marion blank, ph.d. columbia university [email protected] suzanne goh, m.d. pediatric neurology...
TRANSCRIPT
Marion Blank, Ph.D.Columbia University
Suzanne Goh, M.D.Pediatric Neurology
Susan [email protected]
Website www.spectacularbond.com
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
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?
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.
The Social World
newborn is primed to attend to, focus on, and interact with the adult
one-day-old infant with her mother
Diane Deland age 2 (prior to starting the Spectacular Bond program)
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.
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
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
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)
The Second Element
Self Control of Stimming and Other Unproductive Behaviors
(in the presence of adults)
The Third Element
Managing Meltdowns
temper tantrums
overloads
The Fourth Element
Sitting Quietly
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”
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
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
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.
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 growing
new, productive patterns can’t be established
How to Reshape Neural Networks
Change is possible if we
Diminish those repetitive behaviors that are
working against positive brain growth
Expand neural networks for the skills that will
allow the children to live full and productive lives
Calm the Brain before Stimulating It
Reduce the stressful stimulation that the
child must face
Simplify the child’s world
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
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
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.
Element 1 – simplify the world
changing the physical and
interpersonal environment
Diane would no longer eat
meals in the playroom
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.
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
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
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.
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
Marion Blank, Ph.D.Columbia University
Suzanne Goh, M.D.Pediatric Neurology
Susan [email protected]
Website www.spectacularbond.com