Vol 4 • Issue 2 • Mar 2013

Grafton Celebrates Developmental Disabilities Awareness Month

Earlier this month, Governor McDonnell proclaimed March Developmental Disabilities Awareness Month in the state of Virginia. In his proclamation, the governor recognized the value and potential of the nearly 145,000 children and adults across the Commonwealth who are estimated to have a developmental disability.

http://www.governor.virginia.gov/OurCommonwealth/Proclamations/viewproc.cfm?id=268

According to recent data and statistics from the Centers of Disease Control and Prevention, the prevalence of Developmental Disabilities has increased 17.1%–that’s about 1.8 million more children with Developmental Disabilities in 2006-2008 compared to a decade earlier. The prevalence of autism has increased by 289.5%. Today, one in 88 children is diagnosed with autism.

Developmental Disabilities Awareness Month provides a great opportunity to raise awareness and educate community members about how organizations providing services across the Commonwealth are partnering with one another to create better outcomes for individuals with developmental disabilities. Kaitlynn, who you will meet later in this newsletter, is an engaging five year old with autism who is making remarkable progress in the Applied Behavior Analysis (ABA) program.

Grafton’s ABA program focuses on antecedent and reinforcement-based strategies to improve skills acquisition in the areas of communication, social interactions, motor control, daily living activities and play. We work with children and their families in home, school, clinic and community based settings to target skill acquisition such as language, self-care and social skills as well as reduce challenging behaviors that may be a barrier to success. For more information about our ABA services offered in the following areas (Charles Town, West Virginia, Shenandoah Valley, Northern Virginia and Richmond), please contact Bonnie Zampino via email at bonnie.l.zampino@grafton.org. For ABA services in Bradenton, Florida, please contact Bob Schnorf via email at ABAFlorida@grafton.org.

Grafton and Project Horse

Grafton is pleased to announce a partnership with Project Horse, a not-for-profit organization based in western Loudoun County, Virginia that provides equestrian therapy to our clients. Equine therapy offers
an experiential learning model that helps clients deal with symptoms and feelings associated with Post Traumatic Stress Disorder, Trauma, Depression, Anxiety and other disorders.

93% of adolescents in inpatient setting reported a history of trauma and 32% had severe symptoms of Post Traumatic Stress Disorder (Lipschitz et al, 1999). We often attribute behavioral problems in children to non-compliance, assuming that they have the capacity to perform to our expectations. A child or adolescent survivor who is in a state of hyper-arousal due to perceived threats in their environment may not have the cognitive or emotional capacity to perform to our expectations. Project Horse provides a safe haven for children to explore feelings, develop trust and meaningful relationships, improve problem solving skills and improve their self-concept.

Horses are sensitive, social creatures fully attuned to an individual’s emotional needs. Within a safe and non-threatening environment, children can learn and practice new behaviors and new ways of thinking. Horses provide immediate feedback, while remaining nonjudgmental. This encourages the children to try new ways of being and acting, as they develop meaningful connections with the horses. Many of the program’s horses have experienced trauma, neglect and abuse, and the children deeply relate to this and develop a sense of empathy. The horses, having been rehabilitated and now living productive and happy lives, inspire hope for healing and a better future.

The program offered at Project Horse for Grafton clients is organized around the following themes:

• Observation and awareness of environmental cues
• Observation and awareness of physiological states
• Awareness of thoughts and internal dialogue
• Problem solving
• Awareness of internal and external triggers
• Modification of negative thought patterns
• Gaining perspective and empathy
• Relaxation (knowing when to chill)

Following sessions at Project Horse, children have greater self-awareness, feelings of empathy, improved self-confidence and a sense of hope.

For more information about Project Horse or to make a donation, please visit http://www.projecthorse.org

Kaitlynn’s story

The Challenge

Kaitlynn is a happy five year old girl with autism. She resides with her mother, father, older sister and younger brother. As any five year old little girl, Kaitlynn loves Disney princesses. She demonstrates an eager willingness to learn and has just discovered the wonders of an iPad. Difficulties identified by her family at the beginning of treatment included having behavioral and screaming episodes that lasted about twenty minutes when she was presented with different foods. Kaitlynn’s preschool reported that she would not try any new food and would have difficulties when presented with options. Issues during meals and eating limited where the family could go out to eat together. In addition, Kaitlynn would only wear certain clothes or no clothes at all. Prior to receiving treatment, Kaitlynn displayed limited language skills. In addition, on a daily basis, Kaitlynn would smear feces all over her room. She would have behavioral episodes that would last for 20 minutes to an hour due to her limited language skills and not being able to have what she wanted.

