5 Ways to Get Ready for School

August is just around the corner and many are preparing for their children to go back to school or build an alternative school setting in their home. For children with Autism, a summer “break” or the foundational years spent at home may leave parents wondering what they can do to help their child prepare for school readiness. 

    1. Increase time at the table: Whether it’s sitting with preferred items at the table during play or working on pre-academic skills during non-preferred time at the table, increasing table time will help your child transition to sitting in the classroom setting at a desk. 
    2. Work on initiating writing actions and coloring: No matter where your child is at with writing skills, working on initiating more time writing, tracing, or coloring will help your child be able to practice these skills in a school environment. 
    3. Practice going through a calendar daily: Sitting and having your child listen to the day, month and year will help them prepare for calendar time at school. Feel free to play songs associated with the month and year along with seasons and/or weather. This will help your child be more interested in calendar time. Allow them to have as much ownership as possible by having them help placing the numbers into the calendar if possible. 
    4. Work on group skills and following group instructions: Have your child practice following instructions in a group of other children. Whether it’s at the playground, during a playdate or with siblings at home during play time, this will help your child be able to engage in group activities throughout the day at school.
    5. Practice walking in lines with other kids: Similar to the group instructions, having your child practice walking in lines will help get them into the routine and transition in a group.

3 Types of Planned Ignoring

Have you ever thought about ignoring your child? I’m sure there are times when there is an appeal to ignoring their behavior and other times it gets to the point where it’s driving you insane and you feel like you have to intervene. 

As far as behavior goes, planned ignoring is a consequence of a behavior that is directly thought out and as it says in the name, planned ahead of time. This can bring anxiety to a lot of parents and therapists alike. Ignoring can be really hard and can take several minutes to several hours. After knowing the basics and understanding that ignoring will lessen a behavior in the future, planned ignoring can become easier and feel like your best friend when unwanted behaviors arise. 

What exactly does it mean to ignore? Typically ignoring means avoiding eye contact, avoiding physical touch, avoiding engaging in conversation, avoiding reactions to behaviors, and creating obvious and possibly even exaggerated ignoring so the child gets the idea that the behavior is unwanted. 

According to the Rubi Autism Parent Training Network Handbook, there are three types of planned ignoring, all of which have their place in helping manage your child’s behavior:

  • Ignoring the behavior but not the child
    • For example a child repeating your name, you could still engage with the child and bring up several different conversation starters but ignore the repetitive behavior
  • Ignoring the child but not the behavior
    • This means that in certain situations you would still need to intervene and help during certain behaviors such as dangerous situations where your child could get hurt, you would still want to remove their bodies from danger but ignore them while doing it so that the behavior decreases in the future and safety is no longer an issue.  
  • Ignoring both the child and the behavior
    • In cases where both the child and the behavior are needing to be ignored would occur when the child is not in danger AND the behavior is disruptive or repetitive. For instance, a child dropping to the floor and tantruming during dinner could be ignored altogether for the behavior to decrease in the future. 

While the task to ignore may seem daunting, remember that it will be hard in the beginning but it will be worth it later and you’ll be so happy that you were able to ignore the behavior. Planned ignoring is a powerful consequence that is used in ABA daily because it works wonders and removes small “junk” behavior quickly and tougher behavior in the long term. 

Source: Bearss, K., Johnson, C. R., Handen, B. L., Butter, E. M., Lecavalier, L., Smith, T., & Scahill, L. (2018). Parent training for disruptive behavior: the Rubi Autism Network. Oxford University Press.

5 Sensory Friendly Ideas for 4th of July

Is your child not a huge fan of fireworks? We get it, the 4th of July can be a difficult time for a family trying to find firework alternative activities. Here are some tips and ideas for a sensory friendly holiday. 

  1. Backyard BBQ- While it may not be a((as fun of an outing)) fun outing, having some fun outdoors with a BBQ and your child could be just as meaningful as getting out in the community. 
  2. Baseball- Going to a baseball game could be just the thing your family is looking for and you can skip out before the fireworks begin or bring headphones for a child with auditory sensory needs. Go Royals!
  3. Zoo- going to the zoo could be a great way to spend time with your family and some amazing animals that you don’t get to see everyday! 
  4. Water time- whether it’s an outing on a boat, splash pad or pool having some family time in the water could be a great way to incorporate a sensory experience for your child that is positive and a great way to stay cool in the summer! 
  5. Make popsicles- Making a cool treat may be a great way for your child to engage with it’s((their)) sense of taste while staying cool on the fourth of July. You could even go really festive and make red, white and blue ones. Back to the Book Nutrition has an easy and healthy popsicle to make the day special! 

