Helping children -- Leah Verkuylen, a master’s student in behavior analysis and therapy from Appleton, Wis., works with Drake Hazel, 3 ½, during a therapy session at SIU Carbondale’s Language and Cognitive Development Clinic. (Photo by Steve Buhman)
November 16, 2016
Clinic helps children find their voices
CARBONDALE, Ill. -- Drake Hazel didn’t respond to his name, even though multiple tests revealed nothing was amiss with his hearing. He didn’t appear to be interested in talking, either, and often seemed to be in his own little world, according to his mother, Sara. At 20 months, the family learned the little tot from Marion is autistic.
They discovered Southern Illinois University Carbondale’s Language and Cognitive Development Clinic (LCDC) last January and these days, Sara is excited to say they are seeing a different Drake. During a recent therapy session, Sara watched through a one-way mirror in an adjacent room as her son, now 3 ½, interacted with Leah Verkuylen, a master’s student in behavior analysis and therapy from Appleton, Wis. Drake and Verkuylen played with bubbles and toys and connected in other ways.
“The changes are very noticeable since he started here,” his mom said. “His eye contact is extremely better. When you open the door and come into the room, he looks up to see who it is. He plays with toys more and he’s much more aware of what’s going on around him. It’s like he’s learning there is a world out there.”
Drake is still largely non-verbal but communicates with his mom via motions. Sara is hopeful that as he continues to come out of his shell, he will become more communicative with the family and friends who try so hard to connect with him. She is seeing progress.
“It’s the small things sometimes,” she said. “Before, if you looked at him, he turned away. If my nine-year-old stepson, Kainen, tried to play with him, he paid no attention. Now, Drake follows Kainen around and will walk up to him and hold his hand. The first time that happened, I cried. Drake’s making a lot of progress in the right direction. If you could see my son a year ago compared to now, you’d be amazed. He does have a voice and this program is helping him find it.”
For some clients, like Drake, the changes are gradual and progressive. For others, the breakthroughs can seem dramatic.
Ayla Schmick’s first client at the clinic was a four-year-old girl with autism whose language primarily consisted of repeating things others said. The goal for Schmick, a second-year master’s degree student in behavior analysis and therapy from Sunnyside, Wash., was to reduce the child’s echoic responses and elicit real conversation.
After a few months of working together, Schmick coughed and sneezed repeatedly in the middle of one of their therapy sessions. At the time, the little girl was occupied with toys but as Schmick’s coughs and sneezes continued unabated, the child approached, touched her on the arm and asked, “Ayla, are you okay?”
“My mind was blown!” Schmick said. “Here was this child who for the past six months was heavily echoic and now she was not only able to recognize that I was in distress, but she stopped playing and asked if I was okay! I was so excited about her asking me that question that I told her I was fine, gave her a big hug and then ran out to talk to her parents about what she just did. Since then, she has grown dramatically in her language and now she talks a lot.”
Helping children find their voices is what LCDC is all about, according to Mark Dixon, professor and coordinator of the behavior analysis and therapy program at SIU. The clinic, within the College of Education and Human Services’ Rehabilitation Institute, is staffed by Dixon and behavior analysis and therapy students. It provides one-on-one, individualized therapy and intervention services to help children from toddlers to age 18 develop basic and advanced verbal skills and cognition.
Clients include children with autism, genetic disorders, ADHD, Down syndrome, social/emotional challenges or other similar disabilities; neurotypical children; those with intellectual disreactive delay anxiety; and children with no formal diagnosis who are experiencing language delays or issues.
Modern, evidence-based applied behavior analysis approaches are utilized during sessions that last 90-120 minutes.
“We work one-on-one, directly with the child, implementing learning opportunities that help draw out language and cognitive abilities where they didn’t exist using techniques that are proven to help them form and grow,” Dixon said. “The clinicians offer the children small clusters of opportunities and work to get responses. Then they provide praise and reinforcement for appropriate responses to encourage repetition of the preferred responses. We use gradual training measures and interventions to reinforce appropriate choices and behaviors.”
Dixon’s methods are peer reviewed and bring about “scientifically proven results,” he said.
“The main difference is our underlying goal is to teach them how to learn, not what to learn,” Dixon said. “We want to help them see what’s going on in the world around them. And our deeper agenda is figuring out how we turn on the deduction and inference abilities these kids have. How do we foster that awareness of the world? Here, they are learning how to learn, not what to learn because there is no way kids can be taught to memorize the whole world. We want them to take the knowledge and training and skills they learn here and transfer it to other things in their lives. We are helping them forge new paths of inference and deduction rather than just teaching them skills. We want them to acquire more novel skills and minimize the challenges they face.”
Typically, it would cost $150 an hour or more for services like those available at LCDC, if you could find a place to get them, Dixon said.
“These kids really need this type of intervention right here,” he said. “Insurance often doesn’t cover services like this, even if you can find them. There is also a wide disparity in the quality of programs available and typically, top-notch programs like ours are found only in large metropolitan areas or places where big studies are taking place. At SIU, all children who can benefit from the program are welcome and there is absolutely no cost. And they can continue coming as long as they are benefitting.”
The clinic is open 8 a.m. to 7:30 p.m. Monday through Friday and recently, Saturday hours of 9 a.m. to 1 p.m. were added to meet needs. The program has tripled in size in the last nine months and currently serves 40 families. Saturday hours may expand if needed.
Graduate students work with the children, assisted by undergraduates. SIU just launched its undergraduate behavior analysis and therapy program in 2015 and Dixon said the clinic is a “great on-campus training incubator.” About 20 students are now involved. Dana Paliliunas, a doctoral student in behavior analysis and therapy from Arlington Heights, is the clinic manager and she said the successes are remarkable.
“The biggest changes we are seeing are a reduction in challenging behaviors and an increase in spontaneous and creative language,” she said.
“It’s not just about the kids, either,” Dixon added. “It’s the parents, too. When you see their reactions to the positive changes in their kids, it’s great. When they see the differences in their kids and thank us, it’s better than any grant or public awards.”
After the sessions, students debrief parents, explaining what occurred during the therapy and offering feedback about how parents can continue working with their children at home. Being able to observe is one of the things Sara Hazel likes best about the clinic.
She said her “sweet little man who loves to give hugs and kisses” is now working on making and maintaining eye contact, modeled play, taking turns, motor imitation and matching.
“I love how they get down on the floor, on his level, and play with him. He learns a lot more through the applied behavior analysis therapies than with the other things we’ve tried. I have nothing but praise for this clinic. It’s wonderful and these people are amazing. We’ve learned so much, too. They help me know what to do to help him learn his way. And they’ve taught me to continue with him even if he screams or cries or gets mad. He used to think if he did that, he could get out of doing something. Not anymore. We continue with the task. It makes a difference.”
Conversations with parents and work with the children are valuable to the students as well, helping them learn and giving them data they can use in research to enhance their work.
Beginning in January, additional research will begin and Dixon anticipates it will be groundbreaking. Through neurological evaluations and MRI scans, they will determine how the sessions at the clinic enhance the children’s brain pathways. Dixon previously used similar testing to prove that the brains of chronic gamblers displayed a dopamine effect when they were gambling but after eight weeks of therapy, the effect wasn’t present.
For more information about the Language and Cognition Development Clinic, or to inquire about enrolling a child, call 618/536-7704 and ask for Char or email LCDClinic@siu.edu.