Naomi Johnson (BA ’13), a master’s student in Applied Disability Studies, is examining the effectiveness of a therapy program to help children with high functioning autism spectrum disorder (ASD) reduce and alleviate obsessive-compulsive behaviours (OCB).
The Cognitive-Behavioral Therapy program — ‘I Believe in me Not OCB!’ — was developed by Brock researchers Tricia Vause and Maurice Feldman (Child and Youth Studies and the Centre for Applied Disability Studies).
Vause, who is Johnson’s supervisor, led a randomized controlled trial to evaluate this package.
Johnson first became interested in this area of research when she enrolled in Vause’s CHYS undergraduate autism course during her third year of a concurrent undergraduate degree in Education and Child and Youth Studies at Brock.
She was hired as an Experience Works student by Vause for the summer to work as an assistant therapist with the program.
For nine weeks, Johnson worked with small groups of parents and children, ages seven to 13. Johnson met with the groups once a week for two hours to help equip children with cognitive and behavioural strategies for alleviating obsessions and compulsions. The hope is that these strategies will become part of a toolbox that children can use at later stages in their lives.
Some examples of obsessive-compulsive behaviour include: frequent hand washing, repetitive questioning, a need to collect and save items, ordering and arranging, and rituals for day-to-day routines. Cognitive-behaviour therapy has been shown to be helpful in reducing obsessive-compulsive behaviours in as many as 85% of children who experience them.
“These types of behaviour can be debilitating for children and families, making daily life for the child and family members’ difficult and affecting children’s ability to socialize and actively participate in school activities,” says Johnson.
‘I Believe in Me not OCB!’ focuses on four main areas:
• psychoeducation – teaching the child about the behaviours
• function-based behavioural assessment and intervention – getting the child to make lists of their behaviours and thoughts and the severity of them
• cognitive and behavioural skills training – challenging inaccurate thoughts the child has surrounding their behaviours
• exposure to anxiety provoking thoughts/situations and prevention of compulsive behaviours
“The program is well suited for children with ASD as it provides the therapy in a group setting in order to foster social skills,” says Johnson. “We work with both the children and parents in order to ensure that the strategies learned are being applied and generalized to other settings from week to week.”
Johnson says parents would return each week to tell her about how the therapy was making a difference to their children’s lives.
“Parents were so excited. It was life-changing for them,” she says. “I remember one parent telling me that their child went to a sleepover for the first time. They never thought it would happen. As the program went on, it was clear that the therapy, in a lot of little ways, was making a huge difference in the quality of life for children and parents.”
Now, Johnson will dig into data collected during the program to help assess knowledge acquisition as a result of the therapy. Her study is being supported with a Canadian Institutes of Health Research Master’s scholarship.
The data she will be looking at is based on specific applied exercises. These exercises involved presenting case scenarios to the children and parents, and asking them to individually write down what kinds of helpful advice or responses they would offer in these situations.
They were asked to respond to the scenarios at the beginning of the program and again at the end.
“Analyzing the responses will allow us to measure if the children and parents are able to remember and apply the strategies that they learned in the therapy program to these hypothetical situations,” Johnson explains.
The results of Johnson’s study will assist Vause and her colleagues in refining the program and then making it available for therapists to use in organizations within Niagara and beyond.
Johnson says the success of programs such as ‘I Believe in Me not OCB!’ will lead to a healthier outlook for children as they move on in life. According to the Centre for Addiction and Mental Health, OCD afflicts about one adult in 40 and approximately two-thirds of the people with OCD develop the disorder in adolescence or early adulthood.
“We are helping to improve the quality of life for these children now and in the future,” Johnson says. “It’s important to ensure that through the therapy, children and parents are learning and internalizing these strategies so that they are able to use these skills and strategies in the future if a relapse occurs or if new behaviours show up.”
October is Autism Awareness Month in Canada. Brock Research has posted a podcast that features a discussion with Brock researchers about the common challenge for people living with Autism Spectrum Disorder (ASD) to recognize and develop social skills so that they can interact effectively with others.
Talking about the issue are Rebecca Ward, Assistant Professor and clinical co-ordinator of the Centre for Applied Disability Studies, Maureen Connolly, Professor in the Department of Kinesiology and Kimberly Maich, Assistant Professor in the Department of Teacher Education.
