4 Affordable products that can Help keep your child with Autism Safe in an Emergency

As a parent, you want to believe that you will always be ready and able to protect your child. There is no greater bond than that between a parent and child. Most parents would give their lives to save their child without even hesitating. 

However, a time could come when you are rendered incapable of being able to take care of your child. For example in an accident or a house fire. In this case, the best way you can be sure to keep your child safe is to take some advanced precautions.

I could write a book about Autism and safety. In fact, I am thinking about doing just that. But for now, here are four simple things you can do immediately to help make sure your child is safe in the event of a disaster or emergency situation.

A Seat Belt Cover that identifies a child as having Autism

This tool notifies emergency responders that your child has Autism and they may not respond, or respond differently than other children to verbal instructions. 

Depending on where you live, police officers and other first responders have little to no training on recognizing Autism and how to work with those individuals. 

There have been countless examples of news stories where police have mistakenly identified teenagers with Autism as having been under the influence of drugs or alcohol and arresting them instead of helping them in emergency situations. 

The good news is that law enforcement agencies are starting to provide more training for police officers to identify when a child has Autism and how to respond. 

However, getting a seatbelt cover to identify your child as having Autism providing simple clear information to police officers that could be invaluable in the event of an emergency. 

While I hope your family never experiences this, if you are ever rendered unconscious, or incapacitated due to a car accident, having a seatbelt cover to identify your child as having Autism will help responders assist him.

When interviewing an emergency responder and asking the number one thing parents of children with Autism could do to proactively help responders in the event of an emergency, EMT Chris F. suggested something to identify your child as Autistic is helpful in an emergency situation. 

He says, “It is useful so first responders can identify the occupant’s needs and treat the patient accordingly.”

There are several options on Amazon, I find this one above to give the clearest instructions to police officers and other first responders.

While, I hope you never have to use it, this is something every family of a  child with Autism should have. 

A Medical Bracelet 

A medical bracelet is another easy and common way to identify your child as having Autism.

Some parents feel worried about the social stigma around having Autism and do not want to identify their child as having Autism.

However, if your child is non-verbal and cannot provide basic information like his name and a parents name and phone numbers to a police officer, it is imperative that they are wearing something that would identify that information.

I have also researched this one called RoadID www.roadid.com that has some great options for medical and identification bracelets. For kids with sensory issues they have one that is stretchy silicone (so no buckle issues). They also offer access to an updateable and secure online emergency profile to which you can attach documents and add additional information. You can also add badges to it for things like Diabetes T1 or T2/  the puzzle piece symbols, etc.

A GPS tracking device

Every parent wants to believe that their child will be safe when they send them to school. However, the truth is, there are far too many stories about missing children with Autism from schools in the news. 

In fact, today as I am writing this article, a four-year-old child is missing from school. Putting a GPS tracking device in their pockets could help in the event of a tragedy. 

This is usually met with a lot of controversy.  Parents often express discomfort having their child walk around with a tracking device.  

It can also be a bit impractical.  The truth is you would have to try to figure out a way to keep it on your child’s body without having them fuss with it.  Putting it in a backpack wouldn’t work because it is unlikely in the event a child were to wander, they would have it with them. 

 However, most kids can learn to keep something in their pocket without touching it. 

If you know your child wanders away, the benefit of this may significantly outweigh the inconvenience. 

It is another one of those things, you hope you never have to use, but retrospectively, never want to wish you had. 

After doing some research, I recommend this one due to its low price for monthly service. 

Exterior Door Alarms

Children leaving the home during the night once they are able to open doors is a fear every parent has. 

Get an alarm for your front door so you are alerted if your child were to leave. 

It is critical that if you have a young child in your house that may leave the house at night that you put an alarm on your door, whether or not they have Autism.

You don’t need an elaborate home security system. For just a few dollars, you can get a simple motion detector alarm for each door in your home.

This way, if your child left the house when you were sleeping or even distracted by a phone call or doing dishes, they won’t get very far without you knowing it.

It’s truly a no-brainer and worth the peace of mind. 

Everybody thinks an emergency won’t happen to them. However the truth is, anything can happen to anyone. Being prepared is the best way to keep your child safe. These simple easy things can truly save your child’s life in the event of an emergency. 

It’s the classic case of better to have it and not need it then need it and not have it. 

What are the verbal operants and why do they matter?

Verbal behavior seems like the newest buzz word in the world of Autism. Parents ask me almost every day what it is and how it is different from applied behavior analysis (ABA). Truthfully, it is usually used interchangeably. Technically speaking though, it is the part of ABA that teaches children how to use language to communicate.

Verbal behavior was developed by Skinner back in the 1950’s. Contrary to what many people think, it is not a new term. Truthfully in my personal opinion, which is not a popular one, behavior therapists are being forced to reconcile the dark history of applied behavior analysis and are using new words to create new connotations.  Whether that is true or not, verbal is a critical instructional methodology for kids with Autism.

Children who have only a speech delay benefit largely from speech therapy. Speech therapy will help most kids who do not have any developmental delays with talking as long as they are physically able to. However, children with Autism require more than just speech therapy. That’s because children with Autism by definition have delays in all areas of communication. All people with Autism start off with communication delays.  It is important to note that many people with Autism learn to communicate just as well as any neurotypical person. However, without delays in communication a person cannot get a diagnosis in Autism.

At this point, it is very important to understand a delay in communication is not the same as a delay in language. Language is vocal. Most of communication is non vocal. Early stages of communication includes eye contact, especially using eye contact to initiate and respond to joint attention and using gestures such as pointing.  Reaching or grabbing for something or trying or bringing someone to a desired object is typically not considered communication.

