Q & A with Dr. Wayne Fisher on New Role at Rutgers Brain Heath Institute
July 17, 2019
Rutgers Brain Health Institute recently announced the appointments of three new faculty members to launch a center for autism research. The renowned autism experts are joining teams at Rutgers University and Children’s Specialized Hospital to lead a new center at the Rutgers Brain Health Institute. Dr. Wayne Fisher, was appointed as the inaugural director of the Rutgers Center for Autism Research, Education, and Services (RUCARES).
He previously held leadership positions at the Kennedy Krieger Institute, the Marcus Autism Center at Emory University, and most recently at the Munroe-Meyer Institute at the University of Nebraska Medical Center. Autism New Jersey had the opportunity to conduct a Q&A with Dr. Fisher to learn more about what he envisions for this important new program.
Please tell us a little bit about yourself, your previous professional experience, and what drew you to a career helping people with developmental disabilities.
As an undergraduate student at Michigan State University, I volunteered in a classroom for children with autism spectrum disorders at the Beekman Center in Lansing, Michigan. On my first day, I met a student in the classroom, a young boy with severe aggression who had bitten off the end of another student’s finger. I was immediately struck by the challenge this boy posed for the teachers and aides and the enormous need for professionals who could help this child and other children with similar problem behaviors. The teachers and aides were surprised by my interest in this child but grateful that someone wanted to help.
This experience helped me understand what was at stake for these children – a lifetime of isolation, limited opportunities, and restrictive placements if their behavior did not change. I realized the importance of understanding why this child behaved this way and knowing how to replace these problem behaviors with more appropriate and adaptive behavior.
Similar repeated experiences ignited a passion in me and a commitment to working with children with autism and severe behavior disorders. To do so, I knew I had to pursue advanced training in psychology with a focus on the assessment and treatment of severe behavior disorders in children. I received my Ph.D. in school psychology from the University of Texas and completed a postdoctoral fellowship at the Kennedy Krieger Institute and Johns Hopkins University School of Medicine.
At Kennedy Krieger, I specialized in the assessment and treatment of severe behavior disorders in children with autism and related developmental disorders. I then joined the faculty at Johns Hopkins University School of Medicine. I became the founding director of the Neurobehavioral Programs at the Kennedy Krieger Institute. This position allowed me to hone my skills as a clinician and researcher. I later developed similar programs at the Marcus Institute at Emory University School of Medicine and at the Munroe-Meyer Institute at the University of Nebraska Medical Center. Throughout my career, my passion for and commitment to children with autism and related developmental disorders has continued to grow.
What have you learned from children and adults with autism and their parents?
I’ve learned that I never stop learning from these children and families. I’m always amazed by the dedication of the families and the tenacity of these children in the face of challenges – there is no end to what they teach me and what they can teach everyone.
One important thing I have learned is that people behave in certain ways for a reason. For example, you might say, “Please” when you ask someone to do something. You probably have learned that people are more likely to do what you ask when you say “Please.” Children and adults with autism are the same. Their behavior, even problem behavior, happens for a reason. So, to treat problem behavior, we have to figure how why the individual is having the problem behavior, what is the reason. It’s likely the individual is using the problem behavior to “tell us something.” For example, a child might be saying, “Go away, I don’t want to work right now,” when he hits his teacher. Another child might be saying, “Get off the phone and play with me.” When we know why the individual has problem behavior, then we can treat it. We can teach the child a more adaptive way to get a break from work or get attention.
Parents have taught me never to take no for an answer when I advocate for individuals with autism and related developmental disorders. I am amazed by how much parents have achieved for individuals with autism over the last two decades. They have also taught me to be a better listener, which has helped me to understand the importance of developing more flexible services and programs that focus on the specific needs of each family.
What are your primary goals for the Rutgers Center for Autism Research, Education and Services (RUCARES)?
Rutgers is in the position to become the premier university for translational research on autism. Translational research typically involves the adaptation of findings from basic research to develop a new treatment or improve an existing one. But translational research also can involve the assimilation of findings from clinical research to refine a theory or a basic research question. Translational research is critical to improving our understanding of and ability to address problems like autism. We will build strong two-way bridges between basic neuroscience research and impactful clinical research. From this translational research foundation, I am confident that we will address the following goals.
- Facilitate cutting edge interdisciplinary research, education, and clinical-service programs that will truly make Rutgers a world-class leader in autism.
- Identify the existing gaps in autism research, education, and clinical services at Rutgers and fill them such that our programs are comprehensive, so there are no “missing pieces.”
- Increase Rutgers portfolio of federally funded grant research, and in particular, to obtain federal funding and recognition of RU-CARES as an Autism Center of Excellence, or ACE, by the National Institutes of Health.
- Work collaboratively with local groups, such as Autism New Jersey, and national groups, such as Autism Speaks, to address important public policy, health, and education issues related to autism.
My research has focused on the translation of basic behavioral processes to improve clinical treatments for autism and related disorders. In particular, I have sought to (a) understand how and why individuals have problem behavior, (b) understand why individuals choose to have problem behavior instead of adaptive behavior and vice versa, (c) use the how and why information to decrease problem behavior and increase adaptive behavior, and (d) teach adaptive behavior that the individual will use over time and in different settings instead of problem behavior. Currently, my grant-funded research focuses on the basic processes underlying the problem of treatment relapse. The goal of this research is to improve treatments for severe destructive behavior so that treatment effects last and episodes of relapse occur infrequently or not at all.
I also have been working on a conceptual model that integrates stimulus control theory with Skinner’s taxonomy of verbal behavior, with the goal of promoting generative language. The goal of this research is to develop procedures where we teach just a few critical verbal skills, such as a few words, but we do so in a way that children can then generate novel combinations of words on their own without us having to teach them each new combination. For example, in a recent study we completed that focused on teaching children with autism to learn to label large numbers, the children learned seven numbers on their own for each number we directly taught them.
How do you think the work that you intend to do at RUCARES will impact the 1 in 34 individuals in New Jersey who are diagnosed with autism?
The results of our research are often applicable to most children with autism because we study how and why children behave in certain ways. For example, most children with autism have some problem behavior, such as aggression, tantrums, self-injurious behavior, feeding difficulties, or bedtime problems. We can use the results of our research to understand and treat any of these problems. Or we can use the results of our research to teach adaptive behavior, such as communication. As such, parents and other professionals can use our results with most children with and without neurodevelopmental disorders. In fact, my wife and I have used communication training with our own neurotypical children.
Tell us a little bit about the partnership between RUCARES and Children’s Specialized Hospital (CSH).
I am thrilled that two powerhouse organizations like Rutgers University and Children’s Specialized Hospital have teamed up to develop the clinical components of our autism center. Rutgers brings an abundance of research and educational expertise and resources. Children’s Specialized Hospital is a premier provider of clinical services to children with neurodevelopmental disorders, including autism, in the state of New Jersey and the region. With these two incredible organizations behind us, I believe that we will be able to integrate autism research, education, and clinical service at the highest possible level.
It is reported that the first program from this partnership will be for the treatment of children with ASD who have severe behavior challenges. What is your vision for this program?
New Jersey is in the unenviable position of being No. 1 in autism prevalence. That is, more children are diagnosed with autism in New Jersey than anywhere else. It makes sense that New Jersey should make the biggest effort to address the problem. I have been told that the largest gap currently in autism services in New Jersey is in the area of severe destructive behavior. As such, my goal is to develop the best research and clinical service programs for severe destructive behavior in the world.