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Saturday, July 22, 2017

Academics & Research

Therapy company gives hope to students with autism


Concept Connections focuses on teaching students social understanding. | Courtesy of Jennifer Keese

When three-year-old Cooper DeBruin started exhibiting signs of developmental problems, his parents thought it might just be a speech impediment. Then, his social skills began to lag and he started self-stimulating — a catch-all phrase for a range of repetitive behaviors.

His parents, Christy and Barry, found University of Houston alum Jennifer Keese’s company Concept Connections — a therapy provider for children on the autism spectrum — through Cooper’s speech therapy center. The company holds group learning sessions, takes clients out into the community for service events and helps arrange job placements.

“I’ve watched a lot of my clients throughout the years grow up,” Keese said. “It’s pretty crazy to see their progress.”

Keese and her team offered in-home therapy dating back to 2012 and founded Concept Connections Therapy Center in 2014. Concept Connections therapists treat autism with a method called applied behavior analysis. They focus on communication, conversation and social skills and want to teach their patients social understanding, rather than just how to respond correctly in a given social situation.

“Basically it’s the study of human behavior and how you can alter the presentation of the environment to help the person learn and grow,” Keese said. “When you apply it to kids with autism, they learn often in a very different manner than a neurotypical child. You have to present things differently to them and get to know them very well and use motivation to excite them to learn.”

Companies like Concept Connections take a highly personalized route to providing therapy for patients on the autism spectrum, Keese said.

The first skills therapists teach are self-help skills, language skills and play skills.

‘Night and day’ transformation

For Cooper, every day consists of one-on-one time with a therapist at the center, but he also has group time where he gets to interact with other children. He loves seeing his teachers and getting hugs and kisses from people he knows, Christy DeBruin said.

“They just potty trained him at the center. They were taking him to the bathroom every ten minutes,” DeBruin said. “He can put his own pants on now, he’s learning to eat with a spoon. Everything’s been very delayed with him. It’s crazy how far he’s come.”

Christy said she was overprotective before Cooper began therapy at Concept Connections, but after seeing how good the therapists were — and seeing Cooper love going there — she became much more comfortable leaving him there every day.

“Their school has done a lot for Cooper. He’s changed noticeably after going there,” said Barry DeBruin. “He’s got a long way to go, but I just watched videos of him from about a year ago, and it’s just night and day.”

When Cooper started therapy — or “school,” as the DeBruins call it — at Concept Connections, he was very aggressive with the staff, Keese said.

According to the Diagnostic and Statistical Manual of Mental Disorders, Autism Spectrum Disorder is a disability that ranges in severity from mild social quirks to a complete inability to communicate effectively.

Autism patients often have highly specific interests that they fixate on and will exhibit an abnormal over or under-reaction to stimuli, such as not reacting to pain or temperature, or growing angry at specific sights or sounds.

Keese said some autistic patients struggle to learn basic life skills, but tend to be gifted in a specific area. She said children on the more severe side of the spectrum often have trouble learning social skills and communication.

Goals within reach

Kids at Concept Connections have a schedule involving visiting their therapy centers, going out into the community for therapy and the therapist visiting them at home for two to three hour sessions.

They have specific goals set by their behavior analysts, who then work with them towards reaching those goals.

Therapists visiting children at home will utilize play therapy to help the children live happy, fulfilling lives while also teaching them valuable skills like cooking their own food or communicating effectively with others.

“We don’t sit at a table for hours and hours and drill the kid,” Keese said. “We’re in their house, running around, playing with their toys, helping them learn how to bathe themselves, cook their own meals. We’re going on with their own life.”

Parents of autistic children are required to do training with therapists to help with behavior intervention if the child is aggressive. If the child has siblings who are old enough, they are trained in more constructive interactions with their sibling with autism.

“We also ask the siblings what’s important to them: ‘What would you like your brother or sister to be able to do with you?’” Keese said. “A lot of times the siblings will say, ‘I just want to play with my older brother or older sister,’ so we’ll set goals for that.”

