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Innovative Approaches to Emotional Regulation: Using Sense Technology to Improve Quality of Life

WelcomeRicki Robinson, MD, MPH and Serena Wieder, PhDConference OverviewConnie Lillas, PhD, MFT, RN“Keep Calm and Carry On”: Using Sense Technology as a Bridge Between Mind and Body”Rosalind W. Picard, ScDA physiological state of calm attention is the foundation to all growth and development. Rapid state changes into stress responses, underlie many conditions across diagnostic categories. Our keynote speaker, Dr. Rosalind Picard,founder of the Affective Computing Research Group at the MIT Media Lab, will present her groundbreaking research with sense technology devices that are changing lives. This technology alerts caregivers to rapid changes in the child’s physiology. The device can assist in detecting some kinds of seizures and can alert parents to changes that indicate activating stress responses. This can be a critical tool for parents and professionals supporting emotional regulation of individuals across diagnoses. This is in keeping with the recent shift by the National Institute of Health towards a more sophisticated view of the mind-body connection, looking at common denominators that apply to all “diagnoses”.Making Sense of the Body: The Potential of Sense Technology in Understanding Behavior and Supporting Emotional Regulation and Joint AttentionWEBCAST NOT AVAILABLETal Baz, MS, OTR/LThis longitudinal case presentation with a neurologically complex child will show how attunement and engagement were informed by an understanding of the child’s stress responses. Video clips will demonstrate observational skills and developmental relationship based methodologies used to lead a dysregulated and anxious child with significant developmental constrictions towards calm joyful interactions with his mother. We will follow the child from the initial contact with the therapist through the peaks and valleys of treatment, while looking closely at the subtle shifts between Shared Attention to higher, and more sophisticated levels of Joint Attention. Recently, Ms. Baz has utilized the sense technology created by Dr. Picard. We look forward to hearing about the clinical application of the E4 technology in treatment for the first time in this groundbreaking application to cutting edge interdisciplinary practice.Panel DiscussionWEBCAST NOT AVAILABLEModerator: Connie Lillas, PhD, MFT, RNThe interdisciplinary panel of Serena Wieder, PhD; Rosalind W. Picard, ScD; Traci D. Swink, MD; Tal Baz, MS, OTR/L and Theresa Hamlin, EdD, PD, will share the reflections on this rich process of research and clinical applications.Sneak Peek! The Profectum Parent ToolboxRicki Robinson, MD, MPHJoin us as we introduce this groundbreaking new “How To” Webcast series for parents and professionals. Discover how the PPT Webcasts presents and demonstrates the 16 key strategies that help parents engage, play and interact with their child! You won’t want to miss this premiere showing of the PPT!

Identifying Needs and Bringing Hope to Underserved Infants, Toddlers, and Parents in the Child Welfare System

Identifying the Physical, Developmental, and Emotional Needs of Infants and Toddlers in the Context of Abuse and Neglect Within the Developing BrainOffered as part of the complete conference series only. Videos were edited from presentation.Brenda Jones Harden, MSW, PhDIsolated silos of training have created an artificial split between those treating developmental delays, trauma, and physical needs. For example, Part C professionals are often not trauma informed, mental health practitioners are often not trained in developmental delays and disabilities, and medical practitioners may only recognize the short-term effects of physical neglect. Best practice approaches require that providers are trained in recognizing all arenas, in the context of understanding the long-term effects of abuse and neglect on the developing brain. This is particularly relevant to the children in the child welfare system where over 80% of foster children have suffered from developmental, behavioral, or emotional problems – 2 to 8 times the national averages (Child Welfare League of America, 2006). Dr. Harden, an Associate Professor in the Department of Human Development & Quantitative Methodology, University of Maryland College Park, will orient us to the complex and multiple needs of infants, young children, and their parents in the context of the effects of abuse and neglect on the developing brain.Bringing Hope Through Inter- and Transdisciplinary Teamwork to Underserved Populations in the Child Welfare System: A Longitudinal Case PresentationWEBCAST NOT AVAILABLEConnie Lillas, PhD, MFT, RN, Chair; Jessica Richards, LCSW; Uyen Nguyen, OTD; Susan Hollar, SLP; Amy M. Pellman, JDFostering Family Partnerships Case Presentation: From Hope to Despair, the Early Years Building upon Dr. Harden’s keynote, this presentation will inspire participants to work together to bridge service gaps by building inter- and transdisciplinary teams using a common language and shared approach to mitigate the impact of abuse and neglect on at-risk and underserved populations. The presentation will include a longitudinal video-based case of three generations – a mother, a teenage daughter who used substances, and the teen’s 11- month-old infant. The infant entered the child welfare system and all three generations participated in the South Los Angeles pilot project – Fostering Family Partnerships (FFP) Court Team. Cultural, legal, and developmental impasses that occurred along the way, required the work of an inter- and transdisciplinary clinical team, integrated with the judicial team’s effort, in order to move forward. This case will unfold in two Parts. As each nodal point unfolds in this journey, key team members from the FFP Court Team will share the real-world, real-time story, showcasing the power of a shared approach, a common language, and an open-ended attachment relationship wherein change occurs gradually and over time. Volunteer efforts across Los Angeles County that model systems changes will be highlighted.Panel DiscussionWEBCAST NOT AVAILABLEModerator: Connie Lillas, PhD, MFT, RN Panelists: Brenda Jones Harden, MSW, PhD; Jessica Richards, LCSW; Uyen Nguyen, OTD; Susan Hollar, SLP; Amy Mejia, Educational Attorney at the Alliance for Children’s Rights; Judge Amy M. Pellman, JD; Robin Younger-Holmes, MAThis panel discussion, along with written questions from the audience, will digest this rich and complex case presentation with all of the challenges, disappointments, and gains that have been made in the context of creating communities in Los Angeles County (and beyond) that aim to build inter- and transdisciplinary teams.

