President's Message: Adaptive Behavior and its Assessment

Peter Gerhardt, Ed.D.

The next volume in OAR’s Life Journey through Autism series will be A Parent’s Guide to Assessment. This installment in the guidebook series is intended to provide parents of children on the autism spectrum with the tools to better understand the assessment process and, subsequently, utilize assessment outcomes to improve services and interventions for their child. With that in mind, this month’s President’s Message looks at one, particularly important area of assessment: adaptive behavior.

Among the many (and repeated) assessments completed with individuals with autism spectrum disorders (ASD) while they are growing up is the assessment of adaptive behavior. Adaptive behavior generally refers to the skills and abilities associated with age-appropriate, personal self-sufficiency across multiple environments and in contrast to the assessment of intelligence, which represents potential behavior, the assessment of adaptive behavior represents actual behavior, i.e., what an individual is actually able to do at a given point in time. For individuals with ASD, there is typically a discrepancy between IQ and measures of adaptive behavior with IQ generally being reported as higher (Klin, Saulnier, Tsatsanis, & Volkmar, 2005). For individual learners with ASD, the assessment of adaptive functioning is particularly important for a number of reasons (National Research Council, 2001). First, accurate measures of the individual’s typical pattern of functioning in familiar environments can be obtained, which may point to 1) specific areas in need of intervention and 2) potential problems with skill acquisition and the subsequent generalization of learned skills cross environments. Second, the assessment of adaptive behavior is necessary to document whether or not an intellectual disability (i.e., mental retardation) is also present which may impact an individual’s eligibility for some services.

The most commonly used standardized assessment of adaptive behavior is the Vineland Adaptive Behavior Scales –II (Sparrow, et al., 2005). The Vineland Adaptive Behavior Scale-II (VABS-II) is designed to assess self-sufficiency across a number of domains and sub-domains including communication (receptive, expressive, written), daily living skills (personal, academic, school community), socialization (interpersonal relationships, play and leisure, coping skills), motor skills (fine, gross), and maladaptive behavior leading to the development an adaptive behavior composite profile. Recently updated, the VABS-II can be completed on individuals from birth to 90 years of age and can be used to support the diagnostic process, determine eligibility for services, help plan intervention programs, and track and report progress.

Other adaptive behavior assessments in current use include the Scales of Independent Behavior-Revised (Bruininks, et al, 1996) and the AAMR Adaptive Behavior Scales – School Version (Lambert, et al, 1993) and Residential/Community Version (Nihira, et al, 1993).

On a day-to-day basis, perhaps the most relevant application of an adaptive behavior assessment is the identification of potential adaptive behavior, or life skills goals, for inclusion in the Individualized Education Plan (IEP). A primary consideration when identifying adaptive behavior goals should be the extent to which the skills targeted will promote age-appropriate independence. At times, however, it should be considered both reasonable and appropriate to look beyond the individual’s current age and, based upon the results of the assessment, consider providing instruction in those skills whose relevance might be more directly apparent two or three years down the road. For example, providing instruction in appropriate menstrual care prior to the onset of menstruation can help to make that particular life transition much simpler than if such instruction was delayed until the skills were regularly required. Similarly, while it might be considered age-appropriate for young children to take a bath instead of a shower, providing instruction in independent showering before he or she reaches puberty (when the transition to showering tends to occur) might be both easier and to the benefit of everyone concerned.

While the assessment of adaptive behavior with learners with ASD is common practice, the results of these assessments are often underutilized as a relevant source of information for the development of individual specific instructional goals. On one hand, there may be concerns on the part of the family that the inclusion of more adaptive behavior goals in the IEP would mean that a number of academically oriented goals would need to be sacrificed. On the other hand, teachers and other professionals may feel ill-prepared to provide effective instruction in the areas of self care or even daily living. This is unfortunate as on a day to day basis one’s degree of independence/self sufficiency tends to define the conditions under which academic skills can prove most useful. In other words, just having math skills does not mean you can shop independently for groceries but being able to shop independently for groceries does mean you have a chance to use whatever math skills you may possess.

