Thursday, December 20, 2012

Special Time

Spending quality time with your child every day can help prevent behavior problems and helps build a loving family environment. Special time with your child is also an excellent way to reward your child for good behavior and to teach your child appropriate ways to behave.

Quality time consists of those special moments when parents give their undivided one-on-one attention to their child and needs to occur on a regular basis. It is the one-on-one time that really builds intimacy and a positive relationship.
If your child is playing quietly in his room, don’t sneak away to make a phone call. Reward your child for the good behavior with some quality time and then explain to him that you need to make a call. Playing with your child is also an opportunity to demonstrate and model appropriate behaviors, for example taking turns, sharing, winning, losing and waiting. Comment on what he/she is doing and commend him/her by saying something like “You won – good job”.
Most parents, especially working parents, do not get down on the floor to play with their children enough. You can change the dynamic of your household by making a daily habit of setting aside certain times of day to spend quality time with your children. The outcomes and the effect on your child’s behavior will be immeasurable.
Here are some tips for successful quality time with your children:
  1. Schedule it ahead of time.
  2. Schedule regularly – daily is best.
  3. Quality Time is to be spent between parent and child alone, no others present.
  4. Your child chooses what to do, he/she is the captain (parent may impose limits such as amount of time, amount of money spent, if junk food allowed, etc.).
  5. Activities should be age appropriate for the child.
  6. Parent gives the child their full attention. No phones and no TV allowed.
  7. Parent follows the child’s lead. Child gets to be boss and direct the parent in their play.
  8. Parent does not discuss limits or discipline during this time. It is positive interaction only.
  9. Parent does not talk about other family members or their own issues. The child is the center of the universe during this time.
  10. Special time is not to be canceled as a result of misbehavior. Choose other consequences.

Spend special time with your kids. And start now. The Holidays are a great opportunity.

Happy Special Time!

 
Daniel Adatto, BCBA

 

Wednesday, December 12, 2012

Bribing or Rewarding?

“Parenthood” (NBC- Tuesdays at 10PM) is an excellent show. Good actors and good and unpredictable scripts that present believable stories that make it easy to identify with the characters and their lives.

One of the families just adopted a boy and they are having a hard time making him do his homework and household chores. The mother goes to her sister, who has three kids, one of them with Asperger’s Syndrome, and asked her “How do you do it?”
“We bribe them. As much as they called it rewarding, we bribe them. A piece of candy for taking out the trash, two pieces for doing homework, and so on.”
She goes home, tries it with her adopted son, and, oh surprise, it works.  

Is she bribing, or motivating her child to perform a non-preferred activity? Are they bribing me when they pay me for doing my job? Do parents bribe their kids when they tell them “First eat your food and then you can have dessert”?  Do teachers bribe students when they tell them they have to finish their work before they go to recess? Or give them points towards a pizza party? Do you bribe your plumber when you pay him to fix that annoying leak?
According to Wikipedia, bribe is “Something (usually money) given in exchange for influence or as an inducement to dishonesty.”
Does working, doing homework, helping with house chores or learning at school fall under that definition?

Allow me be very clear, NO. I think it’s time to understand that we engage in behaviors because they work, we get something. And when we ask children to do something they don’t want to do, we need to motivate them, so they want to do it. Plain and simple.

So when our character offers candy to her child she is motivating him, not bribing him. By the way, it doesn’t have to be candy. Moreover, I don’t recommend using always candy, because then you have to deal with the sugar rush and the side effects of unhealthy food.  Good rewards can be preferred activities, such as playing computer or video games. Allowance is another option. Points to earn a special treat or a day at Disneyland are always very effective if your child is old enough to understand delayed rewards. I have a client that earns pieces of a puzzle that shows the McDonald’s logo. Once he completes the puzzle, parents take him to McDonalds on Sundays after church. Raffle numbers, lotteries type systems, playing favorite games, are more examples. And candy on moderation if your child is healthy is OK. After all, they are kids.
You don’t bribe when you motivate your kids to do something in their benefit. Do you bribe your mechanic when you pay him to fix your card, or the dentist to take care of your teeth?

So, three words: Motivation, Motivation, Motivation. Let’s get out there and motivate our kids instead of forcing them, or hoping they will comply.

 And if it doesn’t work, try bribing them.

