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Autism, 5.02 (V) What Care is Available?

» In this lesson, you will gain an understanding of the complexities involved in the systems of care for individuals with autism spectrum disorders as well as the costs associated with providing interventions, supports and treatments across the lifespan. The value and benefits of early intervention will also be shared, as well as some of the research-based programs currently being developed for very young children with autism. The services and supports provided to individuals on the autism spectrum involves many different agencies, as well as family and community supports. Parts of the system of care include family, early intervention, the educational system, can include rehabilitative services, medical care through commercial insurance or Medicaid, mental healthcare as well as housing and many other resources that an individual may need to access in their adult life. Autism is also considered one of the highest cost disabilities or disease states in the United States. Part of the individual annual costs in the United States include not only the cost of special education, but also productivity loss by caregivers, productivity loss by the individual, medical services as well as none medical services. And as an individual ages and moves into adult services, residential care becomes a primary cost. One of the important considerations as the rates of autism increase is can anything reduce the impacts? There is a strong consensus within the research community that intensive early intervention can reduce the cost of lifelong care by two-thirds. It also yields the most positive life outcomes for individuals affected by autism spectrum disorders. In this video, you will learn about one effective early intervention program called the Early Start Denver Model developed by Dr. Sally Rogers of the UC Davis Mind Institute. » Merrily, merrily, merrily, merrily life is, but a- » Dream. » Dream. » [LAUGH] » Today, Matthew Williams seems like a typical two year old, but just six months earlier, this father-son play time would have been much different. » And we just notice that he didn't pay attention, he didn't turn to his name. He didn't play with toys in a typical way. » Unlike his twin sister Morgan, Matthew didn't speak. Instead, he expressed his many emotions and frustrations with outbursts and tears. So on their pediatrician's recommendation, Mark and Marcella Williams took their son to the UC Davis Mind Institute in Sacramento where their suspicious were confirmed. » I kind of in the back of my mind always knew there was something no quite right and it possibly would be autism. But when you hear it, it's a different thing. » We just kinda get concerned with what it could mean, like is he gonna be normal for the rest of his life? And what kinda things are really gonna affect him down the road? Is he gonna be like any other kid? [SOUND] » Autism isn't typically diagnosed until a child is older, but doctors recognized many of the risk factors in Matthew, including a lack of communication, a narrow range of interests and unusual repetitive behaviors. Experts here at the MIND Institute, diagnosed Matthew as at risk for autism and considered him a good candidate for a promising new treatment called the Early Start Denver Model. » The Early Start Denver Model is a method on intervention developed for very young children and it draws from a number of different sources, both theories and science. » Dr. Sally Rogers co-authored the Early Start Denver Model or ESDM, which she has been working on since the early 1980s. It's a program that has gained worldwide recognition, including a ranking on Time Magazine's top ten medical breakthroughs in 2012 for its promising results in children as young as 12 months. » Something about these really, really little ones. I they're still in a developmental period where their peers are learning to talk. They're not out of sync yet with other 18 to 20 month olds. Everybody in that age is learning to talk. » And we'll go open boats. » At 18 months old, Matthew was noticeably behind his twin sister and his peers in verbal and social development. » Cupcakes? » Cupcakes. » But researches believed they could help him catch up, fairly quickly. » Caterpillar. When her first came to us, he had no language. He made very little eye contact, he had very few play skills. This would be a great way to work on jumping with two feet. » He's very good at jumping. » Do you want more juice? » Yes. » Yes. » Amy Board is a speech pathologist and the team lead for Matthew's intervention, which included a handful of therapists as well as his parents who also receive training so they can continue the treatment at home. It's an intensive 20 hours of therapy each week. » Where was Matthew's focus during the ball routine, do you think? » The therapy combines several science-based practices for working with autism into one intervention program. So rather than analyzing just communication or eye contact, the ESDM model is designed to work on improving several skills at once. » So during the book routine, you saw me illicit eye contact, you saw me do vocal imitation with him, you saw me illicit sound effects with him with the, [SOUND] with slurping of the soup. Worms are- » Yucky. » Yucky and the idea is that we get to teaching about every ten seconds. So that every ten seconds, you're gonna see some kind of a learning opportunity and that's our fidelity