Jump to breakout sessions at:
Welcome Announcements, Opening
Opening Keynote Address
Alec Pemberton, Shelley Spence, & Dr. Nancy Freeman
This 45 minute opening key note address will provide a brief history of Toronto Autism Services, the partnership of 6 agencies delivering the Ontario Autism Program (OAP) in our city. Under the leadership of Surrey Place, our community of practice includes Adventure Place, Aisling Discoveries, The Etobicoke Children’s Centre, Geneva Centre, and Kerry’s Place. This presentation will focus on the lived experience of Alec, a young adult who received IBI as a toddler, and his mother, Shelley, and their family’s journey over the past two decades.
The Program to Assist Social Thinking (PAST): Supporting social & self-regulatory skill development in children with ASD Level 1 in an alternative classroom setting.
Kara Dymond, OCT, PhD, & Karena Schneider, OCT, B.A. (Hons), B.Ed (Program to Assist Social Thinking, TCDSB Autism Team) – Toronto Catholic District School Board
The Program to Assist Social Thinking (PAST) is an alternative curriculum offered by the Toronto Catholic District School Board (TCDSB) for elementary students in grades 3-6 with a diagnosis of autism level 1 and average to above-average cognitive functioning. PAST is Tier 2 intervention offered to small groups of students on a withdrawal basis, once a week for up to three years, to address their social and self-regulatory needs. The PAST Team works collaboratively with general classroom teachers, parents, and students to develop and track individualized goals alongside the delivered curriculum. Grounded in the Social Thinking methodology developed by Michelle Garcia Winner and Pamela Crooke, PAST focuses on the enhancement of perspective-taking abilities of students. Skill areas addressed within this context include understanding emotions of self and others, communication, cooperative play, development of relationships, understanding of diagnosis, and self-advocacy. It is currently available at 7 program locations in the TCDSB and is delivered by a teacher and a support staff.
This session, facilitated by PAST teacher-consultants from the TCDSB Autism Team, will present an overview of PAST and PAST teacher perspectives on program delivery. Preliminary results from a study by York University on student and parent experiences of PAST will be shared. Presenters will also incorporate qualitative feedback from collaborating general classroom teachers, families, and students who have participated in this intervention.
Prompting and restraints: Ethical considerations Ethics CEU
Alicia Antunes M.ADS., BCBA. Adventure Place
When prompting procedures are not prompts? Physical prompts are a strategy used in teaching skills. Research has demonstrated that using prompts can teach new skills as well as reduce problem behaviours. Martin and Pear (2003) describe physical prompts as a teacher touching a learner to guide them appropriately to learn a behaviour. In teaching skills sometimes escape-extinction, follow through or response blocking are utilized which require the use of more intrusive physical prompts. During these escape-extinction situations, the physical prompts can be more of a restraint or serve as a punisher (Iwata, Pace, Kalsher, Cowdery & Cataldo 1990). Vollmer et al (2001) states that restraint involves physically holding for a brief period of time to interrupt and intervene with severe problem behavior p.104-105. In the United States, the Department of Education, Office of Civil Rights (OCR) Civil Rights Data Collection (CRDC) define a restraint as a personal restriction that immobilizes or reduces the ability of a student to move his or her torso, arms, legs, or head freely. The Ontario College of nurses and those working with youths and the elderly define a physical restraint as physically limiting a patient’s movement. If physically intrusive methods that restrict body movements are being used, when is it a prompt and when is it a restraint? Morales and Duphorne (1995) ascertained that least restrictive measures be used and staff need to have knowledge on a range of treatment strategies. As behavior analyst, we need to ensure that we are following best practice and our ethical standards. Are there hands-off approaches that can be utilized during escape-extinction, non-compliance or follow-though situations? Participants can expect to become more familiar with ethical concerns regarding use of restraints. Understand the definitions of prompts and restraints and review a variety of alternatives to procedures that utilize more intrusive physical prompting as demonstrated in recent research.
The importance of respite: Why families need it and why/how practitioners should recommend it
Lisa Cohen, Tina Gandhi B.A., M.S.W., R.S.W. Surrey Place Centre
This presentation will outline the importance of respite for families who have children, youth and young adults with special needs living at home with them, within the community. It will include the importance and types of respite available to families, involve a conversation around tactics for introducing the conversation about respite to families, tips for reinforcing the message of the importance of respite to families and idea for problem solving around common parent concerns. This presentation will then take time to explain the current respite funding options for families, define the role of respiteservices.com and introduce the CHAP program and working with the families to complete the intake with the CHAP facilitator. The presentation will also highlight the various respite options AND respite providers available within Toronto. The goal is for staff to walk away with a stronger understanding of what respite is, what the different respite options are and some tools for introducing this very important resource to a family and a better understanding of why respite support is so important for every family to have. Practitioners will walk away from this with new skills for supporting the family unit as a whole and strategies for having those difficult conversations with families.