 Daniel Adatto, BCBA

 

Monday, November 26, 2012

The Five Most Common Parenting Mistakes


Making positive behavioral changes can help every parent avoid these common parenting mistakes:
  1. Giving attention to bad behaviors
  2. Ignoring good behavior
  3. Placating the whining or crying request
  4. Saying No when you can say Yes
  5. Using time-out as a punishment
1. We parents devote far too much time attention when our children misbehave. In a child’s mind, negative attention is better than no attention so by eliciting a negative reaction (yelling, punishing etc.); the child has in essence won the battle. By rewarding the bad behavior with attention, you are teaching your child that bad behavior (crying, hitting, non-compliance etc.) is the way to get your attention and you are perpetuating the bad behavior.

2. This brings us to common mistake no. 2. We punish the bad behaviors, but do we take notice of the good ones? Reverse your negative patterns by catching your child doing something good and reward the desired behavior. Is your child playing nicely? Don’t turn away to make a phone call. Commend that behavior first, reward your child with a positive interaction and you will increase good behaviors while reducing the undesired ones.

3. Placate now – pay later. And pay dearly you will! We parents are so irritated by the crying or whining child that we so often give into the request just to make it stop. Children are very clever. They know that this works.  But ask yourself, is the price worth it? By giving into the request, we are teaching the child to cry or whine to get whatever he wants. I can not stress this enough - Never ever give in to a crying, whining or tantrum request! If your child requests something while crying, you must request that he stop crying and ask nicely before you give him whatever he wants. If you are consistent, the crying and whining will decrease over time.

4. We say no 100 times a day and I can almost guarantee that 75% of those NO’s could be YES’s. If we rephrase our response to a more positive alternative and redirect the child instead of just saying no, we can reduce the child’s frustration in being told NO.

·       Instead of saying just NO, what he CAN’T do, tell the child what he CAN do. “Can I have a cookie mom?” Instead of immediately saying no, you can say “Yes, you can have a cookie when you finish your dinner”.

·       Do not forget to give at least two YES’s for each NO. “I want to play outside” Try “It’s too cold right now but we CAN play blocks or dance inside”.             
 
By the way, when you say “NO” to your child, you are teaching him/her to say
“NO” to you when you place a request on him/her. So, save the NO’s for when it is
necessary. If you child is running to the street or playing with a knife, that’s a NO.

5. A Time-Out should be used to remove a child from an environment where he is being rewarded for a bad behavior, such as getting attention, and place him in an environment where he receives NO reward for the behavior. If you are in the grocery store and your child throws a tantrum, be ready to leave the cart full of groceries and remove your child from that environment where he is getting a lot of attention from you and the rest of the customers, and take him to the car, where you are able to ignore the crying and screaming, thus placing the behavior on extinction: no attention. Be sure that the tantrum is your child’s way to get attention. If your child is over stimulated by the environment, in pain, scared, hungry or tired, do not use time-out, do not ignore the behavior. Your child needs your help.   

Learn how to behave so your child will too.

 

Daniel Adatto, BCBA

Wednesday, November 21, 2012

Social Skills and Autism


Going to the movies, hanging out with friends, chatting on the phone – these are simple rituals most individuals take for granted. For a person with autism, these experiences are few and far between. A lack of social skills and the inability to relate to people, are two seminal characteristics of autism. But the mistake most people make is to assume that someone with autism does not want to have social interactions.  In reality, it isn’t that they don’t want to interact socially, it’s that they can’t.

An inability to anticipate how people think and feel in social situations is a hallmark feature of autism.  Individuals with autism might want to enter a conversation, but they don’t know how. As a child gets older, this can be devastating and cause the individual to further withdraw.

The problem is compounded when children with mild autism are mainstreamed in school with typical developing kids and forced into an environment where they feel different. The same thing happens when attending a birthday party or a family gathering. This often causes families to isolate in order to avoid meltdowns in public.

Therefore, a big chunk of our efforts should be devoted to teaching social skills. Social interaction is a must in a child’s environment since this is a skill they will need throughout life. A child’s struggle with social skills can neither be concealed nor overcompensated by any other skill. Most children learn social skills through imitation but children who have a harder time learning these skills need to be taught. Children who do not develop appropriate social skills will suffer loneliness and isolation. This can create difficulties with communication and result in behavior problems.

