cover-storyIssue 9

Creating Pathways from Autism to Possibility

by Justin Souza

Beyond the secure door at Therapeutic Pathways office on 14th Street in Modesto, a stack of brochures topped with tiny smiling faces radiate with possibility. The front of the brochures bear the words “Motivated by caring. Supported by science.”

For the parents of children with autism, there is perhaps no more important facility in the world than this. Since 1996, Therapeutic Pathways has been committed to making it possible for children with autism spectrum disorder to reach their potential with the help of intensive therapy founded in Applied Behavior Analysis. In its 18 years in operation, the organization has created a legacy of helping children with autism learn to live full and productive lives.

Therapeutic Pathways

Therapeutic Pathways was founded by Board Certified Behavior Analyst and Licensed Psychologist Dr. Jane Howard and Speech Pathologist Coleen Sparkman, two Modesto-based professionals who had seen firsthand how devastating untreated autism could be for children.

According to Howard, it was Dr. Howard Cohen, the legendary Clinical Director at Valley Mountain Regional Center, who first suggested bringing the women’s specialties together. “Dr. Cohen could look into the future and see the need for an intensive treatment approach based on scientific evidence,” said Howard. “The need for evidence-based treatment programs for autism was huge. The possibility was here, and the need was everywhere. It was that approach that made it possible for us to start Therapeutic Pathways.”

By combining their skills, Howard and Sparkman combined the latest research in their respective fields into an intensive Applied Behavior Analytic (ABA) approach to autism spectrum disorder that helps children with autism grow into adults capable of full, independent lives. Today, the two serve as Program Directors and oversee development of the center’s four locations, which has expanded to serve about 250 kids concurrently.

Inside Therapeutic Pathways’ Modesto office, the halls bustle with children from as young as 13 months to around five years old. Each child is accompanied by at least one Behavioral Technician for at least a portion of their intervention session. Behavior technicians receive special training in the direct implementation of ABA and are overseen by Clinical Supervisors who are Board Certified Analysts. The Behavior Technicians continually help encourage and reinforce what the founders have identified as the essential elements of social interaction, from making eye contact to answering questions. These essential elements ultimately add up to the key components of observational and social learning, something that children with autism are often missing. According to Howard, by focusing on establishing these components, they can optimize their impact on the children’s lives. “We evaluate treatment outcomes primarily based on direct observation of behavior. So what skills are present now, what skills are absent, what behavior problems are interfering with this individual’s ability to be successful in his home or community. The improvements we get are what’s driving treatment planning decisions.”

“We measure some of our success by how much these kids are out in the typical community,” said Sparkman. “We’re thrilled to hear that a parent is going to be able to take their child to a regular movie or the zoo or somewhere else that would be considered very stimulating, and do that successfully. It’s not just about what happens here, it’s about extending it out into the world. Having an eye on that has been a driving force for us.”

autism infographic

In addition to their observation-directed treatments for individual kids, Howard and Sparkman remain at the forefront of research on the disorder. “When I graduated college in 1979, 1 in 10,000 kids was diagnosed with autism. Today, it’s 1 in 88,” says Sparkman. While there has been a steady increase in the incidence of autism during that time, the numbers aren’t quite as dramatic as they seem. As clinical understanding of autism grows, so too does the breadth of children who fall under the spectrum diagnosis. For example, kids who might have been diagnosed with Childhood Aphasia in 1979 are now grouped under the autism spectrum. “We all did the best we could with what we had at the time,” says Sparkman. “But I can look back and see that some of the kids I worked with then clearly would have landed more accurately in this diagnosis.”

As the scientific understanding of the disorder grows worldwide, Howard and Sparkman say that they’ve become aware of a crisis they dub a coming tsunami. “There’s a demographic bubble of children with autism spectrum disorders who haven’t had access to high quality intervention of sufficient duration and intensity at an early age or simply need more in order to promote their independence and successful integration into the community. These individuals are going to start aging out of elementary, junior high and high schools in the coming years. As a state and nation, we don’t have the safety net of programs in place to give them supportive job skills, work environments and living spaces,” said Howard.

Howard adds that she believes that if these children had had access to intensive treatments like that offered at Therapeutic Pathways, they might not have needed this lifetime of expensive support. “It’s a clear cut case of an ounce of prevention being worth a pound of cure.”

“I’d like to see a future where every family and child has early diagnosis,” says Howard. “When I look five years down the road, I hope there are enough high quality services available, that there are enough Board Certified Behavior Analysts around and that we’re doing early intervention even earlier. I want these individuals to have an absolute chance to be independent and give back and live a complete life.”

This is ultimately why Therapeutic Pathways means so much to the parents and families of children with autism. Over the last 18 years, the organization that Howard and Sparkman founded has made a true and lasting difference in thousands of lives. And each day, that impact continues to ripple out and make the world a better place for people with autism.

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