Expect Success with Autism | Ep 101

Updated: Nov 15

The mission of our new autism podcast, Connect with Success, is to lead you to a new and exciting way of understanding, responding to and helping people with autism.

In our first episode, Dr. Rich Smith and I welcomed everyone to our first episode of Connect with Success, a podcast built around The S.U.C.C.E.S.S. Approach, a model for intervention for individuals with autism. Every podcast episode will focus on a new term. We want to help you understand the terms we use as professionals when we assess, treat and care for children with autism. The term in episode one is transdisciplinary. Transdisciplinary is a word that we say when we talk about the team that is serving a person with autism. The team is usually comprised of the parent, and other professionals like teachers or therapists, doctors, dieticians, who all work together in transdisciplinary care. This term is not used to just explain what we're doing with the child or the adult, we're actually cross training and role releasing to our other team members, so they too can uphold whatever it is that we, as a single team member, feel that the child needs holistically. Our team at Integrations Treatment Center in Wickliffe, Ohio, has spent the past 25 years unlocking the true potential of children with autism. We believe we have a very important and potent alternative that allows parents to come away from despair and come to a place of confidence and understanding. We have been dedicated to autism, and we have discovered some very important tools that keep us going forward in our journey. First, A Little About Me I come from a very large Italian family, and I am the last of eight children. Because of the loving way that our families work together and were supported by our parents to grow into adulthood, I was always interested in thinking ahead, and deciding what I wanted to do with my life, even from a very young age. So when I was in seventh grade, I was volunteering for a local program that helped children with special needs that happened to be sponsored by the Cleveland Catholic Diocese. In my role of a little junior camp counselor, I met some individuals with autism, and one of them, whose name is Katie, struck me in a way that I've never been struck before. Katie absolutely grabbed my heart. Katie had autism, which at the time I probably couldn't even spell back in sixth or seventh grade, but she was compelling to me because she wore her nervous system on her sleeve (which looked like running around and galloping, and some people might say fleeing). She was very free spirited. And I was compelled to try to help her, which the other camp members were very happy about because they saw her as challenging or difficult. And so I worked very hard to understand, Katie, and to reach her. And as I did, I realized that adults have the capacity to influence children in a positive way. I helped her channel her energy into applying herself and enjoying the camp, as opposed to just running and maybe not engaging so much, socially, or meaningfully with others. So I started talking to my family, this big loving Italian family, about my experiences and one of those people was my sister-in-law Laurie. Laurie was a nurse who knew anatomy, and a lot about development and children. She asked me what I thought I wanted to do with my life or my future and I said, “Well, I'll probably be a physical therapist because I really like moving, and I like the body, and I like anatomy, and I really always kind of thought that would be nice to help people.” And then she told me about occupational therapy, and how the emphasis of what we call OT is about function. And I couldn't help but think of Katie, and how much easier she was able to function, by the way that I was able to help her ground herself and come in contact with her world. So long story short, I started exploring occupational therapy way back in the seventh grade. I found a three-page little trifold brochure on it. and I fell in love with the idea of helping people to function to their best possible capacity. Fast forward 30 years, and I find myself now helping children and adults with autism (and even those without autism who struggle with other diagnoses) to be the best version of themselves by helping them function. I am also a proud mom and proud wife. I think part of that experience of being a mother and parenting, along with my amazing husband, John, who is an amazing co-parent and co-partner in that process, has helped me see autism more clearly. John has helped me see what some people would call normal development, and I always have a hard time with the word normal, because I always say “whatever that is.” I'm much more comfortable with the word typical, but in raising four very neuro-typical children, three boys and one girl, I was able to see how firsthand development evolves. It's evolutionary. It evolves, and therefore, it's kind of linear, and yet it's not an exact science. When I started as an occupational therapist, I learned how people with special needs, sort of deviate if you will, or spur outside of that kind of linear streamline. It comforted me that I had a target to bring them to. And so by giving them a solid foundation, giving them more skills, they aligned with that path that we might consider normalcy or typical development, quite easier than I think most people give the process credit for. That's where the therapies that we do help to align people, relatively quickly, depending