To help your child be successful in social situations and learn the social skills fundamental to his or her development, it is necessary to prepare your child for the social situation and prepare the social situation for your child. Here is a list of recommendations that will help children thrive in social situations:

  • Prepare your child before entering a social situation by giving precise instructions and expectations.
  • Make sure the social situation is appropriate for your child.
  • Have a “Plan B” in case things go wrong when planning to attend a social event.
  • Teach your child through role-playing games using dolls and toys, reading stories, singing songs etc.
  • Teach them to share, take turns, and follow rules.
  • Make use of natural situations to teach them: set examples of desired social behaviors in your everyday life; comment on what you see in videos and TV shows.
  • Reward positive social behavior.
  • Use photos and videos to introduce your child to different people.
  • Help build your child’s self-esteem by assigning them leadership roles within the family.
  • Encourage your child to help and take part in daily household chores.
  • Use mistakes as opportunities to teach appropriate social behavior instead of punishing them.
  • Encourage and increase opportunities for successful social experiences and offer praise.
  • Avoid and minimize social failure as much as possible.
And include your child in every family interaction possible, as long as it is child appropriate. Talk about emotions so you child learns the words to express what he is feeling.

It is a battle worth to fight.

 

Daniel Adatto, BCBA

 

Friday, November 2, 2012

Behaviors and the Environment

One of the core principles of Applied Behavior Analysis is that behaviors are related to the environment in which they occur. And no, we are not talking about global warming nor are we going to tell you to “go green”. When we talk about the environment, we are referring to (a) the physical setting in which a behavior occurs and (b) the behaviors of the people who interact with the child.

a.     Physical Setting: This means the places where he/she spends the most time, home, school etc.  Lack or abundance of sensory stimuli such as lighting, temperature, noises, clutter, activities, curriculum, demanding routines (or lack thereof) are some examples.

b.     But behaviors are also affected by other factors in the environment such as the people and how they behave. “You change child behaviors by changing the behaviors of the adults who deal with that child. Pure and simple” (Cipani and Schock- 2011)

When attempting to change a behavior, a behaviorist’s first step is to assess environmental factors that trigger behaviors. Something either IS in the environment or IS NOT in the environment, which is causing the occurrence of the behavior.  One example (discussed in a previous blog, “Tantrums in Public”) of this is meltdowns that commonly occur at large retail stores like Target or supermarkets.

Another example is when parents tell us that their child behaves well at school but not at home or vice versa. When analyzing the situation one easily concludes that since the child is capable of handling himself at school, there must be something in the environment or something missing from the environment at home (or vice versa) that is causing the problematic behaviors. 

If you are experiencing problems with your child’s behaviors, take a look at some of the environmental factors that could be contributing to the problem. A few examples include:

-        Lack of structure and consistency, or too demanding routines, which can increase anxiety and/or boredom, some of the top causes of acting out in children.

-        Physical environments that don’t fit the child’s sensory needs (like the one described at Target).

-        Lack of opportunities to release energy appropriately, such as when a child is expected to sit still for too long at the dinner table or restaurant.

-        Unrealistic expectations: too many “No’s” and “Must Do’s”.

-        Lack of following through with instructions, giving in to challenging behaviors.

-        Others’ undesired behaviors that the child imitates.

-        Adults’ stress.  

If parents pay attention to the environmental factors and become aware of the cues that a meltdown is about to occur, it can go a long way in prevention.

 

Daniel Adatto, Board Certified Behavior Analyst

Tuesday, October 23, 2012

Hey, kids, it’s not fair!

Have you ever wonder how your kids get away with so much? I’m pretty sure they didn’t attend a “Kids Training on Behavior Management Class” before they were born and yet, they know how to push our buttons and get what they want. One thing is for sure, in all fairness: they don’t play by the rules; and we as parents have to. Kids, it seems, are allowed to scream, cry, hit, runaway, etc.

How are they getting away with it? Let’s take a closer look:
-        They ignore us. They do not follow our directions. And when they follow the directions, they do it slow or wrong or half way so we come to the conclusion that next time we should do it.

-        When they want something they can’t get, they cry and scream very loud. And I mean LOUD. If this doesn’t work, they throw things. If it’s still not working, they pinch, scratch, hit and kick.