Brown, et al, (1976), with their “criterion of ultimate functioning,” succinctly distilled the importance of adaptive functioning into one simple question: “If the student does not learn to do the task, will someone else have to do it for them?” If he does not learn to make or purchase lunch, will someone have to make or purchase lunch for him? Arguably, the answer is “yes” and making lunch, therefore, would appear to be a pretty adaptive skill. If she does not learn to distinguish the color magenta from mauve, will someone have to do it for her?  Most likely, someone would not and so color discrimination, at this level, would not be considered an adaptive skill. The criterion of ultimate functionality is certainly not meant to be a hard and fast rule. It is, however, a simple and useful tool to help determine the extent to which a particular goal, when mastered, will contribute to greater levels of personal independence.

The English philosopher Herbert Spencer (1820-1903) wrote, “The great aim of education is not knowledge but action.” Understanding the importance of adaptive behavior and its assessment allows us to provide an education that, ideally, integrates both knowledge and action in a way that promotes individual competence, greater independence, and a more beneficial quality of life.

Brown, L., Nietupski, J., & Hamre-Nietupski, R. (1976). The criterion of ultimate functioning. In M.A. Thomas, (Ed.), Hey, Don’t Forget About Me! (pp. 2-15). Reston, VA: Council for Exceptional Children.

Klin, A., Saulnier, C., Tsatsanis, K., & Volkmar, F.R., (2005). Clinical evaluation in autism spectrum disorders: Psychological assessment within a transdisciplinary framework. In. F.R. Volkmar, R. Paul, A. Klin, & D. Cohen, (Eds.) Handbook of Autism and Pervasive Developmental Disorders, 3rd Ed. (pp. 772-798). Hoboken, NJ: John C. Wiley & Sons, Inc.

National Research Council. (2001). Educating Children with Autism (Committee on Educational Interventions for Children with Autism). Washington, DC: National.

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Autism Speaks Steps Up as Major Sponsor For Conference

Autism Speaks Clinical Programs Director Nancy Jones, Ph.D., will offer a special luncheon presentation at OAR's upcoming conference.

OAR’s plans for ensuring that its Fifth Annual Applied Autism Research and Intervention Conference would be the best yet received a tremendous boost when Autism Speaks became the first major sponsor ($25,000) in the history of the conference.  In addition to underwriting a sizable portion of conference expenses, the funds allowed OAR to extend the Early Registration deadline leading into the conference last week.  This is the second year that Autism Speaks has lent its support to OAR and this conference.   

Nancy E. Jones, Ph.D., clinical programs director for Autism Speaks, attended the conference on Friday and delivered a special luncheon presentation on Autism Speaks’ current research initiatives. Dr. Jones oversees the Autism Treatment Network, a network of hospitals and medical centers dedicated to improving access to comprehensive, coordinated medical care for individuals with autism. She also directs the Clinical Trials Network (CTN), a network developed to promote and expedite clinical trials in autism. She has played a key role in the expansion of the CTN and the development of its first sponsored clinical trial in partnership with a specialty pharmaceutical company in the UK.

Conference Overview

As in the past, OAR again offered a two-day forum with four distinct subject tracks.  On Friday, the tracks were:  Research and Research to Practice.  The former included firsthand reports from OAR-funded researchers; the latter emphasized translating findings from research into practical uses.  Friday concluded with a “Meet the Speakers” reception.

Saturday’s tracks were: Transition Planning and Support and Planning Intervention with School Age Learners on the Spectrum.  Both were more functionally oriented than Friday’s presentations.  The Transition track looked at both practical and programmatic aspects of the topic in various settings.  The Planning Intervention track focused on intervention as it applies to the educational setting.

Behavior analysts and speech language pathologists that attended were eligible to receive Certified Educational Units (CEUs) from the American Speech-Language Hearing Association (ASHA) and Behavior Analyst Certification Board (BACB), thanks to support from the Eden II Programs in New York and the Maryland Association for Behavior Analysis (MABA). 

Next month's newsletter will include a full post-conference report.

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Salute: Honored OAR Scientific Council Member Has made a Career of Tackling Tough Problems

In April of this year, Sam Odom, Ph.D., the newest member of OAR’s Scientific Council, received the Special Education Research Award from the Council forExceptional Children, honoring the work he has done over the course of his 31-year career in special education, an interest that began when he was an undergraduate studying psychology and turned into a career of working with and on the behalf of children and their families.

“Dr. Odom is a national leader in special education research, particularly in the areas of autism and early childhood inclusion,” says Lynda Van Kuren, a spokesperson for the Council for Exceptional Children. “He identified strategies and interventions that led to significant changes in the way we educate students with disabilities, and as result thousands of children with special needs have found success educationally and  socially.”

