Both Maternal and Paternal Age Linked to Autism

Older maternal and paternal age are jointly associated with having a child with autism, according to a recently published study led by researchers at The University of Texas Health Science Center at Houston (UTHealth).

The researchers compared 68 age- and sex-matched, case-control pairs from their research in Jamaica, where UTHealth has been studying autism in collaboration with The University of the West Indies, Mona Campus, Kingston, Jamaica.

"This should put to rest discrepancies in previous studies showing that just maternal age or just paternal age are linked to having a child with autism," said Mohammad Hossein Rahbar, Ph.D., principal investigator and professor of epidemiology and biostatistics at The University of Texas School of Public Health, part of UTHealth.

"Our results revealed that the age of the father and the mother are jointly associated with autism in their children," said Rahbar, who is also director of the Biostatistics, Epidemiology and Research Design (BERD) component of the Center for Clinical and Translational Sciences (CCTS) at UTHealth.

In the study, researchers found that mothers who had children with autism were on average 6.5 years older than women who did not have a child with autism. The corresponding age difference for fathers was 5.9 years.

In previous studies, Rahbar said that because of the statistical models used, it was hard to assess both maternal and fraternal age as joint risk factors, a problem called multicollinearity. He was able to use more complex statistical models to avoid the problem.

Autism Spectrum Disorders (ASDs) are complex, neurodevelopmental and behavioral disorders characterized by impairments in social interaction and communication and repetitive, sometimes obsessive, behaviors. According to the Centers for Disease Control and Prevention (CDC), a conservative estimate is that one in every 100 children has an ASD.

The research was published this month in the Journal of Autism and Developmental Disorders. Data for the study was collected at the UWI and utilized an existing database established by co-author Maureen Samms-Vaughan, M.D., Ph.D., professor of child health at UWI and principal investigator of the UWI subcontract. Funding for the research is provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Institutes of Health Fogarty International Center (NIH/FIC). Additional support came from the CCTS, which is mostly funded by the NIH National Center for Research Resource (NCRR) Centers for Clinical and Translational Sciences.

Co-authors from UTHealth are Katherine A. Loveland, Ph.D.; Eric Boerwinkle, Ph.D.; Deborah A. Pearson, PhD.; Jan Bressler, Ph.D.; Megan L. Grove-Gaona; Zhongxue Chen; Manouchehr Ardjomand-Hessabi; and Kari Bloom. Co-authors from UWI are Sydonnie Shakespeare-Pellington and Compton Beecher.

(Source: sciencedaily.com)

Subacute/Long Term Care Council Meeting

Not too late to sign up!!!

Integrating Rehab Software and Electronic Medical Records for Rehab Success.
With mandates to establish electronic medical records impacting all long term care facilities, rehab managers are being challenged to identify rehabilitation software which can be integrated into the facility’s selected EMR system.  Rehabilitation software provides managers with a             sophisticated management tool which tracks reimbursement data and measures revenue generating trends while providing treating therapists with a powerful  documentation tool. This session provides a demonstration of the power of Cassamba, a leading software provider who is currently working on integrating their software with the most widely used electronic medical records systems. A Cassamba software representative will present an overview of its management and documentation functionality, followed by a group discussion.

Jane Moffet, RN is the Vice President, Marketing and Customer Relations at Cassamba. Jane has 20+ years of experience in the Acute and Long Term Care settings. Throughout her career, Jane has helped healthcare organizations design and apply technological  solutions to address critical needs and challenges. Today, Jane leverages these strengths in support to current and prospective customers and selects and deploys solutions that add real value to organizations.

Thursday, March 15th, 9:30AM—12:00PM, Adria Hotel & Conference Center
221-17 Northern Boulevard, Bayside, NY 11361

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App Thursday: Rethinking Testing in the Age of the iPad

In the 3,200-student East Haven schools in Connecticut, elementary teachers did their initial student reading assessments a bit differently this school year.

Instead of using paper and pencil to jot down observations about each of their students and then collecting and analyzing those notes by hand, each teacher used an iPad to collect the information and send it to a centralized database through software from the New York City-based ed-tech company Wireless Generation.

