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Grant to Fund
Research on Play-based Early
Intervention for Autism; Confront
Increasing Numbers of Young Children
on the Spectrum
Ann
Arbor, Mich.—September 24, 2009—Through
the support of a $1.85 million grant from
the National Institute of Mental Health
(NIMH), Richard Solomon, MD, is conducting
a three-year study of The Play and
Language for Autistic Youngsters
(P.L.A.Y.) Project Home Consulting model,
a parent-training program that addresses
the need for intensive early intervention
for young children on the autism spectrum.
Developed by Dr.
Solomon, P.L.A.Y. is a practical,
family-friendly application of renowned
child psychiatrist Dr. Stanley Greenspan’s
Developmental, Individual-differences,
Relationship-based (DIR) framework,
popularly known as DIR/Floortime. Through
structured monthly home visits focused on
modeling, coaching and video feedback,
consultants train parents to engage their
child with autism in ways that promote
emotional connection and communication. By
training parents to participate in their
child’s intervention, the program also
promises to be cost-effective. The
P.L.A.Y. Project costs under $4,000 per
year, in comparison with other
interventions that cost $40,000 to $60,000
per year.
Read
Complete Press Release
The
Developmental, Individual
Difference, Relationship-based (DIR/Floortime™)
Model is a developmental,
interdisciplinary framework that enables
clinicians, parents and educators to
construct a comprehensive assessment and
intervention program based on the child’s
and family’s unique developmental profile.
It enables the individual working with the
child to enter the child’s world, bring
the child into a shared world, and, from
there, interact with the child in ways
that build the foundations for social,
emotional, and intellectual development.
The profile includes understanding the
child’s emotional, social, and
intellectual level; individual differences
in motor, sensory, and language
functioning; and the existing caregiver,
child and family functioning and
interaction patterns.
Built
on years of research in developmental
psychology that underscores the importance
of early relationships and family
functioning, the DIR/Floortime Model also
integrates research contributions from
various disciplines, such as speech and
language pathology occupational therapy
social work, and marriage and family
therapy. Neuroscience research lends
further support to developmental
interventions. Early relationships and
reciprocal interactions between infants
and caregivers appear vital for the
creation of healthy brain development,
including for example wiring the
pre-frontal cortex. These diverse
contributions provide a rich structure so
that clinicians can understand the child
and family’s unique profile. This
understanding is crucial for implementing
a comprehensive assessment and
intervention program for children with
autism spectrum disorder (ASD) as well as
related special needs conditions.
Read,
print and disseminate complete
article.
by Stanley I. Greenspan, MD, T.
Berry Brazelton, MD, José Cordero, MD,
MPH, Richard Solomon, MD, MPH, FAAP,
Margaret L. Bauman, MD, FAANP, Ricki
Robinson, MD, MPH, FAAP, Stuart Shanker,
DPhil and Cecilia Breinbauer, MD, MPH
Congratulations to the American Academy
of Pediatrics (AAP). Two of their recent
clinical reports published in Pediatrics,
"Identification and Evaluation of Children
With Autism Spectrum Disorders"1 and
"Management of Children With Autism
Spectrum Disorders,"2 will enable
pediatricians to address parent concerns
sooner, facilitating the early
identification of children with autism
spectrum disorders (ASDs). As physicians
and developmentalists with decades of
accumulated experience in working with
children with developmental challenges, we
applaud and welcome these publications.
However, we would like to expand on these
reports. In this commentary we (1)
describe a broader
functional/developmental framework for
screening for ASDs, (2) provide a critique
of the current trend toward behavioral
treatments as primary intervention
strategies, and (3) present research
evidence for functional/developmental
approaches.
To read the complete article please click
here (please be aware that you
must click the link titled "Full Text
PDF" to the right of the page to
access full article)
by Richard Solomon, Jonathan Nechels,
Courtney Ferch & David Bruckman
Autism © 2007 SAGE
Publications and The National Autistic
Society Vol 11(3) 205–224
Sixty-eight children completed the 8–12
month program. Parents were encouraged to
deliver 15 hours per week of 1:1
interaction. Pre/post ratings of
videotapes by blind raters using the
Functional Emotional Assessment Scale
(FEAS) showed significant increases (p ≤
0.0001) in child subscale scores.
Translated clinically, 45.5 percent of
children made good to very good functional
developmental progress. There were no
significant differences between parents in
the FEAS subscale scores at either preor
post intervention and all parents scored
at levels suggesting they would be
effective in working with their children.
Overall satisfaction with PPHC was 90
percent. Average cost of intervention was
$2500/year. Despite important limitations,
this pilot study of The PLAY Project Home
Consulting model suggests that the model
has potential to be a cost-effective
intervention for young children with
autism.
To read the complete article please click
here.
