What is Autism? To begin, the Pervasive Developmental Disorder (PDD) diagnoses: Autistic Disorder, Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS), and Asperger’s Disorder are going to be consolidated into one single diagnoses in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) which will be published in May of 2013. The other PDD diagnoses: Childhood Disintegrative Disorder (CDD) will vanish whereas Rett’s Disorder, as the cause for the particular chromosomal dysfunction has now been discovered, will be removed from the DSM.
Soon to be called Autism Spectrum Disorder (ASD), it is a perplexing neurodevelopmental disorder with deficits in social communication – or more specifically, social interaction and non-verbal communication – and the presence of “restricted, repetitive patterns of behaviors, interests, or activities”[a] that may be due in part to “hyper-or hypo-reactivity to sensory input.”[a]
With a severity level scale of 1, 2, and 3, verbal communication delays are present with a 2 or 3 while with a 1, formerly known as Asperger’s Disorder, academic and language skills are generally high. Also with a 1, these individuals have a narrow array of interests (meaning ‘savant’-like ability to recall exact details about a particular topic which becomes overly obsessive); difficulty with using pragmatics in a conversation (ranging from difficulties in facilitating and maintaining a conversation to a perseverative, and often, redundant flow of a conversation); as well as a lack of understanding the basic fundamentals of joint attention used for perspective taking, also known as Theory of Mind or social cognition; and non-verbal communication, such as reading someone else’s body language and establishing eye contact. Obsessive compulsions, sensory integration deficits, social anxiety, and tics often overlap.
In addition, experts say Asperger’s is quite similar to Attention Deficit Hyperactive Disorder (ADHD), just more severe. Asperger’s is also marked by profound “mind-blindness,” as well as inappropriate social approaches, the failure to understand emotions (also known as cognitive empathy),[a] and these individuals cannot interpret social cues which leads to them not forming friendships.
Temple Grandin, Ph.D., a world-renowned author and lecturer living with Asperger’s who was diagnosed with severe autism in 1949 (prior to receiving intensive, home-based speech therapy), suffers from the social anxiety trait of the disorder. She “described her inability to understand social communication of neurotypicals, or people with normal neural development, as leaving her feeling ‘like an anthropologist on Mars.’ “[b] In addition, Dr. Grandin recalls being bullied throughout middle and high school. For instance, she demonstrated clear difficulties with conversational skills as she spoke in a perseverative and redundant flow. Because of this, the students ridiculed her by calling her “tape recorder.”
Despite Grandin’s struggles, she has a flourished career. Her obsessions and ‘savant-like’ ability enabled her to develop cattle livestock facilities currently used across the United States. Dr. Grandin is also a best-selling author; her most famous book being Thinking in Pictures: My Life with Autism. She received a Ph.D. in animal science from University of Colorado. Moreover, she presents sold-out lectures on the autism spectrum throughout the nation and was the subject of the Emmy Award-winning HBO biopic TV movie Temple Grandin (2010).
Individuals with mild Autism Spectrum Disorder (ASD) need to receive Social Skills Training (a form of Applied Behavior Analysis or ABA[1]), Social Cognition and Interaction Training (SCIT), Social Thinking®, Speech Therapy (including Social Communication Intervention Project (SCIP) and The Hanen Program®‘s TalkAbility™), Cognitive-Behavior Therapy (CBT, a common form of psychotherapy used for the treatment of anxiety and mood disorders), and often, a supportive school environment to succeed.
PDD-NOS, a diagnosis sometimes used to address only social and communication deficits, will now be called Social Communication Disorder (SCD).
Visible signs of ASD early in life may include: not responding to their name and a lack of eye contact (i.e., staring at the ceiling for hours); repetitive behaviors that include lining up their toys, spinning objects, and stereotypic movements such as hand-flapping, rocking back and forth, or head banging; significant delays in language by 12 months of age; and echolalia, the repetitive use of speech without meaning; insomnia, the inability to sleep at night; and periodic hissy fits. With severely autistic children, they are also withdrawn socially.
Currently, as of spring 2012, affecting more than 1 in 110 children and over 1.4% of boys in the United States, it is more common than AIDS, cancer, and diabetes in youth. Nevertheless, the increase from 1980 to 1994 was due to the revision of the diagnostic criteria. Because, prior to 1980, “Infantile autism” was classified as a form of childhood schizophrenia combined with mental retardation. Despite this, it is truly an epidemic because the diagnostic criteria for autism has not changed since 1994, back when it was as common as 1 in 1,000 children in the United States.