"One of our primary goals was to be able to develop a system that would bring a lot of the data into one place," says Taylor Auger, a technology-integration teacher in the district who helped incorporate use of the iPads into classrooms. "Previously, the data was processed by hand, and it wasn't really being put to use effectively. I'm all for data, but that data has to drive instruction."

Moving assessments onto mobile devices may open the door to quicker feedback for students and teachers as well as richer data, but without proper management of the devices and a strong infrastructure to support them, integrating the devices can be a challenge.

"It's great to have the technology," says Erica Forti, the district's assistant superintendent for curriculum and instruction, "but once it's purchased, there is a management piece involved."

Leaders in the East Haven district decided to buy 210 iPads when the lease for desktop computers in the elementary schools' computer labs was up. Instead of replacing those computers, they decided to explore mobile technology.

"We liked the idea of having mobile computing devices, since most of the technology was fixed," or stationary, says Forti. "It opened up the doors for different types of teaching and learning."
In addition, having the data collected on the iPads allowed the information to be easily shared with parents during conferences, Forti says.

Maintaining that one-teacher-to-one-student assessment ratio through the mobile devices is also important for students, especially in the earlier grades, says Krista Curran, the general manager of assessment and intervention products for Wireless Generation.

"In the early grades, the [mobile] assessments are used by teachers with their students so it's less obtrusive, in order to make that interaction friendly to the student," she says. "The end goal is to provide that immediate access to data that informs instruction."

(Wireless Generation's founder and chief executive officer, Larry Berger, is a trustee of Editorial Projects in Education, the nonprofit corporation that publishes Education Week Digital Directions.)

Making iPads Work
After the East Haven elementary students were initially assessed on their reading levels, the iPads were distributed onto seven carts—one for each elementary school in the district—to be used for instruction.
From a teacher's standpoint, the iPads are an easy device to use, says Auger. "They can pick it up, turn it on, and use it how they wish," he says.

"But the ability to do that," he cautions, "requires a lot of background work from the rest of the technology team that if you do not have, it will not work."

The district also underwent an upgrade to a fiber-optic wireless network during the 2010-11 school year, which was critical to the success of the iPad implementation, says Auger.

After the initial reading assessments, he says, some teachers have continued to use the iPads for assessment by having students take screenshots of their scores on various educational apps and email the images to the teachers to be stored in the students' electronic portfolios.

"One of the greatest things about the iPad is its versatility," he says. "It can really be what you want it to be."
Similarly, the 2,000-student Lowndes County school system in Hayneville, Ala., rolled out 1,100 iPads to teachers in the district last fall with the help of Information Transport Solutions, or ITS, a technology-services company in Wetumpka, Ala.

Students in the district undergo a pre- and post-test every 45 days in core subjects that helps pinpoint where students may need more support, says Lucy Long, the director of professional learning for ITS.

"We use the data from the post-test to really structure how we approach the next 45 days," she says. In between those assessments, teachers use the iPads to create their own assessments, which are pushed out to the students and then returned to the teacher for data collection, says John Loiselle, an integration technology specialist for ITS.

In addition to using mobile devices to gather observational data, teachers can use the devices to get a glimpse into the thought processes of students, says Reshan Richards, the director of educational technology at Montclair Kimberley Academy, a private school serving grades preK-12 in Montclair, N.J.

"You can gather a lot of data quickly, and you can do a lot of quick checks of understanding in a class, but I'm more interested in the deeper, more qualitative understanding that mobile might bring," Richards says.
For instance, screencasting, which records what students are doing on the display screens of their devices, allows teachers to see students work through problems without having to stand over their shoulders the whole time, he says.

That kind of assessment on a mobile device turns testing into more than just one number, Richards says. Most schools are hesitant, however, to jump into assessing with mobile devices, he says.

'Rich Feedback'
But those schools and classrooms that have embraced mobile devices have seen them as a catalyst for change in teaching, learning, and assessment, says Julie Evans, the chief executive officer of the Irvine, Calif.-based Project Tomorrow, a national education nonprofit group that promotes technology use in the classroom.