No matter what you end up doing with your friends, family and child, thinking a little outside the box and getting creative will mark a memorable holiday weekend!

6 Ways to Manage Meal Time

“My kid barely eats anything, they’re very picky,” is something I’ve heard commonly throughout my seven years in the  Applied Behavior Analytic (ABA) field. Parents can feel overwhelmed, annoyed or have completely given up on meal time behavior from their child with Autism Spectrum Disorder (ASD). Up to 89% of children with autism spectrum disorder (ASD) experience challenging mealtime behaviors (Ledford & Gast, 2006). This can include a child refusing to eat, only eating certain foods based on texture, color, smell or taste, refusing to sit or unable to partake in meal time discussion with family members.

While the behaviors surrounding mealtimes and eating patterns of children with ASD do not have a ton of research to go off of currently, there has been some progress on feeding techniques with children that have seemed successful thus far. Here are some strategies that may work for you meal times: 

  • Take Data: According to best selling author and BCBA-D, Dr. Mary Barbera, speaks on she recommends taking 3 days of data collection on exactly what your child eats will help you be able to assess if your child needs more intensive therapy such as feeding therapy along with being able to look at the list of food they are eating and be more strategic about how you’re feeding them. Even if you can’t take all three, or it seems overwhelming to do so, start by taking data one time a day!
  • Be strategic: Barbera also says that categorizing food into three categories can help you see what nutrients they are eating daily and how to meal plan around that. She recommends categorizing food by: Easy food (those that your child eats often and easily), Medium food (those that they eat occasionally throughout the month but not daily), and hard food (foods that you would like them to eat but they do not eat currently). This can help for a parent to actually know how much the child is eating of each item and the parent can adapt to feed more of the healthy items throughout each meal instead of allowing the child to fill up on filler foods and snacks. 
  1. Limit snacks/drinks: these may fill them up but are not giving them the nutrients that they could get naturally in the foods they eat. For instance, if your child is only eating chicken tenders, skittles, goldfish and strawberries, you could focus on providing strawberries in the morning for fruit content and giving them the pizza in the afternoon or evening along with the snacks occasionally. This would increase the chances of your child being hungry enough to eat more of the strawberries or be open to trying new foods and drinks such as a strawberry smoothie or strawberry yogurt.  
  2. Engage with children during meal times: Research by  Odar Stough et al. (2015) found that direct commands and parents physically feeding their child during mealtime were related to increased bite acceptance. Bite acceptance means that children were more likely to eat more food or new foods by their parents sitting with them, encouraging them and helping to feed them. 
  3. Eat with your child: This goes hand in hand with the research above. Eating with your child will help them imitate the behaviors they see you do such as sitting at the table, accepting new foods, and eating different foods with different textures/colors/smells. 
  4. Place a variety of foods on their plate: You might be thinking that you’ve tried this before or your child will just be wasting food but there’s a good chance that by putting yogurt and granola on the plate with their preferred strawberries will increase the likelihood of them trying the other foods on the plate. 

Hopefully these tips bring you encouragement and excitement that you’ve been looking for in  your family’s meal time. Remember, when in doubt, consult your child’s medical team to see if there is more that needs to happen for your child nutritionally.

Happy eating! 

Citations:

  1. Am J Occup Ther. 2019 Jan-Feb; 73(1): 7301205070p1–7301205070p10.Published online 2019 Feb 5. doi: 10.5014/ajot.2019.024612
  2. Barbera, Mary BCBA-D. (2018). How to overcome picky eating for children with Autism. Published online 2018 October 10. www.Marybarbera.com
  3. Ledford J., & Gast D. (2006). Feeding problems in children with autism spectrum disorders: A review. Focus on Autism and Other Developmental Disabilities, 21, 153–166. 10.1177/10883576060210030401 [CrossRef] [Google Scholar]
  4. Odar Stough C., Dreyer Gillette M. L., Roberts M. C., Jorgensen T. D., & Patton S. R. (2015). Mealtime behaviors associated with consumption of unfamiliar foods by young children with autism spectrum disorder.

Pairing and Building Rapport

In the field of applied behavioral analysis building rapport or “pairing” with the child is a vital step in early intervention. What is pairing? Pairing is when you pair yourself with reinforcement. This creates a positive therapeutic relationship between both therapist and child through the delivery of desired edible incentives, attention, or activities without the presence of demands (Lugo et al., 2018). The end goal of this process is that the child wants to see you and your company is liked. When the child finds you reinforcing by your presence, attention, and praise, they will be more motivated to comply with your demands.

Below are five easy steps to help you pair yourself with the child to make sessions both fun and effective.

