Structure and routine during the summer

“Your daughter officially finished 7^th grade,” said my wife.

“Iujuuuu,” said I.

“No iujuuuu, it means my peace is gone.”

“Oh, oh.”

We are already there. It’s summer and there is no school. Parents’ peace, at least for part of the day, is gone. Behavior problems are creeping in. So it is a good time to review some “summer behavior management strategies.”

Remember: boredom is one of the main culprits of behavior problems in children. The lack of predictability that goes hand in hand with summer and the absence of regular routines can cause stress in children.

Parents usually assume that most children would be happier during the stress-free days of summer. But this isn’t always so. Many children do much better with routines that are more synonymous with the school year. When a child can anticipate what is coming it increases his sense of control and independence and therefore encourages cooperation. Having a familiar routine builds confidence and decreases anxiety.  

But not all is lost just because it is summer. If your child is not attending a summer camp or doesn’t have a daily activity to depend on, it is still possible to build structure and routines into the day. Some useful tips are:

- Maintain times and sequence of events as structured as possible. For example, stick to sleeping and eating routines.

- Since children feel more secure when they know what to expect, it is best to plan the day ahead of time and discuss it your child the day before.

- Build some choices into the day to help your child feel some control and nurture self-esteem.

- If necessary, use visual schedules (pictures, drawings, etc.) to cue a child about what is happening. 

- Present scheduled of activities in a positive manner and try not to be overly rigid. Some flexibility is always necessary. If you remain flexible and adjust your expectations, it will be easier to maintain a stress-free environment for your children.

- Plan physical outlets daily. Kids need to burn energy. Sitting in front of the computer or playing video games for hours long is a recipe for disaster. Planning play-dates at the park or at the beach could be good ideas. Going hiking and bike riding is always fun. 

- Watch what they eat. If your child is not overweight some “junk-food” is OK as long as you balance it with healthy food. Food is the main source of energy. Too much sugar and processed food have a direct effect on mood changes. When in doubt, consult with you pediatrician or a nutritionist.

- Plan some quality one-on-one time with your kids where they are the “boss” and you play with them. 

 

And finally, always include some free time in the day – children need some down time and it can be exhausting to be overly scheduled.

And have a happy summer!

 

Daniel Adatto, BCBA

cadatto@tesidea.com

A new take on Autism

I came across an interesting video on YouTube called “In My Language”, written by an Autistic adult. It depicts a very interesting angle on Autism and may answer some questions to those of us who have looked at autistic individuals and wondered what must be going through their heads. It also paints a picture of this father’s perseverance and determination while her daughter struggles with the isolating challenges of autism.

Overall it is an inspiring story that is dramatic but at the same time encouraging and offers a good glimpse into the mind of someone with autism. It shows how communication is paramount in the relationship with your children, and especially at this level of autism. For most behavior difficulties, communication emerges as part of the problem and is an essential part of the solution. If the behavior problem is related to the child’s communication needs, then teaching more effective communication skills needs to be a major part of the solution.

For this reason teaching and encouraging functional communication should be a key component of any intervention program. As teachers and parents we should take every possible steps to build healthy communication repertoires. And as the video shows, communication is not limited to talking. There is plenty of technology to compensate the lack of verbal communication. Pictures, signing, visual clues are some other ways you can help your child to communicate.

The first part of the video is in her "native language," and depicts a typical perspective of someone disabled, unable to communicate, weird hand flailing and repetitive movements. But then the second part provides a translation, or at least an explanation of how the autistic individual’s mind works. It is a wonderful statement about what gets considered intelligence, personhood, language, and communication, and what does not.

I think the point she very effectively communicates is that the fact that we don’t understand them, in their language, does not mean that they are the disabled ones. 

Let’s understand them. We should not give up. They are there, we just need to find them.

 

This is the link to the video.

http://www.youtube.com/watch?v=JnylM1hI2jc

 

Daniel Adatto, BCBA

cadatto@tesidea.com

Urine test to screen for Autism

Women have been doing it for over a decade: Pee on a stick in the privacy of your own home and moments later, find out if you are pregnant. Two lines or one, positive or negative, pregnant or not pregnant. It’s as simple as that. Could it now be this simple to diagnose Autism?

According to a research published a couple of years ago, children with autism have a different chemical fingerprint in their urine than non-autistic children. The researchers behind the study, from Imperial College London and the University of South Australia, suggest that their findings could ultimately lead to a simple urine test to determine whether or not a young child has autism.

According to the CDC, Autism affects an estimated one in every 100 people in the US. People with autism have a range of different symptoms, but they commonly experience problems with communication and social skills, such as understanding other people's emotions and making conversation and eye contact. Currently, diagnosing a child with Autism can be a very subjective process. Parents often notice something is not right about their child between the ages of 12-18 months. At present, the only way to assess a child for autism is through a lengthy process involving a range of tests that explore the child's social interaction, communication and imaginative skills. Many children don’t get diagnosed until even later, missing a critical window of opportunity for early intervention.

