Boston University. University Professors Program Senior theses. / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-02

The purpose of the current study was to evaluate the effectiveness of whether Behavioral Skills Training (BST) was effective in teaching PEAK-DT to parents of children with Autism Spectrum Disorder (ASD). Along with, if parent implementation of PEAK was effective in increasing the children’s PEAK scores. Three parents and their child with autism were participants in the current study using the PEAK Relational Training System-Direct Training module (PEAK-DT). The procedure first required the parents to read information on how to implement the programs found in the introduction of the PEAK-DT module. Following this step, parents observed their child’s therapy sessions conducted at an ABA clinic by student therapists. Next, the parents were instructed to implement three programs and received feedback from the child’s therapist. Implementation fidelity was collected based on the parent performance and child progress was recorded based on percent correct responding within the actual program. Each parent was able to successfully implement programs within the PEAK-DT module within their child’s therapy sessions and the children were accurately responding and two of the three children had increases in skill acquisition. The results of the present study suggest that training parents using a BST model to implement PEAK-DT was effective in teaching children with autism.

CASE: A 6-year-old boy with a diagnosis of autism spectrum disorder (ASD) presented to primary care for a newpatient, transfer-of-care evaluation. At the initial encounter, the patient used a maximum of 60 words and was receiving speech and language therapy (SLT) through school. Family history was positive for seizures in the father and paternal grandfather as well as ASD in an older brother. Referrals to genetics, private SLT, and an autism specialist were offered, although the latter was declined by family. The subsequent genetics evaluation resulted in discovery of a small gain on chromosome 1q42.2 and associated partial duplication of the DISC1 gene. The assay could not determine the exact clinical significance of the abnormality, but similarly sized and located abnormalities involving the DISC1 gene are reported in some patients with ASD and developmental delay. During a follow-up pediatrics appointment, the father expressed his wish for further evaluation of causes of autism spectrum disorder (ASD) and requested an electroencephalography (EEG) evaluation. The family concomitantly reported slow improvement in speech with therapy, the use of up to 200 words, and the ability to count to 10. The primary care physician reiterated that EEG and imaging studies are not indicated for an isolated ASD diagnosis with no supporting history or physical examination indications. The clinician discussed ASD-recommended therapies with the family. Neurology referral was made per parental request. The patient subsequently presented to neurology at the age of 7 years. The parents reiterated during the initial neurologic developmental history that the patient had shown some improvement with speech and language therapy in the past 18 months, knew as many as 200 to 300 words, and could put some words together into simple sentences. Gross and fine motor development were felt to be within the normal range for age. The parents also reported some scripting, and mild echolalia was noted on examination. Notably, there was no history of language regression. Apart from language delay, the neurologic examination was otherwise normal at initial evaluation. Given this clinical picture, ASD treatment options were again discussed. Despite education, parents continued to request for EEG evaluation as a workup for the etiology of the patient's ASD. Electroencephalography was ultimately ordered owing to the strong and repeated paternal request despite denial of any seizure-like episodes in the patient. EEG unexpectedly showed extremely frequent, almost constant focal electrographic seizures arising from the T3/T5 electrodes in the speech area of the left temporal lobe, prompting the initiation of oxcarbazepine maintenance therapy. Because of the noted abnormalities on EEG, magnetic resonance imaging (MRI) was obtained. Mild abnormalities were noted on MRI study including possible minimal inferior cerebellar vermian hypoplasia, mildly prominent bodies of the lateral ventricles, and nonspecific, nonenhancing punctate T2 hyperintensities in the subcortical white matter. These findings were not felt to be clinically relevant to the patient's presentation or seizure evaluation. No repeat imaging was ordered. Hindsight is always 20/20. As a clinician evaluating the patient initially, would you have pursued further workup sooner?

Boston University. University Professors Program Senior theses. / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-02

In this study, a promising new intervention implemented for adults with aphasia due to stroke, Multimodal Communication Treatment, was modified for its use with one child with autism spectrum disorder to identify if the child could learn and communicate new words through learning multiple modalities. Data was collected on the child’s communicative output as well to assess the frequency and types of his communication attempts. The child presented with challenging behaviors throughout the intervention period, and its potential impact on the execution of the intervention was studied. The study found that Multimodal Communication Treatment was not an effective intervention approach for this child. The majority of his output was not communicative in nature and challenging behaviors impacted the effectiveness of implementing the approach. Further research is needed to identify whether Multimodal Communication Treatment could be an effective intervention for children with more communicative intent and increased attention. / text