Moreover, according to one of the directors of the Centers for Disease Control and Prevention (CDC), it has become more of a struggle to diagnose; young children do not receive a diagnosis until they are over four years of age. Since this is data taken from 2006, I noted that it actually affects more than 1 in 110 children.
With the rise in children diagnosed with ASD,[c] a large portion of them seem to have gastrointestinal issues, celiac disease, and a series of other immune dysfunctions. Moreover, a number of replicated studies have tested autistic children positive for methyl mercury, which is a highly noted neurotoxin that cause developmental delays and brain damage.[c] This can be successful treated with a biomedical intervention (such as diets). Environmental toxicants[c] – such as methyl mercury in air pollution[d] and tuna fish,[c] as well as arsenic poisoning in chicken, apple juice and aluminum cans – are most likely to blame. Nonetheless, it is vital to conduct more research to substantiate these theories.[c]
There is a wide range of early intervention modalities used to treat autistic children. They include behavioral, biomedical interventions, and developmental, play modalities.
Despite the absence of a “definite” cure, studies show that a child may fully recover from autism if they receive intensive therapy before age five. Some children have been reported as fully recovered in later years such as six or seven years old; in rare cases, they fully recover as late as adulthood. The reason as to why most do not feel this is possible is because of the following: scientists argue that the control groups conducted featured only a small portion of children, studies have yet to follow these children up to adulthood who remain fully recovered nor has anyone provided evidence of the countless factors that contribute to it, and finally many people are still viewing previous research made over a decade ago. With that said, whether or not a child fully recovers, it is vital in a child’s development to receive intervention as early as possible.
For those who have not obtained skills from typical behavior intervention, a new method of treatment has recently been developed that is a developmental behavior therapy and is clinically proven to help some autistic children gain academic and language skills.
Lovaas Method of Applied Behavior Analysis (ABA)
The Lovaas/UCLA Model is an Early Intensive Behavioral Intervention (EIBI) using a philosophical practice known as Applied Behavior Analysis (ABA)[1]. It was pioneered by the well-known college professor and clinical psychologist Dr. Ivar Lovaas at University of California, Los Angeles (UCLA). Substantiated as the most effective intervention for autistic individuals, its effectiveness has been noted by such federal agencies as the Surgeon General’s Office (US), New York State Department of Health, American Academy of Pediatrics, American Psychological Association (APA) and the Centers for Disease Control & Prevention (CDC). Often times, it is used in combination with Positive Behavior Support (PBS, a form of ABA) to manage a child’s violent and self-injurious behavior.
History of Dr. Lovaas’ Use of Behavior Modification at UCLA
Unfortunately, in 1965, Dr. Lovaas had experimented on autistic children by implementing traditional Behavior Modification techniques to stop repetitive behaviors such as hand flapping, rocking back-and-forth, head banging, and injurious types of behavior. Such forms of punishment included aversive conditioning; the latter of which refers to appalling punishments, such as electric shocks and spanking the child. Lovaas had later stopped the use of such chastising treatment and began using positive reinforcement – rewarding positive behaviors – while not drawing attention to wrong responses or unsuitable behaviors.
In 1980, Lovaas was the author of the widely known book Teaching Developmentally Delayed Children: The Me Book, which recorded the controversial work he and his colleagues initially did with the children at UCLA. (It should be noted, however, that the electrical skin shocks were implemented by graduate students who are currently elderly or have passed on, and do not associate with any of the graduate students listed below).
In 1987, Dr. Lovaas and colleagues at UCLA conducted a groundbreaking study with 19 children in it who received 30-40 hours a week of behavior modification treatment.[e] Nine of them – 47% – obtained “normal educational and intellectual functioning”[e] and a follow-up study showed that eight of those children fully recovered and were successfully mainstreamed into regular education classrooms. In the study, the children had undergone Lovaas’ pioneer of, what is now known as, Discrete Trial Teaching (DTT). A one-on-one, adult-directed approach, it is based on repetition, breaking complex tasks down into simple ones, and rewarding correct responses with praise and reinforcers. There has since been a replication of that study in 2005 revealing a recovery rate of 48%.
