Marion Blank, Ph.D. Columbia University [email protected] Suzanne Goh, M.D. Pediatric Neurology Therapeutics [email protected] Susan Deland [email protected].

Marion Blank, Ph.D.Columbia University

[email protected]

Suzanne Goh, M.D.Pediatric Neurology

[email protected]

Susan [email protected]

Website www.spectacularbond.com

[email protected]

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

[email protected]

Suzanne Goh, M.D.Pediatric Neurology

[email protected]

Susan [email protected]

Website www.spectacularbond.com

[email protected]