Little is known about the experience of families of children with autism spectrum disorder (ASD) in community settings. The purpose of this research is to learn about the family experience when visiting a science museum, focusing on the motivations of the family, environmental features of the museum, strategies used by family members, and definitions of a successful visit to the museum. Data were collected through semistructured interviews and observations of four families that included a child with ASD. The families in this study appear to want the same community experiences for their children as families with typically developing children. Both the motivations for the visit and features of the environment appeared to influence the family’s approach and strategies they employed for a successful visit. Strategies included those completed before the visit (visitor planning strategies), as well as during the visit (strategies at the museum). The strategies enabled families to enjoy and experience success within the museum environment. The information learned in this study may help families with a child with ASD prepare for and use features of the museum to enjoy successful museum visits. Recommendations are provided for museums seeking to create inclusive opportunities for all families.

Since the passing of the Education Act (1989) special education policies and documents have promoted partnership as a key component of establishing relevant and inclusive school practices. Professionals and families have been encouraged to work together to resolve issues for children with disabilities. However, little information is available to families and professionals about how to negotiate and achieve authentic partnerships. This thesis makes an important contribution to current knowledge about partnerships by investigating how a group of people (a parent, teacher, paraprofessional and teacher/researcher) make sense of working together to support the inclusion of a student with ASD in his regular school. It is hoped that our descriptions of how we have worked together may help other professionals and families in similar situations. In saying this, the lessons we have learned are ours and are peculiar to the context in which we worked. In New Zealand partnership between professionals and families of children with disabilities is usually enacted through the Individual Education Plan (IEP) process. This study utilises an alternative partnership model, the Quality Learning Circle (QLC). The participants’ learning journeys are described and the experience of partnership for the participants is discussed. Data are drawn from a range of sources to identify those strategies that support, and barriers that hinder, the development of authentic partnerships. Findings identify those conditions that were essential for the partnership in this study to work effectively. Within this research I contrast the key dimensions of the IEP and QLC, showing the IEP process to be wanting. I suggest a partnership model that embraces a dual focus on both the student and those supporting him/her is a more effective tool for supporting the inclusion of children with disabilities. It is argued that there is a lack of recognition in current funding criteria for the difference an effective partnership can make in supporting the inclusion of students ii with severe behavioural challenges. Consideration needs to be given to the costs and issues of ineffective partnerships, with a particular focus on current Ministry of Education practices.

Objectives: 1) to determine if children and adolescents with autism spectrum disorder (ASD) encounter difficulties accessing dental, 2) to identify barriers that diminish access to dental care for this population. Methods: This descriptive study is based on a web-survey conducted at the Geneva Centre for Autism in Toronto between November 2008 and March 2009. Forty-nine multiple choice questions including open-ended fields were developed. Parents of children with ASD (ages 5–18) completed the survey. Results: The majority of participants visited a dentist regularly (71%) and had private dental insurance (64%). Parents/caregivers were more likely to have difficulties finding a dentist as unmarried parents (OR=3.7, P=0.075) or when their level of education was high school/less (OR=10.4, P=0.043). Conclusions: The majority of children/adolescents with ASD had access to dental care. Difficulties accessing dental care were related to family structure, parents’ education and their perception of dentists’ knowledge of ASD.

Objectives: 1) to determine if children and adolescents with autism spectrum disorder (ASD) encounter difficulties accessing dental, 2) to identify barriers that diminish access to dental care for this population. Methods: This descriptive study is based on a web-survey conducted at the Geneva Centre for Autism in Toronto between November 2008 and March 2009. Forty-nine multiple choice questions including open-ended fields were developed. Parents of children with ASD (ages 5–18) completed the survey. Results: The majority of participants visited a dentist regularly (71%) and had private dental insurance (64%). Parents/caregivers were more likely to have difficulties finding a dentist as unmarried parents (OR=3.7, P=0.075) or when their level of education was high school/less (OR=10.4, P=0.043). Conclusions: The majority of children/adolescents with ASD had access to dental care. Difficulties accessing dental care were related to family structure, parents’ education and their perception of dentists’ knowledge of ASD.

Bright Mosaic is a 30-minute documentary about a comprehensive autism center for children with an organic and unconventional approach. The Bright Mosaic Autism Therapy Center's exceptional curriculum consists of a mix of Montessori practices, natural sciences, applied behavior analysis, occupational therapy, speech therapy, physical therapy, play therapy, music therapy, sensory integration, daily life skills and art. Bright Mosaic mixes observational and participatory styles in an effort to portray an exceptionally skilled and passionate team who fights a tough daily battle to prepare their children for the life ahead of them.