Teaching general mands for idiosyncratic events within a school-based setting
Alex Hamilton, Adriana Marini, Paul Szikszai Surrey Place
Criteria to receive an ASD diagnosis includes displaying restricted or repetitive patterns of behavior, interests, or activities. While the literature base regarding repetitive motor movements and speech continues to grow, less research is available on the assessment and treatment of inflexible adherence to routines and ritualized patterns of behavior. Although many instances of these behaviour patterns are benign and may have minimal impact on functioning, for some individuals they can present at a level requiring treatment. Attempts at treatment can be hindered due to the idiosyncratic nature of rituals, a change in the topography of ritualistic behaviours, and an inability to functionally communicate motivation to engage in them. This symposium will present two case studies displaying the assessment and treatment of severe problem behaviour occasioned by the interruption of multiple ‘ritualistic’ patterns of behaviour via teaching a general mand to engage in these chains.
Treating food refusal using escape extinction and blending treatment CEU
Salwa Maarouf, M.ADS, BCBA Surrey Place; Janet Mann, Aisling Discoveries; Alexandra Kolpakow, M.P. Ed. Aisling Discoveries
A limited food repertoire, refusing to eat, or inappropriate mealtime behaviours can be significant concerns for parents of children with autism. This presentation will summarize a treatment plan using escape extinction to target severe food refusal by a 6-year-old child with autism. Food acceptance increased and problem behaviour decreased during food presentations, when compared to baseline. Parents were trained to implement the procedure at home using Behavioural Skills Training and generalization was successful to the home environment. In addition, a blending treatment was implemented, and consisted of mixing preferred foods (i.e., newly accepted foods) with non-preferred foods (i.e., novel home-made pureed foods) in various ratios (e.g., 90% preferred food with 10% non-preferred food). Preliminary results show that acceptance increased for home-made pureed food following implementation of the blending treatment.
(On Your Own)
1:00 – 2:00
Naturalistic developmental behavioral interventions: Evidence, insights, and examples from ESDM and the Social ABCs
1. Social ABC’s
Dr. Jessica Brian Ph.D., C.Psych.- Co-lead, Autism Research Centre; Holland Bloorview and University of Toronto
2. Early Start Denver Model – ESDM
Pam Lawrynowycz MA, BCBA, Clinical Lead, AlphaBee
Lisa Kota, M.ADS., BCBA Clinical Supervisor, AlphaBee
Naturalistic Developmental Behavioral Interventions (NDBIs; Schriebman, 2015) have gained momentum in autism intervention over the past several years. NDBI approaches use behavioral principles, such as three-part contingencies, measurement of treatment fidelity and child progress, and prompting, with an overlay of developmental science. This presentation will describe the key elements of NDBI approaches and the evidence supporting their efficacy. We will highlight how such approaches are applied in clinical settings, with a focus on two prominent NDBI models, the Early Start Denver Model and the Social ABCs.
Assessing the assessment of assessment: An interactive presentation of a study evaluating the validity and inter-rater reliability of the open-ended Functional Assessment Interview for severe behaviours CEU
Shany Biran, iMBA, M.ADS., BCBA Surrey Place; Kelly Ubdegrove MA., BCBA Surrey Place; Valdeep Saini, PhD, BCBA-D, Brock University; Rebecca Duncan, MA, BCBA, Private Practice
Recently, the use of open-ended interviews has become more commonly adopted in applied clinical practice, despite no studies evaluating the psychometric properties of such assessments. In the present study, we evaluated the interrater reliability and concurrent validity of an open-ended functional assessment interview. We compared the results of two open-ended indirect assessments conducted with a common caregiver and subsequently conducted functional analyses in attempt to validate hypotheses generated from the interviews. Interrater agreement for the open-ended interviews was higher than previous research on closed-ended interviews (75%), however, concurrent validity with functional analysis was relatively poor (50%). We discuss these findings in the context of assessment and treatment for severe behavior disorders as well as best practice methods during functional behavior assessment.
Differential reinforcement to reduce screaming in a child with autism
Rebecca Logan M.PEd., BCBA; Lisa Giewercer, BCBA; Angelica Arnott; Renee Bonneau; Carmen Mau; Lauren McCarthy; Jessica Ridding; Peggy Sam; Victoria Znajewski Aisling Discoveries
A differential reinforcement of other behaviour (DRO) protocol was implemented to reduce screaming vocalizations. Screaming was defined as the “learner emitting any vocalization above indoor speaking volume (does not include screaming/yelling that occurs in the gym or outside)”. Screaming was identified for reduction as it interfered with programming, communication, and interactions with others. The participant was a primary school-aged female receiving full-time intensive behavioural intervention. The program was implemented by her full-time therapists and monitored by both the supervising therapist and clinical supervisor. Baseline data indicated frequent screaming, occurring on average every 7.5 minutes. A DRO was implemented using a two-sided card (red and green) to indicate availability of reinforcement for using an indoor voice. Reinforcement was provided on a fixed interval schedule in the absence of screams. Frequency of screams was the dependent variable. The data demonstrated a significant decrease in screaming within clinical settings. Generalization to school was also observed. Implications and future considerations will be discussed.