His research has focused on the needs of people, particularly preschool children, with developmental disabilities, including peer social relationships, autism spectrum disorder, and school readiness.

“I enjoy examining tough problems in a really systematic way to gather data to answer questions. I enjoy working with kids and I enjoy writing. The combination of those three things keeps me motivated,” he explains. And he gets to put all three to use in his current position as director of the Frank Porter Graham (FPG) Child Development Institute at the University of North Carolina at Chapel Hill where he is also a professor in the School of Education.

He describes two research projects he is currently overseeing and which he believes may hold promise for children with autism and their families.

The first project, in collaboration with Dr. Brian Boyd and colleagues at the University of Miami, University of Colorado at Denver, and University of Minnesota, is a comparison of two early childhood education programs, TEACCH (Treatment and Education of Autistic and related Communication-handicapped Children) and LEAP (Learning Experiences: An Alternative Program for Preschoolers and Parents). “We believe both models are effective in promoting different types of skills for kids. The question is what programs produce what types of outcomes and work for which types of kids.” And, he adds, it’s important for the field to know how programs work and for which kinds of children programs are most effective.

The other project, in collaboration with Dr. Hannah Schertz at the University of North Colorado and Dr. Kathleen Baggett at the University of Kansas, is an examination of an intervention approach to promote joint attention for toddlers with autism and their caregivers. Dr. Odom says that the results of that study could help educators and parents create a system of care and support for very young children with autism and promote communication and interaction.

Dr. Odom earned three degrees from the University of Tennessee and then a doctorate in special education from the University of Washington in 1982. He has been on the faculty at Vanderbilt University, served as the William C. Friday Distinguished Professor of Child Development and Family Studies at the University of North Carolina and Otting Professor of Special Education at Indiana University's special education program before returning to North Carolina in 2006.

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Research Review: Adaptive Behavior

Among the many assessments completed on individuals with ASD while they are growing up is the assessment of adaptive behavior. Adaptive behavior is a somewhat broad term and generally refers to the skills and abilities associated with age-appropriate, personal self-sufficiency across multiple environments. The term adaptive behavior is used to describe that set of skills that allow us to live independent and, ideally, productive lives. These are often times complex skills that difficult to teach but, when they are taught can make a significant difference in the lives of individuals with ASD and their families.

In this month’s article reviews, we at look three studies that examined different aspects of personal self-sufficiency.

The Effects of Graduated Exposure, Modeling and Contingent Social Attention on

Tolerance to Skin Care Products with Two Children with Autism

Noting that children with autism may display atypical or even fearful responses to common stimuli such as skin care products (often with a negative impact on adaptive functioning), Ellis and colleagues investigated the use of a treatment package including graduated exposure, modeling, and social attention on the fearful responses of two learners with autism. The participants in this study were two 4-year-old boys with autism, independently diagnosed using the Childhood Autism Rating Scale (CARS). Attempts by their mothers to apply skin care products (moisturizer, antibacterial cream, suntan lotion) were met with displays of physical (aggression, withdrawal) and verbal (verbal protests) resistance. All sessions of the investigation were conducted in the boys’ homes. Modeling was used if either boy failed to respond to the initial presentation of the skin care product and involved by verbal (“Hey, look, it’s all gone.”) and physical (rubbing lotion into the skin) presentations. Avoidance hierarchies were developed for each child and positive reinforcement, in the form of social praise, was presented contingent upon successful completion of each step in the hierarchy. The results of this study demonstrated that graduated exposure coupled with modeling and social reinforcement was effective in teaching tolerance of skin products to these two learners. Further, results were obtained relatively rapidly and were maintained over time with the intervention package itself being rated very positively by the each boy’s parents.

Ellis, E.M., Ala’i-Rosales, S.S., Glenn, S.S., Rosales-Ruiz, J., & Greenspoon, J., (2006). The effects of graduated exposure, modeling, and contingent social attention on tolerance to skin care products with two children with autism. Research in Developmental Disabilities, 27, 585-598.

Strategies to Promote Adaptive Competence for Students on the Autism Spectrum

In this review of intervention strategies, the author stresses that the overall goal of effective intervention for learners with ASD is functional independence. Beginning with an individualized and comprehensive assessment (often downplayed in regular educational settings) with an emphasis on competencies as well as deficits, this ongoing analysis of student performance forms the “basis for functional, meaningful intervention” (p. 17). Focusing on three areas of intervention, Preis provides an overview of antecedent strategies/environmental modifications designed to support adaptive responding along with a brief survey of interventions in the areas of communication and socialization. With any intervention, she notes, generalization across environments and people is the final consideration and must be programmed into intervention beginning at a very young age.