-        Eventually we give in just to stop their behaviors. Now is the time when they are quiet and behave like angels, thus rewarding us, which increases the likelihood of us giving in the next time.

-        They do not brush their teeth. This is an easy one; we are so tired at that time of the day that we give up pretty quickly. If we insist, they distract us by running away, asking for water or fighting with their brother. Or they say they have a stomach ache. This never fails.

-        Usually, moms and dads do not agree on what to do. So our kids play us against each other, they go to daddy when mommy says “No”, or vice versa. And we argue between us and forget about them.
Do you see where I’m going with this? All these behaviors make us give in and get them what they want.

It’s not fair, they manipulate us. So, we should be able to manipulate them. So let’s learn from their behaviors and see how we can turn the tables in our favor:
-        Learn to ignore their crying and whining. This does not mean you ignore them. It means you do not give them what they want because of their behaviors. It doesn’t matter how tired you are or how little time you have. Every time you give in, you are making your life more difficult. The “I’ll deal with these behaviors when I have time” mentality does not work, you’ll never have time. It is NOW.

-        Do not give up when they ignore you or do it wrong. It’s OK to choose your battles, so if you don’t have time or energy, do not ask them to do it. Because if you do, you’d better follow through. Brushing teeth is a great example. Be sure that when you ask them to brush their teeth, you can follow through.

-        Do not argue with your spouse in front of them. Talk about behavior management strategies when there are not present. Reach an agreement and be consistent. And if your spouse told them something, support him/her in front of the kids. You need to present a united front.
We parents can feel like complete failures sometimes but we are not bad people. We love our kids. The problem is that we never imagined that being a parent and managing behaviors would be so difficult. Education and knowledge is the key. It’s up to us to get the best of them and help them become the children we want.  Or at least go down fighting.

 
Daniel Adatto, BCBA

Wednesday, September 26, 2012

LA Times article uncovers risks of alternative treatments for autism

“Autism: Kids Put at Risk” is the name of an article that appeared in the LA Times Health Section (http://www.latimes.com/features/health/la-he-autism-main7-2009dec07,0,5807576.story ).  The article is in essence an expose of biomedical treatments for autism being promoted by a select group of physicians.  The piece follows another investigation conducted by the Chicago Tribune and states that “after reviewing thousands of pages of court documents and scientific studies and interviewing top researchers in the field, an investigation by the Chicago Tribune found that many of these treatments amount to uncontrolled experiments on vulnerable children. The therapies often go beyond harmless New Age folly. Many are unproven and risky, based on flawed, preliminary or misconstrued scientific research. Lab tests used to justify therapies are often misleading and misinterpreted. And though some parents fervently believe their children have benefited, the investigation found a trail of disappointing results from the few clinical trials conducted to evaluate the treatments objectively.”

Some of the more questionable approaches include Chelation, a treatment where the patient is given a drug that binds to heavy metals to be excreted in urine. The theory is that it will rid the body of heavy metals but it carries significant risks including death. According to court records, a 5-year old boy with autism died in 2005 after experiencing a heart attack while being intravenously chelated at his doctor’s office.

Hyperbaric oxygen therapy (HBOT) is another highly risky treatment purported to help treat autism by reducing inflammation. Patients are sealed in pressurized chambers which are enriched with extra oxygen. It carries a risk of oxygen toxicity.  Last month, the Center for Autism & Related Disorders (CARD) published the results of a randomized double-blind placebo-controlled trial stating that researchers found no differences between HBOT and placebo groups across any of the outcome measures. The present study demonstrates that HBOT does not result in a clinically significant improvement in the symptoms of Autistic Disorder.

With such high risk and questionable results, why would a parent be willing to expose their child to such dangerous therapies? The article contends that many of the parents are desperate.  Until someone has spent a day in the shoes of a parent dealing with autism, it would be unapprised to pass judgment. But the real reason probably has to do with lack of treatment recommendations by the medical community.  If a desperate parent attends a conference and hears stories of improvement that offer hope from other parents and physicians, that is far more persuasive than a pediatrician who is going to spout off statistical studies.  But parents need to know that the results of these therapies may have more developmental explanations. With early intervention, children with autism often show natural improvement at the age of 3 or 4 and by age 5, many make so much progress they can be indistinguishable from their typical peers. This happens regardless of whether the child is undergoing alternative therapies.

