KEYSTONE TIMES
Keystone Behavior Pediatrics Newsletter
June 2015
A Letter from the CEO: Katherine Falwell, Ph.D., BCBA-D
Summer Camp Benefits
Summer is almost here and that means school's out! Parents find themselves in a rut when they have so much to do,
but their children do not.
While having your child watch countless hours of television a night or play video games throughout the day sounds
like an easy fix, it can often impair their cognitive development. The National Summer Learning Association (NSLA)
reports that most students lose about two months of grade level equivalency in mathematical computation skills over
the summer months.
Alarmingly, children who are at high risk of obesity tend to gain weight more rapidly when they are out of school in the summer
due to the lack of physical productivity many face just sitting at home.
Summer camp — day or overnight — provides the opportunity for children to hone their life-skills and enhance their cognitive
and behavioral development. Every year, more than 11 million children in the United States attend camp - 7,000 are resident
(overnight) and 5,000 are day camps reports the American Camp Association (ACA). These camps provide children with a safe,
nurturing environment that gives them opportunities for leadership and personal growth.
The decision to send your child off to an overnight summer camp is not an easy task as a parent, especially if you don't know if
they are ready.
Children need to start to learn how to separate themselves from their families in order to become resilient and less reliant on
their parents for healthy cognitive and behavioral development. Separation skills are not only necessary for the children but also
for the parents. The advice and tender love and care a parent has provided a child throughout the years will affect their overall
development. Once the parent reassures themselves that they are ready for their child to go to camp and accept that the separation is part of life - both parent and child can move forward to planning for summer camp.
How Resilience Gives Children Encouragement
KBP Mission
To help children
reach their fullest
potential by providing individualized
treatment using evidenced-based clinical
practices. Our team
has the specialized
training and experience needed to address a broad-range
of concerns including
common behavior
problems as well as
severe behavioral and
psychiatric disorders.
We strive to ensure
the most comprehensive interdisciplinary
approach possible by
maintaining close
relationships with a
variety of multidisciplinary service
providers.
Children who attend summer camp gain a sense of resiliency when they face new challenges like learning how to build a tent, going on a hike or conquering a high ropes course. A camp is a nurturing environment where children are encouraged to take safe risks and learn from them whether they succeed or
fail. Unlike school, children can try to implement new methods of how to do things without a set time
limit on when the task should be done. Summer camp provides the freedom for children to make their
own mistakes and learn from them so they know how to cope with both success and failure.
How Confidence Helps Children Overcome Challenges
Summer camp can aid children with building their self-esteem in a healthy and positive way. The "cando" attitude is a trait many parents want to instill in their kids. However, this can only be achieved if
they are faced with new challenges on their own. When kids achieve something, big or small, like brushing their own teeth or riding a bike, they have a sense of capability and a fuel of confidence. Summer
camps provide plenty of opportunities for kids to face new challenges and build their self-confidence
through the daily achievements they make.
How Independence Builds Character In Children
At camp, children can learn how to do things for themselves without mom or dad supervising them. In
addition, a safe summer camp allows kids to make their own decisions without the guidance of their
parents or teacher. They will begin to take care of their personal space as they feel a sense of responsibility has been delegated to them.
How Social Skills Help Children Respect Others
Enrolling your child in summer camp means that they will be a part of small community. A sense of
belonging will allow your child to establish the social skills that will help him or her have respect for
others.
1
Department of Mental Health
Dr. Andrew Scherbarth, Ph. D., BCBA-D
Autism intervention: Pseudoscience vs. Best Practices
Children bring us joy and happiness, so it is difficult to see them struggle. It’s completely understandable to want to do anything possible to make their lives easier
and help them become more independent. However, some interventions have little
to no support and can have actually harm children and families, or have no benefits
at all. This article will begin the discussion on science vs pseudoscience, and give a
couple examples where families have been strongly effected by wrongly trusting in pseudoscience. A more in-depth discussion will happen here Monday June 8th at 6 pm in the Mainspring
Academy Commons area. Childcare is provided.
