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Caption: A student at Harwood Center for Developmental Disabilities undergoes Applied Behavioral Analysis (ABA)

Hearing the words “your child is autistic” can be devastating news for parents. But once that diagnosis is made, the often bigger challenge is finding therapists who can help treat their child’s symptoms.

Scientists don’t yet understand what causes autism, a complex neurological disorder that affects a person’s ability to communicate and interact with others. Since it is considered a spectrum disorder, it can vary widely in its severity and symptoms, though most autistic children have a strong need for routine and predictability, according to Kathryn McVicar, MD, a pediatric neurologist and associate professor of neurology and pediatrics at the University of Tennessee Health Science Center.


Effective treatment for autism
Since the diagnosis of autism was first defined more than 50 years ago, parents have tried a host of treatment options in an effort to reach and help their children. Some, such as music or occupational therapy, are more conventional. Others are as far-ranging as rebirthing, swimming with dolphins, chelation, and auditory processing therapy.

“Treatment for autism is like it was in the Wild West, when traveling salesmen were selling snake oil and elixirs to cure anything. There are lots of traveling salesmen and parents looking to try anything and everything to help their child,” said David Bicard, assistant professor with the College of Education at the University of Memphis and a board certified behavior analyst. “We need to separate facts from effective treatment.”

According to Bicard, it was the book, “Let Me Hear Your Voice,” by Catherine Maurice that really put applied behavior analysis, or ABA therapy, center stage for autism treatment. This victorious story of one mother’s search for answers in treating her autistic children sent reverberations through the autism community and parents desperate for answers seeking ABA therapists.

Thus far, ABA therapy is the only research-based intervention that has demonstrated improvements for children with autism. Since there are fewer than 30 board certified ABA therapists in Shelby County, the University of Memphis (UM) launched a new degree program in 2007 that provides graduate level training in this specialized field. The aim is to graduate more students who can sit for the national board certification, administered by the Behavior Analyst Certification Board.

“There’s always a need for good ABA therapists,” said Nan Miller, director of the Harwood Center, an early intervention agency for children with special needs. “It’s hard to find someone who’s qualified and willing to drive all over town for state reimbursement.”

Harwood provides ABA therapy to children while they attend the center and continues those services at home. They serve families with children from birth to age 3. “It’s very intense, one-on-one treatment and each program is designed specifically for that child and what it is they need to work on,” noted Miller.
“Autistic kids need to learn what most people already know instinctively, like how to sit in a chair or how to make eye contact.” Miller said through repetition and reward, an autistic child can eventually master these social skills.


The coursework
Presently, the program is funded through student tuition, though Bicard said he and his colleagues, Sara Bicard and Laura Baylot-Casey, are in the midst of writing grant proposals. The program started with 23 students in the fall of 2007. Presently, 15 are on-track to take the certification exam at the end of the spring semester of 2009. Since the program is offered through UM’s College of Education, the majority of the students have a background in special education.

During the year-and-a-half-long program, students take five courses and four practicums (300 hours per semester). The practicum training enables them to work directly with other professionals and children at places like the Harwood Center. Bicard points out that ABA therapists are not limited to working with autism. Since this branch of psychology deals with the relationship between people’s behavior, and their environment, it has many other applications. The Department of Transportation often uses applied behavior analysis to determine where and how to place road signs to change public driving behaviors, and businesses use it to improve the training of employees.


Becoming part of the community
Bicard said he’s also working toward establishing a partnership with Le Bonheur Children’s Medical Center. McVicar, with Fred Perkins, MD, a pediatric neurologist at Le Bonheur, and Vickie Brewer, MD, a neuropsychologist, are developing an autism center at Le Bonheur. The center will be a collaborative effort between Le Bonheur, the University of Tennessee, the University of Memphis, the UT-Boling Center, and others in the Memphis community working on autism. The idea behind the center, said McVicar, is to offer a standardized evaluation of children “which would allow us to tailor treatment for each child to optimize their functioning.”

Currently, McVicar says they are waiting on funding from the National Institutes of Health. Money for medical research has been scarce as the economy has slowed, forcing grant seekers to apply two and three times before being funded, said McVicar. But she believes autism research will likely receive funding with the recent passage of the Combating Autism Act.

In the meantime, Bicard's department will be working closely with other practitioners. Bicard recommends those parents who are looking for ABA treatment ask therapists for credentials. Once work has begun, watch the child’s behavior for evidence of benefit from the therapy. “You should expect small but cumulative success on a weekly basis.”

• To learn more about the ABA therapy program at the University of Memphis, go to: www.coe.memphis.edu/icl.
• To learn more about the treatment of autism, check out the Association for Science in Autism Treatment website: www.asatonline.org.



August 2008

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