What do you get when you cross technology with the skills of two local doctors looking to meet the needs of children suffering from Asperger syndrome and other developmental disabilities?
Ann Arbor-based Dr. Mark Bowers and his wife, Dr. Kelly Bowers, who live in Brighton Township, have created the answer: It's a mobile application called Sosh, which boasts more than 60 screens of information, strategies and exercises for children, tweens and teens to improve social skills.
Designed primarily for children with Asperger syndrome, Mark Bowers said information contained within Sosh also applies to children, adolescents and young adults who struggle with social difficulties for other reasons, like attention-deficit hyperactivity disorder or social anxiety.
In early reviews, parents, too, have found Sosh useful, Mark Bowers said.
The application is available on the iTunes store, and can be used with any Apple device.
Also available is Sosh Lite, a free version that allows anyone to try the full version of the Sosh application for seven days from the date of download before the application converts to a Lite version with limited features.
"Basically, anyone who struggles with social difficulties can get something out of it," Mark Bowers said. He is a licensed pediatric psychologist at the Ann Arbor Center for Developmental and Behavioral Pediatrics.
Kelly Bowers is a licensed psychologist and serves on the Board of the Michigan Autism Partnership.
The duo designed the application around what they call the five R's.
"The whole Sosh theory is broken down into five categories: relate, relax, regulate, reason and recognize. Those five main cruxes of the app are how information is organized," Mark Bowers said.
For example, if a teen with Asperger syndrome joins a conversation and hears slang terminology, he or she can type the expressions into Sosh. Because children with Asperger syndrome often have difficulty understanding figures of speech, idioms or figurative language, Sosh can be used to break these types of phrases down for its user.
In addition, Mark Bowers said, Sosh encourages children to "get out and connect with other people." Sosh provides its users access to huge amounts of information and provides them a platform to store their experiences and track their progress.
"The whole purpose is to gather data and begin to monitor one's own interactions and figure out appropriate response styles," Mark Bowers said. "Anxiety comes about because children are not getting positive feedback from peers, and they start avoiding social situations. Sosh encourages them by giving them activities and exercises they can use in the field."
The Bowers have also released a book called "Sosh: Improving Social Skills with Children and Adolescents." The book complements the Sosh app and serves to help develop a child or teen's social skills. It details the five R's and provides strategies for improving social skills.
Join us for a day dedicated to helping families address the challenges that arise after a child receives an Autism Spectrum diagnosis. Topics of the day include, married with special needs children, strategies for activities of daily living, what happens when your child with Autism Spectrum Disorder grows up, technology and Autism, and advocating for your child in the school setting.
When: Saturday, March 19Develop social competence and confidence! This social interaction group uses discussion and activities like games, group challenges, and social events in the community to teach and practice “unwritten rules” to social relationships. The group targets the needs of students with Asperger’s Disorder, High Functioning Autism, Non-Verbal Learning Disabilities, Social Anxiety, and other neurosocial disorders.
For more information: Mott's Children's Teen Social Group FlyerWhen Ann Arbor residents Samuel and Ingrid Gregg enrolled their daughter Madeleine in the Play and Language for Autistic Youngsters program, they knew they were in for some work. "My wife and I basically rearranged our lives so that we could focus on getting this right," Samuel Gregg said. "It seems to have paid off."
Three years into the program, her parents say 5-year-old Madeleine is interacting well with her peers and has excellent verbal skills.
Results of the program have been so promising that the National Institute of Mental Health has awarded the P.L.A.Y. Project a $1.8 million grant for a controlled trial of play-based autism therapy. It's an increasing need considering autism is the fastest growing disability in the country, with 1 in every 100 children diagnosed.
Dr. Rick Solomon, the creator of the Ann Arbor-based P.L.A.Y. Project, said the program helps parents with young children implement intensive, developmental interventions in their own homes.
The program treats children across the autism spectrum - from mild cases like Madeleine to children on the more severe end. It is designed for children from 18 months to 6 years old. "Madeleine's progress is outstanding," Samuel Gregg said. "She just turned 5 years old and is going to a normal kindergarten this year. Almost all of the exterior signs that one associates with autism are no longer present."