goal with ESDM model. » And the results, after five months of therapy, it would be hard for someone that doesn't know Matthew to see a difference between him and any other child his age. » We didn't think that something as simple as playing and structured play and these things could really modify his brain, cuz it's changed how his brain takes things in and it's just like wow, it's just amazing to see. » And it's not just Matthew Williams. The first ESDM study involved 48 toddlers with the same level of functioning, separated into two groups. One group received the ESDM therapy, the other was referred to a community program for therapy. After two years, the children in the ESDM group had an average IQ increase of 18 points, the other group increased only six points. » Their language improved, as well and seven of the children in the ESDM model had enough improvement in overall skills to warrant a diagnosis change to a milder condition. It's also elicited critics who say it falsely suggests, there's a cure for autism. Dr. Rogers says while it isn't a cure, the research speaks for itself. » Autism is a description of a set of behaviors and behaviors change and if a child no longer meets behavioral criteria for autism, they don't have autism. » For parents like Mark and Marcella Williams who once had so many fears about what the future would hold for Matthew, it's simple. » We know Matthew now, that's the easiest way to say it. Six months ago, he could not communicate with us at all. He couldn't even point to tell us that he wanted something. » All I know is that I'm blown away with how well he's taken to it and it gives me a lot of hope that this is becoming a larger piece of teaching and overcoming against autism. » And so that's really what I'm aimed for. Remove the disability, help children function in every environment. Help them be able to interact with peers and do what life expects for them of their age. That's my goal. » Sally Rogers says, there may eventually be a day when autism is described more as a learning challenge than a severe lifelong disability. But for now, much about autism is still a mystery. For Mark and Marcella Williams, it's a mystery they can finally feel confident will turn out just fine. » Choo-choo. » Choo-choo. » In Sacramento, Kristen Samos for UC Davis. » In addition to early intervention, the use of evidence-based treatments and practices have also been shown to produce positive outcomes. From a funding perspective, the use of evidence-based practice makes sense. As money is used to support interventions that are known to be effective based on scientific research. The use of evidence-based practice can also preserve time to be used on interventions that do work, as opposed to using things that are unknown or unsupported by research.


» In this lesson, you will gain an understanding of the complexities involved in the systems of care for individuals with autism spectrum disorders as well as the costs associated with providing interventions, supports and treatments across the lifespan. The value and benefits of early intervention will also be shared, as well as some of the research-based programs currently being developed for very young children with autism. The services and supports provided to individuals on the autism spectrum involves many different agencies, as well as family and community supports. Parts of the system of care include family, early intervention, the educational system, can include rehabilitative services, medical care through commercial insurance or Medicaid, mental healthcare as well as housing and many other resources that an individual may need to access in their adult life. Autism is also considered one of the highest cost disabilities or disease states in the United States. Part of the individual annual costs in the United States include not only the cost of special education, but also productivity loss by caregivers, productivity loss by the individual, medical services as well as none medical services. And as an individual ages and moves into adult services, residential care becomes a primary cost. One of the important considerations as the rates of autism increase is can anything reduce the impacts? There is a strong consensus within the research community that intensive early intervention can reduce the cost of lifelong care by two-thirds. It also yields the most positive life outcomes for individuals affected by autism spectrum disorders. In this video, you will learn about one effective early intervention program called the Early Start Denver Model developed by Dr. Sally Rogers of the UC Davis Mind Institute. » Merrily, merrily, merrily, merrily life is, but a- » Dream. » Dream. » [LAUGH] » Today, Matthew Williams seems like a typical two year old, but just six months earlier, this father-son play time would have been much different. » And we just notice that he didn't pay attention, he didn't turn to his name. He didn't play with toys in a typical way. » Unlike his twin sister Morgan, Matthew didn't speak. Instead, he expressed his many emotions and frustrations with outbursts and tears. So on their pediatrician's recommendation, Mark and Marcella Williams took their son to the UC Davis Mind Institute in Sacramento where their suspicious were confirmed. » I kind of in the back of my mind always knew there was something no quite right and it possibly would be autism. But when you hear it, it's a different thing. » We just kinda get concerned with what it could mean, like