Spotlight on the Spectrum

Autism Conference offers key takeaways for parents, teachers and other professionals

By Adrienne Cornwall

During the last week of September, the University of Missouri’s Thompson Center for Autism and Neurodevelopmental Disorders hosted a two-day conference on the current health, education and behavioral research and practices in autism at the DoubleTree St. Louis Hotel in Chesterfield.

Here are our highlights:

Genetic research is leading to the development of individualized medical treatments.

Keynote speakers Dr. Antonio Hardan of Stanford University and Dr. Raphael Bernier of Seattle Children’s Hospital Autism Center offered snapshots of the state of genetic research and neuroscience related to autism. Bernier also shared some early findings of his genetics research, which is focused on identifying genetically defined subgroups of individuals with autism. Two of the many such subgroups that have been identified work on identifiable neural pathways that regulate the activity of certain neurochemicals in the brain. By offering specific medications known to act on that pathway, Bernier has found some success in his clinic with alleviating certain behavioral symptoms with these individualized treatments based on the patient’s genetic variation. While each genetically defined subgroup singularly accounts for only a small portion of the total autism patients, for nearly 50 percent of autism cases in his research groups a genetic variation has been identified. While full-scale clinical trials have not begun, Bernier concluded that individualized treatment for autism spectrum disorders based on genetic and biological makeup will complement current best practices in behavioral therapy as the future of autism care.

“We’re not there yet, but that’s where we’re headed,” Bernier said.

Keeping kids safe takes a village.

On the eve of the conference, a panel of experts from the Thompson Center, including Executive Director Dr. Stephen Kanne, behavior expert Dr. SungWoo Kahng, and training expert Anna Laakman, joined Bernier and Dr. John Mantovani, director of the Mercy Kids Autism Center in St. Louis, to field questions submitted by parents and family members.

One primary area of interest for parents was safety, which is understandable considering that nearly half of all children with autism will wander. Training Core Administrator Anna Laakman had several tips for parents in the audience. First, plan ahead: Let local law enforcement, neighbors and others in your community know about your child and his or her preferred environments – often the first places a wandering child might seek. Second, invest in an identification system for your child, whether it’s an ID card (a version is available at nationalautismassociation.org) or temporary tattoos with emergency contact information. Finally, Laakman recommended that all families teach their children to swim. Children with autism are particularly drawn to water – lakes, oceans, ponds, fountains, pools, and retention ponds – and knowing how to swim can save the child’s life. Some online safety resources for families include the Big Red Safety Box and the 100 Day Toolkit from Autism Speaks.

Teachers should include measurable autism-specific goals in a collaborative IEP process with parents.

Lisa Ruble from the University of Kentucky presented key elements of effective educational programs for children with autism for teachers to incorporate into classroom. Her suggestions, which are based on a model she and her peers developed call COMPASS, include setting objective, measurable goals to improve students’ performance in areas specific to autism, such as social communication, adaptive skills, and learning and work behavior skills. She recommended collaborating with families to incorporate evidence-based practices into setting specific, measurable goals on individual education plans that serve each student’s unique needs. Resources for applying these recommendations to classrooms can be found through the National Professional Development Center, Ohio Center for Autism and Low Incidence, and the National Autism Center. The Thompson Center also offers free educator training in individual classrooms or district-wide through the TEAM program funded by the state. Training for other professionals, such as health providers, emergency responders, caregivers and applied behavior analysts, is also provided through TEAM and other programs at the Thompson Center.

Understand the differences between autism and similar disorders to get kids the right services.

Pediatrician Gretchen Meyer, director of Mercy Kids Autism Services, shared her insight on differentiating between a diagnosis of autism versus other disorders that share some overlap in symptoms, such as ADHD, anxiety, speech and hearing difficulties, learning disabilities, oppositional-defiant disorder or social communication disorder. To meet diagnostic criteria for autism, individuals must have deficits in both the social communication and interaction domain as well as restricted interests and/or repetitive behaviors. Many other diagnoses include some similar symptoms in these areas, but the presence of other symptoms or the lack of the other required deficits for an autism diagnosis make another diagnosis more appropriate. So, often children may meet some but not all criteria for autism. Differentiating between these disorders can help specialists treat patients more appropriately, and other disorders should be considered and ruled out. By understanding the true distinguishing symptoms of autism, Meyer hopes that teachers, parents and other health providers can make more accurate referrals to help children sooner with an appropriate diagnosis and relevant services. The Thompson Center offers a free online training module that walks through the screening process and diagnostic criteria for those who are interested in more details.

