and they have become a foundation of the positive behavior support approach (Carr et al., 2002).

Machalicek and colleague (2007) reviewed 10 research studies using “antecedent-based interventions” and each of these studies reported positive results. By using antecedent intervention strategies prior the exhibition of the challenging behaviors, we can influence the challenging behavior and prevent its occurrence.

The following are antecedent interventions techniques that can be used to control or prevent challenging behaviors:

1. Providing choices: Providing choices allows the individual with autism spectrum disorder to feel empowered and in control of their environment and gives the sense of self-determination.

2. Changing the physical environment: This intervention stems from the understanding that extreme temperature, loud noise, rigid schedules, lack of privacy, hunger, limited accessibility, positioning, boredom, may influence challenging behaviors.

3. Modifying activities/routines

4. Non-contingent reinforcement (NCR). There is a notion that individuals act out behaviors to attain a reinforcing factor. Take for example of an individual who is constantly engaging in challenging behavior for attention. Through this technique, we can “flip” the situation by giving the individual attention throughout the day at scheduled intervals.

5. Scheduling: Many individuals with autism spectrum disorder become anxious when they do not know what to expect. Implementing a predictable daily schedule often, helps calm the individual. There are several forms of activity schedules, the most famous consisting of line drawings or photographs with Velcro on the back.

6. Functional Communication Training (FCT). Many individuals with autism spectrum disorder (ASD) are easily frustrated because they cannot communicate their needs and feelings appropriately. Language deficits are common within the ASD population as the development of language and communication may be slow to mature, idiosyncratic, or odd. Using augmentative or assistive technology, Picture Exchange Communication System (PECS), teaching relaxation, alternative replacement behaviors may influence the behavioral presentation (O’Reilly, et. al 2012).

1. Antecedent Exercise: Some research studies have demonstrated the efficacy of antecedent exercise for reducing severe challenging behaviors such as stereotypical behaviors, self-injurious behaviors and aggression ((Bachman & Sluyter, 1988; Bachman & Fuqua, 1983; Baumeister & MacLean, 1984; McGimsey & Favell, 1988).

2. Social Stories: A social story is a short simple story written from the perspective of the individual that provides instruction on positive, appropriate social behaviors (Gray & Garand, 1993). According to Kern (2010), social stories are more effective when addressing inappropriate behaviors than when teaching social skills.

3. Video Modeling: Video modeling is an antecedent-based intervention in which a behavior intervention specialist shows a video of desired behaviors or interactions to an individual or small group of individuals. Video modeling and video self-modeling are both effective means of providing a visual representation of a desired behavior or skill (Sherer et al., 2001).

4. Self-management: It refers to actions purposefully taken by individuals to change or maintain their behavior (Shapiro & Cole, 1994). It represents some skills or behaviors that individuals can engage in to become more self-contained. Self-management has proved effective in development alternative replacement behaviors (Peacock, et.al 2010).

The Importance of Parental Support Groups for Parents of Children with Autism

2013-03-13T09:04:00.000-04:00

Raising any child is a daunting task, even as enjoyable of an experience as parenting can be. Receiving a diagnosis of an autism spectrum disorder often elicits strong emotional reactions from parents of the diagnosed child, but caring for an autistic child can be more than overwhelming. Having a child with autism affects the entire family and puts a strain on both marriages and siblings. Many parents report feeling guilty, as if there was something they could have done differently, or wishing they had more time to spend with their spouses or other children. Parents are often very overwhelmed, with so much to do and process, it is hard to know where to start. Follow-up services and continued support for these families is a necessary component to help families adapt and meet their children’s needs.

There is no reason to carry the burden alone. There are many resources available that can help parents cope with the difficulties of raising a child with autism. Group support can offer parents the knowledge, understanding, and acceptance they seek. In the immediate aftermath of receiving a diagnosis, the encouragement and assistance gained through the mutual aid process of a support group can be invaluable in helping parents to get through this challenging time. Research indicates that having access to a support network and receiving support related to their child had the greatest benefit for parents of children with autism (Guralnick et al., 2008).

QSAC offers several support groups for parents and siblings of children with autism. The support groups offer both a support component and a training component so that family members are given both the emotional support and practical tools they need to feel empowered and take specific actions.

Workshops are free for parents and $15.00 for professionals. Please click here for schedules and more information.