Stefania Terracciano

The birth of the new center 'A hole in the wall' is a long overdue response to those who are struggling to overcome the difficulties of approach to autism speaks of him with Leonardo Fava responsible for the structure.

The international scientific community defined by the term 'autism' a pervasive developmental disorder with serious deficits in the areas of communication, social interaction, imagination, also characterized by various behavioral difficulties. Much progress has been covered by these first observations, developed by Leo Kanner (1943) and Hans Asperger (1944). In particular, recent years have been marked by specific research in neurobiology, neuropsychology, and neurochemistry.

Today we know that early diagnosis and targeted and intensive intervention are essential elements to achieve significant progress in the treatment of autism. This is the first principle on which it was born the new Center for the treatment of autism, "A hole in the wall." And 'now official and is a reality to which they look at the professionals, including international, the first real-Center "reception" at 360 degrees for children with the ABA and their direct references: the families and teachers support.

The first Italian Center can provide early treatment and a real immersion training for families, promoting a specific program, which enables all involved to deal with, even in the home, the complex dynamics that autistic spectrum brings.

• We will ask the manager of the treatments and relationships with the families of the structure, Leonardo Fava, if you can tell how it originated, how it is and what goals the Center offers?

An analysis conducted by the Foundation Handicap 'After Us', reported' impact more children and adults with autism. Born as a need that has emerged from this research, the Centre 'A hole in the wall', thought to be about two years, was made ​​possible thanks to the collaboration between the Foundation Handicap 'After Us' , consists of two founding partners: the City of Rome and the Bank National Labour , the ' Bambino Gesù , l ' Opera Don Calabria and with the participation of the Association 'Parents and Autism' . Made up with funding from the Vodafone Foundation and other supporters such as BNL Foundation , Soul , Mauro Paissan and Romans Markets Company , has among its main aims to give an immediate response to families whose children receive a diagnosis of autism, supporting them not only in treatment but also and especially in the training of teachers and educators to support reference.

• A goal, therefore, that compensates for the lack of concrete answers to the institutional. Where is it and who to contact for access to the Centre?

Located in the Opera Don Calabria, stands alongside the hospital infant Jesus, making the diagnosis at the department of neuropsychiatry directed by Professor Vicars. To access the center, you can then contact the hospital or contact us directly via the following channels: the site www.unabreccianelmuro.it , telephone No 06. 9594.8587 or e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it > This e-mail address is being protected from spambots. You need JavaScript enabled to view it . For those who contact us directly, even if provided with diagnosis confirmed in the other structure, a second diagnostic check will be conducted in the department of Professor Vicars.

• How is the training protocol you have chosen and what stage is marked?

The Staff

With previous experience at the international level, the protocol we have focused on two main aspects, the first concerns the intensive treatment of children at an early age from 18 months to seven years and the second is realized in the formation of the child's world of reference: the families, support teachers and educators working in schools with the child.

For the moment, we can treat about 56 children a year, divided into four groups of fourteen children each will be treated for an entire year. For 2010 you can register up to September, while from January 2011 you can enter new requests.

The training will continue for a year, will begin with an initial intensive period of 3 weeks each marked by different purposes.

The first will feature a cutting theoretical training, which begins with a detailed explanation of the protocol and the basic principles upon which the type of applied behavioral therapy: ABA-VB. All this accompanied by audio-visual experiences of real clinical cases resolved.

The second week of training will be practical, concrete performed on children by the team of therapists. In particular, with explanatory videos made ​​ad hoc, parents and teachers will have the opportunity to observe the therapist interact with your child. This will make it possible to explain and assist their parents in a personalized way.

The third week, however, the family will come in direct relation to applying lessons learned in previous weeks. In the first part of the week alongside the therapist, then the second, to become actors and players in the implementation of the Protocol learned. This phase will make the real consolidation of the training method in the approach to the child.

• A full immersion training, which will modify the behavior of all the way home?

In fact, in the weeks following the treatment should be taken independently at home, at school as well as learned and apply it for about an hour and a half hours per day as directed. This course will be accompanied and facilitated by three media. First, there are programs written for each skill, with specific details about the environment, the materials to be used, the procedure, the methodology to be applied and tailored advice on individual problems detected by both therapists and parents, found in teaching of each skill.

A second type of support consists of DVD demonstration model for each type of program to run with the child, which will collect all the recordings made ​​at the Centre during the first three weeks. Useful in cases where the parent should have some difficulty in applying the protocol at home.

A third type of media will be two hours of weekly supervision to be carried out at the Center for those who live nearby, for those who come from outside Rome, however, you can telephone or computer to accompany them.

• How does the therapy continues throughout the year?