As perfectly stated by an article on Wikipedia, “[Lovaas] was the first to provide evidence that the behavior of an autistic child could be modified through teaching.”[f] Several students of his – including Dr. Robert Koegel and Dr. Doreen Granpeesheh, both of whom assisted Lovaas in his 1987 study – have gone on to become successful professionals in the autism field.
Pivotal Response Treatment® (PRT®)
Pivotal Response Treatment® (PRT®, also called the Natural Language Paradigm (NLP)) is an Early Intensive Behavioral Intervention (EIBI) developed by Dr. Robert Koegel and his wife, Dr. Lynn Koegel, as a naturalistic play approach to teaching children with autism. It uses the child’s interests and motivation to teach certain skills, i.e., language. In addition, as oppose to Discrete Trial Teaching (DTT), the reinforcer is directly related to the child’s request. A clinic had opened up based on the couples’ teachings called University of California, Santa Barbara (UCSB) Koegel Autism Center. Dr. Lynn Koegel was featured on TV’s The Supernanny, where she trained a family how to help their severely autistic child speak.
Center for Autism and Related Disorders (CARD) model of Applied Behavior Analysis (ABA)
The Center for Autism and Related Disorders (CARD) was founded by clinical psychologist and board certified behavior analyst Dr. Doreen Granpeesheh, who currently serves on the board of directors for the Autism Society of America, in 1990. The center implements 30-40 hours a week of home-based Early Intensive Behavioral Intervention (EIBI) and is located in Tarzana, California.
The first technique the center implements is called Errorless Learning, a teaching procedure which uses B.F. Skinner’s Verbal Behavior. The second technique is called Discrete Trial Teaching (DTT, using less prompts). Then, skills are generalized outside of the home setting with play-based teaching techniques using Natural Environment Teaching (NET) and Fluency-Based Instruction. All of these teaching techniques make up the Lovaas/UCLA model.
In 2011, Arizona reported a study conducted by the center which tracked the progress of fourteen severely autistic children. Six – 43% of them – achieved “normal functioning”[g] in all areas of development and fully recovered. Moreover, they were successfully assimilated into mainstream classrooms. Dr. Granpeesheh and her staff have been featured in numerous news castings about dramatic recoveries made there. In addition, Granpeesheh produced and co-directed the award-winning independent documentary film Recovered: Journeys Through the Autism Spectrum and Back.
Recently, Dr. Granpeesheh had developed an online tool, known as Skills® and CARD eLearning™, for parents and teachers to learn how to implement affordable and highly effective ABA therapy which is also available as Positive Behavior Support (PBS) techniques for children with ADHD.
The center also recommends that the children be evaluated by a medical doctor to see if the child should be placed on a Biomedical intervention – such as a Gluten-free/casein, yeast, or dairy-free diet – because their belief is as follows: “How can you expect a child to learn and attend and try to be on task when you are trying to teach them things if they aren’t feeling well?”[h]
U.C. Davis’ Early Start Denver Model (ESDM)
Dr. Geraldine Dawson, who is also the chief science officer of Autism Speaks, and Dr. Sally Rogers developed The Early Start Denver Model (ESDM) at University of California, Davis (U.C. Davis). ESDM combines developmental, play, relationship-based techniques with an Applied Behavior Analysis (ABA) intervention. The two conducted a blind study in 2010 of 49 severely autistic children, whose diagnosis changed from autism to Pervasive Development Disorder, Not Otherwise Specified (PDD-NOS) and had gained significant cognitive, academic, and communication skills.
It is the second scientifically proven intervention next to Early Intensive Behavior Intervention (EIBI). As in EIBI, the first year seeks to reduce the child’s repetitive, stereotypic behavior. Then, as oppose to EIBI, they train the parents how to relate to their child by using structured play therapy techniques based on the traditional Denver Model. If the child avoids or becomes distressed over the social engagement, the therapist or parent will use parallel play to gain the child’s willing engagement. Lastly, they use Pivotal Response Treatment® (PRT®) to teach a child all the skills they are lacking.
Developmental Models
All these developmental interventions listed below lack scientific evidence. However, they can help children who are withdrawn from their parents and caregivers form meaningful relationships.