Healing the Body to Calm the Mind: The Impact of Medical Issues on Emotional Well-Being and Developmental Progress

The DIR Model – Mind-Body Approach: Health and Emotional Well-being is an Individual DifferenceRicki Robinson, MD, MPHUnderstanding a child’s sensory and motor individual differences are central to the DIR Model. While not always considered, a child’s state of health and emotional well-being can influence his ability to relate, communicate and make developmental progress. The entire afternoon panel will address how medical conditions (especially those that are associated with pain) can impact the life of a child with autism, sensory processing disorders or other mental health concerns. When these individuals have symptoms of illness, quite often it is “missed” by parents and professionals. Mis-reading, mis-diagnosing, and misunderstanding of body cues all occur in this situation. We will explore the DIR approach to addressing these “misses” in this panel overview talk.Chronic Pain in Children with ASD: a Mind-Body ParadigmLonnie Zeltzer, MDThis talk will review modern concepts of the neurobiology of chronic pain and how anxiety and pain are linked. Children diagnosed with Autistic Spectrum Disorder (ASD) or other developmental challenges may have pain and anxiety go unrecognized because of difficulties in verbal expression of pain/anxiety and use behavioral expressions of their distress. Risks for chronic pain are high because the neurobiology of children with ASD contributes to increased sensory awareness with confusion and distress caused by ongoing internal “loud” sensations. Also once children with ASD notice the sensation, they may perseverate and have a difficult time moving their focus of attention away from that sensation, so that even children with high levels of verbal communication may continue to focus on pain. Such focus may lead to visits to multiple pediatric subspecialists, many examinations and tests, only for their parents to be told that “nothing is wrong.” This talk will describe patient examples that may lead to a diagnosis of ASD for the first time in a pediatric pain clinic and will provide mind-body strategies for the reduction of pain and anxiety, while enhancing the quality of life for both child and family.Working from the Inside Out- Integrating Medical and Developmental Intervention to Support Health, Well-Being and Developmental Progress in Children with ASD and Related DisordersTraci D. Swink, MDThis case study of a young child on the autism spectrum will illustrate the impact of recurrent illness, pain and discomfort on his developmental trajectory. Children with underlying neurobiological challenges like ASD perceive and respond to bodily sensations differently. Poorly localized and/or misinterpreted bodily sensations or increased responses to pain or discomfort, frequently lead to “challenging behaviors” such as aggression, self-absorption, and/or feeding and sleep disturbances. Rather than being recognized as stress responses, these behaviors are often dismissed as a symptom(s) of “autism” or other developmental differences. Building an integrated team of medical, developmental, behavioral and mental health specialists who can assess and treat all aspects of a child’s health is essential to improve a child and family’s well-being and optimize developmental progress.“Ask the Doctor” (Panel Discussion)Moderator: Ricki Robinson, MD, MPH Panelists: Lonnie Zeltzer, MD; Traci D. Swink, MD; Serena Wieder, PhDThis discussion will give audience members, parents and professionals alike, the opportunity to ask panelists their questions and concerns relating to co-morbid medical conditions in their children or the children they serve. The multidisciplinary medical and psychological experts on the panel will discuss these questions while demonstrating a team approach to evaluating and treating a child in order to restore his or her physical and emotional wellbeing.

