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Liz Unruh (Host): Hello, listeners. And thanks for tuning into the Well With and Reach podcast, brought to you by Riverside Healthcare. I'm your host, Liz Unruh. Joining me today is Kelcey Bruen, who works with the Riverside ABA Therapy Clinic. Thanks for joining us today, Kelcey.

Kelcey Bruen: Thank you for having me, Liz.

Host: Yeah. So today, we're here to talk about what a caregiver should look for when it comes to autism and if a child would be a good fit for the ABA therapy clinic. So before we jump into that topic, can you tell us a little bit about yourself and your role here at Riverside?

Kelcey Bruen: So, I'm a BCBA, a board-certified behavior analyst. I've been a BCBA for four years. However, I've been working with the autism population since I was in high school in my adaptive PE class.

Host: Okay. That's great. So, you have a lot of experience working with this type of client. To jump into the questions here, when a caregiver first starts to wonder if autism might be present with their child, what are some early signs that they might notice at home?

Kelcey Bruen: One of the earliest signs would be the lack of the social reciprocity, so that's the back and forth nature of relationships. And this can appear before a child turns one, this lack of social reciprocity. It might look like an expressionless face, no reactions to bids for socialization, and a lack of responding to their name. You can also look for language delays; sensory sensitivities such as aversions to noises, lights, textures, smells, foods; different restrictive repetitive behaviors such as lining up toys, resisting changes in routine, and displaying limited interests. And a big one to look for would be a regression of skills about 15 to 30 months of age.

Host: Okay. And sometimes people see one—singular—one of those things and start to worry. Is it a combination that would trigger concern?

Kelcey Bruen: Absolutely. So when you present, some of the behaviors that are commonly overlooked individually, they're going to be overlooked. Some behaviors that are attributed to autism include picky eating, toileting deficiencies, sleep disturbances. And when you put all of those together in combination with behavioral challenges that you're seeing, it could paint a better picture for a provider that might point you in the direction of an autism diagnosis.

Host: Okay. So, those, like, just-a-phase moments like that picky eating, that's what we're kind of like looking for.

Kelcey Bruen: Absolutely. Absolutely. And like I said, when presented together, could be indicators of autism. According to the National Institutes of Health, approximately 40-83% of individuals with autism experience sleep disturbances. And toileting resistance was 49% more likely.

Host: Okay. So, you know, we touched on those toilet issues, the sleep issues. But how do the differences in communication or social interaction show up? I know you mentioned the lack of responding to their name. Are there other things?

Kelcey Bruen: Like I said, it looks a lot like isolation and just lack of responding to different social cues. A lot of children with autism don't have those social skills to create meaningful relationships with their peers, so they do tend to either gravitate towards adults. Adults are a little bit more forgiving and can compensate for their barriers. And also, they prefer to be by themselves a lot too.

Host: Okay. So if a caregiver were to start noticing a combination of these things, when should that caregiver trust their gut and start talking to their pediatrician and having that conversation that this is their concern?

Kelcey Bruen: I suggest as soon as possible, as soon as you start seeing the signs, as soon as your gut's telling you something isn't right, I would seek support.

Host: Okay. So, how could a caregiver prepare for that conversation they're going to have with their pediatrician, especially if they're unsure, like, how they want to explain what they're seeing?

Kelcey Bruen: That's a really good question. I highly, highly suggest taking detailed objective notes. So if you're seeing a tantrum, instead of telling your pediatrician "My kid is having tantrums," tell them exactly what those tantrums look like. They're crying, they're falling to the floor. They're kicking and screaming. And also, let them know how long these are happening and how often these are happening. This will help paint a better picture.

Host: Okay. So yeah, definitely keep those detailed notes, come in with notes that you're not just walking in unprepared to the meeting.

Kelcey Bruen: Absolutely.

Host: Yeah, I think that's great advice. We're going to take a quick break to talk about primary care.

At Riverside, our primary care providers are right here in your community, offering personalized care for you and your family close to home, and connected to specialists and services you may need. Having a primary care provider means having someone who knows you, listens to you, and helps you stay well through every stage of life, from annual checkups and preventative screenings to managing everyday concerns, because remarkable care should never be out of reach. Remarkable care right where you live. To find a primary care provider who's right for you and your family, visit myrhc.net/acceptingnew.

And we're back to our conversation here about autism and the signs. To kind of shift the conversation a little bit for families who, you know, might have a new autism diagnosis and are new to the idea of ABA therapy, how would you describe what this type of treatment is in really simple terms?

Kelcey Bruen: Really simple terms. It's hard to come up with an elevator pitch when you think about ABA therapy, but I'll try my best. Basically, ABA therapy is an evidence-based scientific approach to learning, and what it does is it allows practitioners to change the environment in order to create positive behavioral change in their clients.

Host: Okay. Yeah. It's definitely hard to talk about. I've been to the clinic. It's beautiful.

Kelcey Bruen: Thank you.

Host: There's so, so many things around toys to play with in different environments within the space. I'm sure it's hard to explain everything you do in 30 seconds. What would make a child or individual like a good candidate to come to the ABA therapy, or what types of goals can it help support?

Kelcey Bruen: Absolutely. So, any child or any individual with autism is a great candidate for ABA therapy. When we focus on different skills that we're teaching, we focus on five different domains. So, that would be cognitive, communication, adaptive, behavioral as well as social.

So, all of our goals fall into those domains, and that gives us the ability to teach quite a variety of skills, anywhere from using utensils to identifying letters, different play skills, functionally playing with toys and things like that. So, we have a wide range of skills that we could teach these kids.

Host: Yeah, I think that's great. And just, you know, sometimes reinforcing skills from someone outside of the home is very helpful.

Kelcey Bruen: Absolutely. Absolutely.

Host: Yeah. So if there's one reassuring message you could give to caregivers to walk away with today, what would that be?

Kelcey Bruen: You are not alone. You are absolutely not alone. There is so much support that can be found in your community, so don't be afraid to ask for that support when you start finding yourself in different challenging situations.

Host: Yeah, I think that's great advice for everybody. Kelcey, is there anything else that you would like to add today?

Kelcey Bruen: No, I think that's covered everything. Thank you so much.

Host: Yes. And thank you listeners for tuning into the Well Within Reach podcast with Kelcey Bruen from the Riverside ABA Therapy Clinic, and your host, Liz Unruh. To learn more about services provided at Riverside, visit riversidehealthcare.org. To talk to someone about the Riverside ABA Therapy Clinic, call 815-939-4470.