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Beep beep beep.
A timer sounds.
Daniel Toops’s attention strays from the plastic play cash register that sits in front of him. Behavior specialist Tory Christensen leads Daniel to the wall where Polaroids® hang, forming a chronological schedule of the day’s events.
The pictures of a toothbrush and toothpaste, tennis shoes, and playground are an inventive way to visually organize the nonverbal 11-year-old’s agenda.
Daniel was diagnosed with autism at age three by child psychiatry specialists at the University of Iowa Children’s Hospital. By age four, the Bellevue, Iowa, native had an entourage of local doctors, therapists, and educators helping manage the disorder.
But Daniel’s needs eventually outgrew local expertise. Parents Katherine and Tim Toops turned to the bio-behavioral service at the UI Center for Disabilities and Development.
Psychologists, educational consultants, and social workers at the Center listen to the Toopses’ concerns and work cooperatively with Daniel’s local doctors and teachers.
The Center’s specialists answer questions, offer recommendations, and devise plans for improving Daniel’s social interactions, behavior, communication, and academic performance.
UI psychologist Todd Kopelman, PhD, says the Center makes regular contact with the family and the community through conference calls, e-mail, and observations of Daniel at school through a contract with the Iowa Department of Education.
The Toopses appreciate the Center’s willingness to provide the essential integration that ensures everyone contributing to Daniel’s care—whether in Bellevue or at the UI Center for Disabilities and Development—moves toward common goals.
“It’s just a great support network,” Katherine says. “If you have questions, the Center will find the answer. If they can’t, they’ll refer you to someone who can.”
Progress from clinic visits influenced Daniel’s parents’ decision to set up a two-week outpatient program focusing on reducing challenging behaviors.
“Daniel does not use much speech to communicate and has a limited understanding of our speech,” Kopelman explains. “We use a picture schedule and timer so he understands when changes in his schedule will occur. As one part of treatment, we are blocking Daniel when he attempts to pinch during transitions between activities.”
Katherine says the program’s importance cannot be overestimated. “It’s the missing link,” she says. “It takes a team to educate.”
Breaking the silence
Looking back, Katherine realizes that Daniel exhibited the symptoms of autism as a baby.
But when he demonstrated those subtle symptoms—he liked to be held with his back to her chest and didn’t respond to his name, for instance—she really didn’t think much of it at first.
“He didn’t engage,” she recalls. “We started to think he might have hearing loss.”
After a hearing test went fine, Daniel’s pediatrician recommended at-home child development exercises, which yielded no results. His parents traveled to see a team of experts in the child psychiatry clinic at UI Children’s Hospital.
That’s when Daniel, by then age three, was diagnosed with autism.
Autism symptoms vary widely among patients. Daniel cannot speak, so communicating effectively is a huge challenge and a source of frustration.
Serving special needs
In addition to the Challenging Behaviors program, the Center for Disabilities has a long history of serving the special needs of children with brain injuries.
The Brain Injury Service Project, through a contract with the Iowa Department of Education, works with the state’s Area Education Agency Brain Injury Resource Teams and local school districts to help students who struggle in school due to a brain injury.
For more information about the Challenging Behaviors and Brain Injury programs, contact education consultant Sheri Smith toll-free at 877-686-0031, call 319-356-1410, e-mail sheri-smith@uiowa.edu, or visit www.healthcare.com/cdd.
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