Pacing Yourself

Marathon runners know how to pace themselves. They know that if they went all out from the outset of the race they would run out of steam well before the race was done. It is a lesson we all must learn. We must learn how to slow down in order to get the job done well, and to prevent ourselves from burning out along the way.

Slowing down also allows us to see the scenery around us, to take in the beauty and majesty of this magical world in which we live. It allows us to see the sparkle in our children’s eyes, and to catch the nuances that we are likely to miss as we race through our everyday lives.

Those of us who have done this job for a while get a thrill from seeing our children learn to do things and be things that they could not do or be before. We celebrate our children’s accomplishments, and truly take joy in the small roles we have played in their progress. Yet there are times when coming to work does not feel so thrilling or joyful. We begin to forget the reasons we do what we do, we pick up the pace and rush to meet obligations.

When we rush to get through our days we begin to breathe shallowly, and as we breathe shallowly we begin to think shallowly. We do our jobs poorly and sloppily. We live in the future and the past, and each individual moment disappears before we can live in it and feel its power.

Ironically, we rarely get more done by moving faster, or if we do the quality of our work suffers. Remember that we can do better work by recalling the things about our work that brought us here to begin with; the joy of seeing children lead richer lives and making a difference in the world. Remember that we rarely accomplish anything by repeatedly blasting ourselves for past mistakes, and that our past is merely a catalogue of present moments; if we want to create a past that will serve us well the only way to do so is to live meaningfully in the present. Slow down and focus on what is in front of you. Breathe deeply and involve yourself passionately in your work, and reward yourself meaningfully when your work is well done. Maintain your high standards, but refuse to let perfectionism take hold. Be both honest and fair to yourselves. And remain grateful for the gifts you have been given.

PCFA Speaks

April is now receding into the past. As Autism Awareness Month, it is perhaps one of the busiest months of the year. I have just returned from Queretaro, Mexico, where PCFA alum Teresa Tassinari hosted an extraordinary conference called “Primer Encountro Internacional de Autismo y Desordenes del Desarrollo”, which I'm pretty sure means “First International Conference on Autism and Developmental Disorders”. Teresa was kind enough to invite me to deliver the keynote address, which I titled “Myths, Magic and Reality in the Treatment of Autism.” Also on the program were PCFA supervisors Stefanie Finney and Marta Marquez. Stefanie presented on “Implementation of ABA Programs in California: Methods of Intervention and Results” and Marta presented on “What is Autism and What are its Behaviors?” (Not sure if I translated Marta's title correctly from Spanish.) All of our presentations were very well received by the eager audience, composed of parents, students and professionals.
Earlier in the month I presented at the first autism conference in Armenia, providing a basic overview of the history, theory and techniques of Applied Behavior Analysis, and PCFA supervisor Arpi Arabian also presented on “Theory of Mind and Autism.” Arpi's presentation went extremely well.
In Mexico, one of the presenters in the two-day conference was a past PCFA therapist who went on to work for a school district. It was interesting to hear how many other past therapists were also working for school districts, and to play the “where are they now?” game with a group comprised of both current and past PCFA staff members. It is really interesting to think of how PCFA functioned as the training ground for so many professionals over the years, and how widespread their influence has become.

Cal-ABA week

So if you are not familiar with Cal-ABA, it is not a western U.S. version of a Swedish pop music group. It is the organization to which many behavior analysts in California belong, and it holds an annual convention which has become quite a big deal. The convention alternates each year between Northern and Southern California, and this year it is being held in Burlingame, a suburb just south of San Francisco. The conference begins on Thursday, March 12, and ends on Sunday the 15th.
PCFA will have quite a presence at the conference this year. We are sending nearly 30 supervisors and senior therapists. Our very own Cara Entz and Sally Torrens will be presenting this year, so if you are going to be there make sure to show up and give them some support. We will also have a booth in the exhibit hall or lobby, where I will be mostly hanging out. So please come visit me to chat. Looking forward to seeing you in the Bay Area!

