Filmed May 2015 – edited into 14 parts; total 187 minutes

Children with ASD have very high rates of co-occurring mental health challenges, carrying a 75% risk that they will be identified with conditions including ADHD, anxiety disorders and tic disorders prior to reaching adulthood. Frequently it is these conditions and not autism itself that is the most disabling factor in the life of a child with ASD. Treatment typically leads to a substantial improvement in functioning – independent of the degree of disability. Dr. Dua, a leading child psychiatrist, introduces his approach, the Autism Comorbidity Algorithm (ACA), which frames and guides clinical and diagnostic assessment and treatment decisions through a developmental lens. The goal of the ACA is to use a life-span orientation to assess both the benefits and risks of treatment. It is based on a careful identification of the co-occuring disorders, aiming for holistic improvement in the child’s functioning with the goal of preventing future complications. Dr. Dua focuses particular attention on the overuse of potent anti-psychotic medications in the treatment of ASD and the underuse of medications with a stronger evidence base.

About the Presenter

Dr. Dua is Psychiatrist-in-Chief at Surrey Place Centre, and Assistant Professor, Department of Psychiatry, University of Toronto. He is trained as a Child and Adolescent, and Forensic psychiatrist. His clinical and research interests are with complex children, youth and young adults with autism and developmental disabilities – “dual diagnosis”, and systems of care that partner with community providers to improved community access to evidence-based treatments, and efficient use of expert resources. Dr. Dua earned a B.Sc. from the University of Toronto, then completed Medical School at McMaster University, Residency at Harvard Medical School, and fellowships at the University of Massachusetts. He also holds appointments in the Departments of Psychiatry and Pediatrics at U.B.C. Dr. Dua has nearly 20 years’ experience developing and implementing new dual diagnosis services in British Columbia. He authored the “Standards and Guidelines” – a government policy paper establishing eligibility requirements for all public ASD services in B.C. He was the co-founder and first medical director of the BC Autism Assessment Network, a highly-regarded province-wide interdisciplinary disciplinary program. Dr. Dua also co-led the award-winning PARC ASD Training Program. More recently, Dr. Dua has introduced the Shared-Care Pathway in B.C. which spans developmental and mental health frameworks to better address psychiatric needs of those with dual diagnosis.

Part 1: Intro and History of Autism/ Trends in Autism (17:26)

Part 2: Autism in the DSM-5 (8:27)

Part 3: Comorbidity in ASD and Intellectual Disability (8:04)

Studies referenced:

• Goldstein & Schwebach 2004
• Gadow et al. 2006
• Leyfer et al 2006
• Lee & Ousley, 2006
• Grzadzinksi et al. 2011

Part 4: Barriers to Diagnosis and Relevance of Comorbidity (7:53)

Study referenced: Leyfer et al 2006

Part 5: ASD Comorbidity Algorithm – Step 1: Development and Intervention (15:21)

• In this chapter: Case Study: BJ, part 1 – a 10 year old boy with previously diagnosed developmental delays

Part 6: BCAAN Assessment/ ASD and Developmental Disorders (12:32)

• In this section: Case Study: BJ Case Study, parts 2 and 3

Part 7: ASD Comorbidity Algorithm – Step 2: Evaluation (8:20)

• In this section: Case Study: CJ, Part 1 – a 13 year old boy with social and learning challenges. School and pediatrician wonder if it’s ASD?

Part 8: ASD and Anxiety Disorders (12:01)

• In this chapter: Case Study: CJ, Part 2

Part 9: ASD and the Neuro-Psychiatric Triad & Dual Diagnosis (14:07)

• In this chapter: Case Study: CJ, Part 3

Part 10: ASD Comorbidity Algorithm – Step 3: Treatment (20:33)

• In this chapter: Case Study: Boy, 11 year old referred by his pediatrician for consideration of medication for behaviours.

Part 11: Treatment and Medication (15:54)

Part 12: ASD Co-Morbidity Algorithm: Assumptions and Rules (18:02)

• In this section: Case Study, DJ, 13 year old boy with ASD

Part 13: Treatment Initiation – Early Data on Stimulants in ASD (22:50)

Part 14: Treatment Follow Through (5:48)

• In this section: Case Study, DJ, continued

Filmed April 2013 – edited into 4 parts; total 63 minutes

Individuals with ASD often have challenges in accessing appropriate healthcare, with many caregivers citing challenges in navigating between sectors (health and social services), transitioning across age groups, and finding specialized expertise. These challenges can be confusing and stressful for individuals with ASD and their caregivers. As a result, emergency services can end up being one pathway to mental health care. The current study examines emergency service and psychiatric hospitalization in a large sample of adolescents and adults with ASD in Ontario, as part of an ongoing longitudinal study of health care service use in this population. A number of individual, family, and service characteristics are implicated as correlates of service use, and have important implications for supporting health care interventions.