One popular approach is called Floortime™ or the Developmental, Individual-difference, Relationship-based model (DIR®). Pioneered by Dr. Stanley Greenspan in the 1990s, he co-authored a book that tells of his methodology titled Engaging Autism: Using the Floortime Approach to Help Children Relate, Communicate, and Think. Many occupational therapists use the approach and Adelphi University is the only college that still teaches this method. It involves joining a child’s repetitive behaviors and being playfully obstructive when the child moves away from interaction in order to help them relate to their parents and therapists through various acts of play. This is known as “opening and closing circles of communication.”[i] In DIR®, the child “climbs up the developmental ladder”[j] to achieve social developmental milestones.
The Son-Rise Program® was pioneered by campaign manager Barry “Bears” Neil Kaufman and his wife Samahria Lyte Kaufman for their toddler, Raun, who was diagnosed as profoundly autistic with a below thirty IQ in the early 1970s. At the time, it was considered to be a form of childhood schizophrenia, and Raun would spend his toddler years rocking back and forth, spinning plates, starring at the ceiling fan for hours, uncommunicative, and was totally withdrawn from his parents and reality. They were told to either put him in an experimental behavior modification program where they would whip and electric shock Raun or place him in a life-long facility.
Refusing to believe it was a chronic disability, his parents created dialogue sessions amongst themselves to shape their attitudes. Next, they created a non-distracting environment to work with Raun in. They chose their downstairs bathroom. And finally, they spun plates with him for hours and mimicked his repetitious behaviors of rocking back and forth and hand flapping. Through this approach, within several months, Raun smiled and made direct eye contact with his mother. They taught him through “unconditional love and acceptance”[k] as well as with praise, and three years later, he fully recovered with a near genius IQ and was considered indistinguishable from his typically developing peers.
An NBC docudrama, Son-Rise: A Miracle of Love, aired in 1979 that tells of the Kaufmans’ journey and which took home the Humanitas Prize in 1980. Son-Rise: The Miracle Continues, an award-winning book written by Mr. Kaufman, adapted the TV movie. Today, the Kaufmans are the founders and CEOs of The Option Institute and its’ Autism Treatment Center of America™ in Berkshire County, Massachusetts which teaches the methodology and additional counseling services, while Raun, now a thirty-something-year-old man, is the director of global education and graduated with a master’s degree from Brown University.
At The Option Institute, parents purchase to attend a weekly program which consists of the Option Process™ Dialogue, a psychodynamic approach to shape their attitudes. Furthermore, they are taught how to set up their own home-based, distraction-free playroom to work with their child in.
What differentiates Son-Rise from Floortime™ is instead of being playfully obstructive when the child moves further away from interaction, in Son-Rise, they continue to join, only this time through parallel play. They do this in order to get the child’s willing engagement. They also use a distraction-free playroom where the child stays in during their daily sessions.
Unfortunately, the center uses an excessive amount of marketing in an attempt to prove that they are the most efficient and no other therapy works. Despite that, there have been many success stories of families whose children recovered after using The Son-Rise Program®. One mother, after recovering her son from a mild-to-moderate case of autism using this method, created a website online called Kyle’s Tree House which features an array of therapies for parents to attempt with their afflicted children.
Relationship Development Intervention (RDI®) was pioneered by Dr. Steven Gutstein as a parent-directed, play approach designed for relationship building. The therapy was developed based on the concept of dynamic intelligence.
Other interventions
Treatment and education of autistic and related communication handicapped children (commonly referred to as “TEACCH” or “Structured teaching”) is a popular method and used in many schools. Developed by Eric Schopler at University of North Carolina, it is based on teaching visually, primarily through schedules.
Picture Exchange Communication System (PECS) is popular communication system which uses picture cards attached by velcro in a book. It is often times used in combination with EIBI and Speech therapy.
Social Stories™ is a widely used series of books written by Carol Gray, who serves as president of The Gray Center. The book series was developed for children on the autism spectrum to learn how to pick up on different social cues and interact appropriately with other people, such as their peers.
The Hanen Program®‘s More Than Words® is a proven speech therapy than can enhance verbal communication.
Notes
[1] Behaviorism is a branch of psychology that has been around since the 1890s. To understand what ABA is fully, you need to understand what Behavior Analysis is.
