Throughout our day, we all have times that we must stop one activity and start another. It is a natural part of our day to have to change our routine and we are often required to be able to do so successfully. Individuals with autism may have a greater difficultly with changes in routine. They may have a difficult time transitioning from one activity to another (Sevin, J., Rieske, R., Matson, J., 2015). Often individuals with autism, have a greater need for predictability in routine and may have a challenging time understanding what activity will come next (Flannery & Horner, 2004). Some individuals with autism may exhibit challenging behavior when a preferred activity or pattern of behavior is stopped to begin something new that may be less desirable. Thankfully, there are many evidenced-based strategies that you can use to help individuals with autism successfully transition during times of changing activities. These strategies focus on helping the individual prepare for the change as well as offer support during the transition and can be use across all environments (e.g. home, school, and community). These strategies can be implemented in a variety of ways including verbally, auditory, and visually (Hume, K., 2008).

• Priming—This is a preventative strategy that is used to prepare an individual for a particular upcoming situation or task. (Koegel et al., 2003). You should let them know what is going to happen beforehand. For example, “We are going to take a bath in two minutes. Remember after bath time you get to have a snack.”
• Priming can be done verbally or with visuals.
• Visual Schedule—Use a daily visual schedule to show what order specific activities will occur. If there is a change in schedule you can switch out the pictures and use the priming strategy to prepare them for the change and what to expect.
• Timer—A timer can be extremely helpful during transition times. You can use an audio or visual timer so the individual can see how much time they have left before the transition is going to occur.
• Use of Other Visuals—it may be helpful to pictures and/or objects to help the individual before and during the transition. For example, showing a walking sign to help the individual to walk during the transition instead of running.
• First/Then Language (Premack Principle)—You can use this strategy to state the order of activities, often a less desirable one first, then something preferred. For example, first math, then recess. This can be done verbally or in combination with a visual.
• Positive Reinforcement—If the individual transitions successfully from one activity to another without engaging in challenging behavior it can be helpful to use behavior specific praise and tangible reinforcement if needed. Praise throughout the whole transition. For example, “You are doing a great job walking in the hall,” or “I really like how you are picking up your toys so we can start your bath.”

Transitioning from one activity to another is a skill we simply can’t avoid. Transitions are required throughout our lifetime at home, school, community, and places of employment. The goal of these strategies is to prepare the individual for the transition by making it more predictable. Positive reinforcement should be used for successful transitions to make transition times a more positive experience for the individual (Hume, K., 2008).

References

Flannerly, K. & Horner, R. (1994). The relationship between predictability and problem behavior for students with severe disabilities. Journal of Behavioral Education, 4, 157-176.

Hume, K. (2008). Transition Time: Helping individuals on the autism spectrum move successfully from one activity to another. The Reporter 13(2), 6-10.

Koegel, L.K., Koegel, R. L., Frea, W., Green-Hopkins, I. (2003). Priming as a method of coordinating educational services for students with autism. Language, Speech, and Hearing Services in Schools, 34(3), 228-235.

Sevin, J., Rieske, R., Matson, J. (2015). A review of behavioral strategies and support considerations for assisting persons with difficulties transitioning from activity to activity. Review Journal of Autism and Developmental Disorders 2, 329-342.

Let’s set the scene. You’ve tried to teach your child to put their dishes in the sink and they are not moving from doing it with physical help to independence. It can be easy to ponder the ways in which you’ve offered time to train your child how to do a skill. What can be more difficult, is looking at the ways in which you learn skills and transferring how you learned, over to your child. 

Imitation is often an important part of learning. In school, children typically learn in group environments. Imitation is used vastly in the classroom to enhance daily routine skills and self help skills. Imitation is also learned in the home from children either by seeing their parents do something or imitating a sibling. 

Imitating is a very powerful way to learn but it is sometimes overlooked in the aspect of teaching a skill. Imitation leads to verbal, self-help, motor social, and responding skills. Some may call it the foundation of learning. 

So how can you teach imitation? Here are some steps below to help teach your child the basics of imitation if it does not come naturally to them. 

1. Start with basic gross motor skills or vocal skills that you’ve seen or heard the child possibly do spontaneously already. 
2. Provide the instruction “Do this” or “Copy me”. Emit the skill and then have the child do it in return.
3.  If they do not respond with the action, give them physical help. Repeat the above step several times until the child is able to do the action on their own. 
4. Once the child is repeating basic motor skills, you can begin to work on more complex 3 or 4 step activities. 
5. Make learning fun! Do it in an enjoyable way that has you and your child laughing. Use songs or games to create a more inviting setting. 
6. Have others provide imitation instructions to your child to make sure they are able to do the skill in a variety of ways. 

