Individuals with autism spectrum disorder (ASD) often have co-occurring medical conditions such as epilepsy, insomnia, psychiatric conditions, and gastro-intestinal issues. Epilepsy occurs in approximately 20% of individuals with ASD over the lifespan. Insomnia is also common in individuals with ASD. Up to 80% of children with ASD experience sleep disturbance, including difficulty getting to sleep, frequent night awakenings, early morning awakenings, decreased need for sleep, and daytime sleepiness and irritability. In addition, psychiatric comorbidities, such as ADHD, anxiety, and depression, occur more frequently in individuals with ASD than in typically developing individuals. Lastly, individuals with ASD are more likely to experience gastrointestinal problems such as chronic constipation, diarrhea, irritable bowel conditions, reflux, and food intolerances and allergies. Due to increased prevalence rates, it is important providers screen for medical comorbidities in individuals with ASD.

Mealtimes are meant to be enjoyable and satisfying experiences for families. However, for parents of children with autism spectrum disorder (ASD), mealtimes can be extremely frustrating and stressful times. Feeding problems are very common in children with ASD and occur in up to 90% of children with ASD (Kodak & Piazza, 2008). Furthermore, approximately 70% of children with ASD are considered “selective eaters” (Twachtman-Reilly et al., 2008). In collaboration with the family’s other providers (e.g., pediatrician, speech and language therapist, gastroenterologist), behavioral strategies based on principles of applied behavioral analysis (ABA) are often implemented to improve feeding behaviors and broaden a child’s diet.

The two-day training workshop was for Preschool Special Education and General Education Teachers, Teaching Assistants, Behavior Interventionists, Speech and Language Pathologists, Occupational Therapists and School Psychologists from local school districts. The workshop included demonstrations, guided observation, behavioral rehearsal activities to practice new skills, interactive instruction, handouts outlining new skills, and an overview of the research underlining the content. Attendees became familiar with developing and assessing play skills; utilizing strategies for challenging behaviors in the classroom; and assessing social communication.

Naturalistic Developmental Behavioral Interventions (NDBIs) are a type of applied behavior analysis (ABA) that incorporate learning opportunities into a child and family’s existing daily routines. Skills and treatment goals are based on developmentally appropriate expectations and focus on key areas of development like social engagement. Pivotal Response Training (PRT) is one of several NDBI treatments that is available to the community. PRT is a research-based intervention for individuals with Autism Spectrum Disorder (ASD) developed by Drs. Robert and Lynn Koegel at the University of California Santa Barbara. PRT targets pivotal areas of a child’s development, such as motivation, responsivity to multiple cues, self-management, and social initiations. By targeting these critical areas, PRT results in widespread, collateral improvements in other social, communicative, and behavioral areas that are not specifically targeted. Key aspects of PRT include child choice, task variation, interspersing maintenance tasks, rewarding attempts, and the use of direct and natural reinforcers. PRT is used to teach language, decrease disruptive/self-stimulatory behaviors, and increase social, communication, and academic skills.

Research over the last 40 years has identified some evidence-based treatments for individuals with autism spectrum disorder (ASD). Among available treatments for individuals with ASD, applied behavior analysis (ABA) has the most evidence supporting its effectiveness. In addition to ABA, other naturalistic developmental behavioral interventions (NDBIs) have gained evidence for treating core deficits in ASD (Schreibman et al 2015). Despite the growing evidence-base for the effectiveness of behavioral interventions, the use of complementary and alternative treatments (e.g., the gluten-free casein-free diet, supplements, chelation, secretin, melatonin) that lack empirical support continues to be widespread (Golnik and Ireland 2009). Previous studies estimate that 52% - 95% of children with ASD are treated with complementary and alternative treatments (Harrington et al. 2006, Wong and Smith 2006; Hanson et al 2007). It is important to review the evidence-base for commonly utilized treatments so that clinicians can communicate potential benefits and risks to families.

Executive functioning skills are brain processes that help people plan, organize, maintain attention, and multitask. Strong executive functioning has been related to success in school, jobs, and relationships, as well, to improved mental and physical health and overall quality of life. Weak executive functioning in childhood predicts weak executive functioning in adulthood. As such, if the foundation for these skills is not solidly constructed in childhood, they are not likely to improve into adulthood. Executive functioning in adolescence has been related to self-reliance, strong identity development, and work orientation (Galambos et al. 2005). This suggests that youth with solid executive functioning skills can approach their lives in a strategic, flexible, and efficient manner and be more likely to develop a stronger, more independent sense of self.

Executive functions seem straightforward when defined, but understanding how weaknesses in executive functions translate into daily behaviors can be less clear. Often, parents realize that they are frustrated with their teen for their approach to tasks and responsibilities, but aren’t sure why there are problems. Weaknesses in day-to-day executive functioning skills may underlie many of these frustrations.

Research over the last 40 years has identified many intervention approaches for the treatment of autism spectrum disorder (ASD). A huge barrier in the field, however, has been the development of sensitive measures that accurately assess changes in ASD symptoms in response to intervention. While specific behavioral goals are commonly tracked throughout treatment, core social communication behaviors are infrequently measured and tracked at pre and post interventions in the community and educational settings. Dr. Catherine Lord developed the two gold standard diagnostic measures for ASD and recently developed a brief measure of treatment response for social communication behaviors in individuals with ASD. This activity informed learners on the importance of measuring change in individuals with ASD and specific ways clinicians can assess for change in individuals with ASD.