Uncovering Skills for Change

Kaitlynn began to receive Applied Behavior Analysis (ABA) services through Grafton’s program in Richmond, Virginia. ABA services started the first week of January. Through parent interviews and an initial assessment, a number of goals were established included increasing the number of foods Kaitlynn could tolerate without engaging in disruptive behavior, decreasing problem behaviors, increasing her functional expressive language skills, and increasing toileting skills. Heather, Kaitlynn’s therapist worked with not only Kaitlynn, but others siblings within the home as well. Frequently, when working with a child with a developmental disability, there is resentment from other siblings centered around changes that need to be made to accommodate needs, preferences and desires. With her siblings, the therapist focused on helping them understand Kaitlynn’s needs and identifying what they needed within the family unit.

Heather set out to develop a meaningful working relationship with Kaitlynn and worked at Kaitlynn’s pace. New foods were slowly introduced and Kaitlynn received encouragement and positive reinforcement to explore foods presented to her. Gradually, Kaitlynn became more and more open to trying new foods. As Kaitlynn got used to the presentation of new foods, Heather would just present the food and Kaitlynn would begin eating. Heather recognized that it was important to incorporate Kaitlynn’s strengths (willingness to learn), preferences (princesses, chocolate milk, bubbles and time on the iPad) while working on her needs. As Kaitlynn became more comfortable with Heather, new foods were introduced into her diet. This was done through modeling by her therapist, pairing foods with a reinforcer of Kaitlynn’s choice and repeated trials. Kaitlynn now eats healthier food and a wider variety of foods presented to her. Being able to enjoy a wider variety of foods alone has resulted in the family being able to go out together to explore restaurants together and enjoy meals as a family.

Progress

Kaitlynn has significantly increased her express language skills. In addition, she is now eating new foods on a consistent basis. During a recent outing at a local restaurant, Kaitlynn reportedly said to a waiter, “I want water, please.”

Today, Kaitlynn’s vocabulary continues to increase and she is able to communicate her wants and needs on a regular basis. Much to the family’s surprise, Kaitlynn enjoys a larger variety of food which has significantly impacted not only Kaitlynn’s quality of life, but those of her family members as well. Kaitlynn also spontaneously asks to visit different places within her local community, a behavior that was non-existent a few months ago.

• Debbi Richardson, Education Administrator presented a webinar entitled, “Zero Tolerance for Bullying through Partlow Insurance’s 2013 Best Practice Award Series on March 5th.
• A webinar entitled, “Evidence-Based Strategies for Toilet Training & Addressing Common Toileting Problems,” was presented by Lucy Bargioni, Board Certified Behavior Analyst on March 5th.
• Teachers Chad Lesman and Roger Styron presented “From Classroom to Employment for Individuals with Significant Disabilities,” at the Virginia Transition Forum on March 11th in Richmond, Virginia.
• The 2013 Early Intervention System Determination report supports that the Infant and Toddler Connection of Shenandoah Valley has met requirements for 2012 and 2013 and the Office of Special Education Program requirements are at 100% in all monitoring areas. This achievement of 100% for two consecutive years is a first for the ITC of Shenandoah Valley and confirms the commitment and dedication of the early intervention team in meeting the needs of children and families who need services.
• Jason Craig, Director of ABA Services, Shamsi Sadeghzadeh, Director of Outreach and Bonnie Zampino, ABA Practice Manager conducted a training at Lord Fairfax Community College in Middleton on March 12th that included topics such as: “An Introduction to Autism”, “An Introduction to Functional Behavior Assessment and Behavior Management”, “Experience Autism” and “Ten Things Parent of Children with Autism Wish Teacher Knew”.
• At the end of March, Grafton will be consolidating our two psychiatric residential treatment facilities to the Berryville site. This consolidation allows Grafton to continue to develop the community based services at the Leesburg facility, including outpatient, intensive outpatient, ABA and therapeutic day schools (including a designated classroom for children with autism. For more information about our services and programs, please contact admissions@grafton.org

• Grafton won the 2013 National Council Award for Excellence in Behavioral Healthcare Management for the paper entitled “The ‘Least Resistance’ Approach to Crisis Management or ‘Ukeru’. The Excellence in Behavioral Healthcare Management Award recognizes an organization that has demonstrated effective and innovative programs currently in use to minimize risk and liability. The organization will be formally recognized at the National Council Awards banquet scheduled on April 9th in Las Vegas, Nevada.
• Shamsi Sadeghzadeh will present “Innovative and Proactive Strategies for Individuals with Autism Spectrum Disorders,” at the 57th annual American Association of Residential Treatment Centers conference in New York on April 9th.
• Jim Gaynor, CEO/President, Lisa Marshall, Director, Research and Outcomes and Kim Sanders, Executive Vice President and Chief Outcomes Officer will present “Technology Infrastructures for Evidence-Based and Person-Centered Actualization of Sustainable Positive Outcomes,” at the International Association for the Scientific Study of Intellectual and Developmental Disabilities (IASSIDD) conference in Tokyo, Japan scheduled in August 2013.