Walk with the Thompson Center in Mizzou Homecoming Parade

COLUMBIA, Mo. (Sept. 21, 2015) — Supporters of the Thompson Center for Autism and Neurodevelopmental Disorders are invited to walk with center employees and volunteers in the 2015 Mizzou Homecoming Parade on Sat., Oct. 10, 2015.

The Thompson Center group will have space for walkers and riders, and all participants will receive a free Thompson Center homecoming-themed t-shirt.

To prepare for the parade, the center will host an art day open house from 10 a.m. – 1 p.m. at our building at 205 Portland St. We will make banners, flags and posters to display at the parade the following weekend.

Starting time and parade lineup instructions will be given to all participants when the university announces the game time for the homecoming matchup against University of Florida.

To sign up as a walker/rider for the Thompson Center, email Miriam Cullimore at cullimorem@health.missouri.edu or call 573.884.7263.

ECHO Autism program to be expanded to additional 10 sites

From News-Medical.Net, Sept. 2, 2015

Dr. Kristin Sohl, a pediatrician at the University of Missouri Thompson Center for Autism and Neurodevelopmental Disorders, will expand the growing ECHO Autism program, which launched in March, to an additional 10 sites.

Sohl’s ECHO Autism project will be the centerpiece of a recent grant renewal through the federal Health Services Research Administration’s Autism Intervention for Physical Health initiative. The $15 million award is shared among 14 autism centers in North America.

“I am excited to be focusing my efforts on changing the landscape for autism care across North America and working to improve the health system so centers of excellence in autism can improve throughput for more children to enhance quality of life for more families,” Sohl said.

ECHO Autism is based on a telehealth specialist network model developed by a hepatologist at the University of New Mexico, Sanjeev Arora, to serve the needs of hepatitis C patients who had no access to treatment where they lived and were dying on the growing waitlist for his clinic.

Extension for Community Healthcare Outcomes (ECHO) pairs specialist centers, such as those at the Thompson Center, with community providers to help them manage cases and empower them with knowledge to help their patients locally.

Sohl’s pilot cohort for ECHO Autism, the first ECHO-based project for autism care in the U.S., included 15 providers from all over the country, including rural and underserved areas in Missouri.

With a goal to develop 10 additional centers of excellence in autism care through this program, Sohl’s new efforts will bring this specialty knowledge about common medical issues in children with autism and barriers to diagnosis and treatment to an exponentially larger group of physicians.

“Dr. Sohl is a gifted physician who is passionate about caring for children,” said Thompson Center Executive Director Dr. Stephen Kanne. “Her efforts to close the gap in access to quality medical care so that children with autism can have the best outcomes possible are vital to extending our center’s work to help kids beyond our local and regional communities.”

Most importantly, patients served by providers in the ECHO Autism network have the chance to be treated in their own community, without waiting or traveling to see a specialist.

“The ECHO Autism model will improve early identification of autism and increase screening and treatment of common co-occurring conditions in the primary care setting, particularly in underserved communities,” Sohl said.

Sohl to hand off medical director duties to expand autism care network

By Adrienne Cornwall

COLUMBIA, Mo. (Aug. 31, 2015) — After seven years as medical director of the Thompson Center for Autism and Neurodevelopmental Disorders at University of Missouri, pediatrician Dr. Kristin Sohl will transition away from her administrative duties as of August 31 to expand the growing ECHO Autism program, which launched in March, to an additional 10 sites. Her patient care duties will continue unaffected.

Sohl’s pilot cohort for ECHO Autism, the first ECHO-based project for autism care in the U.S., included 15 providers from all over the country, including rural and underserved areas in Missouri.

“Dr. Sohl is a gifted physician who is passionate about caring for children, and we are so grateful to have had her leadership in medical services for seven years,” said Thompson Center Executive Director Dr. Stephen Kanne. “Her efforts to close the gap in access to quality medical care so that children with autism can have the best outcomes possible are vital to extending our center’s work to help kids beyond our local and regional communities.”

Most importantly, patients served by providers in the ECHO Autism network have the chance to be treated in their own community, without waiting or traveling to see a specialist.

Sohl will pass leadership for the center’s diagnostic and clinical services for children with autism to a new medical director. Leadership for the medical clinics will be absorbed internally until a new or interim medical director is appointed.

Tiger Pals program connects kids, builds social skills

By Adrienne Cornwall

COLUMBIA, Mo. (Aug. 21, 2015) – For many families, summer break offers a chance to get out of town. At the Thompson Center, a group of kids instead seized the opportunity this July to make new friends.

The center’s Tiger Pals program pairs children with autism or other developmental concerns with typically developing children of about the same age to play for a few hours each week in the evening.

With the guidance of Thompson Center behavior analyst Anna Hogg and a team of graduate students, the children practice building social skills that all the children can take with them into school and their other activities.

