Autism treatment found beneficial regardless of treatment model

A new study shows that children who receive early treatment for autism benefit regardless of the approach or treatment model used.

Researchers at the University of North Carolina at Chapel Hill have found that preschoolers with Autism Spectrum Disorder (ASD) who receive high-quality early intervention benefit developmentally regardless of the treatment model used -- a surprising result that may have important implications for special-education programs and school classrooms across the country.

"This is the first study designed to compare long-standing comprehensive treatment models for young children with ASD," said Brian Boyd, a fellow at UNC's Frank Porter Graham Child Development Institute (FPG) and one of the study's co-principal investigators. Boyd also is an assistant professor in occupational science and occupational therapy in UNC's School of Medicine.

"We know that more children are being diagnosed with ASD each year, and that it can cost an estimated $3.2 million to treat each child over a lifetime. Understanding that a child can benefit from a high-quality program, rather than a specialized program, may help reduce those costs by decreasing the need for teachers and other school practitioners to be trained to deliver multiple specialized services," Boyd said. He stressed it remains important to ensure educators are trained to provide high-quality programs that meet the special behavioral, communication and other needs of children with ASD.

Previous research has shown that when children with ASD have access to early intervention via treatment programs, they improve developmentally. Until now, however, debate has persisted over which approach to use, said Boyd. The study appeared in the June issue of Journal of Autism and Developmental Disorders.

Two frequently used comprehensive treatment models have a long history: LEAP (Learning Experiences and Alternative Program for Preschoolers and their Parents) and TEACCH (now known only by its acronym).

FPG's study examined the relative effects of the LEAP and TEACCH school-based comprehensive treatment models when compared to each other and to special-education programs that do not use a specific model. The multisite study took place only in high-quality classrooms and enrolled 74 teachers and 198 3- to 5-year-olds in public school districts.

The study found that children made gains over the school year regardless of the classroom's use of LEAP, TEACCH or no specific comprehensive treatment model. "Each group of children showed significant positive change in autism severity, communication and fine- motor skills," said Kara Hume, FPG scientist and co-author. "No statistically significant differences were found among models, which challenged our initial expectations -- and likely the field's."

"This study may shift the field's thinking about comprehensive treatment models designed for young children with ASD," said co-author Samuel L. Odom, FPG's director and the study's principal investigator. "Perhaps it's not the unique features of the models that most contribute to child gains but the common features of the models that most influence child growth."

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Study Claims Sleep Problems In Young Children Linked To Greater Need For Special Education

A study shows that children with sleeping problems are more likely to require special education.

Kids who snore may be more likely to have behavioral problems, but that may not be all. A new study, published in Pediatricsthis month, found that children with sleep problems through the age of 5 were more likely to require special education by age 8.

Karen Bonuck, a professor of family and social medicine at Yeshiva University's Albert Einstein School of Medicine, led the study that gathered data from 11,049 children with sleep-disordered breathing -- a general term covering snoring and sleep apnea -- and 11,467 children with behavioral sleep problems. Bonuck found that children with one of these disorders were 30 percent more likely to need special education, while children with behavioral sleep problems, such as bedtime refusal or delayed sleep onset, were an additional 7 percent more likely to require speciality courses.

"What we found was that absolutely both behavioral and respiratory problems did increase the likelihood of special education," Bonuck told CBS News' HealthPop. "The take home from this is we need to be looking at these breathing and behavioral sleep problems at very young ages in these children."

The research follows from an earlier study led by Bonuck, published in Pediatrics in March, that linked sleep disorders in young children to the development of behavioral problems such as hyperactivity and aggressiveness.

"This is the strongest evidence to date that snoring, mouth breathing, and apnea can have serious behavioral and social-emotional consequences for children," Bonuck said in a statement.

Though Bonuck's new study does not prove cause and effect, sleep problems in young children may lead to a host of other issues outside the behavioral realm, including special education needs.

"We've got a generation of children potentially at risk from long-term developmental deficits that might occur from these sleep problems," Bonuck told HealthDay. "Parents need to be vigilant."

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Study: Sleep problems in young children tied to special ed need

A new study claims sleep issues in young children may be linked to special education needs.

(HealthDay)—A history of either sleep-disordered breathing (SDB) or behavioral sleep problems (BSPs) through the age of 5 years is associated with an increased likelihood of special educational need (SEN) at 8 years of age, according to a study published online Sept. 3 in Pediatrics.

To examine the association between SDB, BSP, and SEN, Karen Bonuck, Ph.D., from the Albert Einstein College of Medicine in Bronx, N.Y., and colleagues analyzed more than 11,000 parental responses in the Avon Longitudinal Study of Parents and Children on children's snoring, witnessed apnea, and mouth-breathing at 6, 18, 30, 42, and 57 months. For 11,049 children, parent report of SEN at age 8 was available.

The researchers found that previous history of SDB and BSPs correlated significantly with SEN, after controlling for 16 putative confounders. For roughly each one-year interval at which a BSP was reported there was a 7 percent increased odds of SEN. SDB was associated with a near 40 percent increased odds of SEN. SEN was 60 percent more likely in children in the worst symptom cluster.

