Health Promotion Healthcare Parity
The Health Promotion/Healthcare Parity Program began in 2011 by Dr. Susan Havercamp with funding from The Columbus Foundation for the Be Healthy Information Program (BHIP); to develop and disseminate nutrition, physical activity, oral health, sleep, abuse and exploitation fact sheets in English and Spanish for children and adults with developmental disabilities. Through a collaboration with the LEND Program, we also developed a patient encounter for medical students that involved adults with autism spectrum disorder and family members in an effort to prepare future physicians to provide quality care to patients with autism; and developed an online Autism Curriculum Guide as a resource on including patients with autism spectrum disorder in healthcare training.
In 2012, through collaboration with the Ohio Department of Health, the University of Cincinnati UCEDD, and the Ohio Colleges of Medicine Government Resource Center; we applied for and received funding from the Centers for Disease Control and Prevention to support a state-wide capacity-building disability and health program (ODHP). Ohio is one of only 18 states to receive this funding. The Ohio Disability and Health Program (ODHP) works to improve access to healthcare, health promotion, and emergency preparedness for Ohioans with disabilities. With input from the disability community, ODHP has worked on numerous activities towards these goals, including raising awareness of disability among programs at the Ohio Department of Health, assessing the accessibility of federally qualified healthcare centers, providing disability training modules for first responders, and more.
In 2013, The Columbus Foundation and the Health Promotion/Healthcare Parity Program also supported the Positive Exposure project which included exhibits and Grand Rounds at the Wexner Medical Center and COSI. Positive Exposure, a campaign designed and created by Rick Guidotti; is a dynamic media campaign that aims to promote positive attitudes towards people with disabilities and genetic differences. A permanent collection of Positive Exposure images now hangs in McCampbell Hall at OSU Nisonger Center.
In the years to come, the Health Promotion/Healtcare Parity program will continue to work to improve the health and well-being of Ohioans with disabilities and ensure that healthcare providers are equipped to provide quality care to this population. For more information please visit our website www.nisonger.osu.edu.
Interdisciplinary Clinical Services
Nisonger has provided interdisciplinary clinical services for children and youth since its inception. Today’s Interdisciplinary Developmental Clinic and School Aged Autism and Developmental Disability Clinic emerged from the early interdisciplinary practices of the 1970’s when families would come a stay at the Nisonger Center for several days while a child was being evaluated. In the 70’s and 80’s there were few professionals in the community trained in developmental disability. Drs. Henry Leland, James MacDonald, Marion Chase, and Don Cavin were some of the early faculty who developed interdisciplinary practices with children with DD and their families.
Outreach across the state was also part of the Nisonger clinic’s mission. In the 90’s and early 2000’s Nisonger collaborated with the Ohio Department of Health and local public health nurses to provide developmental assessments to rural counties across southeastern Ohio. For more than 10 years the interdisciplinary team from Nisonger travelled to these clinics (often meeting in community churches) to evaluate children suspected of having developmental delays.
Today’s interdisciplinary clinics at Nisonger remain a model for training interdisciplinary professionals in neurodevelopmental disabilities. Children and youth and their families receive intensive and personalized care from our highly skilled clinical teams so that they can participate optimally in their schools and communities.
For more information about our clinics, contact us at (614) 685-6701.
Clinical Trials
First funded in 1997 by a NIMH grant award, The O.S.U. Research Unit on Pediatric Psychopharmacology (RUPP) was directed by Dr. Michael Aman, and Dr. L. Eugene Arnold has been the chair of the steering committee for the entire NIMH Autism RUPP Network since 1998. The RUPP conducted pivotal trials of both drugs and psychosocial treatments in young people with autism spectrum disorder (ASD); including risperidone (Risperdal), methylphenidate (Ritalin), guanfacine (Intuniv, Tenex), and parent training in behavior management to help reduce serious challenging behaviors of children with ASD.
With additional pharmaceutical contracts activities launched through (“research investigator initiated”) research projects, the O.S.U. RUPP morphed into the Nisonger Center Clinical Trials Program. Drs. Aman and Arnold have also provided extensive consultation to the pharmaceutical industry and have been involved in a number of multi-site trials including pharmacological and behavioral management of aggression and assessing medication and parent training in children with ASD and ADHD.
This program has since expanded to include not only established medical and psychological treatment, but also complementary and alternative treatments, such as comprehensive motion apparatus, zinc supplementation for ADHD, digestive enzyme for gastrointestinal dysfunction in autism, and cholesterol supplementation for children with autism and low cholesterol. Current studies and research interests include essential oils (aromatherapy) for quality of life, anxiety, and sleep disturbance in autism, neurofeedback (EEG biofeedback) for ADHD, and amitriptyline and loxapine for aggression in developmental disabilities. Current grant applications include the study of probiotics for anxiety and quality of life in autism.