This summer’s elementary-aged group included three children with a range of developmental abilities who are patients at the center as well as three typically developing children who volunteered to help their buddies practice seeking out friends and initiating conversations.

For typically developing children, social interactions come naturally and are fluent, Hogg said. The goal of Tiger Pals is to help make those interactions more fluent for the children with developmental delays with less need for adults to help them make connections.

“There’s not always going to be an adult on the playground to help them communicate,” said Hogg.

The buddies spent two hours together once a week for eight weeks with a range of activities including free play, guided buddy activities, snack time and activities the buddies would choose together.

Tiger Pals follow three rules to help maximize the peer-mediated social interactions they get to practice during each session: stay with your buddy, play with your buddy, talk to your buddy.

For this group, which was the first time the program was offered, those guidelines are working.

“In all three of our clients, we’ve seen a noticeable change in how often they initiate contact with and respond to their buddies,” Hogg said.

Tiger Pals will be offered again in the fall for eight weeks beginning Sept. 14. For more information about the program or to sign up, visit our events page.

Families enjoy games and treats at Family Fun Fair to support MU autism center

By Adrienne Cornwall

COLUMBIA, Mo. (July 31, 2015) – In the final weeks before back-to-school arrives in Columbia, families took the opportunity to enjoy one last day of outdoor summer fun for the whole community at the University of Missouri’s Thompson Center for Autism and Neurodevelopmental Disorders on Thursday.

Shawna Mabe, a nurse at the Thompson Center, is a member of an internal committee that hosts employee events at the center year-round to raise money for holiday gatherings and an annual donation to a local charity. This year, the committee added to their list of priorities: create a fun day outdoors for children with autism or other special needs and their families, who may find that larger fairs and summer activities are not a successful experience.

“The committee loves to plan events that bring a little break and excitement into what can be a long week here at the Thompson Center,” Mabe said. “This year we thought it would be fun to bring the fun out to our families.”

With help from 11 local sponsors, including service agencies, nonprofits and businesses, attendees got to make crafts like paper-plate crowns, play games like bean-bag toss, choose a face-painting design or enjoy some free play time on the GymBus, a former school bus used as a mobile gymnastics education space by instructors at Gymnastics Express.

Gymnastics Express owner Jeff Connors, who has developed adaptive gymnastics programs and works with children of all abilities in local child care facilities, said he was glad to offer the GymBus to kids at the fair for the fun and learning experience.

“Children use gymnastics skills in play – jumping, landing, reaching,” Connors said. “We concentrate on learning how to do it safely.”

Other sponsors for the day were Kona Ice COMO, Windsor Street Montessori School, Parent Link, Columbia Parks and Recreation, Access Arts, Boone County Family Resources, Easter Seals Midwest, Parents as Teachers, and brothers Jake and Logan West, who hosted a booth sponsored by RE/MAX On the Move’s Betty Jo Sydenstricker.

The Family Fun Fair raised $250 for the Thompson Center endowment fund, which was established to secure funding for another 10 years of excellence in care for individuals with autism and other developmental concerns.

“Since we have so many deserving families that are in need of resources and we sometimes help with funding other activities, we decided that the profits from the fair should go back into the Thompson Center to be used for our families,” Mabe said.

Thompson Center welcomes new child psychologist to faculty

By Adrienne Cornwall

Pediatric neuropsychologist Dr. Michael Mohrland recently joined the Thompson Center for Autism and Neurodevelopmental Disorders as a clinical provider and faculty member in the University of Missouri’s Department of Health Psychology.

Dr. Mohrland joined the center on July 20 from Wisconsin, where he practiced in clinical psychology with the Achieve Center conducting diagnostic assessments, outpatient psychotherapy and a concussion clinic he developed through collaboration with a local sports medicine physician.

“Many of our patients are referred to us due to complex medical conditions that could affect the way they think and behave,” said Thompson Center Executive Director Dr. Stephen Kanne. “Dr. Mohrland’s expertise in pediatric clinical neuropsychology will help us identify how these conditions may be impacting the child across a wide range of abilities and domains.”

Dr. Mohrland trained at the University of Missouri during his internship year to earn his doctoral degree from Nova Southeastern University in Ft. Lauderdale, Fla. He earned a post-doctoral fellowship in pediatric rehabilitation psychology and neuropsychology at the University of Michigan.

Dr. Mohrland will see children from infancy through young adulthood for neuropsychology services, clinical assessments, autism evaluation, concussion and traumatic brain injury, and tic-reduction therapy.