Preis, Janet (2007). Strategies to promote adaptive competence for students on the autism spectrum. Support for Learning, 22, 17-23.

Investigation of a Reinforcement-Based Toilet Training Procedure for Children with Autism

Independent toileting is generally considered a core adaptive skill and one which individuals with ASD may find a challenge to master. The inability to independently toilet oneself is associated with a number of negative consequences including the potential for reduced participation in community resources. While other effective methods of toilet training appear in the literature (e.g., Azrin and Foxx, 1971), the researchers sought to document the efficacy of the current intervention as one that may be more acceptable to administrators, teachers, and other direct care workers.

Study participants included three young (ages 4-6 years) learners with a previously established autism diagnosis. At the time of the study, all three were untrained, wore diapers, and had urination accidents on a daily basis. All training took place in the bathroom of the individual’s school. At the start of the intervention a timer was set for 30-minute intervals. At the end of each interval, the student was prompted to request “bathroom.” The student was prompted to sit on the toilet for approximately 1 to 3 minutes with appropriate urination reinforced with behavior-specific praise and tangible positive reinforcement. If he/she did not urinate, he/she was prompted to stand, re-dress, and was told, “Ok, you don’t have to pee.” No verbal praise or tangible reinforcement was delivered. If the initiation of a urine accident was noted, the teacher would deliver a statement meant to startle the student and interrupt the flow of urine while prompting the student to the toilet. If appropriate urination then occurred, reinforcement was delivered and if not, the student was changed out of his/her wet clothes without any further consequence.

The results indicated that for all three students the self-initiation of requests for the bathroom in the absence of toileting accidents was achieved in seven to 11 days and gains were maintained over 6-month and 12-month follow ups.

Cicero, F.R., & Pfadt, A., (2002). Investigation of a reinforcement-based toilet training procedure for children with autism. Research in Developmental Disabilities, 23, 319-331.

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Research Feature: Evalutaing Intensive Behavioral Interventions in Autism

When asked about the OAR-sponsored research he and Saul Axelrod, Ph.D., are undertaking, Phil Hineline, Ph.D., explains that it was driven by the need for assessment of interventional approaches, especially in public school settings. Their study analyzes and evaluates the Lovaas approach, also known as the Discrete Trial model, and the newer Applied Verbal Behavior model.

“We are asking which approach would be better for which children in which situations with what resources,” Hineline explains. “What we also want to know is how different are they?”

Currently, he explains, parents and educators agree on what approach will be used in the child’s Individualized Education Program (IEP). But their decision is generally based on their ideas of what approach might work best for the child. Hineline and Axelrod hope that their study will give parents and educators an objective measurement of what approach is best with what types of children under what circumstances. Because they do not have affiliations with any particular type of intervention, they can provide an objective assessment, says Hineline.

“One of our guiding ideas is that excellent work as been done in developing best practices in research settings. But those best practices may not work as well in classroom settings if staff have not been well-trained or if there’s high staff turnover or if teachers have limited time.” Hineline and Axelrod hope their study will show how two approaches work as implemented in public school settings.

How the Study Works

The proposal details the study’s objectives. “Assessment of before-vs.-after standard outcome measures will indicate whether the Verbal Behavior approach produces improvements comparable to those that have already been reported for Discrete-Trial interventions, and thus whether a subsequent head-to-head comparison would be justified.

“In addition, by tracking progressive changes in detailed curriculum profiles for individual children, this project will also assess the degree to which the Applied Verbal Behavior approach differs in actual practice from the Discrete-Trial model and hybrid models.

“A third objective will be to gather preliminary data regarding the degree to which each approach is dependent upon high levels of staff competence. This objective concerns the possibility that a technique identified as ‘best practice’ when implemented in a well-staffed research center may not be the most effective approach in settings with far fewer resources, such as public schools, which the majority of children must rely on for intervention.”

Hineline describes how the study is being conducted. “We’re doing an initial detailed assessment of the children as they come into the study. We have also developed a curriculum profile of 190 items to assess each child as they are taught using the two approaches. We’ll assess the profile of each child every six weeks.” The third component of the study is an assessment of the expertise of the teachers working with the children, including a written query that asks them to describe what they are teaching and their approaches.

