An Interview with Emily Rubin The alarming rise in the incidence of children diagnosed with autism spectrum disorders (ASD) is well known. The Autism Society of America posted the following statistics on its website about the impact in the United States: The most important statistic for speech-language pathology is that the cost of lifelong care ... Features
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Features  |   January 01, 2011
An Interview with Emily Rubin
Author Notes
  • Carol Murphy, MA, CCC-SLP, is the owner of California-based Speech & Learning Services, which provides consultation in the areas of processing, early language development, attention, memory, behavior, written language, and integrated curriculum. A consultant for the SEEDS Project (Supporting Early Education Delivery Systems) for the California Department of Special Education, she has presented workshops and worked as a special education consultant for private schools.
    Carol Murphy, MA, CCC-SLP, is the owner of California-based Speech & Learning Services, which provides consultation in the areas of processing, early language development, attention, memory, behavior, written language, and integrated curriculum. A consultant for the SEEDS Project (Supporting Early Education Delivery Systems) for the California Department of Special Education, she has presented workshops and worked as a special education consultant for private schools.×
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Special Populations / Autism Spectrum / Research Issues, Methods & Evidence-Based Practice / Features
Features   |   January 01, 2011
An Interview with Emily Rubin
The ASHA Leader, January 2011, Vol. 16, online only. doi:10.1044/leader.FTR5.16012011.np
The ASHA Leader, January 2011, Vol. 16, online only. doi:10.1044/leader.FTR5.16012011.np
The alarming rise in the incidence of children diagnosed with autism spectrum disorders (ASD) is well known. The Autism Society of America posted the following statistics on its website about the impact in the United States:
  • ASD prevalence is estimated at 1 in 110 births

  • 1 to 1.5 million Americans live with ASDs

  • ASD is the fastest-growing developmental disability

  • There is 10%–17 % annual growth in the number of children diagnosed with ASDs

  • $60 billion is the estimated annual cost in health care services and productivity, 60% of which are in adult services

  • In 10 years, the annual cost will be $200–400 billion (Autism Society of America, 2010)

The most important statistic for speech-language pathology is that the cost of lifelong care can be reduced by two-thirds with early diagnosis and intervention (Prizant, Wetherby, Rubin, Laurent, & Rydell, 2006). I have read about the various treatment methods for children with ASDs and have been fascinated with the range of approaches. One of the leading learning system curriculums, developed over a long period of time, is the SCERTS Model®. The acronym refers to the focus on:
SC: Social communication—the development of spontaneous, functional communication, emotional expression, and secure and trusting relationships with children and adults.
ER: Emotional regulation—the ability to maintain a well-regulated emotional state to cope with everyday stress, and to be most available for learning and interacting.
TS: Transactional support—the development and implementation of supports to help partners respond to the child–s needs and interests, modify and adapt the environment, and provide tools to enhance learning (e.g., picture communication, written schedules, and sensory supports). Specific plans are also developed to provide educational and emotional support to families and to foster teamwork among professionals (Prizant, Wetherby, Rubin, Laurent, & Rydell, 2006).
The SCERTS Model includes a well-coordinated assessment process that helps a team measure the child–s progress and determine the necessary supports to be used by the child–s social partners (educators, peers, and family members). This assessment process ensures that:
  • Functional, meaningful, and developmentally appropriate goals and objectives are selected.

  • Individual differences in a child–s style of learning, interests, and motivations are respected.

  • The culture and lifestyle of the family are understood and respected.

  • The child is engaged in meaningful and functional activities throughout the day.

  • Supports are developed and used consistently across partners, activities, and environments.

  • A child–s progress is systematically charted over time.

  • Program quality is measured frequently to assure accountability.