  1. Play
  • Take a honest interest in what the child likes. During this step, you find out what the child enjoys and join in the activity with them. For example, if the child is playing with a kitchen set, ask if they would want to be the server or customer and role-play dining scenarios. Another useful tip during this time would be to ask them what their favorite food is, where they like to go to eat, etc.
  1. Assess
  • Preference assessments help to identify possible reinforcers for the child. There are multiple ways to conduct these but some simple ways would be to ask the child or ask people who know the child such as their parents or guardians.
  1. Reinforce
  • Use preferred items during therapy sessions. If the child likes to play Zingo, have them label a function of a particular item in the room when they match a chip to their board.
  1. Make learning fun
  • While working with the child, provide opportunities of turning “work” into games. You can turn a scavenger hunt to assist the child in recognizing colors, numbers, or finding items based on their features. There can be more enjoyable ways to help achieve their goals to keep the child motivated to learn.
  1. Never stop pairing
  • The process of pairing should be a continuous process that never ends and should be acted on during every session. The sessions then become something the child looks forward to which makes the therapy sessions more gratifying for both you and the client.

Building rapport through pairing is helpful in not only developing a positive therapeutic setting for both parties, but it can also help in decreasing problematic behavior.

References:

ABA pairing. (2020, November 17). Retrieved March 08, 2021, from https://howtoaba.com/aba-pairing/

Lugo, A. M., King, M. L., Lamphere, J. C., & McArdle, P. E. (2017). Developing Procedures to Improve Therapist-Child Rapport in Early Intervention. Behavior analysis in practice10(4), 395–401. https://doi.org/10.1007/s40617-016-0165-5

Lugo, A. M., McArdle, P. E., King, M. L., Lamphere, J. C., Peck, J. A., & Beck, H. J. (2018). Effects of Presession Pairing on Preference for Therapeutic Conditions and Challenging Behavior. Behavior analysis in practice, 12(1), 188–193. https://doi.org/10.1007/s40617-018-0268-2

5 Reasons to Use CAPS 

CAPS stands for the Comprehensive Autism Planning System. CAPS is a planning system that provides children with ASD or related disabilities a structured schedule. Multidisciplinary teams including teachers and parents, work together to provide support the client needs to be successful. Using a comprehensive daily schedule can lead to meaningful educational, social, and communication opportunities for our clients. This means more time being spent in the classroom learning, and less time having tantrum behavior throughout the day. This structured schedule includes objectives and goals for the client and the continual development of those skills. CAPS recognizes that the needs of clients with ASD may be complex, and is a tool to make sure that these needs are met during the school day. Here are 5 reasons why to use CAPS to support clients with ASD throughout the academic school day: 

It’s individualized. 

Each client has his/her own CAPS that is planned by his/her own team. This ensures that the client’s unique needs are addressed and met. All of the activities that the client participates in are taken into account and provides support during the day. From preschool aged to college aged students, CAPS can be used. 

Compatible with the current educational standards. 

CAPS builds in efficiency, accountability, and evidence. CAPS is a simple document that provides the client’s daily schedule and the skills the client is working on including – IEP goals, common core, socially valid skills, social interactions, and hidden curriculum skills. 

Ensures that research-based practice is implemented. 

Evidence-based practices are embedded in the client’s daily schedule to promote progress and skill development throughout the day. 

Monitors the client’s progress continuously using data as support. 

Data collection is taken across all settings throughout the day. While skill development and current educational goals are being targeted, data is being collected. This helps ensure that the client is being set up for success. 

Structured Flexibility. 

CAPS can be used in multiple settings from school to home to the community. This structured flexibility means that different strategies, methods, and supports can be used depending on the client. 

CAPS is a detailed daily schedule that is used to support an individual client and set him or her up for success in any environment. This schedule addresses reinforcement, structure/modification, communication, and sensory needs of the specific client. Schedules are individualized, flexible, continually monitored using data, use evidence-based practice, and are compatible with educational standards. The goal of CAPS is for the client to spend more time in the classroom, building meaningful relationships with peers, and growth. 

Resources:   Henry, S. A. (2013). Comprehensive autism planning system (caps) for individuals with autism spectrum disorders and .. Autism Asperger Pub.

