Amanda Himes doesn't know what the future holds for her 4 1/2-year-old son, Logan.

"Having an autistic child now is so much better than just 10 years ago," she said. "Because of early intervention, I know however he ends up, he will be very much further along than he would have been without it."

Himes and her husband, Jonathan, also have two daughters, Audrey, 3, and Elinor, 17 months. They knew something was different about Logan by the time he was 2, when their family doctor suggested he be tested for an autism spectrum disorder.

Over the next two years, the Siloam Springs couple, who both teach English at John Brown University, educated themselves about autism. Through trial and error, they discovered an educational approach that is working well with Logan. So, Amanda Himes was excited to discover that approach, applied behavior analysis, was the topic of a two-day Autism Spectrum Disorders Symposium on the University of Arkansas campus.

"Almost everything Greg Hanley said, I'm going to be able to use sooner or later," Himes said. Hanley, a professor of psychology at Western New England University in Springfield, Mass., has worked for 20 years in the field of developmental disabilities.

The symposium March 30-31 was sponsored by the College of Education and Health Professions at the University of Arkansas, the Arkansas Behavior Intervention Consultants, and the Arkansas Department of Education and Special Education. Educators could earn continuing education credit for attending.

"I'm really glad I got to go," Himes continued. "It's exciting to have a program presented that has research behind it, that has been tested. This was the right time for me to go. Everything was practical information for me."

Living with Autism

Much of the information and data Hanley provided for educators and teachers who attended the symposium came from his work at a child development center at the University of Kansas. Hanley now directs the behavior analysis doctoral program at Western New England University.

Barbara Gartin, University Professor of Special Education, with speaker Greg Hanley.

The U.S. Centers for Disease Control and Prevention reported March 29 that 1 in 88 children has some form of autism. The neurological disorder is characterized by varying degrees of impairment in communication skills, social interactions, and restricted and repetitive patterns of behavior. According to the CDC, not all causes of autism spectrum disorders are known, but it is likely there are many causes.

Himes said Logan displayed some of the repetitive behavior associated with autism and he didn't start walking until he was 19 months old. Although Himes often read to him, some books hundreds of times, he didn't repeat words. He resisted touching the pictures in a book designed to give tactile sensations to toddlers.

Initially, Logan attended a preschool for children with disabilities, but Himes said she and her husband were very discouraged because he did not make much progress. Then, they found Beth McKee, a special education teacher who uses applied behavior analysis methods in working with children.

McKee worked with Logan at the Himes' home for about a year; then he started going to a facility McKee opened. His speech and play have improved, Himes said.

"It was like watching a miracle, and we were sold on applied behavior analysis," she said.

Both Hanley and Himes said children with autism have to be taught every skill, including many that other children will pick up on their own. Himes said the family works on skills at home that Logan is learning during his 30 hours at week at the Northwest Arkansas Center for Autism and Developmental Disabilities directed by McKee.

Evidence-Based Advice

The most significant change Hanley has seen in his career is a shift in focus from behavior modification to behavior analysis. He explained that behavior modification techniques focus on motivating children to behave differently through a system of rewards and punishments. These techniques can be very impractical, he said. For example, you can't give a child a milkshake for every five seconds she goes without hitting herself.

In contrast, behavior analysis is characterized by first understanding why problem behavior occurs and basing treatment on that understanding, Hanley said. Behavior analysis incorporates a measure of humility not found in behavior modification.

"In behavior analysis, severe problem behavior is understood as learned behavior influenced by outcomes and context, the same as shooting a basketball," he said. "First, we understand the conditions; then, we teach alternatives."

Hanley teaches parents how to use behavior analysis to help their children sleep better without medication, to toilet-train the children and to lessen problem behavior. For both parents and teachers, he emphasizes ways to increase appropriate behavior in children such as responding to their name. He discusses how to discover what is causing problem behavior, how to teach the child how to get his needs met without engaging in the problem behavior and how to wait patiently when necessary.

In many classrooms, teachers deal with problem behavior by avoiding situations that may cause it, Hanley said. For example, having multiple sets of the same toys cuts down on fighting but it doesn't help children – all children, not just children with autism – learn the skills they need to get along with others. Hanley dubbed his curriculum "life skills" that can be modified for children of all ages.

Sleeping Well

Children with an autism spectrum disorder often have sleep problems that include not complying with bedtime routines; crying, playing, rocking or other repetitive body movements to interfere with going to sleep; taking a long time to fall asleep; waking up during the night and staying up; waking up early and not going back to sleep. Falling asleep and staying asleep is a learned skill, according to Hanley, which is one reason he strongly advises against medicating a child. Drugs interfere with that child's ability to learn to sleep, he said, and there is also little research on the use of sleep medication in children.

Tips for Better Sleep

• Develop a routine that allows the child's body to predict sleep is coming
• Keep the structure general, not strictly regimented
• About 45 minutes before bedtime, make activities more passive, such as reading
• Move the bath earlier in the routine to give the child's body temperature time to go back down
• Adjust light and sound in the house to be progressively dimmer and quieter as bedtime approaches
• Put the child in light pajamas since being too hot can wake the child
• Give the child a light snack without caffeine prior to bed
• Use a sound machine or fan to provide constant noise, masking out other sounds
• Make sure that the child falls asleep in their bed without the assistance of a parent or television
  — Source: Greg Hanley

When he asks parents about their primary concerns, they usually don't mention sleep problems, Hanley said. He suggests sleep be the first issue to tackle because a child who gets a good night's sleep and wakes up refreshed doesn't get into as much trouble the next day.

"When kids don't have good sleep, they are more irritable, more easily fatigued, more likely to suffer unintentional injury and less likely to follow instructions," Hanley said.

Himes said she thought Logan's habit of staying awake for up to two hours after being put to bed was typical of a child with autism.

"Sleep was not on my radar before, but we started trying the techniques over the Easter break," she said.

After using Hanley's formula that takes into account a child's sleep requirement by age and Logan's schedule, the Himeses are gradually adjusting his bedtime so that he gets the rest he needs but is not awake in his bed for hours.

In the Classroom

Julie Busch teaches preschoolers in a class for children with special needs from Benton and Washington counties. After attending the symposium, she planned to incorporate the life skills curriculum that Hanley explained. It appealed to her because of the way it can be done with other curriculum already in place.

More than half of the children in Busch's class have been diagnosed with autism, she said. Another part of her job is to conduct transition conferences with local school districts in which her students live. Whether they go on to a regular classroom or to a room for children with special needs depends on the child and on the school, she said.

"I see all of the schools working to improve their services," said Busch, who works for the Northwest Arkansas Education Service Cooperative in Farmington. "I like working with children this age. I feel I can make a difference for them. It's good for all educators to know this information. You will have kids in your room on the spectrum."

---

Resources

The College of Education and Health Professions offers other programs in addition to the Autism Spectrum Disorders Symposium. 

The Graduate Certificate Program in Autism Spectrum Disorders will enable current teachers and education professionals to gain much needed information and skills that will translate into a positive impact on the education of students with autism spectrum disorders. Professionals will enroll in the proposed program to learn specific knowledge and skills that will greatly facilitate their ability to effectively identify and educate students with autism spectrum disorders.

The goal of the University of Arkansas Autism Support Program is to provide the intensive assistance students with high functioning autism, Asperger’s Syndrome, PDD-NOS, and non-verbal learning disability need in order to be successful in college. The program offers services focusing on academics, accommodations, independent living and integration into life at the University of Arkansas.