Prozac Nation

Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor, which is a rather fancy way of saying that it works by making more of the neurotransmitter serotonin available in the synapses (the spaces between neurons) in the brain. Given that serotonin levels have been linked to much of what spiritually ails we humans (and mice of course), and that parents of children with autism and all of us in the field are so desperate to find avenues of improving our childrens' lives, it is no wonder that studies are being conducted to investigate the effectiveness of using SSRI's such as Prozac for children with autism.

A study currently being conducted by a specialty pharmaceutical company called Neuropharm Group, which manufactures a new form of fluoxetine, has so far yielded disappointing results. This study investigated the effects of this new form of Paxil on the repetitive behaviors of children with autism. In this double blind study, results have demonstrated that both Paxil and placebo reduced the repetitive behavior of children with autism, and that the differences between the two were not significant.

There are two interesting aspects of this study to me. First, the study was sponsored by the same company that manufactures the medicine, and their conclusions were that it was no more effective than placebo. This conclusion will result in tremendous financial losses for this company, yet they had the integrity to publicize these negative results. While one certainly can't conclude that all drug companies have integrity, it is clear that at least one does. Second, it is always interesting to me to think about the power of a placebo. Simply the belief that an intervention will work will often "cause" the intervention to work. The general effectiveness of placebos begs the classic mind/body question. Does it make any sense at all to assume that the mind is somehow different from the body?

Classic studies done in the 1970's revealed that the neurochemistry of actors who pretended to be depressed or schizophrenic yielded the same metabolites in their urine as patients hospitalized for those conditions for many years. So if we do separate our thoughts from our chemistry, then we must always ask the chicken and egg question. And if our thoughts change our chemistry, and our chemistry changes our thoughts, how should one intervene?

..... Our deepest regrets and prayers are with our Southern California scheduler Linda for her recent loss. Also, we wish Chrisa Sadd a speedy recovery, and a very happy birthday to Elizabeth Fraines.

The Little Things

What is it that we miss most about someone when they're gone? It may or may not be the things we love most about them when they are with us. The things we miss the most are not always the most obvious. They are not always the large things. They are not necessarily the great achievements, the number of books published, the amount of money someone makes, the fancy car they drive. What we miss most are the small things. Sometimes they are the awkward moments, the moments of spontaneity, a tear shed at an unexpected moment, the thoughtful gift, the kind word at just the right time, the odd laugh, the warm and secure embrace in a moment of fear.

In Ben Affleck and Matt Damon's film Good Will Hunting, there is a moment when Will's therapist Sam McGuire talks to Will about McGuire's wife who died of cancer: "My wife used to fart when she was nervous. She had all sorts of wonderful idiosyncracies. She used to fart in her sleep. One night it was so loud, it woke the dog up. She woke up and asked, "Is that you?" I didn't have the heart to tell her. Those are things I miss the most, wonderful things, the little idiosycracies that only I know about. That's what made her my wife."

It is, of course, these little things that make us all who we are. It is those little things we miss the most when we lose something or someone precious to us.

Those of us who devote our life's work to children with deep needs share much in common. One of these is a passion for helping. But we all help in different ways. Let us struggle to celebrate the small differences we discover in each other, the small accomplishments our children make. It is these small accomplishments we will remember in the years ahead. It is the small differences we make in children's lives that our children's parents will remember us for. It is the small acts of devotion and kindness that we will cherish in each other.

We Have a Budget

So the legislature finally got around to approving a budget. As it stands, the 3% cut to Regional Center services has been approved, so that is very likely going to happen. It will mean a 3% reduction in the payment RC's give us across the board. That is the bad news. The good news is that further reductions in Regional Center budgets that were proposed did not occur. Regional Centers will apparently also have to absorb about 100 million dollars in cuts in July, but this is much less than the proposed 300 million dollars. There is no way at this point to know how if at all this may affect our services. The 3% cut will call for some belt-tightening, but overall will not have a significant impact on our ability to provide services.
Also on the positive side, the president's stimulus package seems to liberate some money for special education programs within school districts, so this might help us to provide more services for children through our relationships with the over 30 school districts we contract with in California.