Solomon, who created the program in 2001, said children with autism need intensive intervention, which means 15 to 25 hours a week of one-on-one or one-on-two engagement. "It's play with a purpose," Solomon said. "The child to adult ratio is supposed to be very high, and it should be engaging interaction."
Solomon starts by giving a refined diagnosis of where the child is on the autism spectrum and what he thinks would help the child. One of his trained consultants then visits the family's home to teach family members - parents, siblings and grandparents - how to do play therapy with the child.
"The P.L.A.Y. Project starts with doing what your child loves, with them, in a way that gets them connected to people," Solomon said. "What I say is that when you do what the child loves with them, then the child will love being with you. That starts to break down autism's isolation. We have a whole system that helps parents connect with their child. We want parents to be their child's best play partner."
Play can be spread throughout the child's day, including in everyday rituals such as getting in the car, getting ready for bed, and during meals.
Every month, the consultant returns to the house for a follow-up appointment, and videotapes a play session. Solomon analyzes the tape, making adjustments to the therapy and offering suggestions to continue progress.
The Greggs say they've made the P.L.A.Y. therapy part of their lives, and it's now second nature.
"For any parents whose child receive a diagnosis of autism, be it extremely mild or extremely severe, they are bound to experience it as shock," Samuel Gregg said. "But the P.L.A.Y. Project is one of an emerging play-based therapies that offers real hope. Of course there is no guarantee in this business, but it certainly does offer a proactive way to help a child to transcend their difficulties."
Solomon created the program while working as a developmental and behavioral pediatrician at Allegheny General Hospital in Pittsburgh, Penn. He based it on the work of child psychotherapist Stanley Greenspan and his developmental, individualized, relationship-based theory.
"When I got to Pittsburg, the state had just passed this law to pay for autism services and a bunch of families came to me and asked if I would order these services for them," Solomon said. "Pretty soon I was swamped, and I became an expert in autism simply because I had to. The families chose me, and I fell in love with these children. It has been a group of kids who needed help, and I was in a position to help them."
When Solomon came to Michigan, he said he discovered the state had few public services that met the requirements for the intensity autistic children needed. He is now the medical director of The P.L.A.Y. Project at the Ann Arbor Center for Developmental and Behavioral Pediatrics.
The P.L.A.Y. Project is now in five countries and 27 states.Solomon said his research showed more than half of the children enrolled made substantial gains in their development when they participated in the P.L.A.Y. Project.
Solomon, a father and grandfather, diagnoses a child with autism in the Ann Arbor area several times a week and calls it a heart-breaking experience.
"Autism is a very serious condition and nobody wants to have a kid with serious difficulties, nobody wants to see their children suffering," he said. "But this program is alleviating the suffering."
For more information, visit http://www.playproject.org or call (734) 997-9088. Scholarships are available through The Michigan Autism Partnership.
As her son Richard lies on the floor, Holly Carter plays patty-cake with his feet.
When the 4-year-old swiftly crawls across the floor, she's right with him. He leaps up and darts across the room; Carter is by his side. Although it looks like she's performing some sort of maniacal mirroring marathon, playing this intensely is not all for fun and games. Richard is autistic, and doesn't speak.
Their activity is part of a three-year research study of the Play and Language for Autistic Youngsters (known as the P.L.A.Y. Project) home consulting model, a parent-training program that addresses the need for intense early intervention for young children with autism. Parents commit to playing with their child 20-25 hours a week with consulting from a play therapist. The goal of the project, supported with a $1.85 million grant from the National Institute of Mental Health, is to see whether this type of intensive play can help children with autism come out of their shells.
In a nation where about one in 150 children are diagnosed with autism, such a program provides a glimmer of hope for parents who wish something could become different. Because it's the fastest growing disability in the United States, too few people are trained to handle the intensive intervention recommended by the National Academy of Sciences. The P.L.A.Y. Project, the largest study of its kind, is designed to address the shortage by using a "train the trainer" approach, which is helping to rapidly spread the program around Michigan, the nation and the world.