Using differential reinforcement of alternative behaviour with contingent escape to increase compliance during circle time
Sian Howard M. ADS., Geneva Centre for Autism
Research supports the use of differential reinforcement of alternative behaviours (DRA) procedures to decrease maladaptive behaviours and increase socially appropriate behaviours in individuals with Autism Spectrum Disorder (ASD). A common criticism of differential reinforcement procedures is that they do not address the function of the problem behaviour (Kahng, Boscoe, & Byrne, 2003). The use of escape contingencies has been found to be an effective addition to DRA interventions for escape-maintained behaviours (Kahng et al., 2003; Piazza, Moes, & Fisher, 1996). This study evaluates the effects of a DRA plus extinction procedure on decreasing escape-maintained maladaptive behaviour and increasing appropriate sitting behavior exhibited by a 5.5 year old boy with ASD during circle time. The intervention employed a token economy and an escape contingency on a fixed interval reinforcement schedule to increase the duration of time spent in group and decrease instances of aggression and self-injury.
Supporting families with complex needs: The role of social work and counselling on an inter-disciplinary team in TRE-ADD
Tina Gandhi B.A., M.S.W., R.S.W. Surrey Place
The role of the family and counselling issues in the daily lives of children with autism who exhibit highly behavioural needs in the home will be discussed. This presentation will outline the role of a Social Worker as a key member of the treatment team and various types of counselling and strategies that families can be offered, based on a systemic assessment of family needs, in managing their significant levels of stress. This will include an overview of some specific approaches such as CBT and ACT to improve parent resilience and coping.”
Small group instruction for children with autism: Promoting observational learning opportunities that leads to skill development in social, on task and communication skills. CEU
Alicia Antunes M.ADS., BCBA; Ashka Raval; Donnette Goldschmid Adventure Place
Group instruction has advantages as it can promote observational learning and generalization. Polloway, Cronin, and Patton (1986), in a review of group instruction, stated that instruction should be appropriate to the individual and organized in an efficient fashion to facilitate maximum learning by each student. Small group teaching fosters the continuity of behavior change across settings (e.g., school, community settings, and work sites) in that students gain practice in performing in groups. Students who have group attending and performance skills also have a history of involvement in teaching processes that promote highly engaged, interactive, and socialized behaviors with adults and peers (Kamps et al. 1991, p.2). Kern and Clemens (2007) illustrated that praise need not be directly delivered to a student to be effective. It has a vicarious effect, in that students who observe others being praised for a particular behavior are more likely to model that behavior. We will show that children who are working in groups start to engage in observational learning behaviours; without being directly prompted and reinforced for behaviours children began to learn from their peers. We will show how group instruction has led to formations of peer relationships, copying work tasks from peers and increased social play. Our presentation will provide you with an explanation of observational learning, examples of how to set up group targets, and ways to facilitate learning opportunities for students across various domains.
2:30 – 3:30
Turning the LAMP on language CEU
Kevin Cauley M.Ed., BCBA; Jianne Baban; Judy Neal; Sylvia Tse; Angela Wu Adventure Place
According to the National Institute of Mental Health (2019), Autism Spectrum Disorder (ASD) is a developmental disorder that affects both communication and behavior. Mild to severe deficits are often observed in communication and social interaction, interests and repetitive behaviors, and day to day functional actions. More specifically, Noens et al. (2006) has found that approximately a third to half of all children diagnosed with ASD do not reach a level of vocal speech sufficient to meet their daily communication needs. In many cases, these children are candidates for augmentative and alternative forms of communication (AAC). AAC systems have been established as an evidence-based practice for individuals with ASD to promote the development of functional communication skills (Zeina, R., Al-Ayadhi, L., & Bashir, S., 2015). However, in many cases, the primary role of these systems is to supplement and replace challenging behaviors that are related to getting needs and wants met. This presentation will highlight the combination of a unique AAC system, Language Acquisition through Motor Planning, and a Direct Instruction program to go beyond functional communication and towards using language as a tool to describe the world, think and solve problems for a young non-verbal child with autism.
Addressing undifferentiated results in functional analyses CEU
Morgan Ross; Suzanne Robertson Surrey Place
Many clients with autism and developmental delays engage in severe problem behaviour ranging from aggression to self-injurious behaviour that prevents them from participating in common daily activities. It is considered best practice to run a Functional Analysis (FA)in order to determine function of behaviour prior to developing an intervention, however often FAs end in undifferentiated results. In this presentation we will discuss a variety of strategies to address barriers to running FA’s as well as modifications that can be used in order to achieve differentiated results to create effective interventions.