You will return to the Center for a week, you can make an assessment of the child, realigning and adapting in an ever more personalized treatment programs, according to the development of the child during the previous three weeks. We will always work in an intensive nine to five and eventually return home for another three weeks. Replicating the time of absence / presence at the center as shown above, for the rest of the year of treatment.

• Training in the round and then to make self-sufficient therapists, teachers and family support. How did you get this therapy and to identify what is innovation?

We have proposed this model of treatment based on findings from scientific assessments performed on various types of behavioral therapies at an early age. The participation in an integrated and shared a specific method such as ABA-VB is supported by teachers, and therapists, alongside the families, develop more effective with surprising results, greatly amplifying the results.

Innovation is to promote a protocol validated for several years at the international level, but with a different organizational approach, which consists in applying the method in three different environments:

In the first room, the activity is between a therapist and a child, where you work in a more structured way, in an environment without distractive stimuli, where the action is handled by the adult special education.

The second environment is an environment where gambling activities are planned for social interaction among multiple children, this is where you begin to develop relational skills, particularly inadequate in this type of pathology.

The third environment, always game, similar in shape and size of the previous one, but in which you give your child the chance to express themselves freely, ie to decide whether the activities, games and interact with. Therapists focus on treatment in this environment working mostly on the spontaneity of the child, teaching him how to interact in an adaptive and functional objects of his choice.

• Over time, you think to pool the scientific community a statistic features and results of these therapeutic approaches?

In this respect, right now we have a database with two streams: a system of data taking and another evaluation of the treatment, I have known and used during my previous international experiences.

• We now show that a ticket is required of 450 euros per month, speaking of a public facility in the future maybe we can hope a reduction / exemption of the same?

It 'requires clarification: the center, while collaborating with the Child Jesus, is not a public facility, not a branch of the Hospital. The financial commitment required of families is much lower than the cost of treatment ABA-VB and covers only part of the real costs, for the first year funded by individual supporters and by an intense fund-raising activities, which still continues to ensure the future of the center.

• In light of the findings could, with the opportunity to launch an appeal to the institutions to achieve the objective of free time provided by the NHS?

The 'main commitment we made ​​with all partners of the project is to propose to the National Health System recognition of this type of behavior therapy. Today there are only recognized as the treatment of speech and locomotion, and validated therapies certainly useful, but which are not specific for this type of pathology. For this we are committed to the facts proven to achieve results and presented at a scientific level in an objective manner, hoping thereby to obtain recognition by political and regional contacts, in order to cut costs for families who are confronted with this type of problem.

• As he told us seems to meet the expectations of those who work in the field for years, after a running-in phase is expected snapping to other companies to replicate the existing protocol, and in time hope to open new centers?

We opened the center with just this goal in 2008 following the directions given by the table Autism sponsored by the Ministry of Health, which outlined the need to consider this type of neo-behavioral therapies and to find an Italian way and demonstrated specific functional and effective on this type of disorder. To this end, we got 'network' as well as internationally, as we have already expressed, both in national terms thanks to an agreement with the Child Jesus, as the center for autism hospital of Cagliari "Brotzu" . Of course, this is only the beginning and we are willing to create new networks, for anyone interested in replicating the protocol developed and tested over many years. To construct new realities in the concordance of views similar: both in approach, both in the kind of serious, consistent, both in carrying out a shared care. All of us now work to demonstrate what is possible with this type of care, more and before we achieve our objectives.

• In the future, then we could hope for a real network training .. for trainers?

Of course, a training network that aims to support new teachers as professionals who now work very hard, but could do more if provided with appropriate tools.

Thank you for everything you have shared, then opened his heart for giving us the hope of a better future. With the first 'hole in the wall' of autism, we believe that working hard and relying on a previously validated methodology such as yours, has in fact created an Italian model of reference and we are confident that this first breach in the wall will become a model to replicate not only in Latium, but in all Italian regions.

ST

Leonardo Fava

Graduated in Psychology at the Faculty of Rome La Sapienza PhD executed, in fact, in the Netherlands at the University of Neimegen. Then he formed while working at a center for autism treated with this protocol. In particular, the efforts was to develop methods of organization and intervention more effective for some types of children rather than others. Thus developing a twofold experience: both as a therapist, both as a researcher, reported in evaluation of therapy in both groups of children, and the study of the individual. The work can be continued to the Hospital of Hamburg in Germany, working in the evaluation of the quality of life of parents with children with developmental delays: autism, speech disorders, epilepsy with cerebral palsy, etc.. Particular observation and analysis of how the development and improvement data from a treatment, they could influence and change the quality of life of the family and vice versa. Finally, past experience has been established in Canada working as a researcher at the University at Queens University in Ontario, in its role as coordinator of a longitudinal study, which included a consortium of universities and centers for autism is Canadian, and U.S. , evaluating the effects of treatment and studying the genetic causes this type of syndrome.