2-Day Autism Spectrum Masterclass: Social and Behavioral Interventions to Reduce Complex and Challenging Behaviors in Children, Adolescents & Young Adults

CPD

Planning Committee Disclosure - No relevant relationships

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners.  For speaker disclosures, please see the faculty biography.

Handouts

Speaker

Rebecca Sachs, PhD, ABPP Related seminars and products

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Rebecca Sachs, PhD, ABPP, is a clinical psychologist specializing in the assessment and treatment of individuals on the Autism spectrum who also experience difficult co-occurring disorders, such as obsessive-compulsive disorder (OCD) and severe anxiety. She works with individuals across the life span and believes in empowering individuals and their families with knowledge and skills. Board certified in behavioral and cognitive psychology, Dr. Sachs was recently awarded a federally funded grant through the New York State Office of Mental Health, aimed at helping train community-based service providers better serve children and youth who are dually diagnosed with mental illness, like OCD, and a developmental disability. She has a private practice in New York and is co-director of Successful School Transitions, a comprehensive program for school refusal. Dr. Sachs received her bachelor’s degree, and PhD from New York University and Hofstra University, respectively, and completed a postdoctoral fellowship at the University of Miami. In addition to these roles, Dr. Sachs is mom to an energetic and determined 6-year-old and stepmom to the coolest 15-year-old around.

 

Speaker Disclosures:
Financial: Dr. Rebecca Sachs is the co-founder of Successful School Transitions and maintains a private practice. She has employment relationships with the International OCD Foundation and the LIU Post. Dr. Sachs receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Rebecca Sachs is a member of the Anxiety and Depression Association of America, the Asperger Syndrome and High Functioning Autism Associations, the Association for Behavioral and Cognitive Therapies, and the New York State Psychological Association.

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Objectives

1. Determine information processing differences in autistic clients.
2. Assess, screen, and diagnose autism across the life span.
3. Identify the importance of listening to and validating lived experiences of autistics clients.
4. Create comprehensive treatment plans that target autism related challenges.
5. Use appropriate communication and therapeutic style to facilitate reciprocal collaboration with autistic clients.
6. Create collaborative goals with autistic clients and their families for co-occurring mental health conditions.
7. Identify modifications to CBT for autism with co-occurring anxiety and OCD.
8. Use CBT techniques, including behavioural activation and DBT, to treat depression in clients with autism.
9. Choose developmentally appropriate interventions to teach autistic clients about safe sexual behaviours.
10. Develop individualised strategies to assist clients with challenges in executive functioning improve their daily living skills.
11. Evaluate the ethical dilemmas associated with utilizing restraint and seclusion punishment techniques.
12. Identify the potential side effects of psychotropic medication that can mimic or cause behavioural issues related to autism and co-occurring conditions.

Outline

Rethinking Autism

• DSM-5™ and Medical Model
• Autism vs autism spectrum disorder
• Information processing differences
• Language matters
• Why listening to autistic voices is important

Assessments: From Observational to Standardized Tools

• Diagnostic tools and evaluations across the lifespan
• Screeners for anxiety, depression, OCD
• Modified checklists for infants and toddlers
• Neurodiversity affirming and strengths-based assessment
• “Pink flags” and gender considerations
• Accurately interpret reports to guide interventions
• Functional assessments to guide interventions

Effectively Intervene Early

• How to support lagging skills and unmet needs
• Developmental interventions to express feelings
• Ethical principles to educate and support families in treatment choices
• Case study: 4-yr-old, difficulty with expressing thoughts and feelings when frustrated

It’s Never Too Late: Intervening at Later Stages of Life

• How to support lagging skills and unmet needs
• Self-developed compensatory strategies
• Diagnostic trauma: Impact of chronic invalidation and being misunderstood
• Social camouflage and “unmasking autism”
• Educational interventions for family members
• Case study: Mid-thirties, recent diagnosis, social and employment difficulties

Thinking Differences to Help Autistic Individuals Thrive

• Increase predictability and understanding
• Incorporate intense interests and passions
• Meet the preference for sameness and structure
• Case study: 16-yr-old, self-injections for medical condition, fear of needles

