for Autism, Asperger’s Disorder and PDD-NOS
The goal of a full environmental assessment and the development of a program of care, as carried out by Autism Consulting Service, is to help those who are working with an individual with autism, whether as family members or as professionals, develop a clear understanding of what he/she responds to, both positively and negatively, how to recognize their current coping mechanisms and to suggest various interventions and interactions which will allow them to help them grow and develop to their highest potential as a human being. Available for all ages.
Focus of Assessment
According to the DSM-IV, autism is diagnosed through a triad of symptoms. These include a qualitative impairment in communication, a qualitative impairment in social relatedness, and the use of repetitive or stereotypic behaviors. Throughout the years since autism was first discovered in 1943, the focus of treatment has concentrated on these three symptoms with little permanent change in the condition of those with autism.By focusing our efforts on looking at autism from the outside, we created the situation that autism has been considered hopeless
During the late 1980’s and early 1990’s a new view of autism emerged. This comes directly from people who have autism, who are able to describe how they experience life. These people claim that overstimulation through the sensory system is their greatest problem. Their reactions to this overstimulation leads directly to the three symptoms described in the DSM-IV. Their claims have been supported through a variety of empirical scientific studies. A recent study from California measured the arousal rate of normal children in stimulating circumstances using the Galvanic Skin Response and compared their reactions directly with children with autism exposed to the same situations. The arousal levels of the children with autism were consistently higher, more erratic and more extreme in all situations tested. For example: when normal children experienced direct eye contact they experienced an average of three spikes of arousal per minute, while children with autism experienced 12 or more. This indicates that the responses of people with autism in any environment are higher than the responses of typical people. Recent research at the University of Georgia has pinpointed the difference in the brain structure of those with autism, which results in this sensitivity to stimulation. People with autism have smaller minicolumns in their brains and more of them which leads directly to this higher level of response.
During the nineteen nineties, new information on autism has emerged with the realization that some children and adults with autism are experiencing gastrointestinal (metabolic) disturbances, bowel problems, heavy metal toxicity and immune difficulties which appear to lead to heightened levels of arousal, which in turn lead to heightened levels of acuity to sensory stimulation and to the use of autistic like behaviors. Treatment of these problems through medical and dietary intervention have led to a decrease in autistic symptoms. This information is also taken into account during each observation and assessment. An initial session on the SCIO is now included in the full assessment process.
People with autism claim the repetitive and stereotypic behaviors they partake in are used to control their body’s reaction to their environment. The higher level of stimulation, the higher the need to use coping behaviors to calm their sensory systems. Extreme stimulation results in the need to go into survival mode at which point they block out all sensory input. One must be aware that the coping behaviors of people with autism deal with three different areas of concern:
1. Overstimulation from the environment (a threat to ones safety),
2. Overstimulation from within. These can be positive (pleasure, excitement) , or negative (anger, fear, anxiety), and
Paying attention to the times that the person with autism partakes in protective behaviors allows the consultant to determine the level of anxiety that he/she is experiencing from one situation to the next and throughout the various times of the day as well as which of the above concerns are leading to the use of protective behaviors. By carrying out the assessment directly in the individual’s actual environment we remove the stress of putting him/her in a new environment and are able to develop a program of care that works for him/her directly in their own world.
Focusing directly on behavior and trying to eliminate what we define as negative behavior, or to change behavior to make it appear more normal means that one is ignoring the reasons behind the behaviors. This is much like focusing on developing a salve to deal with the red bumps of measles, instead of a vaccine to kill the measles virus. One can choose to try to alleviate measles with the salve, and the measles may appear to be gone, if the red bumps are gone, but one will have only dealt with one symptom. This is why one has to access behavior programs over and over again for people with autism. The problem may appear to have been resolved through the use of positive and negative rewards on a single behavior, but it will not disappear for good until the reasons behind the behaviors are dealt with.
Breakdown of Service
A full environmental and behavioral assessment through Autism Consulting Service consists of 60 hours of consultant time for a total cost of $5000. 5 days in total.
The breakdown of the assessment includes:
30 - 40 hours of direct environmental and behavioral assessment with the client. Some of this time is used to allow those being observed time to relax in the consultant’s presence. Past cases indicate it takes more time for the staff and other family members to relax, than it does the person with autism.
up to 10 hours meeting with parents, other family members and staff and reading files to discover his/her history and the impact this history is having on the current situation.
up to 10 hours of report writing. Reports are very detailed and average from 20 - 30 pages. They include the a complete description of the assessment process detailing the conclusions and evidence about the sensory system of the person being assessed, numerous suggestions for future care and programming as well as a summary of the report for those who do not have the time to read it all.
3 - 5 hours of presentation of method of care to staff and family members.
The actual division of the 60 hours depends on the individual situation. More or less time is needed depending on the number of environments the person is involved in, the number people who are directly with the individual, and the age of the person being assessed. For example: the amount of time spent on reviewing history of an individual would be much higher for a teenager or adult compared to a preschooler.
After the assessment is complete the consultant is willing to continue to monitor the child’s progress through telephone consultation and direct observation at a rate of $100.00 an hour if desired. However, this is not usually necessary and in most cases the parents choose to monitor the situation themselves. The consultant is also available to act as an advocate for the individual by attending meetings, educating the community through workshops and individual consultations (in person or via the telephone) with the family or professionals, and for short term assessment during crisis situations at a fee of $100.00 per hour or portion thereof.
The work of Autism Consulting Service, based directly on this information, concentrates on measuring the impact of the environment on the sensory system and arousal level of the individual being assessed by observation of the behaviors used in a the variety of environments. The environment includes both the physical space and the interactions of people within that space. By carrying out the assessment in all of the environments a person deals with on a day to day basis, as well as all of the people that he/she interacts with, the consultant is able to determine what causes the highest levels of anxiety as well as where and with whom the client feels safest. This program also allows staff and family members to acknowledge the reality of the life of the person with autism and concentrates accessing individual abilities rather than disabilities, a technique which is effective for all human beings.
On the other hand, developing an understanding of how the individual responds to the sensory stimulation coming in from the environment and developing a program which
makes changes in the environment to make it possible for the individual to feel safe, and not to have to resort to the use of protective behaviors
respects the coping skills that the individual has developed and helps him/her discover alternate coping skills which may be more effective and positively accepted by society
provides accommodations for the individual based directly on how their individual sensory system is responding
provides the opportunity for the person with autism the freedom to take part in new experiences and to learn
and works directly with the person abilities allowing the individual the chance to reach his/her highest potential instead of limiting him/her to a world in which he/she must continuously protect him/herself.
A SCIO assesment is now included in the full assessment which provides the opportunity for the family to see the scio at work with their child.
It makes far more sense to assess a person in the environment they deal with every day than to take them out of their world and try to understand them in ours.
Additional Charges: mileage or airfare to location, if out of the city of Edmonton.
Car mileage at the rate of __.40___ per km. Airfare is arranged and paid by the family in advance.
Plus housing and meals during the assessment process. This can be in the home of the child (especially important if there are sleeping problems), or in a nearby hotel. The consultant is very flexible.
Phone: 1- 780 - 651 - 0946 or e-mail if you are interested in having a full assessment done for your child.