Walter P. Christian

Development of a continuum of services for children and adults with autism and other severe behavior disorders

The development of a 12-step continuum of services for individuals with autism is described. The operation and funding of outreach parent training; homebased early intervention; preschool, vocational, and adult intermediate care; and school consultation programs are outlined. The use and importance of evaluative data on both treatment outcome and staff skills are emphasized.

Preparing the Family for Client Transition

As described by Luce and his colleagues in the previous chapter, client transition cannot be accomplished without an adequate preparation of the client’s future environment. In the case of clients returning to their homes and families, this requires the orientation and training of family members in the procedures that are effective in managing the client’s behavior and in meeting his or her special physiological, psychological, and/or educational needs.

Inpatient Behavior Therapy with Autistic Youth

In comparison to other disabilities, autism is a very rare life-long disability that is typically observed prior to a child’s third birthday. Afflicting only about one in 3,000 live births, this disorder has received a level of scrutiny and interest that far exceeds its prevalence. One might conclude from such a high level of attention that there would be a well-established approach to questions on etiology, assessment, and treatment. Unfortunately, little agreement exists on any of these issues. Unlike some of the other developmental disabilities, the cause of autism is unknown, its characteristics are similar to those of other diagnostic categories (e.g., mental retardation, schizophrenia), and its troubling behaviors have been shown to be largely unresponsive to traditional medical interventions and psychotherapeutic approaches.

Peer Review and Human Rights Committees

The protection of clients’ rights to safety and effective treatment is a basic goal of any human service agency. These rights are ensured through effective organizational, staff-training, and management practices. Professional peer reviews and human rights committee reviews are two activities that are undertaken to (1) underscore the protection of clients’ rights during the clinical decision-making process, and (2), assure the consumers, the trustees of the agency, and the public that the basic rights are protected.

State-of-the-Art Programming in Massachusetts: A Brief Description of the May Institute

The May Institute is a private, non-profit human service agency serving persons with autism and other severe developmental disabilities. The Institute began as the parents’ School for Atypical Children in 1955 and was founded by Dr. and Mrs. Jacques M. May as a center dedicated to the understanding and rehabilitation of autism. Dr. May, who was famous as a physician, author, and researcher with the World Health Organization, established the program in the town of Chatham about 145 km. from Boston on scenic Cape Cod in Massachusetts. Having fathered twin autistic sons, Dr. May was interested in establishing a treatment center focusing on study of the autistic child which contrasted to the treatment of the day which was parent-centered. The Mays found such an approach which linked autism to parental personality traits, counter productive.

Work performance contracting: An essential feature of accountable mental health administration

Procedural guidelines are presented for the use of work performance contracting in mental health administration. After describing the rationale and criteria for performance contracting in human service settings, procedures are recommended for (1) developing work performance standards, (2) negotiating performance agreements, and (3) contracting for an acceptable level of employee performance. The utility of performance contracting in working with governing boards and consultants is also described.