To prevent a parent from agreeing to these risky alternative therapies, the medical community needs to offer a more streamlined response in terms of treatment recommendations, resources, and ongoing support.

To date, Applied Behavior Analysis (ABA) is the only safe and effective method of autism treatment backed by evidence-based scientific research. It is considered the gold standard in autism treatment and has been endorsed by the U.S. Surgeon General. But ABA requires commitment, support and can be quite costly.

Information is paramount for parents. The more you learn, the better you can help your child with special needs. The road ahead is challenging, but it can also be very rewarding.
 
Daniel Adatto, MA, BCBA 

Tuesday, September 18, 2012

I admire your courage!

To the parents of a child with autism or other developmental disorder, I admire your courage to advocate and seek help for your child. Having a special needs child changes everything about your life, from whether you get enough sleep at night to enduring everyday challenges like buttoning your child's pants during a tantrum. The demands of raising a child with a developmental disorder are great and families frequently experience tremendous stress coping with daily life.

Being a parent myself, I know the love you have for your child and your deep desire to provide him/her with the best possible future. My hope is that these blogs will provide guidance of which treatment to pursue and reassurance that your child's behavior will change for the better.  Believe in your child's potential. The desired results might not always develop at the speed you expect, but have faith your child will achieve the goal.

If you feel your child may be in need of behavioral services, I strongly urge you to seek help immediately. Research and clinical practice has repeatedly demonstrated that early intervention is linked with positive treatment outcomes. I am confident that in seeking effective and research-based treatment for autism, you are on the right path.

I believe the key to a successful treatment program is a plan that is specifically tailored to your child's behavior needs. Each child is an individual with his/her own unique feelings and needs.

As Behavior Analysts, it is at the core of our science to track and measure your child's progress through the treatment plan. Our greatest reward is identifying when and why a treatment plan is not working and making the necessary changes that bring success and effectiveness.

Whether you are a parent in need of services for your child or a professional dedicated to improving the lives of children diagnosed with autism, we look forward to meeting you!

 

Thursday, August 30, 2012

When parents get involved in ABA the results are amazing!

There is so much research on the benefits of early intervention for children on the autism spectrum that we often forget that parents are really the first line of defense in the uphill battle. Parents can be the strongest influence in modifying a child's behavior when they understand the principles of behavior modification and implement them consistently. Extensive research shows that home-based therapies may be more beneficial to children with autism if therapists also provide parent support and parent training. Many parents reported that learning to use the ABA techniques not only helps their children but it helps them and the rest of the family.

But there are difficulties. As therapists that work with children with special needs we face the challenge of motivating parents and caregivers to implement the therapeutic advice we offer.  Learning the techniques and following through consistently takes a significant commitment on the part of parents, many of whom are already stressed and stretched to the limits. It helps if the therapist approaches the challenge of training parents with compassion and understanding while at the same time treating them professionally, as if they are the client, not just their child. Take into consideration that the same ABA principles and techniques we use in behavior plans for children work with parents also – rewarding desirable behaviors, consistency and persistency, effective instruction and environmental manipulations. 

Some tips on how to implement a parent-training program:

·       Parents need to be motivated. Praising them for their efforts and commitment is crucial. It helps to say “Good Job, mom”, or “You are doing a great job in taking care of your child and advocating on his behalf”. Keep in mind that we reinforce successive approximations towards the goal. We want to reward direction, not perfection.

·       Make it simple. Break complex concepts and techniques into small, more reachable units, and teach each unit until mastered. Provide sufficient modeling, examples and opportunities for turning the theory into practice. If necessary, go to the grocery store and show mom how to handle her child’s behaviors. Provide parents with audiovisual materials, such as research, articles, books, and videos. One thing is to understand the theory. It is another thing is to be able to apply that theory to real-life situations.

·       Consistency and Persistency: People do not learn overnight. Be patient. You will need to repeat the lesson several times. Do not get frustrated when parents reject your ideas and advice. They might need time to assimilate the new strategies. 