Stimulus Fading

What are your thoughts on tracing? Like it? Love it even? Maybe you haven’t really given much thought about tracing. We can trace pictures, letters, we can even trace really big stuff like the inner rings on a tree. I am sure someone, somewhere has needed to do that… for science of course! I have walked into countless classrooms, and watched young kids trace their names, and trace their personal information. I have seen all age ranges, and all skill ranges tracing. But what I don’t see, is the gradual fading of that original stimulus that the learner is supposed to know and be able to write, I am guessing independently. I believe we don’t see this, because people don’t know about stimulus fading! As defined by Cooper, Heron and Heward (2014) fading is “a procedure for transferring stimulus control in which features of an antecedent stimulus (e.g. shape, size, position, color) controlling a behavior are gradually changed to a new stimulus while maintaining the current behavior; stimulus features can be faded in (enhanced) or faded out (reduced)” (p. 7).

For the purposes of this post, let’s focus on fading out a stimulus, and let’s choose a common (and important) one such as writing your name. When looking at an assignment, the top of the page typically has the word name, followed by a line behind it. We know that signals where to write your name, and evokes the behavior of doing just that! But this is something our learners need to be explicitly taught. They also need to be taught how to form the letters of their name, and practice making the necessary strokes to complete the task. We begin by having the student name in a dark color, and thick lines or dots to make it clear and noticeable. The student begins to trace their name with this heavy visual support, and continues to practice this particular skill. After the student is making consistent marks along with the dots or lines, we begin in to reduce this stimulus. This can be done in a few ways; we can make the lines less thick. We can make the dots a little farther apart. We can light the color of the lines to a darker grey. The important thing to remember is that, it still needs to resemble the student’s name, just less pronounced. The ultimate goal with this type of stimulus fading is to gradually reduce it over time, to evoke writing the students name independently. By doing this process gradually, we take away the need for the visual support of the student’s name, and then the original stimulus of name and line will evoke the student writing their name in that location.

Stimulus fading is a wonderful opportunity to promote generalization of skills. This practice will absolutely help to increase the independence of our students, and help them to participate in their daily lives!

Cooper, J. O., Heron, T. E., & Heward, W. L. (2014). Applied behavior analysis (pp. 492-493). Edinburgh gate: Pearson educational international.

Fields, L. (2017). Transfer of discriminative control during stimulus fading conducted without reinforcement. Learning & Behavior, 46(1), 79-88. doi:10.3758/s13420-017-0294-x

Markham, V. A., Giles, A. F., Roderique-Davies, G., Adshead, V., Tamiaki, G., & May, R. J. (2020). Applications of within-stimulus errorless learning methods for teaching discrimination skills to individuals with intellectual and developmental disabilities: A systematic review. Research in Developmental Disabilities, 97, 103521. doi:10.1016/j.ridd.2019.103521

 

Bedtime Pass

Do you have a toddler that holds you hostage at bedtime? Do they still happen to sleep in your bed? The struggle to get kids to go to bed is real, we have all heard stories, and I am sure we have all counseled others on this problem. I would like to introduce you to the Bedtime Pass. Dr. Patrick Friman, and colleagues, have given us this great procedure to help with this oh-so-common issue!

The Bedtime Pass is an extinction-based procedure that allows the child to access their parents at one point after the bedtime routine has been finished, but not after that. They also can only use this pass once a night. The procedure goes a little like this; your child is given one bedtime pass. This could be something the decorate themselves, or something that you make for them. It just must be something that they have ownership of as well, make it fun! Then we teach the procedure; 1. Put the child in to bed, 2. Provide the card that can be exchanged for one “free” trip out of the room, or parent visit in the room to satisfy an acceptable request, 3. Give up that pass, 4. Ignore all additional attempts to seek your attention (Moore et al., 2006).

The last one (#4) is where it gets a little tricky because we need to be prepared for something called the extinction burst. This is where we can say that things will likely get worse, before they get better. There might be crying, screaming, and maybe some behaviors that are emotional in nature. But let me say one more time, it may get worse before it gets better! This can be the hardest part of the Bedtime Pass procedure, but we are going to stay strong. The research shows a significant decrease in bedtime resistance in three areas; calling out and crying, leaving the room, and time to quiet (Moore et al., 2006).

The Bedtime Pass is a great way to set limits and expectations to help kids be successful during bedtime routine. It also increases the independence of our kids, and allows them to have access to parents when they need it, versus when they want it!