The Individualized Funding Library project
Barry Isaacs; Frances MacNeil; Maria Huijbregts; Terri Hewitt; Amelia McIntyre; Judy Verseghy; Shay Johnson; Megan Abou Chacra; Michael Demi; Christina Xamin; Stacie Daponte Surrey Place
In many jurisdictions, governments are providing Individualized Funding (IF) to people with developmental disabilities. In Ontario this is often referred to as Direct Funding. This money is designed to help people and their family and/or support networks purchase or develop supports and services. It is meant to be flexible so that supports can be tailored to the individual.
There are many sources of Individualized (Direct) Funding in Ontario. The most common sources are Special Services at Home for children and youth, Passport Program for adults with developmental disabilities and Direct Funding for Autism Services.
Previous research has shown that accessing and using IF can be challenging. The newly developed IF Library (expected launch June 1, 2019) is a website designed to help people use their IF more effectively. The website provides information and resources on:
- What IF is, how it can be accessed and used
- Hiring and maintaining staff (being an employer)
- Managing budgets
- Developing supports
- Available community services
A 6-stage development process was used:
- A provincial survey to gather information on resources and good practices relevant to IF (293 responses).
- 64 follow-up interviews to gain further details.
- Focus groups across the province with self-advocates, family/caregivers and agency staff to discuss the information gathered and explore possible functions and structure for the website.
- Self-advocate and family/agency advisory groups to guide final content and structure, and sustainability plans for the website.
- Website development, user testing and launch.
- Website maintenance and evaluation.
The presentation will provide details on the development process and a demonstration of how to use the website. Next steps and best approaches to ensure ongoing sustainability and relevance of the website will be explored with the audience.
Establishing question discrimination skills for learners with Autism CEU
Pam Lawrynowycz MA, BCBA, Clinical Lead, AlphaBee; Sonia Stellato M.ADS., BCBA, Senior Therapist, AlphaBee
Generalized WH question discrimination is a behavioural cusp essential for comprehension, recall and conversation. Many children with autism have difficulty answering WH questions despite receiving intensive teaching. They often remain unable to answer novel questions involving established tacts: For example, when shown an apple and asked, “What colour is it?” the child may answer “Apple” and have difficulty answering various questions about a topic when questions are interspersed.
This presentation will review procedures developed by Dr. Francesca degli Espinosa to develop generalized responding to discriminating WH questions. It will illustrate procedures to remediate such discriminative failures and identify pre-requisites to teaching question discrimination.
Dr. degli Espinosa’s teaching procedures increase intraverbal control between elements within phrases and recreate contingencies and sources of stimulus control that occur in the natural environment so that children can answer novel questions.
AlphaBee has been implementing these procedures for over 3 years with great success with many learners, and is excited to share program samples and video illustrations of program implementation!
Participants will leave with examples of specific programs for teaching both item and event generalized question discrimination.
Learning Objectives for Participants:
• Participants will identify beginner and intermediate tact objectives
• Participants will describe what an Autoclitic is and specific autoclitic frames which can be used to teach WH questions
• Participants will describe the procedure for teaching discriminations using autoclitic frames
Re-Imaging the assessment and treatment of feeding challenges in children with Autism Spectrum Disorder
Dr. Sharon Smile, Clinical Study Investigator, Developmental Pediatrician Holland Bloorview Kids Rehabilitation Hospital
The management of feeding challenges in Autism Spectrum Disorder can be complex. Behavioural interventions and sensory based interventions continue to be the most frequently recommend modality of therapy to address feeding challenges in children with Autism Spectrum Disorder with variable effectiveness. Given the challenges and gaps in accessing specialized evidenced based practices the presentation “Re-Imaging the assessment and treatment of feeding challenges in children with Autism Spectrum Disorder,” presents an interdisciplinary conceptual framework, MOBSE approach © (medical, oro-motor, behavioural, sensory and environmental factors) to assess and develop a personalized goal directed intervention plan to assess and treat food selectivity in Autism Spectrum Disorder.
Supporting mental health in youth with Autism
Jonathan Weiss Phd, York University
People with autism often struggle with managing anxiety, anger, or depression, with high rates cited from childhood and adulthood. Increasingly, cognitive behaviour therapy and mindfulness-based therapy are being used to help address these difficulties. These treatments are best provided within a context of promoting thriving and positive growth more generally in people across the spectrum. The current workshop will review the state of the evidence and best practice in understanding mental health problems, useful ways of conceptualizing mental health, and ways to adapt existing evidence-based psychosocial interventions for people on the spectrum.