Horovitz presents Research on Working Memory in ADHD and ASD

Max Horovitz, Ph.D., presented a guided poster tour of his research regarding working memory in children who have been diagnosed with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) or both ADHD and ASD as part of the 6th World Congress on ADHD hosted by the World Federation ADHA, April 20-23, 2017, in Vancouver, Canada.

 Working memory is the thinking skill that focuses on memory-in-action, which is the ability to remember and use relevant information while in the middle of an activity. For example, a child is using working memory as the child recalls the steps of a recipe while cooking a favorite meal.

Children who have trouble with their working memory skills will often have difficulty remembering instructions, recalling rules or completing tasks 

Children who have trouble with their working memory skills will often have difficulty remembering their teachers’ instructions, recalling the rules to a game, or completing other tasks that involve actively calling up important information. There are two types of working memory: auditory memory and visual-spatial memory. Auditory memory records what you’re hearing while visual-spatial memory captures what you’re seeing. Weak working memory skills can affect learning in many different subject areas including reading and math.

 For Keystone, Dr. Max serves as a clinical child psychologist, director of Keystone’s Attention Deficit Hyperactivity Disorder (ADHD) Clinic. Keystone’s Anxiety & Obsessive Compulsive Disorder (OCD) Clinic is a specialty clinic designed to provide evaluation, intervention and medication management for children and adolescents who experience anxiety. The Anxiety & OCD Clinic offers comprehensive assessments to accurately diagnose anxiety disorders. Common diagnoses include separation anxiety, phobias, social anxiety, generalized anxiety disorder, OCD, and selective mutism.

Dr. Max has experience working with individuals diagnosed with intellectual and developmental disabilities, particularly autism spectrum disorder (ASD), and children with attention-deficit/hyperactivity disorder in various capacities across development. He additionally has experience working with children with a wider range of emotional and behavioral needs, including oppositional and defiant behaviors, anxiety, depression, toileting issues, and sleep difficulties.  He currently provides a range of services including developmental, psychoeducational, and diagnostic assessments; individual therapy; parent training and school consultation. Dr. Max also has extensive research experience in the areas of ASD and intellectual disability. Dr. Max received a bachelor’s degree in psychology from the University of Florida. He subsequently obtained master’s and doctoral degrees in clinical psychology from Louisiana State University. Dr. Max completed an APA-accredited, predoctoral internship at the Devereux Foundation in Pennsylvania, where he provided clinical services at a residential center for adults with intellectual and developmental disabilities. Following his internship, he completed a postdoctoral fellowship at Keystone Behavioral Pediatrics and then joined the staff at Keystone as a licensed clinical child psychologist. Dr. Max is a qualified supervisor in the state of Florida for mental health counseling interns.

Keystone offers ABA services on Florida’s Emerald Coast

Keystone recently announced that ABA services are available to the Emerald Coast. The mission of Keystone Behavioral Pediatrics – Emerald Coast is to provide Okaloosa and neighboring counties with the same standard of excellence which has been established by KPB in the Jacksonville area. 

Presently, behavior therapists are offering ABA services in Emerald Coast homes, with the eventual goal of offering therapy in a variety of settings including a clinic, community settings and schools, in addition to in-home. Therapy is individualized to each child based on an initial assessment (ABLLS-R, VB-MAPP, AFLS, essentials for living, functional assessments of problem behaviors, etc.) and continually modified based on the child’s progress.

Laura Mathisen, M.S., BCBA, leads the team of ABA therapists for Keystone Behavioral Pediatrics – Emerald Coast.

Applied Behavior Analysis (ABA) therapy is a systematic teaching approach based on B.F. Skinner’s analysis of behavior and the subsequent contributions of other behavior analysts. ABA focuses on changing behavior in socially significant ways to improve the lives of the children and families who seek ABA services.