Innovative Approaches to Building Socio-emotional Development

Welcome and Program OverviewMona Delahooke, PhDThe Use of Virtual Reality for Building Relationships, Decreasing Anxiety, and Developing Competencies“Skip” Rizzo, PhDDr. “Skip” Rizzo is a Research Professor at USC and Director of Medical Virtual Reality at the Institute for Creative Technologies. His presentation will focus on the use of Virtual Reality (VR) for the assessment, treatment and scientific study of a variety of clinical conditions including Autistic Spectrum Disorders, ADHD, Anxiety Disorders, Stroke and Cerebral Palsy. He will also present advanced research and development of artificially intelligent Virtual Human agents that can engage real human users in a credible fashion for use as “Virtual Patients” for clinical training. He will also discuss new work (in partnership with the Dan Marino Foundation) in the use of virtual humans to provide experiential practice for vocational interviews with teens and young adults onthe autism spectrum. The talk will end with a look into the future of Clinical VR across a wide spectrum of clinical health conditions.The Pokemon in the Room: Exploring the Benefits and Drawbacks of TechnologyDeborah Budding, PhDParents often ask how much time children should be allowed to spend with technology or to play video games. In our current world, “devices” have become a part of life for all of us. Dr. Deborah Budding, a neuropsychologist, will talk about the potential benefits and drawbacks of technology for aiding self-regulation. She will also address some concerns parents and professionals have about overuse or misuse of technology, and how to ensure that it doesn’t become a substitute to real life interactions and social engagement. When is it too much and how do we know? How can games foster relationships?Evidence for Video Games that Encourage Social Interactions, Reveal Unique Skills & Abilities and Foster Executive Function in Individual with Diverse NeedsLouAnne E. Boyd, MA, and Monica G. Osgood, Executive DirectorLouAnne Boyd, the principal investigator of a study on collaborative assistive technologies, will discuss how low cost platforms such as the iPad can be used to facilitate social relationships in children with autism spectrum disorder (ASD). LouAnne will describe the results of an empirical study of the use of a collaborative iPad game, Zody, and how this video game is used to support social relationships, even without adult intervention. She will discuss and present video examples of how specific design choices can encourage three levels of social relationship: membership, partnership, and friendship. This work contributes to research on both assistive technologies and collaborative gaming through a framework that describes how specific in-game elements can foster social skill development for children with ASD.Panel DiscussionModerator, Mona Delahooke, PhD Panelists: “Skip” Rizzo, PhD; Deborah Budding, PhD; LouAnne Boyd, MA; Monica G. Osgood, Executive Director; and Steve Keisman, Identifor, representative from Exceptional MindsThis panel will discuss the use of technology and video games for building resilience in socio-emotional capacities and answer written audience questions.Turning Passions into ProfessionsRicki Robinson, MD, MPH and Exceptional Minds

The Impact of Fathers and Father Figures on Children’s Socio-emotional Development

Introduction to the Afternoon SessionMona Delahooke, PhDPlay, Affect, and the Impact of Fathers on Socio-Emotional Development Offered as part of the complete conference series only. Videos were edited from presentation.Sheila Anderson, PhDSpontaneous playfulness has long been viewed as a hallmark of father-child interactions during the early years. Father playfulness is theorized to heighten emotional engagement and scaffold children’s exploration and regulatory skills. These functions of father play are particularly relevant to children who are at risk for developmental and socio-emotional delays. Based on the emerging work of an international group of father researchers, and observational research with over 400 at-risk families in the U.S., including children in Early Head Start, this presentation will explore the following questions: Which aspects of early father play interactions matter to the social and emotional outcomes of at-risk young children? How can strength-based approaches be used to observe and encourage positive father-child play interactions?The Fathers’ Journey: Bringing the Father Factor into Your Home (Panel Discussion)Moderator: Mona Delahooke, PhD Panelists: Sheila Anderson, PhD; Erik Linthorst, father and videographer; Kevin Hamilton, college student; Craig Hamilton, FAIA; Tal Baz, MS, OTR/L; and Yudi Bennett, Exceptional MindsThis exciting panel discussion will include first hand reflections from film-maker Erik Linthorst about the father’s journey. Erik will provide footage of several fathers who candidly share about their personal experiences with their children with developmental differences. The panel, including Kevin Hamilton, a student at Taft College, TIL Program and his father Craig. Kevin will speak about his recollections of his relationship with his father, as well as his experiences living at college as a special needs individual. Kevin and his father Craig will also answer written questions from the audience. We will engage in discussion about how the father factor goes beyond gender stereotypes to the range of joyful human experiences that support the essential need for engaged and strong relationships.