Some supervisors taking UNT coursework have needed the out of print chapter from B.F. Skinner's About Behaviorism called "The Question of Control." It is posted on the secret supervisors' section of our website in the "information" section in pdf format for those of you who need it or for any supervisor who might want to read it.

Happy birthday to Osong Kim and Gloria Medina.

Parent Survey

Just wanted to let you know that (in the event that any of our parents ask you about it) our annual parent survey will be sent via email to all of our parents within the next few days. We always try to get the best return we can on these, so if anyone mentions it to you please urge them to complete the survey. It is online, and takes only about five minutes to complete. The data are collected anonymously, in order to encourage parents to speak freely about the services they are receiving from us. As always, I will do the best I can to collate the data and get the results out to all of you as soon as I can. Realistically, this can take a month or more to put together, but I will work hard to get these results out as soon as I can.
And yes, soon after that the staff survey will be sent out to all of our staff, so that you will have the opportunity of freely commenting on various aspects of your work at PCFA.

Troubled Times Ahead

I am hoping that I can soon pair this blog entry with another one that is headed "Troubled Times Behind." I have been accused (mostly by myself) of being a "terminal optimist," a condition that undoubtedly suits one well for the kind of work we are doing here at PCFA. But for a moment, let's indulge in that delicious state of pessimism and doubt that the world around us, and journalists in particular, are currently so fond of.
Any day now we are expecting a new budget to arrive from Sacramento. (By the way, what do Sacramento and Corpus Christi have in common? Yeah, you got it, they both mean "body of Christ".) Everyone who is anyone, and even a bunch of nobodies, is fully expecting an immediate cut of 3% off of Regional Center budgets. Some RC's are telling us that this cut will be taken "off the top" of any payments made to agencies such as ours. If this comes about, we can certainly live with it, but there are threats that this is "only the beginning." All sorts of dastardly plans are being thrown up against the wall, and no one yet knows what is going to stick.
Protests, marches, and all those wonderful things that sometimes do make a difference are being planned. But in the darkest corners many believe that they are going to fall onto deaf ears; everyone is out there protesting, but as the economy falls to pieces and more and more people are out of work up and down the state there is little sympathy to be garnered.
So we wait, maybe days, maybe weeks, to find out what is going to happen. This company is strong, certainly relative to the others out there. We are one of the largest ABA agencies, with a healthy line of credit, that will give us the flexibility we need in order to retool if there is any retooling that needs to be done. But we are also one of the best out there, so our services are likely to be called upon by those in need even if other agencies should not be able to weather the storm.
As clouds gather overhead, join with me in keeping a watchful eye for silver linings. They are there to be found. And should the rain come, let's use our creativity, cleverness, and passion for this work to forge ahead.

El Paso, Texas and the Military

A warm welcome is due to our new clients and staff in our latest office in El Paso, Texas. We now have physical locations (offices) in three states: California, New Mexico, and Texas, and we are hoping to add several more before the year's end. Currently, our clients in El Paso are affiliated with Fort Bliss, one of the largest military bases in the U.S. We are providing services there through a contract with Tri-West (Tri-Care), through a program the government has set aside for assisting children of military families. We welcome our new staff to our family, and look forward to seeing some of you at our annual retreat.

We are also providing services to military families through several of our other regional offices.

New to Blogosphere

I am thrilled to enter the blogosphere with this, my first installment of what I hope to be many. My intention in entering this world is to keep you abreast of developments here at PCFA, in the world of autism treatment in general, and to allow you the opportunity of commenting and participating. Please send me suggestions on what you might like to see me discuss here, ask any questions you might have, or let me know how this space might best be used by you. I hope to keep you in the loop with frequent entries, but let's see how it all develops.
Welcome aboard!