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| AUTISM HOME |
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| Q&A with Dr. Travis Thompson (originally posted April 2007) |
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 Travis Thompson, Ph.D., is Professor of the Autism Program of the Department of Pediatrics at the University of Minnesota School of Medicine; a faculty affiliate of the University of Minnesota's Center on Neurobehavioral Development; and he serves as Supervising Psychologist for the Minnesota Early Autism Project, a community-based treatment program for young children with autism spectrum disorders (ASD). Dr. Thompson has been involved in research, teaching, and clinical activities related to developmental disabilities and related topics for many years. He has seven grandchildren, including a grandson with ASD. |
Q: What is the one thing you would say to a parent who has just found out her child has autism? A: I’d want to give them a hug, but that’s not very professional I suppose. I would find it difficult to say just one thing. “He’s your child who happens to have autism, but he’s first and foremost your child who needs your love and support.” Second, “You’re not in this alone. There are lots of people who will help if you ask.” Third, “Enroll her or him an early intervention program that focuses on communication and social skills, sooner than later.” Q: What inspired you to work with kids with autism? A: When I first began working with people with developmental disabilities in institutions in 1968, usually the lowest of the low functioning people with the most severe behavior challenges were people with autism. They were locked up, restrained and given antipsychotic medications to sedate them. They were often treated harshly by staff. No one took the time to figure out what made them tick, and how to overcome the profound disadvantages they experienced. I found their uneven skill profiles fascinating. Having had some success working with adults with autism, I began working with adolescents, them elementary school kids, and finally preschoolers, with the goal of preventing the most disabling aspects of the disability for many kids. I eventually began to be able to see the world through their eyes, which I believe is important in being effective with kids with autism. Having empathy for what they are experiencing is very helpful. When we learned that our grandson Michael had autism, that provided an additional reason to better understand this complex disability. Today, I mostly see Michael as a cute kid who has a lot in common with his brother and sister, though he's a bit quirky at times.
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Don't miss these books by Dr. Thompson     Learn more about Dr. Thompson's work at http:www.travisi-thompson.net. |
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Q: What do you see as the next breakthrough for autism? A: We are going to do a better job of identifying subtypes of autism, some of which may be treatable with a combination of medications and social/educational interventions, and others with largely behavioral/educational interventions. The latter interventions will eventually become more targeted—much as we focus on specific muscle, tendon, and ligaments in physical therapy, we will target behavioral and educational interventions to overcome specific cognitive, emotional, and neural processing deficits. Q: What book have you read lately that you are excited about, and to whom would you recommend it? A: Again I have trouble with ones. Roy Richard Grinker's Unstrange Mind is a wonderful book, and he writes gracefully to boot. Grinker's book is a good read for anyone, but professionals who work with children with autism should definitely read it. I recently re-read C. P. Snows The Two Cultures, which is based on lectures he delivered at Cambridge in 1959 as the famous Rede Lectures. He was the first modern writer to capture the essence of the conflict between the sciences and the humanities and arts, which is constantly at the back of my mind when I write. Snow's little book should be required reading for our presidential candidates, and anyone who struggles with these yin and yang conflicts will find it interesting reading. Q: What is the greatest obstacle you have overcome in your work? A: Implementing practices that are best for youngsters with autism depends on support and cooperation from administrative structures and systems that are often guided by other priorities, such as economic and political considerations. In my clinical role, I find it intolerable to first explain to parents of a child with autism what types of services she or he needs, such as intensive early behavior therapy, and then in the next breath tell them it may not be available because their insurance won't pay for it or because there is no one in their school district who is trained to implement those procedures. What makes this doubly difficult, is that those making policy decisions that determine which services will be provided or reimbursed for children with autism don't seem to grasp the notion that there is a critical window of opportunity for each child between 2 and 6 or 7 years of age that can determine the course of the rest of their life. Q: What is the most rewarding experience you've had in working with a child with autism? A: How about two experiences? When our grandson Michael, his mom, sister, and brother came to stay with us for a while when they were relocating and looking for an apartment, he had severe autism. He had nearly no functional speech, engaged in nearly constant repetitive non-functional activities, exhibited no eye contact and little social interest, and had tantrums several times daily. Over the next couple of months, my wife, Anneke, who is a retired special education teacher (who started one of the first autism public school programs in Minnesota), and I used an entirely naturalistic (i.e., incidental) teaching approach to help Michael develop speech and social participation in daily family life. He learned very quickly, especially if we provided choices whenever possible. His stereotypies dropped dramatically and his tantrums virtually stopped. Over the course of the school year, he progressed sufficiently to be placed in a regular education kindergarten. Another example is in Straight Talk on Autism. Kammy Kramer, mother of Elliott, tells the wonderful story of our therapy team working with Elliott and his family. Elliott was trying to hurt his little brother many times daily, and exhibited very little speech. He was very hyperactive, climbed on countertops and furniture, and seemed to have very little interest in adults. Sibling rivalry was in high gear, and he had no speech with which to make his wishes known. He was also very physical, and enjoyed horseback rides and roughhousing, but he had few opportunities for that. We devised an intervention plan focusing on communication and positive social interactions with his brother, and rambunctious physical play as a reinforcer. After a couple of months, Elliott's aggression had nearly stopped and he was speaking in short phrases to make his wants known. I visited the Kramer home to see how things were progressing. As I sat in the kitchen talking with Kammy, the doorbell rang, which meant our therapists had arrived. Elliott ran through the house, yanked open the door, thrust his hands in the air at Bill, out clinical supervisor, and looked him square in the face and shouted, "More up!" Last Fall Elliott began attending a regular education kindergarten. |
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From the Ask the Expert page featuring answers* by Dr. Travis Thompson Q: What are some strategies for a child who headbangs? I am a principal and have a second grader who has gone so far as to cause a concussion. A helmet is the only intervention tried to this point. A: Children with autism and related developmental disabilities most commonly head-bang for several reasons:
(1) escape from demands
(2) escape from alarming situations
(3) interruption of a preferred ritual activity, as a means of forcing adults to allow them to resume the activity
(4) for attention, or
(5) as a form of self-stimulation, sometimes involving neurochemical self-stimulation caused by pain-induced chemical changes.
Which intervention strategy one uses depends on the reasons for head-banging. Children who are non-verbal and who have very few skills are most prone to head-bang. For them the preferred intervention is usually communication training plus teaching adaptive skills. If the child also has visual or auditory disabilities (e.g., deaf or blind) that greatly increases risk of head-banging. Children with chronic recurring pain are also more prone to head-banging, in which case the cause of the pain should be treated. The child should first be evaluated by a pediatrician experienced with autism to rule out possible physical causes. Second, a skilled behavior analyst should be able to conduct a FACTS (Functional Assessment for Teachers and Staff). This will identify possible setting events, like sleep problems, triggers, and consequences that may be maintaining head-banging. It will also identify specific situations that are trouble spots that can be the focus of more focused intervention. Your best bet is to work closely with your SLP and school psychologist trained in Functional Behavioral Assessment. |
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A: Meltdowns by children with autism occur for many reasons, most often in response to a request by parents or teachers, interruption of a highly preferred activity, denial of a request to do something that caregivers deem inappropriate, or at times in response to a disturbing or alarming situation. They can be aggravated by poor sleep or other health problems. The solution depends on what is precipitating a meltdown. |
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*Please note that any information provided is for educational purposes only and is not intended to be a substitute for medical or professional advice or care. Opinions do not necessarily reflect the views of Brookes Publishing, and links or references to third-party materials are provided for convenience only and no endorsement is implied. |
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