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ADOS/ ADI-R Training course
Improved access to diagnosis services in Scotland.
Why is there a need for improved diagnostic services?
The latest statistics for schools in Scotland compendium (Dec. 2010) indicates that 1:104 Scottish children are currently diagnosed with ASD, although head teachers and teachers have reported the figure to be higher due to short fall in diagnosis services. There is a further 1:30 child known to have a speech and communication condition, or social, emotional and behavioural problems, with the strong likelihood that some of these children in fact present with ASD. In total, 1 child in 24 is affected with related developmental and behavioural problems. At the moment, there are no indications of any reduction in the number of affected children. It is generally accepted that the rise in diagnosis is due to a combination of genetic susceptibility and exposure to environment triggers. However no causal agents have yet been identified.
These figures are matched by others conducted elsewhere in the UK. The current UK rate is 1 in 66 children aged 5-11. Evidence of geographical disparity is dramatically illustrated by the recorded rate of ASD in the Orkney Islands. The audit of services for people with ASD identified 91 children with ASD resident in Orkney NHS catchment area, making this the highest rate of autism in Scotland and in the UK, with 1 child in 44 being affected.
The majority of studies suggest a typical male:female diagnostic ratio of 3-4:1, with very few of the girls diagnosed being of the high functioning type. Yet recent publications suggest that women and girls are particularly under-diagnosed because of the relative subtlety of their presentation. This is an observation we have also made with an increasing number of young adult women coming forward seeking help in understanding the nature of their social and developmental difficulties. These young women have essentially fallen through the net of the diagnosis service, because their presentation is not typical of that of high functioning autism in boys. Commonly these women have been diagnosed with an eating disorder when the core of their difficulties is in fact ASD.
Early intensive behavioural interventions have helped many ASD children to acquire the core skills they are lacking and enable them to integrate successfully into the mainstream school system. The lifetime cost of autism has been estimated to exceed £2.4 million per individual.
Based on the above findings Scotland faces a lifetime care bill of between £40.2bn (Scottish figures) and £175bn (if the English prevalence is accepted as a more accurate figure for Scotland).
‘The age of autism’ presents an enormous challenge and ATT-Training is at the forefront of organisations trying to find ways of improving the life and prospects for people with autism.
The diagnosis-training we provide includes the standardised assessments used for making an autism diagnosis, namely, Autism Diagnostic Observation Schedule (ADOS), and Autism Diagnostic Interview Revised (ADI-R), and is complemented by other cognitive and developmental assessments. These include assessments of non-verbal intelligence, language comprehension, expressive communication, attention, behaviour, “autism level”, and overall neurological development across domains. These complementary assessments are beneficial because they assist in assessing the children comprehensively, guiding further intervention and providing a measure of progress throughout an intervention programme.
The course will be delivered over 7 days in total, split into two 2 blocks. The blocks will be run 1 month apart. The reason for this sequential organisation is that the first week will teach all required knowledge for professionals to practice in delivering and scoring across all assessments. The second week will review the work conducted during these practices from video recordings and by discussing any issue encountered. There will be further practice opportunities conducted in the second training week. After completion of this 7 days training, the participants will be invited to administer two ADOS modules and 1 ADI-R interview and rate some videos materials. The course organiser will then review the video materials and scores returned, upon which a course qualification can be obtained. Participants will be invited to meet twice yearly as consensus rating groups in order to insure a consistency in ratings.
Requirement
Typical applicants will have a background in psychology, psychiatry, paediatrics, nursing, speech therapy or similar, and will be currently employed in that capacity either as a clinician, part of a clinical team or part of a research team. Qualifications and employment information must be provided on the course application form. Participants must have access to an ADOS Kit (Hogrefe product code 5580001) for completing the pre-course and post-course assignments and be in a position to video record their sessions for evaluation.
Course dates
Part I: 19th-21th March 2012
Part II: 30th April – 4th May 2012
More information available here
Please call 0131 558 7444 for more information.