Moore, B., Friman, P., Fruzzetti, A., & MacAleese, K. (2006). Brief Report: Evaluating the bedtime pass program for child resistance to bedtime—A randomized, controlled trial. Journal of Pediatric Society, 32(3), 283-287. https:// doi:10.1093/jpepsy/jsl025

Friman, P., Poling, A. (1995). Making life easier with effort: Basic findings and applied research on response effort. Journal of Applied Behavior Analysis, 28, 583-590. https:// 10.1901/jaba.1995.28-583

4 Tips for Desensitization of Everyday Tasks

Individuals with Autism are likely to become avoidant, non-compliant, and may protest with negative emotions when it comes to events such as: medical or dental procedures, haircuts, and eye exams (Buckley et al., 2020; Cavalari et al., 2013; Conyers & Miltenberger, 2004). Behavioral techniques called desensitization, graduated exposure, positive reinforcement, stimulus shaping, and modeling are used to help increase the levels of tolerance related to the fields and others similar listed above (Cavalari et al., 2013).  These techniques do not always yield immediate results, which can be frustrating for our clients because they are required to be repeatedly exposed to non-preferred tasks. It can also be nerve racking for their caregivers at times because they want to see the child succeed and attend appointments with ease.

  • Little successes along the way are just as important as reaching the end.
    • Remember to praise every accomplishment along the way whether big or small. Positive reinforcement plays a key role in encouraging the client to keep working at building their tolerance.
  • Try not to jump the gun!
    • Sometimes we can get a bit too excited about the increase in progress that we are seeing and are tempted to move at a faster pace or skip steps. It is critical to not fall in this trap! A negative outcome can result in an extreme regression of progress and put the child back to square one. Remember slow and steady wins the race!
  • Encourage the client to express their concerns.
    • We can observe that our clients have negative emotions pertaining to the procedure, but are they able to tell us what about it they do not like? Also, do they understand why the procedure needs to occur in the first place? Making space for dialogue is important in increasing tolerance as well. If we understand that our client is primarily afraid of the squeeze of the blood pressure cuff, then we can adjust our focus to that specific area. Explaining that the squeeze only lasts a couple seconds and not forever (with a model most likely) can provide a peace of mind.
  • Let them take the lead.
    • A possible reason for engaging in avoidance or noncompliance with these kinds of procedures is due to the feeling of having no control. Try having your child or client take the lead with roles reversed, meaning have them be the doctor and you be the patient! This can help increase confidence levels and give them that sense of control back.

References

Buckley, J., Luiselli, J. K., Harper, J. M., & Shlesinger, A. (2020). Teaching students with autism spectrum disorder to tolerate haircutting. Journal of Applied Behavior Analysis, 53(4), 2081–2089. https://doi.org/10.1002/jaba.713

Cavalari, R. N. S., DuBard, M., Luiselli, J. K., & Birtwell, K. (2013). Teaching an Adolescent With Autism and Intellectual Disability to Tolerate Routine Medical Examination: Effects of a Behavioral Compliance Training Package. Clinical Practice in Pediatric Psychology, 1(2), 121–128. https://doi.org/10.1037/cpp0000013

Conyers, C., Miltenberger, R. G., Peterson, B., Gubin, A., Jurgens, M., Selders, A., Dickinson, J., & Barenz, R. (2004). AN EVALUATION OF IN VIVO DESENSITIZATION AND VIDEO MODELING TO INCREASE COMPLIANCE WITH DENTAL PROCEDURES IN PERSONS WITH MENTAL RETARDATION. Journal of Applied Behavior Analysis, 37(2), 233–238. https://doi.org/10.1901/jaba.2004.37-233

Differential Reinforcement of Low Rates of Responding (DRL)

Have you ever had your child, or any child really, ask you 100 questions in rapid fire succession? Have you ever had a student who raises their hand to answer every question in the lesson, and then becomes frustrated when they haven’t been called on each time? Most of us are not alone in answering these questions with a yes, because these are pretty common situations to find ourselves in. Enter, differential reinforcement of low rates of responding (DRL). Simply put; do this, but not so much, or not so often!

DRL has three different procedure components; Full-Session DRL, Interval DRL, and Spaced-Responding DRL. One of the best components of DRL is the fact that the reinforcement is not delivered based on the nonexistence of the behavior, but delivered when the behavior is below a set criterion. Let’s look at Full-Session DRL in a little more depth. In this specific procedure, reinforcement will be delivered at the end of the session, so long as the behavior occurred at or below a specified number of responses. For instance, a student leaves their seat without permission quite a lot and that starts to distract others in the room. After collecting data to see how many times the student gets of out of their seat, we determine an appropriate amount that would be allowed during a specified time frame. Using a Full-Session DRL procedure, the specified reinforcer would only be delivered if the student got out of his/her seat at the specified amount, or lower. If the out of seat behavior happened more than the specified amount, then reinforcement would be withheld!

This procedure would be great to use for behaviors that do not need to occur at zero rates, or simply need to lower the rate at which with they occurring.

Cooper, J. O., Heron, T. E., & Heward, W. L. (2014). Applied behavior analysis (pp. 492-493). Edinburgh gate: Pearson educational international.