Toy & Technology Library
With initial start-up grants written by Dr. Jane Case-Smith and approximately 300 available items for loan, The Toy & Technology Library first opened its doors in December of 1990 (originally The Adapted Toy Library); and held open houses to community and educational leaders in January of 1991. By the end of 1992, services had been provided to 157 children with developmental disabilities.
In the early 90’s, through the support of Dr. Elsie Heslel, parent mentor positions developed and have continued, in addition to implementation of satellite library locations at Easter Seals Rehab Center, Childhood League, Dublin City Schools, Columbus Speech and Hearing, E.S. Weiant School, and Nationwide Children’s Hospital.
In addition to supporting families, the Toy & Technology Library has always had a strong commitment to expanding the knowledge and awareness of university students in the area of Assistive Technology. Guest presentations for courses have been given since the first year the TTL opened its doors. These presentations have covered a wide range of AT related topics and have been given to a wide range of majors, including special education, speech and language, occupational therapy, physical therapy, psychology, engineering and early childhood education in addition to the LEND trainees at Nisonger Center. Thanks to a partnership with the OSU College of Engineering, each year several toys are adapted and donated to the library.
Today, under the leadership of Mary Jo Wendling, the library holds over 1500 available toys and has served more than 3,000 children and their families across Ohio and the U.S.
The LEND Program
LEND is an advanced graduate interdisciplinary leadership program of The Ohio State University Nisonger Center. The program is funded by the Maternal and Child Health Bureau (MCHB), and coordinated with clinics and projects at Nationwide Children’s Hospital.
The training program teaches MCH leadership competencies through an integrated curriculum of coursework, interdisciplinary clinical and leadership activities, and research. LEND leadership projects focus on health promotion and prevention, early diagnosis, treatment, and follow up care for individuals with neurodevelopmental disabilities (NDD) and their families.
The curriculum includes learning opportunities in urban and rural community based settings and participation on a variety of regional and state projects related to public health services. Trainees learn to critically evaluate and analyze the influence of family, community, and society on the health outcomes of individuals with NDD. Factors relating to culture, the environment, geographic location, and the influence of socio economics on health and healthcare quality and availability are explored, critiqued and analyzed to develop innovative responses to these problems. Family Centered Care is a core tenet of the LEND curriculum.
Dental Program
The Nisonger Center Dental Program has been providing comprehensive dental services to individuals with intellectual and developmental disabilities for approximately 45 years. Dr. Jack Whittaker directed the initial program when it was located at Buttles and High, but no direct dental services were able to be provided. The program blossomed when Dr. Ed Sterling was recruited from Oregon. Drawing on his experience from a similar program, Dr. Sterling opened the facility in McCampbell Hall as a fully functioning pediatric dental program. Dr. Sterling initially received some funding from the State of Ohio with the assistance of Ray Anderson. Starting in 1978, however, the program began to receive funding from what is now the Franklin County Board of Developmental Disabilities (FCBDD). The program still contracts with FCBDD to this day, and the program owes much of its success to the support of the county. Over the years, the program has served thousands of individuals with a broad range of intellectual and developmental disabilities.
Between the program’s two clinical sites, the majority of people the program serves are still pediatric patients, but the program has evolved significantly over the decades. The McCampbell Hall location has grown along with its patient base, and the majority of individuals seen in this location are adults. For quite a while now, the on-campus facility has served individuals through their lifespan. In 2003, with the support of FCBDD, the dental program expanded. A dental treatment area was included in the Franklin County Family and Early Childhood Center on Johnstown Road. This collaborative community facility was well received and began its rapid growth when Dr. Diego Solis was hired to oversee this clinical site. The Johnstown Road dental clinic serves children and has become a dental home for many children affected by disparities in access to dental services due to socioeconomic and ethnic factors.
The dental program at the Nisonger Center with the support of the College of Dentistry and Nationwide Children’s Hospital is one of the only programs in the country that provides didactic and clinical experience for all dental students, dental hygiene students, and pediatric dental residents in the care of people with developmental disabilities. The program has impacted thousands of students through the years.
Following Dr. Sterling’s retirement and Dr. Solis’s interim directorship, the Nisonger Center recruited Dr. Tim Followell as director in 2012. Dr. Followell is excited to follow in the rich legacy established by Dr.Sterling. Over the next 50 years, it is anticipated that the Nisonger Center Dental Program will evolve as our society continues to learn how to best care for individuals with disabilities. The program will maintain and promote an atmosphere that emphasizes people’s abilities and fosters an environment of diversity, respect, and inclusion.