Keystone’s Emerald Coast team is led by Laura Mathisen, M.S., BCBA, who serves as senior clinical supervisor. She has experience providing behavior analytic services for children and adults with developmental disabilities, genetic disorders and traumatic brain injuries. Mathisen specializes in early intervention services, problem behavior reduction and supervision of BCBA candidates. She worked at Keystone Behavioral Pediatrics for three years and eventually served as director of behavior analysis. After her military husband was transferred to Destin in 2013, she continued to work for Keystone as a senior clinical supervisor and board certified behavior analyst (BCBA), while also working as a BCBA clinical supervisor for a private ABA clinic in the Florida Panhandle, where her caseload primarily focused on problem behavior reduction and early intervention cases.

For questions and to make an appointment with the team at Keystone Behavioral Pediatrics – Emerald Coast, complete the Appointments or Contact form at www.keystonebehavioral.com or call 904.619.6071.

Keystone Behavioral Pediatrics, based in Jacksonville, Fla., offers consultation and integrated healthcare to children who may have one or more behavioral, developmental, socio-emotional or learning issues, for example, autism spectrum disorders (ASD), attention deficit hyperactivity disorder (ADHD), intellectual delays, aggression, self-injury, tantrums, anxiety, compliance, self-help skills, toileting, speech/language or cognitive, physical, sensory, and motor skills. Keystone’s comprehensive and highly skilled team of providers – child psychologists, board certified behavior analysts, licensed mental health counselor, occupational therapists, speech/language pathologists, feeding therapists, registered behavioral technicians and clinical assistants – work together to develop a plan of action to provide success for each child through change. Medication management is also available, if medication is recommended as part of a child’s plan.

“Monkey See, Monkey Do”: Protecting Kids from Negative Social Influence in the Media

By Andrew Scherbarth, Ph.D., BCBA-D, Clinical Child Psychologist

What exactly is social influence? Social influence is the effect of modeling – not runway models with their fancy clothes but the effects that happen when kids see how others behave. Social influence can be a good thing, such as when kids see good role models who make them want to work hard or be kind. However, social influence can be negative if kids see someone act out inappropriately, rudely or aggressively, followed by that person coming out ahead. This article will describe how social learning works, social rewards shown as a result of negative behavior in the media, the effects that happen when kids or teens observe negative social influences, as well as what can be done by parents to reduce the influence of negative social role models on our kids and teens.

Social influence can positively or negatively affect children, depending on the behavior being modeled.

Does social learning change behavior? It absolutely does.

In a classic experiment in 1960 by social learning theory theorist Albert Bandura et al, two groups of kids were separately shown a video. One group saw a child treating an inflatable child-sized clown blow-up doll with respect. The other group saw a child punching, kicking and knocking over the doll while laughing. After seeing the video, each group was put into a room with the exact replica of the doll in the video. In both groups, the kids treated the doll the way they saw the kids in the video treat the doll—either with respect or with aggression.

Negative social learning can happen as a result of a child viewing any type of media source—video games, television, movies, social media or even the news. What kind of incentives for negative social behavior does a child observe in the media?

Video gamesvideo-games-fan-893839-m like Grand Theft Auto show prostitution as being paid off with health and aggression/robbery with more items, cars and cash. Other video games give more money or more experience points for increased killing. TV shows or movies may depict criminal life and drug use with the characters receiving higher amounts of money, fame, respect, attention from romantic partners, the thrill of defeating those who are trying to bring them to justice, laughs and/or popularity.

In various countries, dictators or other leaders who are socially aggressive can be revered and described as being “great,” “powerful,” or “strong leaders.” Violent protesters can be seen as being “heroes” fighting for a just cause—even when they are actually causing people to get hurt or property to be destroyed. Ironically, even if these acts shown in the media ultimately push many people away from the behavior, the short-term positive results they portray can still influence kids or teens to do these behaviors. Social media, such as YouTube and Facebook, may show stories about aggressive, crude or reckless people which receive a high positive view rating.