"The access of having a [mobile] device in your hand changes the way that classroom environment feels," she says. "Students are walking around with the devices, doing things to get them out of the structured environment of the traditional school."

And because students feel a sense of connection and ownership over their mobile devices, they feel "enabled to be part of the assessment process," says Evans.

Christopher Dede, a professor at the Harvard Graduate School of Education, also notes the unique relationship between students and their mobile devices. "Kids think of phones as an extension of themselves in a way that they don't think of with laptops or workstations," he says. "Part of what you have is this intellectual partnership with your cellphone where you do some of the thinking, and your cellphone does some of the thinking, and then you're smarter."

Educators are beginning to tackle how such devices can be used for assessment, taking into consideration screen size and assessment platforms, says Dede. But it's clear, he says, that mobile devices have potential as assessment tools in at least two ways: asking a question and getting an answer, and recording and capturing a process.

"We can give students some kind of thought question and look at the response they give and understand formatively where they are in their comprehension, and perhaps modify what comes next based on that kind of feedback," Dede says. "It's very rich feedback for students on how they're doing and how to get better."
Dede is also exploring how mobile devices can be used as assessment tools through "augmented reality," a process by which students interact with the real world, which is enhanced by information from a mobile device. For example, students in a science class could take mobile devices onto school grounds and use them to identify plants or trees, or students in a history class could use the GPS capabilities on their mobile devices to lead them to sites of historical importance.

Student-Owned Devices
Johnny Kissko, a math teacher for the 2,000-student Frenship High School in the Frenship Independent School District in Texas, is also interested in using augmented reality in his classes.

This school year, Frenship High has changed its policy to allow students to bring their own mobile devices into class at the discretion of the teacher, says Kissko.

Taking advantage of the new policy, Kissko has created worksheets for his classes that use QR, or quick-response, codes that pull up video solutions for the problems his students are working on. To read the QR codes, which are black-and-white barcode-type images, students download apps; when the apps are running, the students hold their devices over the codes to be linked to the website.

Around the country, the mobile devices are being used primarily for formative assessments rather than high-stakes standardized tests.

For example, in the 5,000-student Canby school district, south of Portland, Ore., teachers are using classroom sets of iPod touches to receive quick feedback on where students are in learning their subject matter, says Joe Morelock, the director of technology and innovation for the district.

"We're doing a lot of formative assessments on them," Morelock says. Using apps such as iResponse and resources like Google Documents, teachers are able to receive feedback from students and record their own observations about students' progress, he says.

Teachers have full autonomy in deciding which apps they use and how they use the mobile devices in the classroom, says Morelock. That leeway cuts down on the management load for the district's technology team.

"The teachers are updating them, syncing them, and they're finding a thousand different ways to use them," he says of the devices. "It's been really incredible, and it really has to do with the ease of using the device, and the teachers really taking the lead."
(Source: edweek.org)

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The ABC's of ABA in a SLP World

We speech-language therapists have a lot of acronyms in our little speechy world. We are SLPs (speech-language pathologists) who have our CCCs (Certificates of Clinical Competence) from ASHA (the American Speech-Language and Hearing Association). When I graduated with my M.S. (okay, you all know that one) in speech-language pathology, I was pretty sure I’d mastered the alphabet soup of our profession.

Until I fell in love with kids with autism, that is. That’s when I was introduced to the world of ABA. If you’ve loved a child with autism, you’ve no doubt run smack into this term, too, and probably very early along the journey you took. Despite the fact that this word swirls around the autism world with great furiosity, it is often misused and a bit misunderstood. Some people love it with a passion; others hate it with the same intensity. Me? I think it both extremely valuable and sometimes overused.

But I’m getting ahead of myself. My goal today is to begin to define the term for those who don’t know it well. Later, when I’ve laid the groundwork just a bit, we’ll delve into the true complexities that exist with what appears, at first glance, to be a very simple concept.

ABA stands for Applied Behavioral Analysis.  It’s based on the work of B.F. Skinner, a psychologist who focused on operant conditioning, or the study of observable behaviors and the events that cause and reinforce those behaviors. The applied part of ABA means that we take this system of looking at the way behaviors are shaped and apply it to everyday life; we use it to shape behaviors that are important to the lives we lead. When we peer at the world through the eyes of ABA, we find ourselves looking at three main things.

