Una Breccia nel Muro (English)

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Our mission | History | Services | Offices and contacts | References | Conferences

 

Our mission

Una Breccia nel Muro is a nonprofit association, created in 2011 to attend closely autistic children aged 2 to 12 years, providing access to individually tailored Intensive behavioral Intervention with the goal to improve their quality of life, immediately and long-lasting.

It helps families from the time of diagnosis, offering support during progress of acceptance and coping and providing specific parent training enabling caregivers to effectively implement the treatment strategies at the child’s home.

It offers Applied Behavior Analysis (Aba) training to teachers and school staff in order to allow for successful class-room integration, increase cognitive achievement and peer socialization.

It provides Aba specialization and extensive internships to behavioral therapist.

It establishes continuous evaluation of treatment effectiveness via a reliable and accountable approach to behavior change as an essential component of Aba programs. It engages in several lines of research on variables that contribute to better outcome, to expose research results to international scientific peer review practice.

It contributes to a dissemination of best practice information to the affected population as well as to an increase in autism awareness in public institutions and other stakeholders.


History

Una Breccia nel Muro’s founders’ first contact with autism has been within the service structure of the Foundation Handicap: dopo di noi. The Foundation providing services for families with disabled adolescent or adult family members, could not meet the needs and respond to an increasing variety of families asking support for their children with neuropsychiatric disorders and specifically with autism. Soon, the Foundation committed to a central engagement towards an autism specific service structure. The experience of the positive impact that has an early intensive behavioral intervention through Aba, Applied Behavioral Analysis), when family members are actively involved in treatment provision inspired us to start at February 2010 the first treatment center for autistic children aged from 2 to 6 years at Rome, named Una Breccia nel Muro – UBM. The scientific support of the pediatric hospital Bambino Gesù and the precious disposition of the relief organization Opera Don Calabria to provide the structure were essential to build up the therapeutic setting.

One year after, the Foundation Handicap: dopo di noi was transformed by the municipal administration of Rome, as one of the associate founder, in the Foundation Roma Solidale. The new Foundation Roma Solidale evaluated the project addressing the needs of autistic children as non-strategic and announced its closure. However, as results obtained with the first children that followed the project went beyond expectations and pressing demands of the included families to continue the services led us seek an possibility to meet their needs. At the end of October 2011, nine former associates founded a new volunteer association named Una Breccia nel Muro that carried over the autism project.

Soon, the pressing needs of families with autistic children let to the expansion of the services for children aged 7 to 12 years, allocated in a second center. Its inauguration took place the 2nd April 2012, the United Nations’ World Autism Awareness Day. In this occasion, a housing structure named Casa di Sergio was renovated and furnished in order allocate during treatment periods the enrolled families that live out of town.

Meanwhile, services have been extended in various directions. The association became partner in specializing Master courses in ABA techniques and provides extensive internships for enrolled Master students as well as stages for students from other universities such as Cattolica-Policlinico Gemelli di Roma, Federico II di Napoli, Tor Vergata di Roma, Università degli studi di Roma La Sapienza).

Una Breccia nel Muro’s commits to the scientific method as the only valid approach to evaluating treatment for autism. Our overall approach to research includes any topic which holds promise to improve the lives of individuals affected by autism and is of practical value to the families we strive to support. Our mission is to disseminate our research findings through scientific publication and active participation at national and international congress, workshops and symposia.

By the end of 2012 the Association has launched in cooperation with Autismo e futuro, Autismo Firenze, Habitat per l’autismo, ScuolAba, the Federation: Traccia, Trattamenti cognitive e comportamentali integrati per l’autismo.

The volunteer association is registered at the Region of Lazio as a nonprofit organization.


