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Drake professor offers alternatives to aid autistic children

January 3, 2019

DES MOINES, Iowa (AP) — Maria Valdovinos was 21 years old when she went to work in a Mobile, Alabama, group home for people with severe intellectual disabilities.

Valdovinos was newly graduated with a bachelor’s degree in psychology from Auburn University and felt wholly unprepared to deal with the men in her care.

The Des Moines Register reports those early career experiences would eventually lead Valdovinos to Iowa, where she’s working to improve access to applied behavior analysis, using techniques to alter behavior for positive social interactions for those with intellectual challenges.

Valdovinos remembers one man who shuffled along day and night at the Alabama facility saying, “Leave that boy alone.” Another patient cried all night. And another struggled with chronic sexual dysfunction.

She tended to the men’s needs, including bathing them and keeping watch overnight.

After her first week on the job, she stopped at a store and bought a six-pack of beer. She called her mother in tears and said she thought she should quit.

Valdovinos’ mom said that she had a duty to care for those patients and that she should carry on. So Valdovinos did.

She made regular reports of the men’s behavior and took them to their psychiatrists, who ignored the data she collected.

“One psychiatrist said, ’These men are disabled. There’s only one answer for this: Haldol,” Valdovinos recalled. Haldol is a powerful anti-psychotic medication that often has serious side effects. “I remember thinking, ‘There has to be a better way.’”

That better way drove Valdovinos through graduate school. There she studied applied behavior analysis, which focuses on methods other than medication to create behavioral modification in people living with mental health issues.

Valdovinos eventually became a Drake University psychology professor, where she founded the graduate program in applied behavioral analysis.

Her work examines the root causes and identifying techniques for adjusting behavior other than medication. She and her students, with the help of lawmakers, are working to broaden access applied behavioral analysts have to schools across Iowa.

Valdovinos does her clinical work at Blank Children’s Hospital in Des Moines. She and her graduate students work with parents whose children are on the autism spectrum.

During regular sessions, Valdovinos and her students interview parents about the kinds of behaviors their children have shown since their last visit.

“The interviews are in-depth,” said Sacha Pence, program director for Drake’s applied behavior analysis program. “We talk about the behavior and then ask about their environment, other potential triggers or stressors during the day or even about what the child might have had to eat and what kind of things they saw or heard that day.”

Autism is broadly defined as a developmental disorder that appears in children by age 3 and impairs normal social relationships and communication and causes repetitive behavior patterns.

Valdovinos and her team work with patients across the spectrum.

Some are non-verbal, while others can communicate but are not always aware of what makes their behavior disruptive or socially challenging.

At sessions, Valdovinos or one of her students will try to induce the behavior that is causing trouble for the child.

They observe the behavior and try to uncover the trigger. Each trigger depends on the individual and could be something as simple as the amount of noise or light in the room.

After triggering the behavior, the parents and Valdovinos’ team discuss ways parents can quell the unrest, look for ways to avoid problems in the future and perhaps change the behavior over time.

“A lot of parents have been told that when a child is ‘acting up,’ that the child is just seeking attention and the best method is to ignore it,” Valdovinos said. “That’s rarely true. Often, attention is the thing that will help a child through a difficult period.”

Valdovinos and her students didn’t invent this method. It’s based on years of research by scores of mental health professionals.

But what they did do is find a way to get trained applied behavior analysts into schools.

Iowa law requires a person providing services to students to be licensed. So Valdovinos and others successfully lobbied the Legislature to create a licensure program for applied behavior analysts in 2018.

School districts and area education agencies can hire people such as Valdovinos’ students to help with tough behavior cases.

Lawmakers also approved a mandate that insurance companies cover applied behavior analysis in 2017. That gives families more options to find treatment for children with autism, but there are still hiccups.

“Right now, there is a six- to nine-month wait to get in to see a specialist, and that’s just in the metro,” Valdovinos said. “In other areas of the state, especially rural areas, the wait is even longer.”

That’s something that needs to change quickly, said Nathan Noble, the physician who oversees Valdovinos’ work at Blank.

“It’s a critical area,” Noble said. “There are so many people out there who are trying to figure out this stuff without any assistance. We need to get that help out there. It’s going to make a lot of lives better.”

The next challenge is pushing insurance companies to see ABA as medically-necessary.

“I’m hoping to broaden access to ABA, period,” Valdovinos said. “Leaving it the way it is now, provides insurance companies with ammunition to say it is an educational service and insurance shouldn’t have to cover it. I want to increase access to ABA across the state, not just in schools.

Beyond that, Valdovinos seeks to get more applied behavior analysts earning their degrees, getting licensed and working in Iowa, Valdovinos said.

She currently has 17 students in her graduate program at Drake. Briar Cliff University in Sioux City also has a undergraduate program. Valdovinos hopes more colleges and universities offer applied behavior analysis.

“It’s a rewarding field,” she said. “It’s very satisfying to work with children and families who are struggling and see them improve, grow and understand one another.”

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Information from: The Des Moines Register, http://www.desmoinesregister.com

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