About the Presenter

Jonathan A. Weiss, Ph.D., C. Psych. is the Chair in Autism Spectrum Disorders Treatment and Care Research at York University. Dr. Weiss’ research focuses on the prevention and treatment of mental health problems in people with ASD and/or intellectual disabilities (ID) across the lifespan. He conducts studies into how people with ASD and with ID access mental health care in Ontario, and is interested in their health service needs, their emergency service use, and their experiences of psychiatric crisis. Families play a critical role in the health of people with ASD and with ID by providing them with care and enabling their access to health services, and he is currently focused on learning about the experience of family caregivers.

Part 1: Introductions and Why Undertake this Work? (12:50)

• PDF: sample caregiver health assessment form for adults with developmental disabilities
• PDF: For Primary Care Providers: Communicating Effectively with People with Developmental Disabilities
• PDF: Guidance on Emergencies, for Caregivers
• Website: Guidelines for Managing the Client with Intellectual Disability in the Emergency Room

Part 2: The Research Study: Who they talked to and what they’re learning (20:15)

Part 3: What Can We Do Next? (7:28)

Part 4: Question and Answer Period (22:04)

This video sponsored by…

Filmed April 2013 – edited into 4 parts; total 73 minutes

This video summarizes the results of two studies that employed ecological, family-centered positive behavior support (PBS) and were designed to be culturally responsive to families of children with ASD. Three themes emerged across the two studies, including the importance of:

• developing rapport that is informed by family culture;
• understanding families’ cultural values, beliefs, and parenting practices; and
• designing interventions that accommodate cross-cultural values and beliefs.

Implications for behavior consultants who work with families of diverse cultural and linguistic backgrounds will be discussed.

About the Presenter

Joseph Lucyshyn, Ph.D., BCBA-D, is an Associate Professor and Board Certified Behavior Analyst in the Department of Educational and Counseling Psychology and Special Education, Faculty of Education, University of British Columbia. Dr. Lucyshyn has extensive experience working in collaboration with families and allied professionals to develop and implement family centered PBS plans in home and community settings for children and youth with developmental disabilities. He currently serves as a member of the Board of Directors of the International Association for Positive Behaviour Support (APBS).

Christy Cheremshynski, MA, BCBA, RCC, is a Board Certified Behaviour Analyst who works primarily as a Behavioural Consultant with children diagnosed with ASD in the Lower Mainland. Christy is also a graduate of both the Special Education and Counselling programs in the Department of Educational Psychology at UBC. Her research interests included supporting parents, in particular those from diverse cultural background, in managing the challenges experienced in raising a child with a developmental disability. As a Registered Clinical Counsellor she will focus her support on families raising a child with a disability.

Part 1: Introduction and the Need for Culturally Responsive PBS services (15:56)

Part 2: Study 1 – Implementation of a Culturally Appropriate PBS Plan by a Japanese Mother of a Boy with Autism (16:55)

Part 3: Study 2 – Transforming Coercive Processes in Family Routines with a Taiwanese Family of a Child with a Moderate Intellectual Disability (22:28)

Part 4: Study 3 – Experiences and Perspectives (18:00)

Filmed April 2013 – edited into 3 parts; total 67 minutes

The research is definitive: families raising children with autism are highly stressed. This makes it vital for professionals to understand the individual needs of families to prioritize interventions that fit their needs. Family Quality of Life (FQOL) assessments can provide a vehicle for productive family-professional conversations that serve as a starting place from which both need and strength can be identified. This presentation introduces the core concepts and research findings related to FQOL, with particular attention to families of children with ASD. The information will be relevant to families, professionals, and policy makers.

About the Presenter

Grace Iarocci, Ph.D., R. Psych. is associate professor of psychology at Simon Fraser University, and the Director of the Autism and Developmental Disorders Lab.  She is also a Michael Smith Foundation for Health Research Scholar and a faculty mentor of the Autism Research Training Program (ART) and a registered psychologist who specializes in the diagnosis and treatment of ASD. Emily Gardiner, M.A. is a Ph.D. Candidate in the Department of Psychology at Simon Fraser University.  She is a member of the Autism & Developmental Disorders Lab. She is particularly interested in research on quality of life for families of children with ASD. Emily has been involved in research investigating how individuals with ASD are perceived by their college-aged peers, as well as the link between executive functions and social competence in individuals with ASD.

Part 1: Introduction to the Study (22:06)

• Beach Center Family Quality of Life Scale
• Autism and Developmental Disabilities Lab at SFU

Part 2: Study Structure and Preliminary Findings (16:42)

Part 3: Implementing into Practice (28:02)