is he gonna be normal for the rest of his life? And what kinda things are really gonna affect him down the road? Is he gonna be like any other kid? [SOUND] » Autism isn't typically diagnosed until a child is older, but doctors recognized many of the risk factors in Matthew, including a lack of communication, a narrow range of interests and unusual repetitive behaviors. Experts here at the MIND Institute, diagnosed Matthew as at risk for autism and considered him a good candidate for a promising new treatment called the Early Start Denver Model. » The Early Start Denver Model is a method on intervention developed for very young children and it draws from a number of different sources, both theories and science. » Dr. Sally Rogers co-authored the Early Start Denver Model or ESDM, which she has been working on since the early 1980s. It's a program that has gained worldwide recognition, including a ranking on Time Magazine's top ten medical breakthroughs in 2012 for its promising results in children as young as 12 months. » Something about these really, really little ones. I they're still in a developmental period where their peers are learning to talk. They're not out of sync yet with other 18 to 20 month olds. Everybody in that age is learning to talk. » And we'll go open boats. » At 18 months old, Matthew was noticeably behind his twin sister and his peers in verbal and social development. » Cupcakes? » Cupcakes. » But researches believed they could help him catch up, fairly quickly. » Caterpillar. When her first came to us, he had no language. He made very little eye contact, he had very few play skills. This would be a great way to work on jumping with two feet. » He's very good at jumping. » Do you want more juice? » Yes. » Yes. » Amy Board is a speech pathologist and the team lead for Matthew's intervention, which included a handful of therapists as well as his parents who also receive training so they can continue the treatment at home. It's an intensive 20 hours of therapy each week. » Where was Matthew's focus during the ball routine, do you think? » The therapy combines several science-based practices for working with autism into one intervention program. So rather than analyzing just communication or eye contact, the ESDM model is designed to work on improving several skills at once. » So during the book routine, you saw me illicit eye contact, you saw me do vocal imitation with him, you saw me illicit sound effects with him with the, [SOUND] with slurping of the soup. Worms are- » Yucky. » Yucky and the idea is that we get to teaching about every ten seconds. So that every ten seconds, you're gonna see some kind of a learning opportunity and that's our fidelity goal with ESDM model. » And the results, after five months of therapy, it would be hard for someone that doesn't know Matthew to see a difference between him and any other child his age. » We didn't think that something as simple as playing and structured play and these things could really modify his brain, cuz it's changed how his brain takes things in and it's just like wow, it's just amazing to see. » And it's not just Matthew Williams. The first ESDM study involved 48 toddlers with the same level of functioning, separated into two groups. One group received the ESDM therapy, the other was referred to a community program for therapy. After two years, the children in the ESDM group had an average IQ increase of 18 points, the other group increased only six points. » Their language improved, as well and seven of the children in the ESDM model had enough improvement in overall skills to warrant a diagnosis change to a milder condition. It's also elicited critics who say it falsely suggests, there's a cure for autism. Dr. Rogers says while it isn't a cure, the research speaks for itself. » Autism is a description of a set of behaviors and behaviors change and if a child no longer meets behavioral criteria for autism, they don't have autism. » For parents like Mark and Marcella Williams who once had so many fears about what the future would hold for Matthew, it's simple. » We know Matthew now, that's the easiest way to say it. Six months ago, he could not communicate with us at all. He couldn't even point to tell us that he wanted something. » All I know is that I'm blown away with how well he's taken to it and it gives me a lot of hope that this is becoming a larger piece of teaching and overcoming against autism. » And so that's really what I'm aimed for. Remove the disability, help children function in every environment. Help them be able to interact with peers and do what life expects for them of their age. That's my goal. » Sally Rogers says, there may eventually be a day when autism is described more as a learning challenge than a severe lifelong disability. But for now, much about autism is still a mystery. For Mark and Marcella Williams, it's a mystery they can finally feel confident will turn out just fine. » Choo-choo. » Choo-choo. » In Sacramento, Kristen Samos for UC Davis. » In addition to early intervention, the use of evidence-based treatments and practices have also been shown to produce positive outcomes. From a funding perspective, the use of evidence-based practice makes sense. As money is used to support interventions that are known to be effective based on scientific research. The use of evidence-based practice can also preserve time to be used on interventions that do work, as opposed to using things that are unknown or unsupported by research.