I met one of the SCERTS creators, Emily Rubin, whose private practice in Carmel, Calif., is dedicated to helping children with ASDs. We met an individualized education program (IEP) meeting; both of us were involved the treatment of the student. Rubin–s vast knowledge and speaking ability reflected her deep concern and understanding of the student and of all those affected by autism. After that meeting, I wanted to learn more and requested an interview.
Q: Can you explain briefly what SCERTS is, where it came from, and how it evolved?
The SCERTS model is a comprehensive, multidisciplinary educational approach designed for children with ASDs and their families. It was designed to provide guidelines for helping children progress through the stages of becoming a competent social communicator. It also was designed to provide families and educational teams with the help they may need to feel successful in supporting children. To ensure a child–s active engagement, there is a strong emphasis on preventing problem behaviors that interfere with learning and the development of relationships. Families and educational teams learn about essential interpersonal modifications, environmental arrangement, and visual supports and how they can be embedded in natural, functional, and meaningful contexts.
The SCERTS Model collaborators include Barry M. Prizant, Amy M. Wetherby, and Amy Laurent. Collectively, the collaborators are trained in speech-language pathology, special education, behavioral and developmental psychology, occupational therapy, and family-centered practice. As collaborators, we embraced a range of evidence-based methodologies and perspectives, allowing families and service providers to draw from a wide range of effective practices in developing an IEP for a child.
Q: How did your thinking about autism change in the course of the developing the SCERTS Model?
When I first began working with children with autism, I remember focusing on each child–s stereotypical or repetitive patterns of behavior and considering these behaviors to be central to their disability. In doing so, I often neglected the function that they served for the child, simply discarding them as “autistic behaviors.”
Since the development of the SCERTS Model, my perspective has changed. I now see many of these behaviors as an artifact of each child–s drive to cope with his or her feelings of uncertainty, anxiety, or even fear of social situations.
As autism is a neurological disorder that makes it difficult for a child to predict the actions of other people, their ability to cope with social expectations in less predictable environments, make transitions, and use others a source of emotional support is often compromised. Thus, many children with autism are coping with a heightened degree of stress and have developed repetitive, soothing behaviors as coping behaviors.
Although I used to ignore or discourage these behaviors, I have learned to understand their function, change my behavior in an effort to prevent these behaviors, and model replacement strategies that may be more socially appropriate and more effective.
Similarly, when children with autism engage in more challenging behaviors, I have learned to move beyond the simplistic response of ignoring these undesirable behaviors to a more humbling process of recognizing that the antecedents may lie in my behavior, a variable that can easily be changed. For example, had I provided a clear and predictable end point, motivating and meaningful materials, and visual and organizational supports, the child may not have engaged in that challenging behavior.
I also have learned that these moments of challenging behaviors present clear teachable opportunities for us to model emotional expression and appropriate coping strategies.
Q: How do you see the SCERTS Model being used in the schools?
Social communicative competence and one–s ability to engage in emotional regulation are predictive of positive long-term outcomes in all children, not just children with ASDs. Although the core academic curriculum that we target as educators is important, an individual–s ability to communicative effectively and demonstrate emotional maturity leads to that individual being more able to relate to others, establish peer relationships, and engage in positive social interactions. The SCERTS Model includes a social communication and emotional regulation curriculum within a formal assessment process that is criterion referenced from the 6-month to the 10-year developmental level. Thus, it can be used to select targets for any child who has difficulty in these areas and is under 10 years of age or is functioning developmentally within this range.
Q: What aspects of SCERTS do you think fit into an integration of the social, emotional, behavioral, and academic parameters of other classroom goals?
The social communication curriculum in the SCERTS Model is derived from longitudinal group research studies that have identified significant predictors of positive outcomes in language acquisition, oral expression, and verbal problem-solving. These developmental skills will likely bolster a student–s ability to access the academic curriculum in areas such as English language development, language arts, and reading.
Similarly, the emotional regulation curriculum in the SCERTS Model is derived from longitudinal group research studies that have identified significant predictors of positive outcomes in self-regulation, organizational skills, and executive functioning. These aspects of a child–s development are similar to those addressed within the health curriculum content area and will likely bolster progress in all academic subject areas.
Emily Rubin, MS, CCC-SLP is the director of Communication Crossroads in Carmel, Calif. She specializes specializing in autism, Asperger–s syndrome, and related social learning disabilities. She is an adjunct faculty member, lecturer, and member of the Autism and Developmental Disabilities Clinic at Yale University. Her publications focus on early identification of autism, contemporary intervention models, and programming guidelines for individuals with high-functioning autism and Asperger–s syndrome.
Sources
Autism Society of America Facts and stats. Retrieved on Oct. 16, 2010 from http://autism-society.org.
Autism Society of America Facts and stats. Retrieved on Oct. 16, 2010 from http://autism-society.org.×
Centers for Disease Control and Prevention What you should know: Autism spectrum disorders. Retrieved Oct. 16, 2010, from http://www.cdc.gov/ncbddd/autism/index.html.
Centers for Disease Control and Prevention What you should know: Autism spectrum disorders. Retrieved Oct. 16, 2010, from http://www.cdc.gov/ncbddd/autism/index.html.×
Prizant, B. M., Wetherby, A. M., Rubin, E., Laurent, A. C., & Rydell, P. J. (2006). The SCERTS Model, Volumes 1&2. Baltimore, MD: Brookes
Prizant, B. M., Wetherby, A. M., Rubin, E., Laurent, A. C., & Rydell, P. J. (2006). The SCERTS Model, Volumes 1&2. Baltimore, MD: Brookes×
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January 2011
Volume 16, Issue 1