Services

Basic therapy program for children aged 2 to 6 years
– Early diagnosis confirmed by the neuropsychiatric unit of the pediatric hospital Bambino Gesù or when requested another specialized pediatric hospital.
– Functional assessment at the treatment center.
– Tailored and intensive ABA-VB treatment (Applied Behavior Analysis-Verbal Behavior).
– Duration: 13 weeks for the total of one year. Comprising 22 treatment hours a week organized from 8.30 to 13.00 (Monday-Thursday) and from 8.30 to 12.30 (Fridays). Treatment takes place in one-to-one sessions as well as in group activities in play sessions. Parents are actively included in treatment provision, facilitated by intensive training. Treatment entry starts with 3 consecutive weeks at the center that address assessment, training and treatment planning. In the following, the treatment is implemented for 3 weeks a month in the child’s home and community setting and 1 week a month the family returns to the center in order to evaluate progress and to adjust treatment plans. At each monthly re-entry parents receive a training update and video reminders from treatment sessions at the center. In addition, parents can make use of psychological consulting. Furthermore, it is ensured that missed re-entries due to health problems or other important issues are promptly recovered.
– During the periods of treatment at the child’s home and community setting, parents receive weekly supervision via phone from the center. Families that are living in the district of Rome may have supervision directly at the center at pre-stabilized appointment (families from outside districts may utilize appointments when disposed to travel).
– Each treatment group of max. 9 children is provided with 2 supervisors and 5 therapists.
– Treatment progress evaluation is ensured at 6 months of treatment and at termination of the full-period treatment at 12 months by the neuropsychiatric unit of the pediatric hospital Bambino Gesù or when requested another specialized pediatric hospital.

Basic therapy program for children aged 7 to 12 years
– Early diagnosis confirmed by the neuropsychiatric unit of the pediatric hospital Bambino Gesù or when requested another specialized pediatric hospital.
– Functional assessment at the treatment center.
– Tailored and intensive ABA-VB treatment (Applied Behavior Analysis-Verbal Behavior).
– Duration: 13 weeks for the total of one year. Comprising 26 treatment hours a week organized from 8.30 to 14.00 (Monday-Thursday) and from 8.30 to 12.30 (Fridays). Treatment takes place in one-to-one sessions, in group activities in play sessions as well as in natural environments such as dining rooms, school mensa, school class, and in the surrounding of the center (shops, bars, supermarket etc.). Parents are actively included in treatment provision, facilitated by intensive training. Treatment entry starts with 3 consecutive weeks at the center that address assessment, training and treatment planning. In the following, the treatment is implemented for 3 weeks a month in the child’s home and community setting and 1 week a month the family returns to the center in order to evaluate progress and to adjust treatment plans. At each monthly re-entry parents receive a training update and video reminders from treatment sessions at the center. In addition, parents can make use of psychological consulting. Furthermore, it is ensured that missed re-entries due to health problems or other important issues are promptly recovered.
– During the periods of treatment at the child’s home and community setting, parents receive weekly supervision via phone from the center. Families that are living in the district of Rome may have supervision directly at the center at pre-stabilized appointment (families from outside districts may utilize appointments when disposed to travel).
– Each treatment group of max. 4 children is provided with 1 supervisors and 4 therapists.
– Treatment progress evaluation is ensured at 6 months of treatment and at termination of the full-period treatment at 12 months by the neuropsychiatric unit of the pediatric hospital Bambino Gesù or when requested another specialized pediatric hospital.

Additional module conducted alongside with the basic treatment programs
– Tailored program planning in accordance with the parents may result in the decision that children aged 2 to 6 years that are enrolled in the basic treatment program need more intensive treatment provision. The center offers the possibility to claim additional treatment hours (up to 8 hours a week, from 15.00 to 17.00 Mondays to Thursdays) during the re-entry at the center.
– The maximum duration is 10 weeks.
– The program supervision of the additional treatment hours is ensured by the same supervisor that is assigned to the family during the basic treatment protocol, although the therapist for one-to-one sessions may rotate.