MORNING WORKSHOPS

DIR Model Therapeutic Play Groups for Siblings of Children with ASDPatricia Marquart, MFT; Jeanne White, MFT; Jillian Boccardo, MA, CCC-SLP; Kristina Fluitt, MS, OTR/LThis workshop will present an intensive look at the rationale and process of a Therapeutic Play Group for the Siblings of Children with ASD. This playgroup, offered to siblings of children enrolled in our DIR/Floortime program at the Center for Developmental Play and Learning (CDPL) gave siblings a better understanding of DIR: what we do, why we do it and how it helps their own family. This workshop will review the “nuts and bolts” of creating a sibling playgroup with emphasis on programming that supports siblings to be more connected to their own feelings and to their family. The group ran for a time-limited series of sessions, with follow up sessions planned at future intervals.Learn and Move to the Sights and Sounds of Writing: Effectively use Music, Movement and Technology to Engage Students in HandwritingMichele Parkins, MS, OTRRecent research supports the importance of whole body movement, sensory cues, and affective connection in enhancing learning. In this presentation, we will discuss this research as well as practical ways to engage students using sensory-motor integration, affective connection, and visual spatial concepts in order to facilitate learning of letter formation and to support early literacy. Handwriting practice leads to improvements in cognition, motor skills, and reading comprehension. This evidence-based creative curriculum uses music, movement, and technology to enhance the learning of pre-writing and handwriting skills and has been effectively used with students with autism as well as students in mainstream. Research studies documenting this will be shared. Through working on pre-writing and handwriting skills in this way we will demonstrate how you can enhance motor development, sensory integration, and early literacy all while teaching students who are engaged and having fun.Focus on Family: Solution Oriented Approaches For Families Faced by Developmental ChallengesRuby Salazar, LCSW, BCD; Ben Zequeira-Russell, PsyDFamilies come together for healthy and meaningful purposes. The modern family is challenged by life’s realities even under the best of circumstances. Sometimes unforeseen challenges occur, such as having a child with special needs. Establishing and growing a perspective of family strengths lays the foundation for negotiating the inevitable ups and downs, as well as individual issues, such as sleeping, eating, aggression, and social development. We will provide a lifespan developmental perspective which includes a historical perspective of family dynamics, a review of the science underlying how humans function, ideas for promoting marital health, developmental stages through case examples, with video, and how to use the DIR template to make meaning of the best parts of individuals and families. This Workshop has relevance for both professionals and parents who will be included in the dialogue during the presentation.The Profectum Parent Toolbox Webcast Series (PPT) – A FREE Resource for Parents, Families, Educators, Paraprofessionals and Professionals – THE LAUNCH!Ricki Robinson, MD MPH; Monica G. Osgood; Serena Wieder, PhD; Sherri Cawn, MA, CCC-SLP; Rosemary White, OTR/L; Exceptional Minds StudentsThis Workshop showcases the innovative online “Profectum Parent Toolbox” (PPT) Webcast series. This FREE online resource consists of 37 Webcasts that demonstrate strategies to mobilize a child’s relationship-based interactions. Parents and families are guided through the “hands-on” video series and a companion downloadable workbook to learn how to tailor interactions to their child’s individual profile. This unique learning resource is presented in a parent-friendly manner that enhances adult learning: all strategies are demonstrated through video examples with children of all ages and developmental profiles. By completing the PPT Webcast series, parents will gain a greater understanding of the uniqueness of their child, and how they can better connect and foster their relationship as a foundation for enhanced developmental growth. Using examples from the Webcast series, the goals, content, and format will be demonstrated. Beta testing research will be presented to show how parents helped shape the final product. Exceptional Minds students will discuss the animation/editing completed for the series. This Workshop will also address how parents, educators, paraprofessionals and professionals can use the PPT as a resource in their homes, clinics and schools.Development Across the Lifespan: Preparing Young Adults for SuccessWEBCAST NOT AVAILABLEKaren McDowellDevelopmental therapeutic approaches can also be extended across the lifespan for adults with diverse needs. These types of interventions can foster executive functioning and build critical capacities in thinking, relating and communication. This workshop will address common challenges young adults face as they move from school to day programs, college or work and strategies to support them. The importance of nurturing independence and self-advocacy as caregivers face their children’s growing up with will be discussed. Videos will be shown that share interviews of young adults and their parents as well as illustrate strategies for working on challenges while building on each individual’s unique strengths.AFTERNOON WORKSHOPS“It’s The Real Thing!” The Symbolic Journey towards Reality Testing and SelfWEBCAST NOT AVAILABLESerena Wieder, PhDFloor Time is most often considered the play that helps parents and young children interact, engage, communicate, and introduces