·       Environmental Manipulations: Parents are not able to implement a behavior plan if they have a full work schedule; if they are currently dealing with an emergency or a crisis, such as an illness or a divorce; if their lives are cluttered; or if they are extremely stressed. Helping them with time/stress management could be crucial in ensuring the success of the program. In some cases, we may need to suggest seeking professional help, taking time off work, changing jobs, getting help and support from family members and/or community sources.

When parents get “on board” the results are amazing. After all, what can be better than 24/7 therapy.

 
Daniel Adatto, BCBA
 

 

Tuesday, August 14, 2012

Behavior consultants: Who are they and how to find the right one?

There is confusion about this strange breed of professionals known as Behavior Consultants. They are not psychologists, but deal with behavior problems. They are not teachers, but teach socially significant and functional behaviors. They are not Speech Therapists, but teach communication. They are not Occupational Therapists, but deal with sensory deficits and excesses.

So, who are they? 

The California Association for Behavior Analysis presents an interesting article about this on its website: http://calaba.org/AAMR-BehConsultantsFlyer.pdf

The article was developed by representatives of three major professional organizations: the psychology division of the American Association on Mental Retardation, the MR/DD Division (Division 33) of the American Psychological Association, and the Association for Behavior Analysis.
As the article explains, board certified behavior consultants, or analysts (BCBA’s) are “professionals with documented graduate training and supervised, hands-on experience in Applied Behavior Analysis (ABA), and have passed a special examination in this area.” This program is managed by the Behavior Analyst Certification Board (please, see www.bacb.com for more information, including a Certificant Registry).  
I especially like the following paragraph from the article:
“We suggest you do not use a behavior consultant who focused mainly and solely on reacting to the problem behavior unless a crisis or other particular circumstances warrant this focus. Focusing only on reacting to the problem behavior will not prevent it from happening in the future and does not represent current best practices. In crisis situations or in the case of an escalating behavior problem that requires immediate action, treatment should address both immediate concerns and preventing strategies, such as changing the environment and teaching appropriate alternative skills. In most other cases the main focus of behavior consultation should be on skills development.”   
Because of a shortage in trained and experienced behavior consultants, I recommend you look for programs directly supervised by BCBA’s. We will assess the meaning (function) of the problematic behavior and be able to determine an appropriate course of action. In other words, an experienced behavior consultant will be able to determine what the individual is telling us through his/her behaviors, what she/he needs. We will measure the current status (baseline) of the problem in quantifiable terms (numbers) and set goals accordingly. We will teach desired replacement behaviors so the individual can communicate his/her needs appropriately. We will measure each step of the process and compare it with the baseline and the goals in order to monitor the effectiveness of the program. We will make changes if those measurements show lack of progress. We will recommend consultations with other professionals when the problem goes beyond our scope of practice. And we will go to the natural environments and train all caregivers (parents, teachers, etc.) in the process so behavioral gains can be generalized across settings and maintained across time, even though when we are not there anymore. 
In summary, we are trained in behavior management and best practices on how to implement these programs. And we are ready to help you.

Daniel Adatto, BCBA

Tuesday, July 31, 2012

Preparing for back-to-school

Is it back-to-school time already? Where did the summer go? Anyway, let’s get ready for back to school.

Children in general, but especially those with autism spectrum disorders, generally have a difficult time with transitions. It stems from the fact that they have trouble shifting attention from one activity to the next and tend to have a greater need for predictability. As any parent of a child with autism knows, preparation strategies are crucial. These next few days are the perfect time to begin preparing your child for the back-to-school routine. By using this time to slowly transition into the routine, it will help avoid the meltdowns and behavior issues that can occur when a child is not adequately prepared for a new situation. Here are some tips:

·       If your child has trouble waking up in the morning, start putting him to bed earlier, using 15-minute increments to get the time earlier each night. Once he is used to waking up at the expected hour, waking up on the big day will be much easier.

·       Next, you need to establish a consistent morning routine. Using a visual schedule is a great way to show to a child the sequence of events that make up this routine. You can prepare the schedule together with your child using pictures or drawings of familiar activities such as going to the potty, brushing teeth, getting dressed and eating breakfast. The visual schedule will give your child a sense of control and allow him to understand which activity follows which. To help avoid power struggles, it is helpful to have a desired activity follow an undesired activity. For example, if TV is part of your morning routine, make sure that more difficult tasks such as getting dressed come first and TV time can serve as a reward.