Developed by behavior scientist B.F. Skinner, Behavior Analysis is the examination of environmental events, or more specifically, antecedent stimuli and consequences, which has two subtypes including the Experimental Analysis of Behavior (EAB, the research in Behavior Analysis) (American Psychological Association, 2012; Behavior Analyst Certification Board). Formerly known as Behavior Modification, which never examined why certain behaviors were happening (Weiss, Harris, 2005; Lesley, 2000; Kohlenberg, Bolling, Kanter, Parker, 2000; Mace, Critchfield, 2010), Applied Behavior Analysis (ABA) is the professional practice of behavior analysis to everyday life through the application of Operant Conditioning (Long Island University, Post; Mace, Critchfield, 2010).
In other words, the goal of ABA is to prevent behaviors from reoccurring, understand its function, and to teach alternative ones (Lesley, 2000; American Psychological Association, 2012; Mace, Critchfield); Behavior Modification never did. This is usually accomplished through the implementation of a Functional Behavior Assessment (FBA) and Behavior Intervention Plan (BIP). In addition, Behavior Modification has a long history of using punishing aversives, i.e., electric shocks and spanking (Weiss, Harris, 2005; Lesley, 2000; Kohlenberg, Bolling, Kanter, Parker, 2000; Mace, Critchfield, 2010).
Apart from Early Intensive Behavioral Intervention (EIBI), other forms of ABA include the basic behavior management technique called Positive Behavior Support (PBS, such as School-Wide Positive Behavior Support (SWPBS)) (American Psychological Association, 2012); Organizational Behavior Management (OBM, to stay organized in the workplace) (American Psychological Association, 2012); Behavioral Economics, also known as Applied Behavioral Economics (American Psychological Association, 2012); Verbal Behavior (VB, used anywhere from teaching autistic children to speak to psychotherapy) (American Psychological Association, 2012); Criminology (James Madison University, 2012); Applied Animal Behavior (AAB, used for training animals such as canines) (James Madison University, 2012); and Clinical Behavior Analysis (CBA) (American Psychological Association, 2012).
CBA overlaps with Cognitive-Behavior Therapy (CBT) and encompasses various subtypes such as Voucher-Based Contingency Management (CM, used anywhere from treating substance abuse to breaking smoking habits) (American Psychological Association, 2012); Acceptance and Commitment Therapy (ACT, used for various things ranging from treating Generalized Anxiety Disorder (GAD) to Obsessive-Compulsive Disorder (OCD) to maintaining diet and exercise) (American Psychological Association, 2012); Social Skills Training of Relational Frame Theory (RFT); Functional Analytic Psychotherapy (FAP); Behavioral Pediatrics; Behavioral Medicine, also known as Behavioral Pharmacology (American Psychological Association, 2012); Behavioral Gerontology (used for elderly people) (American Psychological Association, 2012); Behavioral Activation (BA, used for the treatment of depression); and Habit Reversal Training (HRT, including its subtype Comprehensive Behavioral Intervention for Tics or CBIT).
Someone certified in EAB and ABA is typically called a Board Certified Behavior Analyst (BCBA) unless they are certified in animal behavior. These individuals are referred to as a Certified Applied Animal Behaviorist (CAAB).
*Note: Most people think that ABA is only related to autism treatment. Although a few books written by school psychologists state that ABA is a form of Behavior Modification, several authors of scientific journals have noted that the former is not specific to autism treatment (Dillenburger, Keenan, 2009) and no author of a journal has defined Behavior Modification since 1997 (and no journal has ever stated that ABA is a form of Behavior Modification either). In recent years, some researchers who conduct studies state that they used “behavior modification” in their experiment. However, it is an expired label and these researchers are still unclear about the true science of Behavior Analysis. Furthermore, ABA has a similar ideology to Behavior Modification – using reinforcement to modify behavior – but the two terms are not entirely synonymous.
For more information on the science, see here:
. “About Behavior Analysis.” BACB. Behavior Analysis Certification Board, Inc. Web. 24, Aug. 2013.
. Harris, Sandra L., and Weiss, Mary Jane. “Right from the Start: Behavioral Intervention for Young Children with Autism.” Section: “Behavior Management” (p.152). Right from the Start: Behavioral Intervention for Young Children with Autism. Bethesda, MD: Woodbine House, 2005. 1-171. Amazon Books. Web. 24, Aug. 2013.
. “Guidelines: Health Plan Coverage of Applied Behavior Analysis Treatment for Autism Spectrum Disorder.” BACB. Behavior Analyst Certification Board, Inc., 2012. PDF. Web. 24, Aug. 2013.