“It’s been a lot of fun returning to Columbia and joining the Thompson Center,” Dr. Mohrland said. “The pediatric neuropsychology clinic will provide an additional service for not only developmental disorders but also acquired brain conditions from illness or injury. I look forward to the collaborative work in maximizing young people’s potential alongside their families and community.”

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Mizzou ATO chapter raises $25,000 to endow patient scholarships for autism services

By Adrienne Cornwall

The University of Missouri’s Alpha Tau Omega chapter raised more than $5,300 at its annual family festival fundraiser for patient scholarships at the Thompson Center for Autism and Neurodevelopmental Disorders, fulfilling a $25,000 endowment pledge made a little over two years ago.

In addition to setting a new record tally for the event’s second year, nearly 300 participants lined up to break the Guinness World Record for most high-fives in one minute with the help of Rye Shade, a local 11-year-old boy with autism.

With a GoPro camera strapped to his chest, Shade easily ran the length of the drive around the Columns in 37 seconds, high-fiving the 287 hands as he ran.

“Next year, I think we can shoot for even more participants, because we know we have the time,” said ATO Signature Event Coordinator Zach Carmichael.

Participants last year tried to break the record, too, but the entry lacked the necessary video evidence, Carmichael said. With the help of one stationary and two mobile cameras, Carmichael said he hopes this year’s attempt will officially topple the standing record of 260.

Festival proceeds helped the chapter fulfill its pledge to endow $25,000 to fund patient scholarships at the Thompson Center to help families afford necessary autism services.

“Our Mizzou ATO chapter has been a dedicated partner in helping individuals touched by autism in our community,” said Thompson Center Executive Director Stephen Kanne. “The funds they raised at Sunday’s festival will help countless families get medical and other services that they couldn’t otherwise afford.”

Thompson Center hosts Autism Awareness Month activities throughout the community

Autism Awareness Month in April is always a busy time of year in the autism community. The Thompson Center participated in and hosted a number of events throughout the month to celebrate the successes of our patients and their families.

We kicked off the activity with Light It Up Blue on April 2, World Autism Awareness Day, at the MU Student Center with the help of seven other partner organizations. More than 150 attendees, plus Truman, TJ and the Columbia Chamber of Commerce helped spread the concept of autism awareness on campus by wearing blue and joining us for a blue-lit walk with glow sticks from the Student Center to Memorial Union.

To cap off the month, Alicia Curran and her family brought the house down at the It’s In the Cards fundraiser in St. Louis, sharing their personal story of caring for Samuel, Alicia’s 14-year-old son with autism. Gov. Jay Nixon, MU System President Tim Wolfe, MU Chancellor R. Bowen Loftin, and Cardinals General Manager John Mozeliak were just a few of our special attendees, in addition to honorary event co-chairs Matt and Mackenzie Carpenter. Several families were featured in a video unveiled at the event, which raised $560,000 for the Thompson Foundation through a live auction, centerpiece auction, fund the need and ticket sales. We also shared a brief glimpse at the Thompson Center’s first decade to honor the center’s 10th anniversary and encourage support for the next 10 years.

Thompson Center health professions faculty grows

Health professions faculty at the Thompson Center expanded last fall as the center welcomed two new providers from the Assessment and Consultation Clinic, which was formerly a clinical service in the College of Education.

Since joining us in October, Dr. Andy Knoop and Dr. Megan Carney have been providing psychology services for assessment and treatment of ADHD, learning disabilities, and other psychological concerns in children while also being trained in autism diagnostic measures.

A new clinical offering for patients with severe self-injurious and aggressive behaviors has welcomed its first patients under the direction of Dr. SungWoo Kahng and Applied Behavior Analyst Annie Doyle. The Severe Behavior Clinic currently sees three children for intensive outpatient intervention with as many as two to four staff per patient during each visit. Sessions include conducting an initial functional analysis to identify the root of problem behaviors like self-injury and property damage, followed by implementing individualized treatment plans to address causes and reduce the severe behavior. Referrals currently come from internal providers, and the clinic maintains a waitlist for additional patients that can be added to the clinic as staffing allows. For more information about this new program, contact SungWoo Kahng or Annie Doyle.

In addition to adding more providers, the health professions division has developed a number of summer workshops for professionals and families. A handwriting camp for 5-7 year olds met for six weeks on Mondays starting June 9. A picky eaters group for 3-6 year olds meets Mondays in July to expose children to new foods in a playful way. A transition workshop for professionals working with and parents of teens preparing to age out of school-based services was held at the MU Student Center on June 11 with a keynote presentation by transition expert Dr. Paul Wehman of Virginia Commonwealth University. And, we have scheduled a monthly series of parent workshops through December on everything from toileting to puberty. Visit the Thompson Center’s events page for a complete listing of upcoming events and workshops.