While other therapies can cost as much as $60,000 a year, play therapy at $4,000 is much cheaper. Only about 150 children participate in the actual research study, but about 400 Michigan children receive play therapy as part of 15 play projects across the state, according to Dr. Richard Solomon, an Ann Arbor-based pediatrician and developmental and behavioral specialist who founded the P.L.A.Y. Project. Nationally, about 3,000 children are in therapy, and the technique already is being used in Australia and England.
Solomon says he hopes to see tens of thousands of children helped by this fast-spreading form of therapy.
"We're training the parents to be sensitive and responsive to their child's interest and this has been shown to be a very powerful way of helping children, especially with autism, to connect to their caregivers," Solomon says. "Once the child is connected, their development gets engaged, and that's what leads to improvement."
Carter understands exactly what he means. Since the Howell resident began the therapy, she notes, her son has come a long way.
"When we first started, he wouldn't notice anyone else in the room. He wouldn't even look at anyone," Carter says. "Now, he laughs out loud when he's tickled, grabs a pretzel from a visitor's hand and chomps into it, laughs and runs away. He wanted to feel the snow settling on the balcony separating his playroom from the outdoors, and climbs up the side of the stairs trying to get around a baby gate so he could go upstairs to watch his favorite movie."
Adam Brode, a P.L.A.Y. Project home consultant and speech language pathologist, has helped with that. Not only has he modeled how to play with Richard, he's consulted with Carter about how to go about playing with Richard a minimum of 20-25 hours a week. She says it was difficult for her to catch on to how to play with her son, finding herself making it a mechanical exercise instead of an intuitive and natural experience at first.
"We're making sure nothing stands in the way of reaching his full potential," Brode says. "We work to maximize the relationships kids like Richard can have with their families."
Besides Richard, Carter has a husband and another son, Vince, 2, to care for. Still, she is aggressively working to ensure Richard has the best chance possible. Besides working with Solomon, he is also enrolled in speech, occupation and music therapy programs. Carter, founding of the Boxing Autism Club, a support group in Livingston County and the executive director of the Michigan Autism Partnership, has become an autism activist. She works for change, pointing out that insurance companies in the state of Michigan don't cover these recommended therapies for autistic children.
She also offers reassurance for other parents of autistic children.
"If you really want to learn, have the desire to do this and your heart is in the right place, you are going to be able to do this."
Through the support of a $1.85 million grant from the National Institute of Mental Health (NIMH), Richard Solomon, MD, is conducting a three-year study of The Play and Language for Autistic Youngsters (P.L.A.Y.) Project Home Consulting model, a parent-training program that addresses the need for intensive early intervention for young children on the autism spectrum.
Today, approximately one in every 150 children is diagnosed with an autistic spectrum disorder. As the fastest growing disability in the U.S., autism continues to gain public attention, yet there is a national shortage of personnel trained in intensive approaches as recommended by the National Academy of Sciences (NAS). The P.L.A.Y. Project addresses this shortage by using a 'train the trainer' approach, which promotes rapid dissemination of the program.
Developed by Dr. Solomon, P.L.A.Y. is a practical, family-friendly application of renowned child psychiatrist Dr. Stanley Greenspan's Developmental, Individual-differences, Relationship-based (DIR) framework, popularly known as Floortime. Through structured monthly home visits focused on modeling, coaching and video feedback, consultants train parents to engage their child with autism in ways that promote emotional connection and communication. By training parents to participate in their child's intervention, the program also promises to be cost-effective. The P.L.A.Y. Project costs under $4,000 per year, in comparison with other interventions that cost $40,000 to $60,000 per year.
Details of the study: With research-design guidance from Michigan State University, and community-outreach support from Easter Seals, The P.L.A.Y. Project is conducting a randomized, controlled, and blinded clinical trial. Drawing participants from five Easter Seals autism service locations, the study compares t he outcomes of 60 children who participate in The P.L.A.Y. Project with the outcomes of 60 children who receive standard, community interventions, making it the largest study of its kind. Before and after the 12-month intervention, each child is assessed with a battery of tests to measure developmental level, speech and language, sensory-motor profile, and social skills.