Pseudoscience may seem rational or scientific, but the interventions have little to no scientific
support. Pseudoscience providers may rely heavily on appealing to parent’s emotions. One way
they do this is by relying heavily on a celebrity speaking for them in favor of the product or service, or they give satisfied customer statements. There’s nothing wrong with having a satisfied
customer tell you about their experience, but if the best thing that a product or service can give
you is that someone is convinced it works, then you should think twice. Another set of strategies
is to make these products or services seem legitimate. For instance, they may provide an explanation with medical information and scientific terms, or they may state “research says” without
actual citations. Some products/services have a name similar to a legitimate intervention, even
though the actual produce is clearly different from an evidence based approach. Sometimes their
ads have a doctor or another professional’s name attached to it to seem more scientific too. The
bottom line is that if the information being presented to you uses the same kinds of strategies
you would see on an infomercial to sell a miracle product, then you should stay away.
Scientific, research based practices, have strong research designs. The strongest designs for single subject research include a reversal design or a multiple baseline. The strongest designs for
testing groups of individuals include Randomized Controlled Trials, which may then be evaluated across studies with a Meta-analysis. The write ups are accepted in research journals that are
reviewed by experts in that topic area and presented for professional audiences.
As an example of pseudoscience, take Facilitated Communication (FC). Communication is a
large challenge for kids on the spectrum. FC has a facilitator who guides the child’s hand to a
communicative device and fully supports every movement. FC has endorsed by fringes of the
Speech-Language community, which may make it seem legitimate. Further, some in the FC
community have started calling it Functional Communication to make it sound more like the
ABA based Functional Communication Training. However, FC is nothing like ABA. Although it is
legitimate to occasionally guide a child’s hand to communicate, ABA approaches teach the child
to communicate for themselves with simple messages—not to fully speak for the child with more
complex compositions. Thorough scientific evaluation has completely debunked the use of FC in
experimental analysis, multiple times. Further, there is clear documentation in the media of
families being harmed when a facilitator guided their child’s hand to spell “kill me,” or falsely accused their family of sexual abuse. Practices such as this must not be allowed to pass themselves off as scientific.
2
Department of Rehabilitation Medicine
Dawn M. Berg, BCaBA, Director, Pediatric Feeding Disorders
Pediatric Feeding Disorders
A feeding disorder is identified when a child is unable or refuses to eat or drink sufficient quantities to
maintain nutritional status regardless of etiology. Among children with autism, 45-80% experience
mealtime difficulties that place them at risk for severe nutritional and medical issues. Furthermore, 3380% of children with medical, developmental, or other special needs exhibit feeding problems. Typically,
children with feeding difficulties exhibit strong preferences for certain foods (by type, texture, color and/
or packaging) and consume a narrower quantity of food when compared to their peers. Additionally,
mealtimes are often difficult due to elevated rates of disruptive behavior such as crying, gagging, vomiting, and throwing things when presented with non-preferred foods. Common signs and symptoms of a feeding disorder include:








Poor weight gain
Feeding tube dependence
Bottle or formula dependence
Mealtime tantrums, or mealtimes exceeding 40 minutes
Distress and anxiety with new foods
Inability to increase textures
Inability or refusal to feed oneself
Extreme pickiness (eating fewer than 12 foods)
The cause of pediatric feeding disorders can be biological such as a cleft palate, reflux or allergies. It can also be the result
of a behavioral learning history in which maladaptive behaviors allow escape from the meal or presentation of the unwanted food. It is not uncommon for the problem to morph from medical into behavioral. A child who experiences discomfort
when eating will cry when presented with food and the parent’s natural reaction is to remove the food, thus setting up a
behavioral learning pattern that results in feeding problems.
Several researchers have suggested that behavioral mismanagement (i.e., inadvertent reinforcement of inappropriate eating patterns) frequently contributes to the onset and maintenance of feeding problems (e.g., Babbitt et al., 1994; Palmer,
Thompson, & Linscheid, 1975; Piazza et al., 2003). For example, as mentioned above, if a caregiver uses negative reinforcement by removing the food or discontinuing a meal following the child displaying inappropriate behaviors regarding
eating (e.g. crying, gagging, hitting the spoon), the child is more likely to engage in those behaviors again when presented
with less preferred food items or larger quantities of food. This cycle can continue until the child has selected down to
just a few foods that they will readily accept or in some cases, stop accepting food altogether.