Behavior Support Services
The Adult Behavior Support Services Program started in May, 2001. Drs. Betsey Benson and David Hammer responded to an RFP from the Franklin County Board of DD to develop behavior support services for adults who were receiving board services. A contract was awarded to Nisonger and since 2001, the Adult Behavior Support program has served over 950 individuals. The partnership with FCBDD continued to grow and currently 22 adult behavior specialists are working with over 300 individuals and their interdisciplinary teams in Franklin County to provide individualized behavioral assessment and consultation. In addition, 10 advanced graduate students in Psychology have received valuable training while working as behavior specialists in the program under supervision of experienced staff.
The Child Behavior Support Services Program began in February, 2005 under the leadership of Dr. Luc Lecavalier; with 2 employees and 20 individuals served. Since then, CBSS has served more than 1,000 different families and on average has 8 full time staff and 130 consumers being served.
Transition Services
Transition Services began in 1993 with the submission of a 4-year $300,000 supported employment grant application by Drs. Tom Fish, Bruce Growick and Margo Vreeburg Izzo in collaboration with Ohio Department of Developmental Disabilities and the OSU College of Education titled ‘Get SET: Ohio’s Supported Employment Training (SET) and Certification Program’; to design and deliver a nine credit supported employment certification program to 150 school and agency personnel to increase supported employment outcomes for high school students with significant disabilities and recruit inter-agency teams involving service providers from schools, rehabilitation and MR/DD agencies who agree to jointly enroll in the certification program and collaborate to increase supported employment outcomes locally. Transition and supported employment services were delivered to over 450 youth with significant disabilities.
Drs. Fish and Izzo since expanded the Program to serve thousands of persons with disabilities, especially youth and adults with intellectual disabilities (ID). To date, this program has been awarded over $6.4 Million in Federal, State and Local grants to fund initiatives and outreach efforts that focus on enhancing skills and opportunities in employment, literacy, social and community involvement and education. Currently, 14 Transitions Services staff develop, deliver and evaluate state-of-the-art 21st century programs, products, and services that support the needs of transition-age youth and adults with disabilities; ages 14 to adult; from all disability categories as well as their families, teachers, administrators, and service providers. With a focus on college and career readiness, students/participants are able to increase positive post-school outcomes in education, employment, and independent living.
• EnvisionIT (EIT) is a 21st century curriculum that has assisted more than 1,000 students to develop their own self-directed transition plans as they learned information literacy skills. Currently, this curriculum is scaling-up in schools across Ohio, New York, and Connecticut.
• Transition Options in Postsecondary Settings for Students with Intellectual and Developmental Disabilities (TOPS): Over 50 adults with ID have gain a college experience that is designed to increase self-determination and employment outcomes. Through partnerships with employers at Ohio State University Wexner Medical Center and the Columbus Zoo, we have 100% of our graduates employed in positions that range from customer service to general services assistant at an average hourly wage of $9.22 and working on average of 22 hours per week.
• Ohio’s Statewide Consortia: Improving Employment Outcomes through Postsecondary Education is expanding college programs at four of our partner institutions of higher education: Marietta College in the SE Ohio; University of Cincinnati in SW Ohio; University of Toledo in Northwest Ohio; and Youngstown State University in NE Ohio. Together, Ohio’s Statewide Consortium is providing college and career experiences that increase employment outcomes for students with ID.
Under the leadership of Margo Izzo, the Transition Services Program continues to conduct research and deliver high-quality transition services.
For more information on any of these programs, please contact transitions@osumc.edu.
Early Childhood Education/Early Intervention Program
Providing quality early intervention services to students with intellectual and developmental disabilities since the late 1970s, Nisonger Center’s ECE program first originated as the need arose to begin providing services to infants and toddlers with disabilities to enhance their development, increase the capacity of families to meet the special needs of their children, and to maximize their potential for independent living in society. Over the last four decades, we have provided services to approximately 5,500 children between the ages of 12 months to 5 years. Multiple service providers and disciplines including Early Intervention Specialists, Occupational Therapists, Physical Therapists, and Speech and Language Pathologists are the catalyst to helping children meet educational and therapeutic objectives.
During the late 1980s, Nisonger Center was at the forefront of educational inclusion and peer-model research in early intervention and early childhood education and began the practice of including typically developing children in the classroom environment as peer models. This model of inclusion continues today as the Nisonger Center has established its first full-day early childhood childcare program inclusive with the half-day early intervention program. This model strives to support the awareness that all children can learn in a natural and supportive classroom environment encompassing of the needs of everyone.
With an interdisciplinary team approach to providing services and all interventions being provided within the classrooms, our teachers and therapists are able to design and guide early education experiences to appropriately support the needs of the children. We also provide direct family support by conducting home visits that encourage parents and caregivers to participate in meaningful learning activities and experiences with their children. This model of providing intervention in the child’s natural environment builds increased communication, trust, and an unwavering support between families and service providers. The Nisonger Center ECE Program also provides itinerant early intervention services to students enrolled at the OSU Childcare Center who qualify for services under Help Me Grow.