·       Give your child a 5 or 10-minute warning before he is expected to move onto the next activity. Never whisk him away from a preferred activity and demand that he gets in the car when it is time to leave. When giving warnings try to make the instructions as clear as possible by breaking them down into simple steps. Sometimes a seemingly simple statement such as “we’re leaving in 5 minutes” can be too difficult for a child to understand. Instead you can say “in 5 minutes we have to walk out the door and get into the car”. 

·       If power struggles over food or clothing are an issue, be sure to offer choices, as in “you can have cereal or oatmeal”. You can even have your child choose his clothe the night before. Choice making will give the child a sense of control and reduce the power struggles.

·       Needless to say, choose your battles. Give up on combing his hair to perfection, for example.

Once you have established your routine stick to it consistently. Having a predictable and consistent daily schedule builds confidence in a child, decreases anxiety, and encourages cooperation. Preparation and consistency are keys to success in back-to-school. Remember, it is not about “begging” or “forcing”; or “hoping” your child will be OK. It is about manipulating environmental variables (routines, visual schedules, rewarding positive behaviors, providing choices instead of directives, etc.) to prevent meltdowns and facilitate desired behaviors, such as compliance. You can be in control, and you should.


Daniel Adatto,
Board Certified Behavior Analyst







Friday, July 20, 2012

Spanking Again?


I can’t believe it. Another article about spanking? This time the title is “Study fuels spanking debate” (http://www.latimes.com/news/local/la-me-banks-spanking-20120714,0,6374260.column)

How is it that spanking is still a topic of debate?
“If you spank your children, even occasionally, you’re setting them up for a lifetime of mental and emotional distress,” the article reads. There was a study from two Canadian universities published in the journal of the American Academy of Pediatrics and led by Tracie O. Afifi who defines “spanking” as “hitting”. What’s the novelty of this, I asked myself, it IS hitting.
No so fast, Mr. Behaviorist. “I think there is an important distinction”, writes Sandy Banks, the author of the LA Times article, “Hitting, slapping, shoving, grabbing are not the same thing, to my mind, as a parental smack to the behind.”
I don’t agree with that. But I agree with her when she says “The conflict between what we do and what we believe is never tested more than in parenting.” Yes, but that does not make hitting, excuse me, spanking OK. Or yelling, or threatening. Parenting is very rewarding and fulfilling, but it can be very challenging as well, no doubt, and it confronts us with unknown territories of ourselves.
“The point of spanking, after all, is to get kids to behave”, we read in the article. My question is how can we expect them to behave when we don’t? Being able to control ourselves before we request our kids to control themselves is paramount. After all our main job as parents is to teach, not to police. What we teach with hitting? Maybe, just maybe, we teach that conflicts are resolved with violence and aggression, don’t we?
The author of the article finally confessed. “While I would never have called it “hitting”, as Afifi insists, I probably whacked a few backsides when my children were young.” She goes further when she says “Looking back now, I think the spankings of my youth taught me things than lectures and time-outs couldn’t: that my mother’s indulgence had limits. That pain can be a powerful deterrent. That bad choices have bad consequences.”
Seriously?  Are you saying that spanking is the way of teaching all that?
How would you like, Ms. Banks, if someone much bigger than you spanks you every time you do something wrong? What would you say if you know that the teacher spanks your kids? And what if the police officer spanks you for speeding? Problem solved, let’s just spank each other every time we misbehave.
Spanking is not OK under any circumstances. It reflects “parenting ignorance” because there are other ways. Spanking comes out of frustration, anger and lack of resources. If you find yourselves spanking, first apologize to your kids and then ask for help. There are other tools of discipline that build positive behavior repertoires, that teach limits and respect, responsibility and self-control. But through love. Let’s set our kids for success by respecting them at least in the same way we like to be respected.

Daniel Adatto.

Board Certified Behavior Analyst.


Wednesday, July 11, 2012

Common misconceptions about Applied Behavior Analysis

I would like to draw attention to some very common misconceptions about Applied Behavior Analysis (ABA). For example, that ABA is only relevant to the treatment of autism, or that it is synonymous with Discrete Trial Training (DTT). Discrete Trial Training is a teaching procedure that is based on the fundamental principles of Applied Behavior Analysis, but it is only one of the many aspects of ABA.