Behavioral interventions have been demonstrated to be effective for treating feeding problems in children. A multicomponent treatment package consisting of positive reinforcement and escape extinction is the most commonly used intervention for this problem (e.g., Ahearn, Kerwin, Eicher, Shantz, & Swearingin, 1996; Babbitt et al., 1994; Cooper et al.,
1995; Kerwin, Ahearn, Eicher, & Burd, 1995; Piazza, Patel, Gulotta, Sevin, & Layer, 2003). Non-Removal of the Spoon is
a common Escape Extinction procedure in which the spoon is held at the child’s lips until he or she accepts it. This procedure is often paired with positive reinforcement in which the child gains access to preferred stimuli for accepting and
swallowing the bite of food. Antecedent manipulations are also common in the treatment of feeding disorders. The variety, texture or amount is often manipulated to increase acceptance or it can be blended with a preferred food and the preferred food is slowly faded out over time as the child has success.
Each child is different and the treatments developed in behavioral programs should be individualized for every child.
There is no “typical” treatment or “typical” course. Each child progresses at his or her own pace. Some children begin eating within a few days of admission to a program, other children progress more slowly and it takes many weeks before they
eat. A child’s progress will depend on a number of factors, including, but not limited to (a) his or her feeding history; (b)
the extent to which the child has oral motor issues, which impact his or her feeding; and (c) the extent to which the child
has ongoing or emerging medical issues (e.g., vomiting). While the incidence of feeding disorders is high among children
with developmental disabilities, research has shown us that a behavioral approach to treatment is an effective way to treat
food refusal and selectivity.
3
Keystone Child Development Center
Nicole Theiler, M.A
As the 2014 school is coming to a close many families are starting to think about placement for their
child for the next school year. One of the more confusing roads to navigate as a parent of a child with
a disability is eligibility for the McKay Scholarship.
The following is from the Florida School Choice website (https://www.floridaschoolchoice.org/
Information/McKay/eligibility.asp).
In order to be eligible for the McKay Scholarship Program, a student must apply for the program prior to withdrawing from public school. The student must also have an Individual Education Plan (IEP)* or 504 Accommodation
Plan, and:
 Have been enrolled and reported for funding in a Florida public school during the preceding October and February Florida Education Finance Program surveys (Grades K-12); or
 Have been a pre-kindergarten student who was enrolled and reported for funding in a Florida public school during the preceding October and February Florida Education Finance Program surveys and was at least 4 years old; or
 Have been a pre-kindergarten student who was reported as having received Specialized Instructional Services by
the Office of Early Learning and was at least 4 years old; or
Have attended the Florida School for the Deaf and Blind during the preceding October and February student membership surveys (Grades K-12).
A student can meet enrollment requirements anywhere a VPK voucher is accepted—this includes KCDC. The online
VPK registration portal makes this process easier for parents but it can still be a bit difficult to interpret and make
appropriate selections. Students who will be pursuing McKay eligibility requirements their VPK year must be registered for VPK-Specialized Instructional Services (SIS). Doing this allows the student to meet eligibly requirements
for the following Kindergarten year without having to attend a public school for a year.
The first step in completing all of this is to make sure your child has a recent IEP; this is needed for the Early
Learning Committee (ELC) to approve SIS. Once registered, you will receive a VPK voucher. VPK-SIS will allow your
child not only to meet eligibility requirements to receive McKay but also to receive any additional support services
throughout the school system identified in the EIP (eg speech, OT, specialized instruction).
Congratulations to Allison Dempsey for receiving her BCaBA!
Welcome new faces of Keystone!
We are pleased to announce the following new employees have joined
the Keystone Team:
Board Certified Behavior Analyst: Jennifer Grisnik
Behavior Therapist I: Jessica Vermillion
Behavior Therapist I: Haley Edwards
Behavior Therapist I: Haley Curtis
Employee Spotlight: Steve Capista– Senior Psychologist Assistant
Steve grew up in Philadelphia, PA, and graduated from St. Joseph’s University with a
Bachelor’s degree in Psychology. After graduation, Steve was employed at Wediko Children’s Services, a residential clinic in New Hampshire. He spent two years working for Wediko, training in
behavior modification for children and families facing social, emotional, and behavioral challenges. In
2008, he moved to Oakland, California to work as an Intervention Specialist for the Oakland Unified School District.