Incorporating these steps will not only help your child with basic activities, but will also allow them to work in other settings with other adults and children alike. 

A new meaning for the ABC’s: Understanding Antecedents and Consequences

In the early 1950’s B.F. Skinner, the founder of Applied Behavior Analysis, came up with the idea of a 3 term contingency. This 3 term contingency describes the relationship within the environment that a behavior occurs and then what happens next. If you think of any basic story it always starts out with setting up a scene and explaining characters, then an event takes place and then the choices that the main character takes during the event unfolds and consequences are detailed. This is the exact idea and meaning of the 3 term contingency. 

This 3 term contingency also now as ABC data can set up a scene to let us know what may be the main cause of a behavior that is occurring. For many parents and caregivers, it is important to understand ABC data and how to define it so that when a novel behavior occurs or a behavior increases significantly, the family can take data to see if the environment or what happens as a consequence is changing the behavior or is the reason the behavior is occurring. 

Below details the new ABC’s for you and the definition of ABC data:

• First an Antecedent happens, the environment is set up and described. 
• Then a behavior or event occurs. This is any action that a person does. 
• Finally, a consequence is described. Whatever happened AFTER the behavior is noted. 

Once you understand what ABC data is, you can then begin to write out these three parts in detail as data. This will help identify more what is going on and how it is being reinforced so that you can adapt the environment easily.

Finding different ways for children with ASD to engage with their peers socially can be a challenge. Incorporating game play into the child’s social skills repertoire can be a great way to create new social opportunities for the child with his/her friends and family.

Skills that can be targeted using game play:

• Asking someone to play
• Turn taking
• Waiting
• Staying with the group
• Team work- e.g. set up and clean up
• Sharing
• Appropriate voice level
• Collaborative play
• Resolving conflict- e.g. not going first or not getting the desired game piece
• Handling winning and losing

Keep it simple! For children who have limited exposure to game play, don’t work on too many skills at once. As the child masters a skill you can build on that skill and target others.

Keep it fun! For some children, you may need to adjust the rules prior to playing so the game can progress more quickly. Be sure to look for signs of fading interest during the game and find a way to end the game successfully. For example, have each person take one more turn before ending the game. Keeping the experience fun is key so the child will want to play again.

Provide praise! Be sure to provide immediate and specific praise when the child exhibits the skills you are targeting. You need to meet the child’s level on communication when providing praise. For example, “Wow, you’re doing a great job waiting your turn!” or “Great waiting!” depending on the level of the child.

Make the game meet your needs! You may want to adapt the game to take out skills your child isn’t quite ready to work on yet. For example, in Candyland take out the cards that advance or move back your game piece if the child isn’t ready to work on handling disappointment. You can also adapt game by adding in skills you want to target. For example, add in cards that target asking another player a question before moving his/her game piece. You can also find ways to add in movement for children who need it. For example, every time someone lands on green you do 3 jumping jacks. Just think of the directions in the box as being suggestions so be creative and think of ways to make the game meet your needs.

Don’t give up! Remember that the first try might not go as planned so go easy on yourself. Continue to provide the opportunities to the child so they can continue to grow and learn. Progress can’t be made if opportunities are not available. Be sure to collect your data so you can track the progress.

Overall, games allow for a great opportunity for children with ASD to play with peers and family members while learning social skills and life-long leisure skills. Be creative and have fun!

The Behavioral Health Center of Excellence (BHCOE) has awarded Autism Services of Kansas with a three year accreditation, recognizing the organization as a top behavioral service provider in the country. ASK is currently one of 18 companies to earn this accreditation in the U.S.  The accreditation celebrates exceptional behavioral health providers that excel in the areas of clinical quality, staff satisfaction and qualifications, and consumer satisfaction. These areas are measured via a wide-ranging audit, including interviews with agency clinical leadership, a detailed staff qualification review, anonymous staff satisfaction survey, and anonymous consumer satisfaction survey.

WHAT IS A BHCOE ACCREDITED ORGANIZATION?

A BHCOE Accredited ® Organization is an applied behavior analysis provider that has demonstrated it has met and continues to meet an assortment of clinical and administrative standards as determined by an independent third-party evaluator.

CAN ANYONE BECOME BHCOE ACCREDITED?

No, providers are not given the accreditation, it is earned. Providers are evaluated on a number of measures related to clinical quality.

WHAT DOES ACCREDITATION MEAN FOR THE ORGANIZATION’S CLIENTS?