Excerpts from Engaging Autism
Using the Floortime Approach to Help
Children Relate, Communicate, and Think
by Stanley I. Greenspan, M.D., Serena
Wieder, Ph.D. A Merloyd Lawrence Book Da
Capo Lifelong Books A Member of the
Perseus Books Group
The National Academy of Sciences (NAS), in
its report“ Educating Children with
Autism” (National Academy of Sciences,
Committee on Educational Interventions for
Children with Autism, NRC, 2001), states
that there is research support for a
number of approaches, including
DIR/Floortime and behavioral
interventions, but that there are no
proven “relationships between any
particular intervention and children’s
progress” (page 5) and “no adequate
comparisons of different comprehensive
treatments” (page 8). The report concludes
that effective interventions vary
depending on an individual child’s and
family’s needs. The NAS analysis further
indicates that behavioral interventions
are moving toward naturalistic,
spontaneous types of learning situations
that follow the child’s interests, and
note that “studies have reported that
naturalistic approaches are more effective
than traditional discrete trial at leading
to generalization of language gains to
natural contexts: (Koegel, Camarata,
Valdez Menchaca, and Koegel, 1998; McGee,
Krantz, and McClannahan, 1985).
To read the rest complete article please
click here.
By Dr. Stanley I. Greenspan & Dr.
Serena Wieder
A follow-up study of 16 children
diagnosed with an autistic spectrum
disorder (ASD) revealed that with the
DIR/Floortime approach, a subgroup of
children with ASD can become empathetic,
creative, and reflective, with healthy
peer relationships and solid academic
skills. This suggests that some children
with ASD can master the core deficits and
reach levels of development formerly
thought unattainable with a
family-oriented approach that focuses on
the building blocks of relating,
communicating, and thinking.
To read the complete article please click
here
Suggested citation: Greenspan, S.I. and
Wieder, S. (2005) Can Children with Autism
Master the Core Deficits and Become
Empathetic, Creative and Reflective? A Ten
to Fifteen Year Follow-up of a Subgroup of
Children with Autism Spectrum Disorders
(ASD) Who Received a Comprehensive
Developmental, Individual-Difference,
Relationship-Based (DIR) Approach. The
Journal of Developmental and Learning
Disorders 9.
By Gerald Mahoney, Ph.D & Frida
Perales, M.Ed.
This study compares the effects of
relationship-focused early intervention on
toddlers and preschool-age children who
were classified as having either pervasive
developmental disorders (PDDs) (N = 20) or
developmental disabilities (DDs) (N = 30).
The intervention was conducted over a
1-year period through weekly individual
parent-child sessions. It focused on
helping parents use responsive teaching
strategies to encourage their children to
acquire and use pivotal developmental
behaviors that addressed their
individualized developmental needs. Before
and after comparisons indicated
significant increases in parents’
responsiveness and children’s pivotal
behavior. Both groups of children made
significant improvements in their
cognitive, communication, and
socioemotional functioning. However,
children with PDDs made statistically
greater improvements on the developmental
measures than children with DDs. On
several developmental measures, children’s
improvements were related to increases in
both their parents’ responsiveness and
their own pivotal behavior. J Dev Behav
Pediatr 26:77–85, 2005. Index terms: early
intervention, pervasive developmental
disorders, relationship focused
intervention.
To read the complete article please click
here.
by Stanley I. Greenspan, M.D., &
Serena Wieder, Ph.D.
Charts of 200 children who were diagnosed
with autistic spectrum disorder were
reviewed. The goal of the review was to
reveal patterns in presenting symptoms,
underlying processing difficulties, early
development and response to intervention
in order to generate hypotheses for future
studies. The chart review suggests that a
number of children with autistic spectrum
diagnoses are, with an appropriate
intervention program, capable of empathy,
affective reciprocity, creative thinking,
and healthy peer relationships; that an
intervention approach that focuses on
individual differences, developmental
level, and affective interaction may be
especially promising; and that there are
different underlying processing patterns
with a difficulty in connecting affect and
sequencing capacities as a possible common
denominator. It also suggests that there
is an early marker, the difficulty in
engaging in complex purposeful gestural
communication, and that contrary to
traditional beliefs, a significant number
of children may have relatively better
functioning in the first year with a
regression in the second and third years.
This review also suggest that difficulties
with relating and intimacy are often
secondary to underlying processing
disturbances. Many children can become
quite loving and caring, thoughtful, and
creative, suggesting a need to change the
criteria for diagnosing these disorders.
To read the complete article please click
here.
Suggested citation: Greenspan, S.I. and
Wieder, S. (1997) Developmental patterns
and outcomes in infants and children with
disorders in relating and communicating: A
chart review of 200 cases of children with
autistic spectrum diagnoses. Journal of
Developmental and Learning Disorders
1:87-141.
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