The Antecedent: What happened in the environment before the behavior occurred?

The Behavior: This part involves describing the overt behavior that you see or want to see. Not the motives, not the intent, not the feelings behind the behavior. Simply the behavior as you can observe it in front of you. Those who study and use the principles of ABA believe in describing the behavior as clearly and objectively as possible. For example, instead of saying “Sally got mad,” a behavior analyst would say “Sally screamed and hit the door with her fist.”

Consequence: What happens after the behavior? Does this thing that occurs after the behavior (the consequence) increase the chances the behavior will occur again, making it a reinforcement? Or does it decrease the chances the behavior will occur again, making it a punishment?

To help explain, let me share a couple examples.

Say you are teaching a child to say “cookie.” The steps behind teaching the word might go a little something like this:

Antecedent:  You hold up a cookie and say, “cookie”
Behavior: The child imitates “cookie”
Consequence: You give the child the cookie. (This would be positive reinforcement, assuming that giving the child the cookie increases the chances he will say the word again in the presence of the the cookie. Or, in plain English, assuming the child actually wants the cookie–although behavior analysts would probably shy away from describing it this way, as it reflects the child’s internal state, rather than his behavior).

Or, perhaps you are teaching your child to walk.  

Antecedent: You hold out your hands and say “come here!”
Behavior: Your child takes his first step toward you.
Consequence: You cheer and throw your child in the air as he giggles. (Again, this is only reinforcement if it actually increases the chances your child will take a step toward you the next time you hold out your hands and say, “come here!” It wouldn’t be a reinforcement if he hated being thrown in the air- in this case, it might decrease the chances that he’d come to you and would, then, become a  punishment*. Consequences are different for different people- the exact same action that is a reinforcement for one person can be a punishment for another).

These three things- the antecedent, behavior and consequence (Or ABCs of ABA, if you will…yes, another acronym), make up the core of ABA. Those who live in the world of ABA focus very carefully on the ABCs behind any and all behaviors. They graph and chart and study these elements of life and plan interactions around them.

ABA is much more complex than this, of course; I took four full graduate level classes about ABA when I completed my graduate certificate in Behavioral Intervention in Autism.  There are those that study ABA all their life and still don’t have all the answers, and there are entire, complex, and well-graphed treatments for autism that are based the concepts behind ABA.  It is not nearly as simple as I am making it at the moment. And yet, if you understand the ABCs behind ABA, you can begin to understand the world through the eyes of an applied behavior analyst.

How, then, does ABA fit into the world of SLP? As an experienced applied behavior analyst once told me, we all (parents, teachers, speech-therapists, all of us) use ABA in one form or another.  SLPs are no exception. We use the principles of ABA to teach children first words (Antecedent: “Say, Ball!” Child’s Behavior: “Ball!”  Consequence: Child is rolled the ball). We use ABA methods to teach children how to behave and understand language (Antecedent: “Sit down please.” Child’s behavior: sits down. Consequence: “Here’s your snack.”).  We call on ABA to help us figure why children behave in certain ways, so that we might help them find a better response and eliminate challenging behavior. For example, we might look at what comes just before a child hits another child (the antecedent), discover that it happens whenever another child obstructs the way, and then give the  child a new behavior (saying, “move please”) by teaching and reinforcing this new behavior.

So yes, we all use the concepts behind ABA, intuitively and frequently, to teach, motivate, and shape our children’s behaviors. And yet, controversy behind these methods exists. Why so? Because there are significant differences in how and when we apply these methods, in how stringently we define the behaviors we expect, in how we select and apply consequences, and in how strongly we believe that the ABA lens is the only one through which we can view the world.

That’s a post for a different day though.  For now, we’ll just be happy that we’ve learned our ABCs.

 (Source: This post originally appeared on Child Talk; reposted via blog.asha.org)

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We have adult homecare cases in Long Island, Queens, Brooklyn, Staten Island, Manhattan, the Bronx, and Westchester for OTs, PTs, and SLPs

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