"Preliminary research and early dissemination into community agencies, schools and hospitals around the world has demonstrated the effectiveness of our model," said Dr. Solomon, medical director of The P.L.A.Y. Project. "Positive research outcomes would support efforts to encourage private insurers and government agencies to approve increases in funding for play-based autism intensive intervention services and ultimately, help children with autism become more engaged with the world around them."
The Cognitive Behavior Therapy program Exploring Feelings (originally developed by Asperger's expert Dr. Tony Attwood) was designed to be highly structured,
interesting and successful in encouraging your child to manage his or her emotions. The child or adolescent participating in the program will explore the specific feelings of being happy, relaxed, anxious, or angry. At the end of each session, a project
is explained to the child, which is to be completed before the next session. At the start of the next session, the project is discussed with Dr. Bowers.
There are two Exploring Feelings programs, one is designed to explore and manage anxiety, the other to explore and manage anger. An evaluation study of the Exploring Feelings program
for anxiety was published in the Journal of Child Psychology and Psychiatry in 2005. The results indicate that this structured and manualized approach to Asperger's is
scientifically proven to address a child's feelings of anxiety and anger. This intervention is suited for children ages nine years through adolescence.
In general, children with Asperger's begin to feel nervous, sad, and angry due to their difficulties with social interactions. This program will not only address the child's emotional world, but will also offer assistance with social functioning. If you are more interested in a purely social intervention, then you are encouraged to learn more about our Everyday Social Skills group offerings.
Please call us at 734-997-9088 if you would like more information on this exciting treatment program!
If you have any exposure to the PLAY Project intervention for children with autism, then you are aware of the power of home-based intervention. At times, families report to us that their child's behaviors have escalated at home but the child knows how to "turn on the charm" in the doctor's office. We now offer home-based behavioral consultation with Dr. Mark Bowers (aka "Super Manny" and Pediatric Psychologist) to help get your parenting back on track in a condensed block of time rather than over the course of periodic office visits. This approach is appreciated by our families who travel long distances to see us for repeated office appointments, as this eliminates the need to do this. These home visits typically range from 2-3 hours and include a full behavioral recommendation report and follow-up. Costs may be insurance reimbursable.
Please contact our office at (734) 997-9088 for additional information or to arrange for a home-based consultation.
Dr. Mark Bowers, Pediatric Psychologist, provides a cognitive-behavioral treatment program that has been proven effective in eliminating or alleviating OCD symptoms in children and teens with a variety of presenting symptoms. Children with obsessive-compulsive disorder (OCD) suffer intensely from recurrent, unwanted thoughts (obsessions) or rituals (compulsions), which they feel they cannot control. Rituals such as hand washing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these rituals, however, provides only temporary relief, and not performing them markedly increases anxiety. Left untreated, obsessions and the need to perform rituals can take over a person's life. Children and their families are taken through four stages of treatment--education, cognitive training, 'mapping' OCD, and graded exposure and response prevention (ERP) - over the course of clearly structured treatment sessions. Exposure and response prevention (ERP) is essential for treating OCD. In this approach, a child is voluntarily exposed to whatever triggers the obsessive thoughts, and then is taught techniques to avoid performing the compulsive rituals and to deal with the anxiety. To learn more about this exciting treatment offering, please contact our office.
To read more about the difference between OCD and the repetitive behaviors found in autism, read Dr. Mark's blog
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Facilitated by Mark Bowers, PhD
The goal of our Everyday Social Skills group is to increase functional social skills that your child can use in everyday social settings. Our groups focus on reinforcing positive behaviors such as following instructions and routines, functional communications skills, and positive non-verbal communication skills such as eye contact.
Everyday Social Skills groups are typically divided by age; 9 to 11 years old and 12-15 years old. Kids who might benefit from this program are those with High Functioning Autism, Asperger's or Pervasive Developmental Delays. The groups are limited in size and will be filled on a first come first served basis.