The original plan, says Hineline, was to include 12 children in each of four categories--children admitted to the two types of interventions in two age groups (three years old when baseline measures are begun and five to six years old when school-based interventions typically begin) --recruited from a county in Philadelphia and a nearby county in New Jersey. Experience in the first year's recruiting, as well as rapid changes within the regional public-school scene, have resulted in some adjustments to that plan, he explains.

First, the two age groups have proved to be less distinct than anticipated, and thus they have been combined, but with close attention to each child's level of functioning upon entry into the study.

Second, an additional approach for addressing autism, known as the Competent Learner Model, has been gaining currency within the geographic region where the study is taking place. Since this, too, is firmly anchored in the principles and techniques of behavior analysis principles, it has been added to the study.

What began as a comparison of two approaches addressed to two age ranges, says Hineline, has become a comparison of three approaches addressed to a single but somewhat broader range of ages.

He points out that the study benefits from the fact that the people responsible for its components have experience in those components. “For example, the team members who developed the teacher evaluations teach teachers. The team members who developed the curriculum profile are curriculum designers.”

Practical Relevance

The project takes place within public schools, which is where many children with autism receive their educations rather than in specialized institutes or within privately funded in-home programs, thus providing a “real-world” examination of how the interventions work in settings where a majority of children are educated.

It will, hope the researchers, give school administrators in addition to parents, information that will not only help them decide which intervention would work best in their schools but also which might work better with the staff and resources they have available. As they explain in the proposal, “If we find that the Verbal Behavior approach is more dependent upon highly skilled staff than is the Discrete-Trial format, then that fact would need to be brought to bear upon decisions among alternative approaches. Selecting the approach with more intensive staff training requirements entails a commitment to providing that training, and to maintaining conditions of employment that will minimize staff turnover. If one cannot accomplish this, it would be better to adopt a more rigid curriculum that can be reliably implemented under the circumstances.”

Outcomes

While he knows that it is too early to discuss results, Hineline does indicate that he and Axelrod are seeing some interesting things already. “One thing I can say is that in some respects the two models look less different than they claim to be. We’re also seeing that staff expertise is going to turn out to be pretty important. Generally, treatment integrity is understood as whether people have the ability to teach the method when the reality is that there may be a whole range of teaching ability and skill.”

Hineline and Axelrod plan to disseminate the findings through a number of channels, including  conferences and through professional journals and periodicals.

Frith, U., & Soares, I. (1993). Research into earliest detectable signs of autism: what parents say. Communication, 27, 17-18.

Harris, S., & Handleman, J. (2000). Communication intervention for children with autism: A review of treatment efficacy. Journal of Autism and Developmental Disorders, 32, 373-396.

Stahmer, A. C., Collings, N. M., & Palinkas, L. A. (2005). Early intervention practices for children with autism: Descriptions from community providers. Focus on Autism and Other Developmental Disabilities, 20(2), 66-79.

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RUN FOR AUTISM News

Taking Part in the Happiest Race on Earth

The RUN FOR AUTISM went to the West Coast for the first time when a team of runners participated in the Disneyland Half Marathon and 5K held over Labor Day weekend in Anaheim, California. Although the team consisted of just a few runners, it offered OAR the opportunity to partner with another premier event and preview the race for future possibilities.

Members of Team MOFF pose for a photo after running the Disneyland Family 5K on behalf of OAR. The team raised more than $5,000 during the weekend of races.

Disney conducted a two-day fitness expo, Sunday 5K, and the featured Half Marathon race with its typical precision.  Each of the activities was within walking distance of the three Disneyland Resort hotels, so both the runners and their families had plenty to keep themselves occupied before and after their races.

OAR was well represented at the Family 5K Fun Run on Sunday morning by Sandra Sandoval; Julian Watt and her fiancé, James; and 10 runners and walkers from the MOFF team, which consisted of the members from the Marocco, Ostergaard and Faix families.

The 5K Race was named  "The Great Ratatouille Race," and was themed to the recently released Disney/Pixar hit film “Ratatouille.” Along the route, participants encountered their favorite characters from the movie, including Remy and Emile, and passed a specially constructed Disneyland Resort version of the Arc de Triomphe. Even little runners (8 and under) joined in the weekend running fun with 100-, 200-, and 400-yard dashes.