The BHCOE Accreditation serves as a consumer protection mechanism that indicates the organization to quality improvement, transparency, and accountability. Collectively, BHCOE’s lead a growing movement of behavioral health
providers that aim to increase the collective quality of services across the United States.

The BHCOE Accreditation requires that the company continue to meet the Code of Effective Behavioral Organizations. As an employer, you know that your organization’s success starts and ends with its employees.

The BHCOE distinction demonstrates to employees that their company cares about their feedback, is able to look internally, and can set goals for
continuous improvement.

The BHCOE distinction demonstrates a company’s commitment to complaint resolution. Accredited providers are required to respond to compliance concerns brought forth to BHCOE regarding best practices. Many organizations utilize the compliance process to ensure that consumers and staff have a voice to file compliance concerns and resolve any areas of improvement internally. Think of the compliance review process as a mechanism to create a complaint resolution process that relies on independent third-party evaluation.

Learn More About the BHCOE

This year has brought on lots of excitement for our organization.  We opened our new office location, grew our service provider family to serve more client families and received our BHCOE Accreditation!

We are thrilled that Autism Services of Kansas is now a Behavioral Center of Excellence.  We want you to celebrate this accreditation with us. What does this mean to you and why is it important?

What is BHCOE Accreditation?

BHCOE stands for Behavioral Health Center of Excellence and it is an international accrediting body created to meet accreditation needs specifically for behavior analysis.

BHCOE Accreditation requirements are regularly reviewed at high, international standards in order to grant accreditation to organizations that directly work with behavioral health and behavioral analysis.

BHCOE Accreditation is a certification given to applied behavior analysis providers when they show that they meet the highest standards of care. In order to continue their BCHOE Accreditation, they must meet an assortment of clinical and administrative standards determined by an independent third-party evaluator.

History of the BHCOE

BHCOE Accreditation began as a five-year project to provide information about quality assurance for behavioral organizations, and transparency for their futures. It has since grown into the international Quality Assurance Standards and BHCOE Accreditation Program.

Since BHCOE’s official establishment in 2015, over 6,900 consumers have been surveyed and 8,375 staff have been surveyed. In 2017, only 57% of organization’s had a first-time pass rate.

What is a Center of Excellence?

A center of excellence is an organization that values clinical quality, staff satisfaction, and parent satisfaction while providing the highest quality of Applied Behavioral Analysis (ABA) services.

This accreditation is earned, not given, as providers are evaluated on a number of measures related to their clinical quality of work and satisfaction. BHCOE Accreditation shows that the organization meets the highest standards of clinical quality and has been verified by a third-party.

A Center of Excellence is an organization that respects its employees and clients, cares about their feedback, and is able to learn internally in order to better serve their community.

What does this mean for you?

Autism Services of Kansas being BHCOE Accredited means that we are indeed providing quality services.  The accreditation was what we imagine an “audit” to entail. They went through all important documents, surveyed staff and clients, and other extensive measures.  Our goal of becoming accredited was to ensure that we are up to par with all Autism Providers across the nation.  Some states require accreditation for autism providers.  Kansas does not, however we hold ourselves to the highest standards.  We will continue to work to improve and refine our practices.  Each family we serve deserves to work with clinicians who are always seeking ways to grow and better serve them.  This is what we will continue to do.

References

BHCOE Accreditation. (2019).  Retrieved from https://bhcoe.org/

Summertime is my favorite time of the year with warm weather, no school, and baseball! Below are my top three favorite summer time activities and suggestions for making them a hit with your child.

Sidewalk Chalk:

Sidewalk chalk is the perfect activity for kids with creative minds and perhaps not enough paper to write or draw on. It is also an enjoyable way to work on  shapes, letters, and color recognition.   Ed Emberly has a variety of step by step drawing books that use simple shapes to create an assortment of objects, animals, or faces.

Skills to add on:

• Basic Concepts
• Endless Expressive-Receptive Language
• Fine Motor Skills: Writing Letters, Name, Numbers; Drawing
• Gross Motor: Draw a maze to navigate through or ride bike/scooter

Scavenger Hunts:

Scavenger hunts can happen anywhere: your backyard, in a park, on a walk, or even inside your home on rainy days! Invite some friends/peers to join you and your child, which gives an opportunity to facilitate social interactions. Chelsey at Buggy and Buddy put together an amazing list of free printable scavenger hunts that are sure to keep you and your child learning while targeting some of the skills listed below.