In Oakland, Steve used the models of transformative justice and non-violent communication to help children and
families strengthen relationships between family members and their local school and community. His experience
includes experiential education, strengths-based behavior modification, and group and family therapy. Steve provides therapy, tutoring to after school clients and group therapy.
4
Exceptional School. Exceptional students.
We are excited to announce the transition from The Keystone Academy to:

Highly supportive environment that maintains a low student/teacher ratio which addresses the unique, educational and therapeutic needs of each child.

Small class sizes, with a low student to teacher ratio, make it possible for each student to have their own unique educational and therapeutic needs addressed while
still maximizing the educational benefits of the classroom experience.

Behavior therapists provide support in each classroom daily by integrating sensory,
language and motor exercises within each academic activity.
For more information please contact:
Mainspring Academy works collaboratively with other departments to
Garrett Adamson:
educational journey. These services include, but are not limited, to the
[email protected]
following:
provide special, related services to further support your child in their
Maegan Howell:
[email protected]
-Speech/Language Pathology
-Psychiatric Consultation
-Psychological Services
-Intensive Behavior Therapy
Amanda Garrettson:
[email protected]
Keystone Behavioral
Pediatrics Phone: 904-619-6071 ext. 6
6867 Southpoint Drive . www.mainspringacademy.org
Suite 103 Jacksonville, FL
32216
-Occupational Therapy
-Feeding Therapy
-Physical Therapy
-ABA Therapy
5
Services Offered
We frequently provide treatment for...
Keystone Behavioral Pediatrics
6867 Southpoint Drive .
Suite 103 Jacksonville, FL
322161
Jacksonville, FL 32216
Phone: 904-619-6071 ext. 6
Behaviors: Noncompliance/ Refusals, Physical and Verbal
Aggression, Social Skill Deficits, Self-injury, Toileting Resistance, Sleep Disturbances, Language/ Communication
Delays, Excessive Fear/ Phobias, Attention Difficulties, Academic Struggles/ Homework Refusal, Trauma Related to
Abuse and Neglect, Family Relational Problems, Attachment
and Separation Issues, Medication Refusal, Resistance to
Medical Treatment.
Keystone promises to:
* Provide a safe and nurturing environment for all children
* Promote personal growth (e.g., self-discipline, self-esteem,
self-knowledge)
* Foster a climate that promotes social values such as
responsibility and respect for others
* Challenge children with individualized achievement
standards and community programs that will enable
them to progress at their own pace, encourage them
Diagnoses: Autism Spectrum Disorders, Attention Deficit
Hyperactivity Disorder, Oppositional Defiant Disorder, Disruptive Behavior Disorder, Conduct Disorder, Communication, Speech, and Language Disorders, Learning Disorders,
Feeding Disorders, Post-Traumatic Stress Disorder, Obsessive Compulsive Disorder, Eating Disorders, Mood Disorders,
Anxiety Disorders, Developmental Delay, Tics, Sleep Disorders, Encopresis/ Enuresis.
to strive for excellence facilitate self-help skills, and
foster independence
* Encourage strong family involvement in the life and
treatment of the child
* Establish and maintain partnerships between Keystone,
client families, and the community at large
* Extend learning beyond the Keystone walls by exposing
children to resources within the community
* Provide advocacy, educational, psychological, and
health-related services for children and families
* Explore and celebrate individual differences and
contributions
Does your child have difficulty: Communicating wants/needs, using appropriate sounds,
following directions, self-feeding, getting dressed, playing with toys, or manipulating objects?
Do you have questions, but you’re not sure where to go for answers? A FREE
Developmental Screening may help! Keystone Behavioral Pediatrics is offering a FREE oneday Speech and Language, Self-Care, and Motor Screenings for Children, ages 6 months
through 7 years! The FREE screening will be held Wednesday, June, 17th, 2015 from 8am
to 6pm! Walk-ins are welcome!
Keystone Behavioral Pediatrics
6867 Southpoint Drive North, Suite 110
Jacksonville, FL 32218
Phone: 904-619-6071
6