Afternoon program
– Addresses 2 target groups of children: (1) continuous after care of those aged 2 to 12 years that finished 12 months of basic treatment, as well as (2) alternative to the basic treatment program for children that need a less intensive but continuous treatment program or parents may prefer ongoing servicing.
– Early diagnosis confirmed by the neuropsychiatric unit of the pediatric hospital Bambino Gesù or when requested another specialized pediatric hospital.
– Functional assessment at the treatment center. **
– Tailored ABA-VB treatment (Applied Behavior Analysis-Verbal Behavior).
– Duration: 4 hours a week for the total of 11 months from 15.00 to 17.00 (Mondays AND Wednesdays or Tuesdays AND Thursdays). Treatment takes place in group activities in play sessions. Parents are actively included in treatment provision, facilitated by intensive training. Parents receive monthly video reminders from treatment sessions as well as progress reports from the assigned supervisor. In addition, parents can make use of psychological consulting.

Community setting program: Home and School
– Addresses 2 target groups of children: (1) continuous after care of those aged 2 to 12 years that finished 12 months of basic treatment, as well as (2) alternative to the basic treatment program for children that need continuous support in their natural environment due to particular issues at home and school (requires permission from the school authorities).
– Duration: 6 hours w week for the total of 11 months. Treatment provision is divided by setting assigning 3 hours a week to each, home and school. Parents are actively included in treatment provision at home.
– Parents receive monthly supervision and progress reports from the assigned supervisor at the center.

Follow-up
– Addresses children aged 2 to 12 years that finished 12 months of basic treatment and may need a continuous progress monitoring.
– Duration: 12 evaluations.
– Parents receive monthly supervision and progress reports from the assigned supervisor at the center.

Supervision to external therapists
– Addresses families that conduct treatment on their own with private therapists but may want utilize supervision services.
– Supervision can be requested for 3 hours monthly and a total of 11 months.

Housing: Casa di Sergio
– Casa di Sergio comprises a structure of more than 300 square meters and a garden, close to our center within the relief organization Opera Don Calabria.
– The casa features 7 private rooms with bathrooms and shared spaces such as the kitchen, dining room and living room.
– The Casa can host families during treatment periods in Rome, moreover the families can have a rest, socializing, cooking, e.g.
– The families from outside Rome can remain and overnight during the period of intensive treatment of children.
– The House is managed independently from families with the support of volunteers.

Post school
(provided in partnership with the Association “Habitat per l’autismo”, no-profit organization at treatment centers in Rome) ***
– For children aged 6 to 12 years with high-functioning autism or Asperger’s syndrome, with a good school level.
– The activities aim to improve school outcomes, increasing social skills.
– The service is provided by trained volunteers and coordinated by one or more professional therapists in relation to the number of children.
– The activities take place from Monday to Thursday (17:00 up to 19:00).

House of autonomies
(provided in partnership with the Association “Habitat per l’autismo”, no-profit organization at treatment centers in Rome) ***
– For adolescents aged 12 to 18 years for a maximum of 7 students every two weekends, from 17.00 on Friday to 17.00 on Sunday, during the period from 15 September to 15 June of the following year.
– Activities mainly take place at the Casa di Sergio and in various natural environments and it is aimed to increase the autonomy and development of adaptive skills in different social situations.
– The service is provided by trained volunteers and coordinated by professional therapists.

Summer Camp
(provided in partnership with the Association “Habitat per l’autismo”, no-profit organization at treatment centers in Rome) ***
– For children aged 3 to 12 years.
– Activities take place in the period from 15 June to 15 September, from Monday to Friday from 9.00 to 13.00
– Including leisure activities to increase social skills and adaptation to natural environments, moreover there will be sporting activities in the swimming pool and on the sports fields of the Opera Don Calabria.
– The service is provided by trained volunteers and coordinated by professional therapists.
– There will be one supervision by a supervisor of the Association “Habitat per l’autismo”.


Offices and contacts

The legal residence of Association is via Giambattista Soria, 13, in Rome.
There are two treatment and research centers, for children from 2 up to 6 years, and from 7 to 12 years, not far is located the Casa di Sergio (House as b&b).
The Center of Salerno is located in via Picenza, snc.
We are working to the next new centers openings (during 2014), located in Turin and Sicily.