Executive Functioning Differences in Autistic individuals and “AuDHD”

• Planning, prioritizing, and initiation skills
• Attention, organizational, and self-management skills
• Form helpful habits, routines, and repetition
• Value-driven goals and pacing to individual needs
• Self-advocacy, accommodations, expectations, and supports
• Case study: College student, needs help with balancing academic and social demands

Communication and Social Interaction Needs

• Functional systems to improve communication
• Pragmatic language and the “hidden curriculum”
• Assertive communication training
• Neurodivergent and affirming communities
• Typical social cues may not be rewarding
• Impact of sensory, emotion regulation, EF on communication
• Case study: 8-yr-old, anxiety when transitioning or classmates crying

Emotion Information Processing Differences and Supports

• Understand alexithymia and teach emotion identification
• Arousal and amplitude of emotional experiences
• How emotional processing and sensory differences interact
• Implications of the double empathy problem and how to address
• Distress tolerance skills

Manage and Sensory, Motor, and Interoception Needs

• Preventative strategies and accommodations
• Supports for ADLs and reframe stimming
• Exposure to sensory stimuli, in the context of choice and empowerment
• Alternatives to support fading out severe selfstimulatory behavior
• Case study: 5-yr-old, sensory overwhelm from sounds, crying, and scratching self and others

Behaviors that Challenge vs. Challenging Behaviors

• When core needs are unmet and how to respond
• Functional assessment and empower preventteach- respond interventions
• Untreated co-occurring conditions and “oppositional behaviors”
• Teach new skills and make behavior choices concrete
• Use positive, negative, and differential reinforcement
• Educational interventions for family members
• Case study: 10-yr-old, disruptive when speech therapist engages with other students

Treating Co-Occurring Anxiety, OCD, and Related Conditions

• CBT model, gradual exposure and hierarchy creation
• Modifications to CBT for autistic and ID clients
• Teach relaxation and other calm down skills
• Teach problem-solving and coping skills
• Ritual delay and ritual shortening
• Good vs. bad accommodations
• Case study: 12-yr-old, emetophobia impacted ability to engage in school and social activities

Reduce Depressive Symptoms and Suicidal Ideation

• How depression looks different in autistic individuals
• Factors impacting co-occurring autism and depression
• Self-injurious, non-suicidal behaviors in autistic individuals
• Psychosocial interventions: Experiential activities
• Cognitive-behavioral therapy modifications, including DBT
• Case study: 23-yr-old, skipping college classes, fights with parents, depressive symptoms

Romance, Sexuality, and Identity Considerations

• Body awareness, exploration of self, consent, and boundaries
• Address dating and sexual relationships
• Sexual arousal, puberty, education, modeling
• Gender identity, gender fluidity and LGBTQ
• Case study: 15-yr-old, frequent masturbation, provocative sexual talk

Psychopharmacological Interventions

• Commonly prescribed medications and efficacy
• Address medication management needs
• Risks vs. benefits
• Case study: Young adult, taking medication to stabilize mood, takes food from others

Ethical Challenges in Autism

• Informed consent and assent
• When an autistic child doesn’t want to be in therapy
• Use of restraints, time-out vs. seclusion
• Case study: 13-yr-old male, attacks others when prevented from touching necklaces on attractive girls

Special Considerations

• Trauma and autism: Similarities, differences, when they co-occur
• Sleep issues and sleep regulation
• Multicultural and gender differences
• Independent living/career planning
• Guardianship and legal issues
• Limitations of research and potential risks

Target Audience

• Psychologists
• Counsellors
• Social Workers
• Marriage and Family Therapists
• School Psychologists
• School Counsellors
• School Social Workers
• Speech-Language Pathologists
• Occupational Therapists
• Occupational Therapy Assistants
• School Administrators
• Special Education Teachers
• General Education Teachers
• School-based Personnel
• Behavioral Intervention Specialists
• Psychiatrists
• Educational Paraprofessionals
• Youth Leaders
• Probation Officers
• Clergy
• Other helping professionals who work with children/adolescents/young adults