The featured Half Marathon, affectionately dubbed "The Happiest Race on Earth," had 13,000 participants. Before the sun came up and the starting gun sounded at 6:00 a.m., they paused as the national anthem was played and  fireworks lit up the morning sky.  Then they were off on a 13.1 mile jaunt through Disneyland and surrounds. 

The runners battled the warm weather, beginning with a temperature of 81 degrees at the starting line that rose to 94 degrees by the time the last runner crossed the finish line.

The 13.1-mile landmark-filled route winds through the two Disneyland Resort theme parks, through the grounds of the Anaheim Ducks Hockey Arena, along the Santa Ana River Trail, makes a loop of the Angels Stadium baseball field, and finishes in front a large crowd in the Downtown Disney Shopping area.  

“The course is especially friendly for spectators,” explains Cary Ostergaard of Pensacola, Florida. “I saw my family at several locations, which really helped me get through the race.”

Some runners could not resist stopping mid-race to pose with Mickey Mouse and his pals for photos commemorating both the race and Disney Parks' ongoing “Year of a Million Dreams” celebration. Half-Marathon race finishers earned a special, over-sized commemorative medal depicting Sleeping Beauty’s Castle at Disneyland.

George Ashley, Nancy Bargman, Luz Cortex, Dennis Faix, and Cary Ostergaard competed in the Half Marathon representing OAR and the RUN FOR AUTISM. Ashley will travel to Washington later this month to be part of the team at the Marine Corps Marathon as well.

Though small in numbers, the team raised almost $6,000. Although the date for the 2008 race has not yet been set, look for the Disneyland Half Marathon to be part of the next year’s RUN FOR AUTISM schedule.  

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RUN Profile: Raising Autism Awareness and Money for OAR One Marathon at a Time

Greg Simpson is on a mission.  When he started in 2006, it was a serious personal challenge—running a marathon in each of the 50 states. Now with 31 more to run, he’s making it something more. By the time Simpson is finished, he will have run 1,310 miles. And that’s just the miles he’ll log running marathons, not the training miles he’ll put in as he prepares for each marathon. His goal is to complete his quest  by 2009.

While his personal challenge began as a way to push his limits to achieve something than not many have accomplished, set a goal and then figure out how it could be done, it changed when he saw the OAR tent at the Marine Corps Marathon last year. “My nephew has autism, and I immediately saw an opportunity to use my running efforts to raise awareness about autism and especially about the issues that older children and adolescents with autism face,” says Simpson, who is the father of two children, Maya, 4, and Gregory, 1. “So much attention is paid to young children with autism as they are diagnosed and get their educations. But there’s not as much attention given to teenagers and young adults who are living with autism. My nephew will graduate from high school soon, and he may never move out of his parents’ house.”

Simpson said fatherhood has heightened his desire to make OAR a partner in his 50-state marathon challenge. “Since our son and know that autism affects males more than females, my wife and I relate even more to parents of children with autism as we watch Gregory and track his development.”

Thanks to Ed Schwallie, an OAR board member, Simpson believes that his efforts can even more successful in raising awareness and funds for OAR. Schwallie, who has sponsored runners in every year since OAR started the RUN FOR AUTISM, jumped at the chance to adopt Simpson and has begun spreading the word among his family, friends, and colleagues about Simpson’s efforts. “I’ve been telling everyone I know that I’m running but after a few marathons, that gets old. I’m so grateful that Ed is going to help me leverage my fundraising,” Simpson says.

“I’ve been involved in fighting battles on behalf of my sons (one diagnosed with autism and the other with Asperger Syndrome) for 40 years,” Schwallie explains. “I admire Greg’s commitment to run for autism by running a marathon in each of 50 states. In many ways, it is symbolic of the long life journey we parents take with autism.  The fact that he is willing to give so much time and effort on behalf of the cause was what made me decide to sponsor him.”

Simpson explains that his approach to training and running is not so different from things people with autism or their parents and teachers do. It’s a matter he says of breaking big goals down into smaller achievable tasks. Take running a marathon for example. “Sure, it’s daunting to think of spending over four months training and then running 26.2 miles. But I don’t look at it that way. I look at what I have to achieve right now, like the training runs I do during the week. While my efforts are similar, running a marathon in each state is nothing compared to the challenges that those with autism face and overcome on a daily basis.”

To find out more about Simpson’s marathon efforts or to contribute to his 50-state marathon challenge, visit his Web site at www.firstgiving.com/50.

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