Worth the struggle

People with autism can sometimes be aggressive towards others or themselves, and they display an “inflexibility of behavior,” meaning that it can be extremely difficult for them to cope with change, and repetitive activities are common.

Sometimes, they are aggressive towards others or exhibit self-injurious tendencies. On the other end of the spectrum, Keese said, you could find people who have jobs, college degrees, and can communicate just as well as anybody else, but they have a few social quirks.

Keese gave an example of an eight-year-old boy she took on as a patient a year ago.

“He had been in a school district in Dallas. He had big behavior problems, so very aggressive toward teachers and himself,” Keese said, “Because of his aggression, he wasn’t allowed to be around peers. It was a very isolated teaching day for him. It was always two adults with him, he wasn’t allowed to visit other classrooms and had one to himself.”

They implemented a very detailed intervention plan, and a year later, he has no aggression and participates in group activities.

“His parents couldn’t take him anywhere previously. It was school and home and that’s it,” Keese said. “So his whole world’s opened up here. He’s happy. He went from an angry child, who could not meet his own needs due to communication issues, to a happy kid. It makes it all worth it.”

But her aim is not just to provide therapy, Keese said.

‘A fulfilled life’

“The goal of Concept Connections for me was to provide services to the whole child,” Keese said. “Not just thinking about what they need for therapy, but what would make them happy, what would give them a fulfilled life.”

Keese received her bachelor’s degree in 2005 and went on to receive a master’s degree from the University of North Texas. She has been in the psychology field for 15 years and has been practicing ABA therapy for 10.

The beginning of Keese’s career was spent mostly working with adults. She said she realized early on that there were very few services offered to teenagers and adults who had aged out of the school system.

“They typically stay home with their parents or go to a day rehabilitation, and they just don’t have a lot of enrichment in their lives,” Keese said.

Jessica Dahl, the supervisor of adolescents and adults at Concept Connections, said autism patients are more difficult to treat as they get older. Insurance companies set their coverage up with the idea that if the autism symptoms haven’t been remediated once the client is in their early teenage years, the insurance company won’t provide the financial incentive to keep treating the patient.

“Jenny just never gives up hope on anyone,” Dahl said. “There doesn’t come a time when it’s too late to help somebody.”

Expensive situation

The DeBruin family had trouble getting insurance to cover the costs of Concept Connections, with their first provider only approving Cooper for 25 hours of therapy a week.

When Cooper’s parents switched providers, they managed a full 40 hours a week of therapy covered for him. If they were to pay out of pocket, Christy estimated they’d be paying around $100,000. As it is, for all of Cooper’s therapy, their out-of-network deductible is about $17,000 a year.

“One the things they do really well at Concept Connections is fight,” Christy DeBruin said. “They fight for all of those kids. I can tell you one thing, one of the insurance companies haven’t been calling anybody back or giving anybody authorizations. We have to get approval, and since January they’ve been calling and calling trying to get approval for all these kids.”

“Because she couldn’t get ahold of them, she actually drove up to their headquarters to try to get some answers,” Christy DeBruin said. “That’s Jenny.”

Christy said there were few cheaper options for parents who want their child to receive ABA therapy. Schools don’t teach ABA, but there are grants available that can help. Christy sits on the board for The Heart of Autism, a fundraising organization that awards grants to parents that need financial help.

“Having an autistic child is very expensive, and we’re lucky that we have the means. But there’s a lot of people that don’t,” Christy said. “All the insurance company wants to do is not pay. I spend hours on the phone with the insurance company, all the time. It’s a constant battle.”

Cooper has now been doing ABA at Concept Connections for seven months, and the progress he has made is remarkable, his parents said.

“I just want to make sure Dr. Keese understands how life-changing she’s been for us. I tell her all the time, ‘Thank you for what you do,’ but it’s never enough,” Christy DeBruin said. “I can’t really ever express how much it’s changed our lives.”

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