As Nisonger Center continues to progress in early intervention and childcare, we extend our support to OSU students and community of learners by involving the program as a practicum site and clinical training site for students interested in the field of Intellectual and Developmental Disabilities. In maintaining a model early intervention and early childhood program grounded in educational and therapeutic best practice, Nisonger Center will continue to thrive on its mission by working with families to support and advance the development of children with and without developmental disabilities.
For more information about ECE/EI services contact Dr. Katie Walton at (614) 685-9087 or katherine.walton@osumc.edu.
Williams Syndrome Clinic/Program
The Williams Syndrome Program began in October, 2007 by Dr. Marilee Martens; after extensive research and consultation with other clinics in Boston, New York (Montefiore); and advisement by Drs. Coury and Reese. From 2007-2014 our clinicians saw an average of 36 patients per year; and of those approximately 30-35% were new patients. An additional clinic day was added each month in 2014 to help alleviate the pressure of a 9-month waitlist and although this clinic typically sees children, Dr. Martens hopes to add an adult clinic by Fall 2016. Only a few families are from Columbus, most are from throughout Ohio and surrounding states, with a few from Wisconsin, Georgia, Illinois, and Colorado. Our interdisciplinary team includes a Developmental Behavioral Pediatrician, Psychologist, Speech/Language Therapist, Occupational Therapist, Physical Therapist, Social Worker and recently, a Music Therapist. If necessary we also may include a Genetics Counselor, Cardiologist, Endocrinologist, Hearing Specialist, Ophthalmologist, or other Specialists.
Each year our Williams Syndrome Clinic/Program hosts an annual gathering in the fall; where families can find support and additional educational resources, and children can learn, play and engage. In 2015 we had approximately 24 families (75 individuals) and 3 pet therapy dogs participate in the retreat.
For more information about our Williams Syndrome Clinic/Program contact Dr. Marilee Martens at (614) 688-3112 or marilee.martens@osumc.edu.
Social Programs
Aspirations is a social and vocational support group program for young adults with higher-functioning autism ages 13–30+; that began with 5 participants in 2003. Under the direction of Dr. Thomas Fish PhD Nisonger Center Social Programs Director, and Ashleigh Hillier PhD a Psychologist with the Department of Neurology; this group helped translate social interaction strategies to the workplace environment and group leaders would facilitate in an atmosphere of acceptance and friendship. While there were some vocational programs in existence at the time, there were initially no programs that addressed the social emotional support needs for these young adults and their families. In 2007, Jeffrey Siegel MSW began as Program Coordinator.
Teen Aspirations began in 2009 to help teens (ages 13-19) through transition years and develop friendships with others. Initially with 4 participants, this program has grown to serve over 170 individuals. Adult Aspirations has since grown to serve over 350 individuals. Aspirations also now includes monthly reunion groups, a Women’s group and Guy’s group that meet monthly. In addition, there are special series topics offered for Adult Aspirations graduates such as employment, relationships, and anger management. Our goals are to develop self-awareness and insight, learn to experience positive social interactions and relationships, foster insight into the importance of rewarding employment, explore solutions to challenging situations in our personal and professional lives, and foster friendships.
The Next Chapter Book Club (NCBC) was established in June 2002 by a committee dedicated to lifelong learning and community inclusion for people with developmental disabilities (DD). This committee consisted of Tom Fish of The Ohio State University Nisonger Center along with representatives from the Ohio Department of Developmental Disabilities, the Franklin County Board of DD, Borders Books and Music, two individuals with DD, and a graduate student.
The committee discussed the prevailing assumption that adults with DD are not readers, nor are they interested in lifelong learning. The group also discussed the isolation and segregation experienced by so many adults with disabilities who are living in, but not a part of, their communities. Committee members suggested that it would be fun for people with DD to participate in book clubs in inclusive community settings such as bookstores and cafés. Thus, NCBC was formed to integrate learning and social activities in community settings. The basic premise of NCBC is that anyone can participate in a book club, regardless of their reading level.
NCBC is now the largest community-based literacy program for people with DD in the world, serving over 2,000 people weekly in book clubs across North America, Europe, and Israel. Clubs gather each week for an hour in public settings such as bookstores and coffee shops, where members read aloud and discuss a book of their choosing. Members are supported by each another as well as two volunteer facilitators who are trained to engage people with a wide range of abilities. In 2011, book clubs led to writing clubs, and Jot It Down was formed. Jot It Down (JID) clubs focus on creativity and self-expression, and like NCBC, include people of all abilities. There are five JID clubs in Franklin County, and many more across the country.
For more information about Nisonger Center Social Programs, contact Dr. Tom Fish at (614) 685-8723 or thomas.fish@osumc.edu.