People with autism are also known to suffer from gastrointestinal disorders and they have a different makeup of bacteria in their guts from non-autistic people.

This research shows that it is possible to distinguish between autistic and non-autistic children by looking at the by-products of gut bacteria and the body's metabolic processes in the children's urine. The exact biological significance of gastrointestinal disorders in the development of autism is unknown.

The distinctive urinary metabolic fingerprint for autism identified in this new study could form the basis of a non-invasive test that might help diagnose autism earlier.

This would enable autistic children to begin treatment for autism, such as advanced behavioral therapy, earlier in their development than is currently possible.

Early intervention using the methods of Applied Behavior Analysis (ABA) can greatly improve the progress of children with autism. The earlier the better.

 

Daniel Adatto, BCBA
cadatto@tesidea.com

 

 

 

Twins and Autism Spectrum Disorders

For years, scientists, parents, and doctors have debated the causes of autism. According to certain studies, there is a higher rate of autism among identical twins and although not as high, fraternal twins. Twin studies may seemingly point to a genetic cause for the autism spectrum disorder; however, the increased risk amongst fraternal twins seems to indicate that environmental factors also play a role.

While there is still much to be studied on this topic, documentation of twins development where one twin suffers from autism and the other is typically developing can help researchers tremendously.

I came across a series of videos released by the National Autism Awareness Month, Rethink Autism a while ago which help to raise awareness of autism among parents. Through the powerful story of Trina McField, a mother who recognized early signs of autism in one of her twin boys, these videos educate viewers on how to spot the early signs of autism, highlighting the contrast in behavior between a child with autism and his typically developing twin brother. The videos also suggest evidenced-based treatment options available to parents and show the dramatic improvement in a two-year-old boy with autism after just five months of treatment at home. Behind the video footage is an incredible story of a mother who perseveres through doubt and uncertainty to bring hope to and create a future for her son with autism. The story inspires and empowers parents to start early intervention treatment using an Applied Behavior Analysis (ABA)-based curriculum. Recommended by the US Surgeon General and the American Academy of Pediatrics, ABA is the only treatment for autism that has been consistently validated by independent scientific research.

When in doubt consult with your pediatrician. And give us a call. We, who devoted our professional lives to this field, are here to help.  

 

Daniel Adatto, BCBA

cadatto@tesidea.com

Let’s teach our kids how to be happy

I recently overheard one teacher’s assistant say “They don’t know how to be happy”, after one of her students responded in a grumpy way for no clear reason. Interesting statement, I thought, why I don’t write a blog about it.

Happiness, being happy, is a subjective state. What is “happy” for one person might not be for another one. But for the sake of this discussion I think we can agree that when we are happy we feel good, we are more in control of our behaviors, and we enjoy ourselves. Most people know how to be happy for the most part because they know what makes them happy. An activity they enjoy doing, a favorite restaurant, time with loved ones, success at work, the satisfaction of fulfilling responsibilities, etc. In behavioral terms, most people know how to meet natural contingencies of reinforcement, or how to obtain rewards. 

For kids with special needs this doesn’t come naturally. They often live in a state of confusion and anxiety.  Not only is it difficult for them to understand what’s going on around, they don’t know how to meet natural contingencies of reinforcement. In plain English, they don’t know how to achieve positive experiences. The chaotic organization of their behaviors can make them feel in a constant state of discontent.  This can cause frustration, anger, disappointment to the people around them who then react with aversive methods of discipline. Which then feeds the cycle.

Therefore, it is our job as teachers and parents to rescue them. We need to teach them how to be happy. In the process, we can also manage their behaviors.
How do we do this?

As explained in my blog post titled “What’s your talent?” we do so by exposing them to experiences where they can feel a sense of success and achievement:

1.      Contrived rewards and praise have to be built into their daily schedule of activities, at home and at school. Instead of waiting for them to fail to reprimand them, let’s create the environment and provide them with the necessary support to succeed.

2.      Catch them being good. Even during challenging situations make an effort to praise them for something. Do not focus exclusively on the “bad.”

3.      As we discussed in a previous blog (See “Fun can change behaviors”), something as simple as fun is the easiest way to change people’s behavior for the better. For example, if a child is resisting brushing teeth, going into the bathroom together and singing a funny song may be motivation enough. If getting dressed is a struggle, initiate a game of tickle, act silly and turn getting dressed into something fun.  Instead of demanding that a child clean up the toys, turn on some music, dance around and turn it into a game.  Make it fun and you will make it easier.