Brady’s Story
‘From the day my son was born he had health problems. He caught every illness going and took twice as long to get over them than any other kid, he had constant and recurrent fevers, he never had a normal bowel movement; alternating between diarrhoea and constipation, and he never slept through the night. He would have terrible screaming fits every night that sounded like cries of pain. Of course, like any mother I took all my concerns to the doctors several times but was always fobbed off with the explanation that ‘it was normal’. When I started my son on solid food at six months he projectile vomited everything out. This went on for weeks. I took myself off to the doctors only to be told, yet again, that this was ‘normal’ for some babies. I was really beginning to hate that word! I started to notice other issues with my son and decided to take matters into my own hands, since none of the professionals seemed to think there was cause for concern I figured it was up to me. I soon realised that my son had autism but I didn’t feel despair at this realisation when I kept researching. I read so much information and several books about biomedical interventions and I was overjoyed. The things I read these parents and professionals say described my son’s problems exactly. When I finally managed to get in to see a specialist I was so excited to tell her all that I had learnt and see what she would start implementing to help my son. To my absolute disbelief she had no interest in listening to any of what I had learnt and refused to even consider implementing any biomedical treatments. Once again I realised it was going to be up to me. I immediately started researching on-line again for doctors specialising in biomedical treatments and that is when I found Dr. Lorene Amet and the Autism Treatment Trust. With ATT all my concerns and suggestions were taken into consideration and I was instructed on how to start making some small changes in my son’s life. The first thing we did was switch him onto a Gluten-free Casein-free diet. Within one week the difference in my son was amazing. He was no longer waking up at night screaming, he was calmer and much more present. We next started him on B12 shots, which is a night I will never forget. Up until this point my son had never shown me any affection but within 20 minutes of his first shot he was hugging me and holding my face and smiling at me. I couldn’t wait to do more! After several tests and a consultation at the clinic a full treatment plan was put together. Over the past seven months as we have been implementing the treatments my son has become a new child. The difference in him is nothing short of a miracle. His autistic tendencies have decreased, his self injurious behaviour has almost vanished, he sleeps through the night, his belly is no longer constantly bloated and swollen, he has eye contact now and is a very loving and affectionate little boy. Before coming to ATT my son had unexplained rashes and spots on his body, he constantly had red cheeks and would grind his teeth incessantly, he would look at everything out of the corner of his eye instead of looking right at you or an object, he would spin and flap and obsessively play with one item inappropriately for hours at a time; all these things are gone now. Now my son is comfortable enough and healthy enough to be able to learn and we have recently started him on an ABA programme. He is doing very well with his therapy and I cannot wait to see what the future holds. We still have a long way to go but thanks to the wonderful people at the Autism Treatment Trust we now have hope that the future will be bright. I give thanks every day for the work that they are doing and for helping my son to feel well for the first time in his life.’
Sean’s Story
Writing some 3 years ago, we described Sean’s progress after 3 months of treatment at the age of 8. Even after this very short time he had shown ‘massive and rapid’ progress in terms of destructive, disruptive and aggressive behaviour, social isolation, poor eye contact and attention, gut problems and toileting and sleep pattern. His sociability had improved greatly, although disordered speech, poor diet, rigidity and inflexibility of habits and autistic bodily movements remained but were showing early signs of improvement.
Now, at the age of 11, his level of progress might be better described as a ‘seismic shift’. Sean’s treatment has progressed through the stages of treating intestinal problems and the areas where vitamins, minerals and amino acids were deficient to detoxification to rid him of toxic heavy metals and on to Methyl B12 therapy and measures to support the immune system. We recently repeated an ATEC, an online assessment tool used by clinicians to evaluate the effectiveness of interventions with ASD children. We had originally completed this based on Sean at around age 5 and he scored 157 in total, rating him as severely disordered in most key areas. He currently scores 15……
Sean’s communication skills began to improve quite rapidly (credit is also due here to his Speech Therapist and Support Teacher). His Speech Therapist recently repeated tests of his ‘phonic processing’ and this is now in the normal range, from a very low starting point. The clarity of his speech and his understanding of others have improved beyond recognition. He became determined to express Harry Potter spells, like ‘wingardium leviosa’ and this proved so positive in helping his pronunciation that his Speech Therapist used them as a tool in sessions to very good effect.
Better communication has allowed him to participate more at school and to form better relationships to the point where he is now capable of initiating and maintaining normal relationships with other children (in short he has mates). Social development has been massive and his range of interests is like any other 11 year old boy.
Intestinal issues are a thing of the past, to the relief of our noses and bowel function is excellent, so it has been a long time since he needed any help or frequent changes of underpants. He had a prolonged period of gluten and casein free diet, which supported treatments on his gut.
Sean became Type 1 diabetic 18 months ago, so we had to relax restrictions on gluten with no detrimental effect, luckily. He has amazed us how he has accepted 6-7 blood sugar tests and 4-5 Insulin jabs each and every day. This is a good example of how calm he is in comparison to the bad old days.
A few months ago, Sean had the chance to go away for 5 days to an outdoor centre with his school. Hitherto, he only allowed one of us to do his Insulin jabs. He worked it out for himself, that in order to go he needed to let someone else do his jabs. He came to us himself with the idea because he wanted to do ‘all that cool stuff my mates will be doing’, so we trained a support teacher to do his insulin and he went away, participated fully and had a fantastic time. It was also the first time he had been away from us longer than overnight.
FLEXIBLE, IMAGINATIVE, INDEPENDENT….MAKING DECISIONS ABOUT HIS OWN LIFE……..HANG ON A MINUTE!!!! HE’S NOT SUPPOSED TO BE ABLE TO DO THAT……HE’S AUTISTIC REMEMBER???
The main constraint on him going away was his diabetes. ASD never entered our minds as there are now no behavioural issues preventing Sean being a full participant in life. There have been too many occasions to list, especially in the last 18 months, where we have said, ‘ hang on, he’s not supposed to be able to do that but he’s just done it’……..He has also made his own decision on which High School he will attend next year and been able to explain his choice to us.
Sean has developed into the real Sean, the wonderful boy he really is, a boy who now has the chance of a positive and independent future. He is a person with imagination and individuality, who attends mainstream school and is socially well integrated. The ‘autistic’ body movements have disappeared, with the exception of a very odd way of running. He can, however, even laugh at himself. He no longer stands out as different in a group of children.
