Friday, January 21, 2011

A new year, A new study

At the Focus Foundation we are committed to bringing state of the art care to all children with neurodevelopmental disorders. It is exciting to venture into unique treatment options in order to optimize the potential of each and every child we meet. This month we have just begun a Robotic study in collaboration with AnthroTronix.
Our past experiences with robots and children on the Autism Spectrum Disorders have been enlightening. We found that children with significant developmental dyspraxia and ASD where profoundly motivated by the robots we used. They worked harder and longer in order to interact with this robot whether it was to play or to lead their peers in games with the robots. Children who typically had fleeting attention suddenly did not want to leave the session.
It was truly empowering to see children who had been unreachable suddenly participate in activities with interventionists for greater period of times each week.
Our new study is a sequel to this and derived from our previous findings. The joy of research is answering a question and then suddenly finding there are two or three or many novel hypotheses which need to be addressed.
When we first started this study we wondered, do children with ASD merely prefer robots over conventional toys or is there something unique about certain robots that foster interaction? Or could it be that the automation of the robot is the BIG motivator for the kids?
This study will be looking closely at various robots as well as automated animals to further investigate the power of the robot and its' unique ability with children who are so compromised in the social and expressive language domains. We are presently collecting data for the next month to six weeks on young children with ASD, developmental delay and neurotypical children between the ages of 2 and 8. The actual session is simple; it lasts about an hour and is a fun and playful experience for most children. It is dyad with two children, often one typically developing and one with ASD. The children take the most unexpected paths as they explore the robots.
Social communication is a necessary skill for success in school, life and relationships. Recently it seems to me that any child who has speech delay and atypical play interactions may be diagnosed as on the ASD spectrum or PDD-NOS. The accuracy of the diagnosis is important for the family, treatment and the eventual recovery.
The differences regarding etiology of the social deficits is important for targeted treatment as well as improvement. Additionally, social communication has so many facets. There is the social awareness, the social cognition and social motivation to name a few.

But the real question is what makes social communication so atypical in children with ASD or any other disorder? Is it that the social interactions are driven by the severe speech delays? Or is it that the severe delay always means social communication deficits? Is there a synergy between not talking and developing social communication or are they related but not causal.
In my career, I have seen many boys and girls with severe verbal and oral motor dyspraxia and motor planning deficits which effect speech and language formulation, who have great social skills and even enhanced social pathways. They often are social superstars in therapy, the classroom and most certainly with their parents. Are these children more motivated or less anxious in spite of their speech disturbances? How does the planning affect their desire as well as their ability to communicate? Our boys and girls with X and Y chromosomal Variations often have better speech and language but still struggle with social communication in ways very different than our children with ASD.
There are so many common threads within all the children with social deficits.
It is important to tease all of the social pragmatics pathways. These answers will expand our ability to develop more targeted treatment and syndrome specific goals that are derived from the brain based findings. It will allow us to see brain and behavior connections in a very under studied area of development. Look for more on our Robotics Study as we proceed ahead with the intriguing aspect of learning.

Throughout this spring, I am going to be discussing IEPs and how one develops an effective IEP that uses the past to determine where you have been and pulls from the present to identify the future targets that will be worthwhile and fun. Most of all, the IEP should foster the greatest independence that each child can achieve. The future comes fast and it is critical to optimize time for all of us, but even more so if you have developmental challenges.