. Madden, Gregory J. “APA Handbook of Behavior Analysis.” APA Handbooks in Psychology. 2nd ser: 1-1174 (2012). APA. American Psychological Association, Aug. 2012.
. Dillenburger, Karola, and Keenan, Mickey. “None of the As in ABA Stand for Autism: Dispelling the Myths.” Journal of Intellectual & Developmental Disability. 1st ser: 1-3 (2009). ERIC. Institute of Education Sciences, Jun. 2009.
. Leslie, Julien C. “Steps towards the wider use of behavior analysis in applied psychology.” European Journal of Behavior Analysis. University of Ulster at Jordanstown, 2000. 24 Aug. 2013.
. Mace, F. Charles, and Critchfield, Thomas S. “Transitional Research in Behavior Analysis: Historical Traditions and Imperative for the Future.” Journal of the Experimental Analysis of Behavior 3rd ser. 93.293-312 (2010). National Institutes of Health . U.S. National Library of Medicine, May 2010. Web. 14. Feb. 2014.
. Kohlenberg, Robert J., Bolling, Madelon, Y., Kanter, Jonathan W., and Parker, Chauncey R. “Clinical Behavior Analysis: Where it Went Wrong, How it Was Made Again, and Why its Future is So Bright.” The Behavior Analyst Today. University of Washington, 2002. 24 Aug. 2013.
. “Behavior Analysis Certification.” Department of Psychology. James Madison University. Web. 24, Aug. 2013.
. “Graduate Certificate in Applied Behavior Analysis.” Graduate Program Departments: Psychology. Westfield State University. Web. 24, Aug. 2013.
. “Advanced Certificate in Applied Behavior Analysis.” College of Liberal Arts and Sciences. Long Island University, Post. Web. 24, Aug. 2013.
. “Applied Behavior Analysis & Autism.” Esteves School of Education. The Sage Colleges. Web. 24, Aug. 2013.
. Morris, Edward K, and Smith, Nathaniel G. “B.F. Skinner’s Contributions to Applied Behavior Analysis.” University of Kansas, 2005. 24, Aug. 2013.
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[b] “Autism.” Wikipedia. Wikimedia Foundation. Web. 24 Apr. 2012
[c] Baral, Matthew, and Adams, James B. “The Severity of Autism Is Associated With Toxic Metal Body Burden and Red Blood Cell Glutathione Levels.” Journal of Toxicology. Hindawi Publishing Corporation, 12 July 2009. Web. 25 Apr. 2012.
[d] Arehart-Treichel, Joan. “Autism Linked to Air Pollution In Preschool Children.” Psychiatric News. American Psychiatric Association, 18 Jan. 2013. Web. 17 Apr. 2013.
[e] Lovaas, O. Ivar. “Behavioral Treatment and Normal Educational and Intellectual Functioning in Young Autistic Children.” Journal of Consulting and Clinical Psychology 1st ser. 55.3-9 (1987): 1-7. APA. American Psychological Association, 28 Mar. 1986. Web. 24 Apr. 2012.
[f] “Ole Ivar Lovaas.” Wikipedia. Wikimedia Foundation. Web. 24 Apr. 2012.
[g] Faller, Mary Beth. “Autism Therapy Group Says It Cured 6 Kids.” Azcentral.com. The Arizona Republic, 12 Nov. 2010. Web. 24 Apr. 2012.
[h] Skills® Curriculum – Adel Najdowski – University of Southern California. Dir. Kunal Seenivasan. Perf. Adel Najdowski and Natasha Zouves. YouTube. YouTube, 16 Jan. 2012. Web. 24 Apr. 2012.
[i] “STAGE 3: TWO-WAY COMMUNICATION.” Dir Floortime. The Interdisciplinary Council on Developmental & Learning Disorders. Web. 24 Apr. 2012.
[j] “Six Developmental Milestones.” Dir Floortime. The Interdisciplinary Council on Developmental & Learning Disorders. Web. 24 Apr. 2012.
[k] Kaufman, Barry Neil. “Son-Rise: The Miracle Continues.” Foreword. Son-Rise: The Miracle Continues. Novato, CA: H J Kramer, 1994. 1-372. Google Books. Web. 25 Apr. 2012.