Board of directors
Alberto Zuliani, Chairman
Annamaria Malato, vice chairman, manager of institutional relations and fund raising
Daniele Caldarelli, councilor, manager of voluntary
Mauro Paissan, councilor, communications manager, newsletter
Claudio De Giuli, treasurer
Guido Monteleone, auditor

Staff
Gerardo Mannoni, general director
Graziana Ruel, managing director
Leonardo Fava, scientific director


References “Una Breccia nel Muro”
2011-2013
Papers and books

Fava, L., & Strauss, K. (2011). Cross-setting complementary staff- and parent-mediated Early Intensive Behavioral Intervention for young children with autism: A research-based comprehensive approach. Research in Autism Spectrum Disorders, 5, 512-522.

Fava, L., Strauss, K., Valeri, G., D’Elia, L., Arima, S., & Vicari, S. (2011). The effectiveness of a cross-setting complementary staff- and parent-mediated early intensive behavioral intervention for young children with ASD. Research in Autism Spectrum Disorders, 5, 1479–1492.

Fava, L., Vicari, S., Valeri, G., D’Elia, L., Arima, S., & Strauss, K. (2012). Intensive Behavioral Intervention for school-aged children with autism: Una Breccia nel Muro (UBM)—A Comprehensive Behavioral Model. Research in Autism Spectrum Disorders, 6, 1273–1288.

Strauss, K., Vicari, S., Valeri, G., D’Elia, L., Arima, S., & Fava, L. (2012). Parent inclusion in Early Intensive Behavioral Intervention: The influence of parental stress, parent treatment fidelity and parent-mediated generalization of behavior targets on child outcomes. Research in Developmental Disabilities, 33, 688–703.

Vicari, S., Valeri, G., & Fava, L. (2012). L’autismo: dalla diagnosi al trattamento. Bologna: Il Mulino.

Strauss, K., Mancini, F., the SPCGroup, & Fava, L., (2013). Parent inclusion in early intensive behavior interventions for young children with ASD: A synthesis of meta-analyses from 2009 to 2011. Research in Developmental Disabilities, 34 (2013) 2967–2985.


Conferences

Fava, L., Strauss, K., Valeri, G., D’Elia, L., Arima, S. & Vicari, S. (2011). The importance and effectiveness of cross-setting complementary staff- and parent-mediated Early Intensive Behavioral Intervention for children with ASD. Atti del convegno: abstract N° 8882, The International Meeting for Autism Research (IMFAR). California: San Diego.

Strauss, K., Fava, L., Valeri, G., D’Elia, L., Arima, S., & Vicari, S. (2011). The influence of parental stress, parental inclusion and parental treatment fidelity in cross-setting complementary staff- and parent-mediated Early Intensive Behavioral Intervention for young children with ASD. Atti del convegno: abstract N° 8886, The International Meeting for Autism Research (IMFAR). California: San Diego.

Fava, L., Strauss, K., Valeri, G., D’Elia, L., Arima, S., & Vicari, S. (2012). Parental stress and treatment priorities in the course of parent-mediated EIBI intervention. Atti del convegno: abstract N° 131.076, The International Meeting for Autism Research (IMFAR). Canada: Toronto.

Strauss, K., Fava, L., Valeri, G., D’Elia, L., Arima, S., & Vicari, S. (2012). Does naturalistic one-to-one training without focused peer intervention have collateral effects on play and peer engagement?. Atti da convegno: abstract N° 131.075, The International Meeting for Autism Research (IMFAR). Canada: Toronto.

K. Strauss, M. Esposito, G. Valeri, L. D’Elia and S. Vicari and L. Fava (2013). How does parent inclusion in playground teaching and parent child interactive style affect the effectiveness the EIBI on PLAY and PEER ENGAGEMENT of children with ASD?N°,IMFAR. San Sebastian: Spain.