4.      Another way to help them be happy is to teach the child a more effective and appropriate way to get her needs met. If your child is having a hard time doing homework, for example, teach her to ask for breaks, or help.

Disciplining our kids is part of our job description as a parents and teachers. I know I’m doing my job right when I make them laugh/smile. I do that best when I’m enjoying my time with them. You need to have “fun” in your toolbox because fun is one of the most powerful tools of discipline.

 

Daniel Adatto, BCBA

cadatto@tesidea.com

Family involvement

We always say that when parents and other caregivers get involved in the interventions, their children show the most gains and progress. Parents become the therapist and thus, the intervention is in place 24-7.

The question is what it means to be involved. Here are my recommendations regarding the necessary steps of family involvement:

Phase 1: Look, listen, and learn

·       This is the introductory phase where the parent observes the behaviorist working one to one with the child. The parent will observe different segments in a variety of domains including independent living skills, functional communication, play, and behavior. Verbal instruction as well as modeling will be used throughout this phase to familiarize the family with common strategies and techniques.  

·       20 - 25% of the session will be devoted to observation. 

Phase 2: Working together

·       The parent has now observed all of the segments and is given a choice of what segment they would like to work on. During this step the parent and provider are both actively involved in the segment. The parent begins to give instructions, redirect inappropriate behavior, and use reinforcement contingencies.

·       The behaviorist is collecting data on the consumer’s interactions with the parent as well as with herself/himself.

·       20 – 25% of the session the parent and behaviorist will work together on achieving the consumer’s goals.

Phase 3: Parent lead

·       The parent is now leading the segment with the support of the provider. Instructions, redirections, and opportunities are all directed by the parent.

·       The behaviorist is taking data on the interaction and is only stepping in when necessary to give feedback to the parent.

·       25 – 30% of the session will be parent lead.

Phase 4: Independence

·       In the fourth and final step the parent is working with the consumer one to one and the provider has been completely faded. The parent is responsible for handling difficult behaviors, following through with demands, and employing environmental modifications.

·       The parent and behaviorist are both taking data that will be compared during the debriefing session to check for reliability.

·       25 – 30% of the session will include parent participation.

 

All this take and investment in terms of work and commitment. But it is worth it because you are investing in your family quality of life.

 

 

Daniel Adatto, BCBA

cadatto@tesidea.com

The First 3 Months of Early Intervention

Numerous research studies show that the earlier the better when it comes to early intervention using applied behavior analysis in the treatment of autism.  What is not so often written about, is how exactly to begin an early intervention program and what are the critical first steps to take when a Behavior Analyst begins working with a child with autism.

At a recent ABAI conference an expert from Poland held a session on why the first 3 months of an early intervention ABA program are so critical. The presentation focused on quality of services and building a strong foundation, reminding us not to jump ahead too quickly, not to target all deficits but to prioritize deficits and skills to ensure quality. The presenter emphasized how important it was to develop a positive relationship with the client in the first month in order to obtain optimum results. This information probably seems intuitive to most Behavior Analysts yet so many of us go about our first treatment sessions the wrong way.

When a typical ABA program begins, a Behavior Analyst will gather information on problematic behavior and details surround that behavior - the frequency, where it occurs, when it occurs, etc. The Behavior Analyst will meet with important people in your child's life, such as friends, babysitters, teachers, and relatives to get an understanding of how they behave within a variety of relationships. Also, they will schedule a time to observe your child to personally witness the problematic behavior. Once they have gathered enough information, the Behavior Analyst will complete an entire behavioral assessment on your child's behavior and then begin to implement the plan in your child’s natural setting such as the home or classroom. A Behavior Therapist will typically show up with a bag of tricks (toys, games, motivators) and get to work. This is where, according to the presenter, some of us may be going wrong.

What she recommended was to use the first month to build motivation in the child by establishing a playful rapport. Do whatever it takes to win him over – jump on the couch, do fun activities or just be silly.  If a child knows that every time his therapist comes he/she will need to work, then a feeling of dread comes over the child when the therapist arrives. But if the first month is used to establish a positive foundation, the child will look forward to the arrival of his therapist and be more motivated to work.

Another recommendation was to take a step back in the beginning to identify the motivating factors that are already in the child’s home. If all the therapist uses to motivate the child are his special toys in the bag of tricks, it will be very difficult for the parents to replicate once the therapist leaves. If there are things in the household that motivate the child – special  DVD’s, one-on-one attention, preferred games – use these motivators rather than the toys that come and go with the therapist.      

And as we always say, consistency in the implementation of the treatment plan across people and time is paramount in the success of the intervention.

We at Total Education Solutions are committed to being at the forefront of the behavioral health services industry. We strive to keep up to date with all the latest research and trends in the industry. It is always our pleasure to pass along to our readers and clients the valuable information we learn.

Daniel Adatto

cadatto@tesidea.com