Transcript
Page 1: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Marion Blank, Ph.D.Columbia University

[email protected]

Suzanne Goh, M.D.Pediatric Neurology

[email protected]

Susan [email protected]

Website www.spectacularbond.com

[email protected]

Page 2: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

OVERVIEW

creating the social and behavioral foundation for learning

Dr. Marion Blank

the neuroscience behind Spectacular Bond

Dr. Suzanne Goh

a family’s experience Susan Deland

Page 3: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

The Starting Point

in contrast to the common focus on what the child needs to learn, our starting point is

seeing the world through the child’s eyes

the “everyday world” is not getting in – WHY?

Page 4: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

The Child’s View

via reportsvia observations

the child finds the world to be overwhelming, confusing, &

painful

Much of that pain and confusion is caused by the very stimulation that NT children find appealing and irresistible – the social realm.

Page 5: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

The Social World

newborn is primed to attend to, focus on, and interact with the adult

one-day-old infant with her mother

Page 6: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Diane Deland age 2 (prior to starting the Spectacular Bond program)

Page 7: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Implications

The social world is the basis for communication.

Communication is the basis of all interaction, including INTERVENTION.

When a child avoids the social world, adult-directed teaching will rarely, if ever, be truly effective.

The “accommodations” made for children are often counterproductive.

Page 8: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

The First Element

Simplify the World

simplifying the world is the opposite of providing stimulation

key points for the two worlds:the non-social worldthe social world

Page 9: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Simplification is not Enough

well-established defenses are in play

child will not readily give them up

one key defense is “stimming”keeps the outside world from intrudingprovides stimulation

Page 10: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Comment from a “Nonverbal” Teenager with ASD

“I treat stims like a welcomed friend….I am so needy to escape

reality and stims take me to another world.” (Ido in Autismland)

Page 11: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

The Second Element

Self Control of Stimming and Other Unproductive Behaviors(in the presence of adults)

Page 12: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

The Third Element

Managing Meltdowns

temper tantrums

overloads

Page 13: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

The Fourth ElementSitting Quietly

Page 14: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Key Elements

focus is on developing inhibition and inner calm

all are done at home – prior to moving to the outside world

goal is 10 to 15 minutes of carefully structured, effective interaction every hour (child is “free” the rest of the time)

child’s room becomes a “haven”

Page 15: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

OVERVIEW

creating the social and behavioral foundation for learning

Dr. Marion Blank

the neuroscience behind Spectacular Bond

Dr. Suzanne Goh

a family’s experience Susan Deland

Page 16: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

The Neuroscience Behind Spectacular Bond

Knowledge about how the brain works has not been factored into most intervention programs

Yet, all intervention programs represent efforts to reshape brain networks

Page 17: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

The Brain in Autism CAN Change

• With early intervention, electrical patterns of brain activity begin to resemble that of neurotypical children*

Before these changes can take place, children need to be receptive to intervention

*Dawson, G. et al. (2012) “Early behavioral intervention is associated with normalized brain activity in young children with autism.” Journal of the American Academy of Child and Adolescent Psychiatry. 51(11):1150–1159.

Page 18: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

The Effects of “Training” on Brain Networks

If unproductive behaviors aren’t addressed in a treatment programstronger neural networks are created in areas of

the brain that should NOT be growingnew, productive patterns can’t be established

Page 19: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

How to Reshape Neural Networks

Change is possible if weDiminish those repetitive behaviors that are

working against positive brain growthExpand neural networks for the skills that will allow

the children to live full and productive lives

Page 20: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Calm the Brain before Stimulating It

Reduce the stressful stimulation that the child must face

Simplify the child’s world

Page 21: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Intervention Must Begin in the Social Domain

Social brain is intimately tied to emotional centers of the brain that control feelings of fear and anxiety

The “Social Brain” Amygdala Prefrontal cortices Temporal cortices

Page 22: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

OVERVIEW

creating the social and behavioral foundation for learning

Dr. Marion Blank

the neuroscience behind Spectacular Bond

Dr. Suzanne Goh

a family’s experience Susan Deland

Page 23: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Diane Deland – a case study

Diagnosed at 3 years of age, Diane began the Spectacular Bond program right away.

We will see the program in action in her particular case.

Page 24: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Element 1 – simplify the world

changing the physical and interpersonal environment

Diane would no longer eat meals in the playroom

Page 25: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Element 2 – build self control

targeting unproductive behaviors

Diane would stop running and shrieking in our playroom. She would stop pulling clothes out of drawers.

Page 26: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Element 3 – manage meltdowns

distinguishing between tantrums and overloads

bypassing rewards learning to say “not now”

Diane would get the things she desired, but at the times that we decided, not at her request

Page 27: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Element 4 – sit quietly

calming the mind reshaping my relationship

with Diane

Diane would sit quietly with her hands on her lap for a short period of time

Page 28: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Element 5 – organize the day

Creating a clear plan for how each day would be structured

There would be time for adult-led exchange, child-led exchange, minimal exchange, and no exchange.

Page 29: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Element 6 – simple actions

Teaching her to follow simple commands under an adult’s direction

Diane would imitate simple actions with me or Dr. Blank

Page 30: Marion Blank, Ph.D. Columbia University msb5@columbia.edu

Marion Blank, Ph.D.Columbia University

[email protected]

Suzanne Goh, M.D.Pediatric Neurology

[email protected]

Susan [email protected]

Website www.spectacularbond.com

[email protected]


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