early symbolic play. But symbolic play has a long trajectory that make Floor Time an essential ongoing activity for further development as children move onto school age and adolescence, including children on the autism spectrum. It is essential for several reasons. Some children do not reach symbolic levels until they are older. Also, symbolic demands increase as children go through school. Comprehension of literature, social studies, and history are continuous tasks. While facts and figures can be memorized, children with uneven learning and emotional development might experience anxiety, conflict and confusion given gaps in such psychological processes as sense of self and self-esteem, separation-individuation, and common sense. Symbolic play and conversations support the symbolization of more complex emotions related to aggression, jealousy, competition, friendship, morality and justice, etc. Lagging development can lead to avoidance and constrictions, holding onto magical thinking, poor reality testing, as well as fears and anxiety or behavioral problems. This workshop will examine the pathways of children with different profiles as they move towards adolescence and how symbolic play with parents, teachers and therapists provide a safe way to keep on developing.The DIR Approach to Feeding Challenges in Children with AutismWEBCAST NOT AVAILABLEJulie Miller, MOT, OTR/L, SWC and Diane Cullinane, MDMany children with autism have challenges with eating. This presentation will provide an overview of the DIR approach, which stresses understanding each child’s individual differences, working with parents and family, and supporting a child’s trust, engagement, and initiative in eating. The goal of this approach is that a child will not only eat safely and receive the proper nutrition, but will also enjoy mealtime with their family and peers.Floortime Strategies: A User’s Guide to the DIR ModelAndrea Davis, PhD and Lahela Isaacson, MS, LMFTOne may have a general sense of DIR/Floortime or an awareness of how it differs from behaviorism, but quite often we need to be able to break Floortime down into step-by-step, teachable and learnable strategies. Floortime strategies encompass new ways of seeing the child and seeing oneself–new ways of thinking, interacting, and being. This workshop will provide practice using a Floortime Strategies system to clearly and more easily:Train parents in the specifics of what they can do to help their child or adolescent Write up Floortime Treatment Plans and Session Progress Notes using clearly identifiable intervention strategies Train staff members to implement Floortime ways of seeing, thinking, playing, and talking Share with parents, staff, funding agencies, and other professionals the research and theory behind why we do what we do!Occupational Therapy: Research and Reflection – a Two Part Workshop for Parents and ProfessionalsWEBCAST NOT AVAILABLERosemary White, OTR/L & Zoe White OTS & via video Students and Faculty of Occupational Therapy Department Eastern Washington University Part 1: Indicators of Engagement: An Early Validity Pilot Study: This presentation, which will be rich with video of examples of DIR OT, will cover the history of the collaboration between Rosemary White, OTR and the Professor & Masters students in Occupational Therapy at Eastern Washington University. Review of early research done to measure improvement in joint attention over the course of a 4 week DIR Floortime Summer Camp will be presented with video examples of pre and post camp. Current research will be presented a single subject pilot study assessing the development of joint attention, interactions for communication and functional attention over the course of 14 one hour treatment session with a child of 2 years with a diagnosis of ASD. Methods of collecting and assessing data to capture the progress of the child will be presented.Part 2: From Therapist to Employer: A DIR OT Case Study Emphasizing the Power of Relationships: Rosemary will highlight her work with a young boy over the course of his DIR OT beginning at the age of 6 years and the shift after discharge to continue contact as he moved through middle and high school. Today the role in the relationship has moved to new ground as this young man is now an employee as a Floortime Player in the DIR Summer Camp. In his role as a player he reflects on the experience and his understanding of the children whom he supported in their interactions with him and with peers. Videos that cover the course of DIR OT sessions and work as a “floortime player.” will be showcased.Finding the Balance: The Benefits and Risks of 21st Century Technology for Individuals with Sensory and Motor DifferencesMonica G. OsgoodThis workshop will discuss the pros and cons of technology for individuals with sensory and motor challenges. In today’s world we have to balance the realities of the need to be proficient with technology resources, how these resources may fill communication and comprehension gaps for some and the need to preserve face to face relationships and the ability to navigate spontaneous, natural, real life experiences. Research is used to support the neurological and developmental risks of the over indulgence in technology, or alternative worlds. In contrast, the identification of skills needed for individuals to be successful, even function, in the 21st century must be recognized. Finally, the tension between understanding the benefits and risks of technology and the demands of real family life will be illustrated through testimonials." 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Ricki Robinson, MD, MPH

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