"Findings presented here strongly support an association between early childhood sleep problems and later SEN, on a population basis," the authors write. "This highlights the need for early screening, because early treatment is often effective for SDB and BSPs." More information: Abstract

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The Best Ways To Integrate Special Needs Students

I found this report on NPR. I hear parents talk about special education issues every day. Accommodations and modifications are a difficult process for all. Children with seizures, autism, cerebral palsy, ADHD and other neurodevelopmental problems are entitled to education. Parents expect a full range of services. In general, schools have motivated and highly professional personnel and accurate services. At the same time, schools have limited budgets for personnel, occupational, physical and speech therapy.  Its a difficult situation.  A physician can help. JR

The Best Ways To Integrate Special Needs Students

May 2, 2012

Budget cuts in many school districts have some parents and teachers questioning whether they have the resources to support their students. NPR education correspondent Claudio Sanchez and Thomas Hehir of Harvard University talk about how to integrate special needs students into mainstream classrooms.

JENNIFER LUDDEN, HOST:

This is TALK OF THE NATION. I'm Jennifer Ludden, in Washington. A troubling new video has reinvigorated the debate over special needs education. A father was told his special needs child was unruly, so he sent him to school wearing a wire. On the recording, his son is harassed and mocked by a teacher and aide in a special needs classroom.

The video is only the latest example of a widespread sense of frustration about special education. What to do? Advocates often want special needs students to get their own classes, but school districts say that's expensive, and certainly in a time of budget cuts, mainstreaming is on the rise.

If you're the parent or teacher of a special needs student, what works? Our number is 800-989-8255. Our email address is talk@npr.org. And you can join the conversation at our website. Go to npr.org and click on TALK OF THE NATION. Later in the program, why some schools are forcing kids off their bikes and into cars.

But first, best practices for mainstreaming special needs students. Joining me now is NPR's education correspondent Claudio Sanchez here in Studio 3A. Hi, Claudio. Welcome.

CLAUDIO SANCHEZ, BYLINE: Good to be here.

LUDDEN: So this is a trend that's been growing in public schools, but mainstreaming may not be a term that everyone's familiar with. Can you just tell us what it means?

SANCHEZ: Mainstreaming means that a child's instruction takes place in a classroom with non-disabled kids, regular kids, a decision based often on the special needs of that child. So, yes, there's an attempt to have this kid feel inclusive, be inclusive, but often it has to be tailor-made. That's where something very crucial here has to happen, and that is that an individual education plan be designed for this child, which calls for special accommodations, certainly special attention if necessary.

And this is all, of course, in the law, the 1975 law that actually was originally called the Education for All Handicapped Children's Act. It later became the Individual Disability Education Act, and that was, for the most part, kind of reauthorized in 1990.

LUDDEN: So, for decades, there's been this effort - so there was a sense beforehand that special needs kids were kind of shunted away and kept out of sight. Parents wanted them in the mainstream. And yet, as I understand it, there have been a lot of bad experiences in these mainstream classes.

SANCHEZ: And remember, they weren't just shunted away. They were literally kept out of school. I mean, for many, many years, these kids were warehoused somewhere else. Schools didn't deal with them. You know, it took several legal cases and challenges to that, most - especially in 1972 in Pennsylvania, which literally led to the creation of the law.

But you're right. The problem has been money, in many ways. You know, there's been an acceptance that these kids can learn, should be mainstreamed, but the money issue is huge. The federal government, when it authorized this law, more recently said we're going to contribute 40 percent - this is Congress talking - 40 percent of the funding for special education.

To this day, it's never been more than 18 percent. So that means that local and state education folks have to come up with the money somewhere, and we're talking about tens of thousands of dollars for every child, every year. So it's a very - it's a very difficult problem for schools because they don't have the money.

LUDDEN: And I guess more so now with - we've seen so many cuts at local school districts.

SANCHEZ: Exactly. And certainly in this time of austere and very limited budgets, I mean, where do you go? The federal government is not coming up with more money, believe me. States are obviously cutting left and right. So, I mean, often, it comes down to litigation on the part of parents. And if you have a good attorney, sometimes they get money out of the district to pay for these services or to put the child in a private program.

LUDDEN: So this terrible, painful video has surfaced of this child's experience. But I take it that's not a surprise to people who look at this field, that there's been a series of studies recently that show this these kinds of instances.

SANCHEZ: Yes, although I would say that the - you know, it's difficult to really document, certainly, every instance of abuse, but they are pretty common. You know, there are cases - there was on in Georgia, a 13-year-old boy committed suicide after being sent to an eight-by-eight, concrete-block time-out room in Gainesville, Georgia, at the public school there.

For students, this was a place that they put students in for behavioral problems. Then there was - you know, there are these famous screaming rooms that some schools have where teachers put kids when they're acting out, when they're out of control. And, you know, there was that famous case, I forget where, it may have been Kentucky, where a child was - who was misbehaving, a special ed kid, had been found stuffed in a duffel bag.

I mean, you know, you hear about these things, and you say this can't be. This has to be the exception to the rule. But you'd be surprised how often - I mean, some of these things aren't even reported, but it happens.

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