As his pace of learning was restricted for so long, when his peers were moving much faster, education, in particular literacy, now need to be the central focus, since he is now more receptive.
His treatment programme needs to continue. We still have a way to go but hopefully soon some aspects of intervention can be put on a maintenance regime. Results so far are fantastic but nobody should imagine that it has been without enormous effort and commitment. Even when your child is totally uncooperative, you still have to find ways to get them to take supplements and treatments because for many the result can be not just worthwhile but life changing.
Without ATT and Dr. Lorène Amet especially, we dread to think where Sean might be…….back in the bad old days of bowel problems, head banging and self-harm and uncontrollable aggression and temper. We prefer the real Sean, who has been given back to us.
Thank you ATT and Caudwell Children for financial support.
Sean’s Story (Testimony 1):
Sean started treatment 3 months ago but already he is showing very encouraging improvements. Aggressive behaviour and major tantrums have all but disappeared and he is much calmer. He is now sleeping much better, ‘touch wood’, and he is always saying, I’m hungry..’ Although his diet is still limited, he is enjoying eating. He loves gluten-free chicken nuggets and even asks for coleslaw, nuts, cucumber and red pepper…unheard of 3 months ago.His stools are much better, no longer messy and he is more independent as a result. Sean is more affectionate to people he was previously indifferent to and is relating to people, even strangers, differently, initiating conversation about meaningful things. Sean’s speech is still disordered but several people have said that they understand him much better and he seems to understand them better. His teacher reports he is more confident and is playing with a wider range of children and has even been helping other kids with ‘cutting and pasting’ in the computer lab at school. He is also developing more variety in his play, thankfully. This may save me from personally killing Harry Potter.
Sean has amazed us by agreeing to take his supplements in capsule form, which has helped with his treatment. He now asks for his ‘vitamins’, morning and night. Sean is now eight. He was diagnosed with ASD at six but the Problems really began around three years. He lost eye contact, his behaviour became disturbed and aggressive and he lost any regular pattern of sleep. He became almost ‘phobic’ of most foods. Speech was non-existent at this stage. Sean has developed in the meantime, slowly, with a lot of effort and support but his recent progress has been massive and rapid. Sean surprises us almost every day. The real boy is emerging more and more and this is wonderful. Sean’s reading, confidence with reading and word recognition has also improved significantly. This is not only evident in his reading homework but also being able to read road signs, when we are out. And. Sean now eats lentils and vegetable soup! More importantly, Sean is a much happier boy with a cheeky sense of humour!”.
Ryan’s Story
We visited the ATT Centre in late October due to our son’s diagnosis of Asperger as we had read about the treatments on offer. Ryan was seen by Dr. Lorene, who felt that he would benefit from a GF/CF diet, as well as supplements and also to be seen by Emma Gillett – Chiropractor. We explained to Emma all about Ryan’s difficulties and after 1 session, we noticed a marked improvement in Ryan’s behaviour, co-ordination, concentration etc, following a further 2 sessions with Emma, we are receiving lots of positive comments about his behaviour, especially from school, which has always been a problem area for Ryan. He recently achieved Reading at Level B only this week and has a main part in the schools play, which prior to these interventions he would have been in the background. Ryan has stated that he feels as if he is smarter now.
We received a letter from Ryan’s class teacher, stating the following:
Dear Mrs Kelly
Just wanted to let you see the great work Ryan achieved in handwriting today.
Miss J Hannigan.
So I would like to send my gratitude for all the work that your clinic has put into Ryan and look forward to more success as the weeks and months go by.
Thanks, The Kelly family
Below you will find images illustrating the before and after in Ryan’s work sent by his teacher:
Harrison’s Story
“In the emotional fear and bewilderment that follows diagnosis and after intensive research we took the decision to embark on the ABA method of early intervention; it was the only option that simply made sense to us. Now nearly 2 years on from that point and under the guidance of Annie MacDonald, our Case Manager, we feel justified in our decision to open up our home to a team of Tutors 6 days a week, to undertake to finance, run and participate in such an intensive programme and watch our son, often in the hands of others work harder than any little boy really should. Our 3year old son was virtually non-verbal, often busy in a world of his own and in many ways an enigma to us. We now enjoy conversations and can easily share experiences with him, simple but important things that we once felt beyond us. He remains supported in Mainstream Education, moving from Nursery to Reception alongside his peers and now friends, participating in all areas of school life. We also have obtained funding from our LEA to facilitate this programme and following Harrison’s obvious success the funding remained in place as we commenced our second year.
Eighteen months into the ABA we embarked with Dr Amet on another journey commencing a Biomedical Intervention Plan and what the ABA achieved for Harrison this has accelerated. From that confusing beginning we now see a very bright future, enjoy a fun filled present and eagerly watch our son, his personality and his skills unfold and grow. Our Tutors have become valued friends who offer support and care to all members of our family and who each bring very individual strengths to our team. Harrison remains the same clever, cheeky loving little boy he always was but at the same time is fundamentally different in almost every way.”