on the approach you use, with that normal trajectory; and that is very helpful to families -- to moms and dads who are worried, or feeling almost despair or hopelessness that their child may never evolve to a certain outcome that they, or society, might have in mind for that child. How Co-host Dr. Rich Smith Came to the Connect With Success Podcast Dr. Smith comes from a background of loving people. His earliest memories are of working with people. He always had a passion for watching learning happen. He remembers second grade with Sister Phyllis Anne, who was at the Shrine in Euclid. She asked him if he would help one of the students with math. They were learning how to add and he was struggling to memorize his math facts; so Rich created a puzzle for him of a big mouth with a big box with a mouth on it. And they put cookies of math facts into the puzzle box. This is his earliest memory of education and just being someone who really loves to watch people learn. Dr. Smith always thought he would either be a priest or a teacher. One of his favorite priests, Father Richard Rash, who is now in Florida, said, “Why not both?” Dr. Smith decided on education/teaching because he really wanted to focus in on that idea of learning. He started in professional development. He started teaching PSR at our parish and really thought that back in the classroom is where he should be. He started teaching at SS. Robert and William Catholic School in Euclid, Ohio, teaching seventh and eighth grade, which is where our paths crossed. Dr. Smith taught my daughter, and I came into contact with his daughter because her preschool teacher referred him and his wife to me. Dr. Smith then did his capstone project for The SUCCES Approach to try and get it online. So that is how Dr. Smith looks at the lens of life -- how are people learning? And how can we better equip them for pulling the data around them to make sense of it? And that's what he says he likes the most about working with all of us at Integrations Treatment Center in Wicklife, Ohio, or "ITC". Dr. Smith enjoys watching people learn and make sense of the world around them. He says, "It's not just about them taking on the world and trying to make sense of it, it's about the world meeting their needs, and how to navigate it. How can we take what's happening in the world and make it make sense for them so that they can use it to the best of their advantage?" And that is what we often say in The S.U.C.C.E.S.S. Approach -- that it is all about sense making. When it comes to autism, people need to understand that the way sense making happens is different for them than it might be for others without autism. So, What is The S.U.C.C.E.S.S. Approach and How Did it Come To Be? The S.U.C.C.E.S.S. Approach (SM) is an education and treatment model designed specifically for people with autism. And when we say education and treatment model, we sometimes just combine those ideas and call it an intervention model. So, The S.U.C.C.E.S.S. Approach is an intervention model designed for people with autism that looks at their care through the eyes of seven different theories. And these seven different theories come from either occupational therapy, speech therapy, psychology, or special ed. So when we think about that transdisciplinary team of OT, Speech, Special Ed, Psychology, and add a parent there for a nice well rounded team. We really see that transdisciplinary spirit, representing all those different disciplines, comes to fruition for the child. And as a result their care is very holistic. When we opened Integrations Treatment Center (ITC) in 1995, we were an outpatient model, which means that parents would bring their kids for maybe an hour of occupational therapy OT or an hour speech therapy or a half hour of tutoring. The idea that “more was better” came from a summer camp that we started originally. And parents said, “Please have our kids for summer. We really need to have the continuity of this of programming. These kids can't be off without school.” So we said, “Okay, why don't we do an eight week summer camp?” which made them very happy because it's a nice long stint, and we would do five hours a day. And parents were saying that their kids improved in an eight week summer program, more so than they may have progressed over the course of three years in their current program. We were kind of shocked by that, I mean, we were outpatient focused, so we didn't really think too much about more intensive care, but because it was summer we took advantage of access to the child. And we started paying attention to parents, because so many were saying, “This is amazing. Can you please go teach whatever you're doing to the people who have them all year round, and to me? Because we want more for our kids and this clearly is working.” So the idea of a, of a treatment model, an intervention model, that is full day for those who can use it that way, came because of experience. We didn't see it coming. We thought it was just going to be a great way to occupy the kids; and it makes sense that more is better as long as it's done well, because more of the wrong thing isn't always so good. And so we started saying, “Well, maybe we need to provide fuller day programming.” And that's where the treatment model -- the day treatment model -- which is a service delivery model where kids can come like a school, all day long, based on their age really came to be. Cross training and role releasing When we have multiple people involved with a child -- an OT [occupational therapist] speech therapist, psychologist, for instance, a special education teacher. Those people are trained very well in their disciplines and have a lot of knowledge about that discipline, but they also have knowledge about the child. But all the information about the child is helpful. So, I would want to suggest the ideas of cross training and role releasing so that the actual staff members give other staff members, their fellow staff members, tips of the trade or techniques or methods, cross train those individuals, so that the child gets what they need, no matter who they're with. And they're not the same thing as expecting them to do the therapy or to become the therapist so a special education teacher would never be expected to be an occupational therapist, and an OT would never be expected to be a psychologist, for instance; but some of the methods, and some of the approaches that we use can be cross trained and role released. And a good example of that might be that if I am working with a child on a swing, on a nice big platform swing, as we often do in occupational therapy, and I'm moving that child and giving them some balance stimulation, or what we might call vestibular stimulation, why wouldn't I work on language at the same time? Because a child is motivated, the child is excited, and in fact that child is alerted, which as an OT is why I'm using the swing, to get them alerted and engaged. So if I have the potential to stop that swing and help the child work on the word “more” or “go” or answer “yes” when I say, “Would you like more?” Why wouldn't I? But I wouldn't do it blindly. I'd have the speech therapist tell me exactly what sound, or exactly what word they're working on, so I can maximize the child's potential to say those words that are developmentally being targeted by the speech therapist, while I'm in OT, and vice versa. While that speech therapist is working with a child on those words, or sounds, or nouns, or verbs, or whatever it is, it might be beneficial and help that little child's nervous system if the speech therapist does it on a therapy ball, so that we have that movement, engaging the child's attention systems, or I should say arousal systems. So that's a good example of how transdisciplinary cross training happens, but if I never have access to that speech therapist as an OT, and the OT doesn't have access to the speech therapists, or vice versa. we're not going to have those skill sets, so that's really when cross training and roll releasing is helpful and that's the sprinkling of everybody doing things the same way that you're talking about. What is the overall goal of the The S.U.C.C.E.S.S. Approach? The goal of The Success Approach is to change the brain, but not just for the sake of changing the brain. The goal of The S.U.C.C.E.S.S. Approach is to change the brain, because the brain controls everything. It controls learning, it controls behavior, it controls thinking and functioning. So by changing it for the better, in other words, making it process better, making it do its job better, it optimizes the person with autism’s ability to function fully, holistically, and have a very enriched and high quality outcome. The goal is to unlock their potential. And the beautiful thing about that is that when we unlock it, it oftentimes is very natural and normal, that word again, a natural and normal capacity to progress through the developmental stages. In other words, they progress naturally and normally when supported. Well, to progress naturally and normally, we don't need… we don't give these things to them and have them do something unusual in human development. We see that they're developing just like other kids do, which I think is important for families to know is possible, and is doable. Dr. Rich Smith asks me, in our podcast, if the Success Approach really does offer a glimmer of hope. He asks if it is a method for everyone? Can everyone do it? My answer is, I guess it sounds easy. I'm helping the speech therapist work on sound; she's helping me work on balance and arousal. I would say that it's easy if the people who are doing it can think very, very intentionally. So sometimes that's a problem. So, I would say that The S.U.C.C.E.S.S. Approach itself is designed for every child, every adult with autism, hands down, but it is not for every professional, or every parent, necessarily. If, if they struggle with intentionality, if it's difficult for them to want to understand, and want to glean answers or insight. They may not be the kind of person that's going to use it well, so it may not be the best approach or model for them, but it is definitely the best model for children that I have experienced in 33 years. When it comes to understanding and assessing their ability to learn and progress, and then designing the methods that promote that. It takes a lot of time and patience. On behalf of the team. And so that sometimes makes us question where we use it. It's very, very potent, but if we're in a facility where the time and the collaboration, and that sprinkling of cross training and role releasing isn't well supported, then it sets it up to fail like any other model. Dr. Rich Smith asks me, "Who do you see as the main players the main stakeholders in The S.U.C.C.E.S.S. Approach?" My answer is the child, always the child. Starting with that child-centered approach. Children, adults, have their own ideas about how they want to be, what they need when they need it. Under what conditions they