Do kids and teens who view negative media engage in negative behaviors as a result? Yes

The effect is shown to be greater when someone develops a preference to choose violent/aggressive media, leading to further exposure to negative role models (Boxer et al, 2008). The effects were measured to determine both the impact on boys (direct physical aggression after playing violent video games for children with less empathy and social understanding, but even those with higher levels of social understanding demonstrated more social aggression—Wallenius, 2007) and also girls (aggressive television viewing leading to more bullying among girls in school settings—Martins, 2008). Even children on the spectrum appear to be impacted by the types of games they play, and it is associated with oppositional behavior (Mazurek, 2013). Clearly, kids are influenced by violent or aggressive media and engage in lower intensity aggressive acts (pushing, name calling, verbal disrespect), even if they never engage in some of the exact acts that were shown on social media (shooting guns, fist fighting, etc.).

What can parents do to prevent negative social influence from the media? Some suggestions are:

  1. Choose holiday gifts wisely. Consider video games with sports and/or that require strategy, such as dialog, social decision making and problem solving—but not graphic violence. Video games have ratings, just like movies do—M for Mature is a clue that it may be unwise to buy it.
  2. Choose carefully the movies and television shows that your child is allowed to watch. Limit exposure to those with negative or “adult” themes and encourage pro-social themes like achievement, respect or kindness.
  3. Consider internet and/or cable box filters for various sites and/or monitor online behavior.
  4. Limit exposure to graphic or extensive news about negative events or role models. As a parent, you want to stay informed, but consider whether your kids need to see or hear the news about terrorists and terror attacks or watch dictators or other leaders act aggressively. It might impact their sense of safety.
  5. For kids who are mature enough, describe in age-appropriate ways what is happening in relation to something that you both just viewed on TV. Explain the choices that were made and the negative result of those choices—even if the show only demonstrated the positive short-term result.
  6. Related to news, young adolescents often talk about current events in their classrooms or view news stories online and have a reaction. You may even want to talk with a younger child if they bring up something that another kids told them in school. While we cannot keep kids in a bubble and we know that they will encounter some of these things, we can limit exposure to negative influences and help them process what they’ve seen or heard about.
  7. Parents can also talk to their children about ways to behave that allow them to be positive role models for others, as well as how to deal with negative influences in real life. Further, by demonstrating at home how to put these positive strategies to work, parents can be a positive role model for their children.

Therapists at Keystone Behavioral Pediatrics, in Jacksonville, Fla., can help children learn positive behaviors and guide parents in how to avoid negative influences. Keystone works with all child behavior disorders and provides behavior therapy for autism and all other types of pediatric behavior, developmental, emotional and learning issues.

Parent Resources:

Simply Psychology: Bobo Doll Experiment

Rutgers Today: Rutgers Researcher’s Study Cites Media Violence as ‘Critical Risk Factor’ for Aggression

Disability Scoop: Autism Behavior Problems Linked To Video Game Play

Keystone walks to support children with autism

Fourteen staff members with their friends and family raised $635 and walked in the 2015 Walk Now For Autism Speaks event on Sept. 19, on behalf of children who have been diagnosed with ASD (autism spectrum disorder). They were joined by more than 2,000 walkers as they walked to change the future for everyone who struggles with autism. The walk itself raised over $45,000 toward the $90,000 goal, and donations are still coming in!

2015_09_19 KBP in Walk Now for Autism Speaks
Keystone employees Christopher Stover with Cindy Xhelo and their son; Maegan Howell; Hannah Edelstein and Rachel Grue are ready to show their team pride in the 2015 Walk Now For Autism Speaks at Jacksonville Landing on Sept. 19, 2015. Seven other Keystone walkers joined them in the event.

Autism Speaks’ mission is to fund research, increase awareness and family services, and advocate for individuals with autism and their families. Keystone, as a full-service, outpatient clinic, helps children with ASD and more than 40 other behavior diagnoses and disorders by providing individual- and family-based services.

Keystone emphasizes an integrated whole-child approach to assessment and treatment. Treatment commonly involves new skill acquisition through evidence-based behavioral programming strategies to promote positive behaviors and to decrease problematic actions.