ABA is a systematic approach to understand and change behaviors and thus, much more than any one particular teaching procedure or intervention. It is based on many years of research into behavior, its causes, and strategies for changing behavior and building functional behavioral repertoires. ABA can be applied in any situation where a behavior change is desired. Other teaching methods included in an Applied Behavior Analytic approach include Incidental Teaching, Pivotal Response Training, Verbal Behavior Training (VB), Behavior Management, and others.

DTT (sometimes referred to as the Lovaas method) is an intensive treatment designed to assist individuals who have developmental disabilities such as autism.  It involves systematically and intensively teaching a variety of skills those individuals with disabilities may not pick up naturally. Because these individuals do not learn the way we teach, we should teach the way they learn.

Programs designed for individuals on the autism spectrum initially teach pre-learning skills (sitting, attending, looking at the therapist, imitation, etc.), social skills, self-help skills, communication skills, safety skills and basic concepts (colors, letters, numbers, etc.).  After these basic skills are mastered, higher-level skills are taught. DTT is conducted using intensive drills of selected materials.  Complex behaviors are broken down into small, reachable components, and taught until mastery before moving to a higher level. A specific behavior is prompted or guided, and the client receives a reward (reinforcement) for proper responses in order to increase motivation. 

Adversaries sometimes suggest that DTT promotes robotic responses in children, but that argument only demonstrates lack of knowledge on ABA. Programs start in very contrived, intensive and repetitive fashion. As progress is achieved, the intervention moves to incidental teaching conducted in natural environments and including all caregivers, thus achieving generalization of gains across settings and maintenance across time. Research has demonstrated a 50% recovery rate for autistic children who participated in discrete trial training 40 hours per week, including parent education, and began treatment during the preschool years. But like any therapeutic program, DTT, as well as ABA, needs to be tailored to meet the needs of the individual client because no two cases are alike. A good behavior analyst will know how to adapt a program to fit the child’s needs because, as all of us working in the field of autism know, “when you know one person with autism, you know one person with autism”.

I fell in love with ABA when I learned all that. The more I learn, the more passionate I am. ABA gives me the answers I need to do my job effectively.  Everybody who jumps in the ABA waters seriously gets hooked. Don’t you wonder why? 


Daniel Adatto, BCBA

Wednesday, June 27, 2012

Discipline

When considered by parents, teachers and other caregivers as a punitive measure, discipline will, by definition, wrongly include an emotional component and carry with it the stigma of retribution or the need to “get even” for someone doing something “wrong.” It usually involves reacting out of frustration instead of responding with the goal of teaching. This approach provides with few benefits and has a number of limitations. In this context, discipline is equated with punishment and is not consistent with our mission. At all times, this mindset is to be avoided. Punitive behavior management strategies become an invitation to find ways to “get even” rather than an invitation to understand the framework for positive behavior.  As a corrective tool, discipline can be used to clarify the potential consequences for “bad behaviors.” By applying the concept of natural and logical consequences, the emotional element normally found in punitive disciplinary actions becomes neutral.

Natural consequences are those which allow children to learn from the physical order of things. Example: “If you spill your juice on yourself, you will be wet until we can get home and you can change.”
Logical consequences are those which permit children to learn from the reality of the social order. Example: the child’s clothes are all over his bedroom floor and he refuses to put them away. He wants to play video games. So the logical consequence would be: putting away the clothes is required before playing. 

 Natural and logical consequences require the child to be responsible for his own behaviors. As a father I want to motivate my kids to make responsible decisions, not to force them to submission.

 Here are some tips:

1. Be both firm and kind. Firmness refers to your follow through behavior. Kindness refers to the manner in which you present the choice. In other words, firm with the problem, nice with your child. But always give the child a chance to choose so that he can have control: “Would you like to your shower now or after dinner?” “Do you want to do homework before or after playing in the computer?”

2. Talk less; act more.

3. Avoid fights; they indicate lack of respect for the other person. Do not give in; that indicates lack of respect for yourself.

4. Motivate instead of obligate. Example: “if you eat your food you can have dessert.”


And don’t forget to play and have fun with your kids. You not only enjoy them but you deposit “money in the bank for rainy times” (when you have to direct them to non-preferred activities). Love and fun are the most powerful tools of discipline.





Daniel Adatto, BCBA