Skills to add on:

• Gross Motor Skills: Walking; Climbing (if needed); Jumping
• Social Interactions
• Shape/Object Recognition
• Identifying items by feature, function, class

Water Play:

What better way to cool off on a warm summer day than to play in the water?! Here are a few water activities that are sure to keep you cool: colored water (food dye) mixing and pouring, water table, water balloons, and playing in the sprinklers.

Skills to add on:

• Color Identification
• Fine Motor-use an eyedropper, funnel, measuring cups to transfer water
• Shape/Object Recognition
• Imitation
• Gross Motor
• Play and Leisure Skills

I hope that you will enjoy these activities with your child this summer. Remember to incorporate meaningful activities into your daily routines and always take DATA!!

Autism affects countless families across the World every day. In 2007, The United Nations declared April 2^nd as World Autism Awareness Day. This year will mark the 10^th anniversary of World Autism Awareness Day. On this day, autism organizations around the world celebrate the day with unique awareness raising-events.

During April, which is recognized as Autism Awareness month, organizations, businesses, communities, and professional sports teams across the United States sponsor events to help raise awareness for Autism. There are countless ways to get involved, whether it’s as simple as wearing blue, volunteering to help with these events, or establishing new activities in your community.

Are you or someone you know looking for a way to get involved?

Here are a few different ways to participate in Autism Awareness Month in our community:

Kansas City Zoo Autism Awareness Day – Sunday, April 2^nd 2017
Do you, your friends, or your family love animals? If you answered yes, then maybe you should check out the Kansas City Zoo Autism Awareness Day on Sunday, April 2^nd. Free admission will be provided to people with Autism and the Zoo will offer reduced admission of $6 per person for those accompanying them to the Zoo. If this sounds like the purrfect event for you, check out the KC Zoo’s website for additional information and explore all nature has to offer!

Kendra Scott Gives Back Party – Friday April 7^th 2017
Kendra Scott has two locations in the Kansas City metro area which will host the party featuring special pricing, with a portion of the proceeds benefitting Autism research. From 5:00pm to 7:00pm the Kendra Scott stores located at Town Center in Leawood, KS and 412 Nichols Road in Kansas City, MO will host the party. If you or someone you know has their heart set on some new jewelry, stop by one of these locations to shop till you drop! Contact the Kendra Scott locations for more details on the sale.

Papa Johns – 40% Off All Orders – Now through April 7^th 2017
Too tired to cook, but still need to eat? Take advantage of Papa Johns discounted pizza from now until April 7^th 2017. Orders must be placed online with promo code AUTISM40. Contact Papa Johns for more details.

Walk to show support and raise awareness for Autism – Saturday April 8^th
Be a Hero and join the Eudora ACES for their 7^th Annual Walk for Autism on Saturday April 8^th from 12:00pm to 2:00pm. The walk will take place at CPA Park in Downtown Eudora, KS. For more details visit the Eudora ACES Facebook page.

Sporting KC Autism Awareness Game at Children’s Mercy Park Sunday, April 9^th 2017
Love Soccer? Hit the pitch with Sporting KC and Light Up Blue at Children’s Mercy Park on Sunday, April 9^th as Sporting KC takes on the Colorado Rapids at 6:00pm. To score tickets, head to Sporting KC’s website:  or SeatGeek and use Access Code: 17AutismCC.

Kansas City Royals Autism Awareness Night Friday, April 14^th, 2017
Few things are better than spending a night watching the “Boys in Blue” play ball at The K. If watching baseball is a hit with you, you can check out the Kansas City Royals as they take on the LA Angels on Friday, April 14^th, 2017. Hit a homerun and get your tickets at KC Royals Ticketing.

Day to day routines can be stressful, a routine is, by definition a sequence of actions regularly followed; a fixed program. Routines are performed as part of a regular procedure rather than for a special reason.

Everyone has them; they are a part of everyday life. Morning routines, school/work routines, and bedtime routines. Many children with autism thrive on predictability and structure. Routines give children a sense of security. When establishing a routine, consistency within the routine is key to its success.

Establishing a new routine isn’t always easy; it’s often difficult, the work you put in while establishing the routine will pay off in the end.

Here is an example of what morning routine looks like for my children.

• Get Dressed
• Put pajamas away
• Eat breakfast
• Brush Teeth
• Pack Backpack
• Get in Car

It is important to be consistent in the teaching and maintenance of your routine.   It’s predictable, reliable, and repeatable. No matter what sequence of steps have been decided on, it is crucial that all steps of the routine are followed. Provide positive reinforcement along the way. When a step is completed, praise your child. Celebrate all successes, no matter how large or small!