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California State University Northridge

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Michael Cameron

on 16 March 2015

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Transcript of California State University Northridge

California State University, Northridge
Presentation to Faculty and Students

Michael J. Cameron, Ph.D., BCBA-D
16 March 2015



Case Study


15 year-old girl (I will refer to her as Cindy) with Autism Spectrum Disorder
Presents with severe self-injurious behavior, including: (a) biting the tissue inside of her mouth; which has resulted in mouth ulcers, 9 staph infections over the last year, and the loss of a section of her tongue; (b) self-hitting and eye gouging resulting in ongoing tissue damage and discoloration; (3) daily occurrences of self gagging and projectile vomiting; (4) a disrupted sleep/awake cycle (wakes every morning at 2:30 AM); and (5) community exclusion (i.e., she does not attend school and does not go into the community due to use of protective equipment uncontrolled self-injurious behavior)
Cindy is underweight (five feet tall weighing 86 pounds) and has been prescribed the anti-psychotic medication (Risperdal) since she was 5 years-old
The family is now working with their sixth Board Certified Behavior Analyst
Mom stays at home, has gained 25 pounds in the last year, sleeps 4 hours (in her daughter's bedroom) per night, and has been told repeatedly by physicians and medical professionals that "it's just the autism".

Clinical Decision Making
When clinicians are faced with complex problems, they make decisions based on systematic assessments and personal experience
Rapid Decision Making
Overcoming poor infrastructures
(siloed services)
Leveraging expertise
(e.g., medical community)
Coping with volatile information dynamics
(e.g., 3 tabs of Advil given every three hours)
Catalyzing information sharing
(e.g., interdisciplinary)
Overcoming mistrust
(e.g., community based psychiatry)
Parsing signal from noise

Reconciling multiple stakeholders
(e.g., child, family, medical professionals)
Delineating boundaries of authority
(e.g., family)
Monitoring and responding to changes in event status

Think Aloud Problem Solving (TAPS)
Students learn how to think, reason, and problem solve by talking their way through new problems in reading comprehension, mathematics, social studies, and science using Whimbey's Think Aloud Problem Solving (TAPS) method. This method, initially designed for college students and further refined for younger learners Robbins (1996), is the core learning-to-learn technology used in our program. In TAPS, teachers model and coach students to think out loud while talking, writing, and diagramming and other supplemental activities which support thinking, using specifically designed protocols that represent effective ways to work through problems. Students are taught five key repertoires that are required for effective reasoning and problem solving. Then they coach each other to "get fluent" in using the TAPS protocol and these key repertoires to
solve a range of problems.
Clinical Decision Making: Predictive Models and Optimization
Michael J. Cameron, Ph.D., BCBA-D
Clinical Decision Making
A behaviorally based laboratory school that helps elementary and middle school students to catch up and get ahead (in reading, language, and mathematics)
Director, Kent Johnson
Am I within my scope of practice?
Do I need an emergency plan?
What assessments?
What interventions?
What evidence-based practices?
What ethical issues?
What other disciplines?
What communication?
What measures (stakeholder)?
The right direction advice?
What family support is needed?
What resources?
What impact on other children?
Can we do this?
What options?
What is the pharmacological history?
What pharmacological intolerances exist?
What pharmacological agent should be used?
Do other interventions reconcile?
What evidence-based practices should be accessed?
Rule in or rule out medical factors
What assessment methods for a non-verbal child?
Risk stratification. What is the risk of suffering a particular condition and need (or lack thereof) for preventive intervention?
Problem-Based Learning (PBL)
A student-centered pedagogy in which students learn about a subject through the experience of creating a problem
The goal is to develop effective problem-solving skills
Strategies and Research
Use the Think Aloud Procedure for training clinicians
Combine with Problem-Based Learning
Use competent models for the Think Aloud demonstration (with diversified topics (e.g., aberrant behavior, skill deficits, language)
Will the combination of pedagogical strategies result in differential outcomes?
Sense-Making Cycles

Sense-making is enhanced by the technologies and practices of collective intelligence. The strategic guidelines for building collective intelligence include visualizing data, conducting ongoing hypothesis testing, developing multiple on-line spaces for different kinds of feedback
Using collaborative technologies for delivering clinical intelligence and guided decision making
Full transcript