Children with Autism do not use eye contact or gestures to communicate unless they are taught to do so in early childhood development. This is where applied behavior analysis comes in. Applied behavior analysis is most commonly known for its ability to address problem behavior. However, the truth is that in its initial applications, it was primarily used to show a person what a correct response is.


Let’s look at a very basic example of how that works.

Let’s say that an adult puts a button on the table in front of a child. The child has no idea what it is for. The child pressed the button and the adult gives the child a cookie. The child may not initially understand that he was awarded the cookie for pressing the button. However, if the same thing happened five times, eventually they will learn that when they press the button, they get a cookie.  Now, whenever the child wants the cookie, they will press the button.

That’s how ABA works. Behaviors that a child does not know or understand are taught using a highly structured approach. A response is given, the child responds either independently or with help and the behavior is reinforced usually by a child getting an object that they desire. Eventually the child will learn to engage in the behavior and the reinforcement can be faded. Then the child can engage in the behavior independently.

Today applied behavior analysis has many practical implications. However, when using applied behavior analysis to conduct what it is commonly called verbal behavior or simply teaching a child to talk, this is the most basic application.

The main reason that parents seek out ABA is because they want their children to learn to talk. While this is not the only purpose of an ABA program, it is often the main component.   Most often children learn language naturally by hearing others speak. But as stated earlier, children with Autism do not. They require language to be taught to them directly. ABA therapist break down language into some very basic components called operants. By teaching these operants or skills individually, ABA therapist can significantly increase a child’s ability to use language to communicate and after reading this section, so can you.

In behavior therapy, the verbal operants are: a mand, an echoic, a tact and an intraverbal. Once you understand each of these terms, it will be easy to tell them apart and you will know what to teach. In typical language development, they are learned in that order. However, from my personal experience, some children with Autism will follow the progression out of order. This is usually depends on what stimulus a child attends to, what lessons a therapist selects to teach first and whether or not they engage in vocal stereotypy.

Some children with Autism are very vocal even at a very young age. They will repeat almost anything an adult says or they will initiate words independently but they are out of context. These are vocalizations but may not be functional language. That’s why is imperative that a person understands verbal operants. The verbal operants provide a way to know if a child is truly communicating. The following section will explore the different types of verbal operants in detail and give examples of them.

A mand is in simple terms a request. The learner wants something, says what they want and gets what they said. It is triggered by a person’s desire for something. The fancy ABA term for that is specific reinforcement. This is the only operant where reinforcement is specific to what is said. Requesting is one of the main components of language. Children constantly ask for things. Requesting is the most motivating type of language and the one children learn first. Think about it, you get what you say. There is very real tangible consequence when you ask for something that is favorable. Therefore, it should be the first operant taught and initially the one that is focused on the most.

The second operant typically learned is an echoic. In this operant, someone says something that the learner repeats and the learner receives something unrelated to what is said. It is triggered by something someone else says. This is called nonspecific reinforcement. At this point, this probably sounds really confusing so let me give you an example to illustrate. A teacher says. “Say blue.” The child says, “blue” and the teacher says. “Great job.”

Sometimes it is hard to differentiate between mands and echoics when children are first learning mands because therapists will assist or prompt a child to give a correct response by telling them what to say. For example, if a child wants an apple and his therapist says, “say apple,” and the child says, “apple.” If the behavior results in specific reinforcement (the child gets the apple), it is a prompted mand, not an echoic.  Echoics are mostly used in ABA to clean up pronunciations or to teach children to build upon their language by speaking in sentences. It can be an important part of an ABA program but it is the operant that occurs least often naturally in language.

The third verbal operant is a tact. A tact is when a person makes a comment about something they see, touch, smell, taste or hear. This operant is triggered by something in the environment. In order to be considered a tact, the comment must be made about something present. For example. “This tastes great.” “I see a yellow bird.” “I can hear a train.” Once again, reinforcement is non specific.  Some tacts that someone may learn in ABA is to identify an object’s color, features, category, attribute or function. When visuals are used to teach this, such as books, puzzles or flashcards, it is a tact.

The final and fourth verbal operant is an intraverbal. This is the most natural conversational tact that is used in conversation. This is when someone makes a comment or asks a question based upon what another person says without the object they are discussing being present. For example, “What’s your name?” “My name is Jessica?” “My favorite color is pink.” “Cool, my favorite color is blue.” Intraverbals are similar to echoics in that another person triggers the behavior. But it is different because with intraverbals reinforcement is non specific.  It is different from a tact in that there is no visual is present.

In order for anyone to have a fluent conversation, they must be able to use all four verbal operants. The next time you have a conversation, think about this final chapter. You will quickly notice yourself using all four operants in conversation.

The following chart will summarize all the info above just to make sure it is really clear:

References

Cooper, J.O., Heron, T.E., & Heward, W.L. (1987). Applied Behavior Analysis.





6 Sensory Friendly Stocking Stuffers for Under 10 Dollars!

It is so hard to believe that the holiday season is already upon us.  This year just flew by. If you are anything like me, standing in long lines at the mall fighting for the best deals is not how you want to spend your holiday.   While some people enjoy holiday shopping, for busy moms like yourself who have a million things to juggle already, it is probably more stressful than fun. Additionally, kids with Autism often have very limited interests so knowing what to buy your child can make holiday shopping even more frustrating. 

I want to take the mystery out of shopping this holiday season for you. One of the number one questions that parents ask me during the holiday season is what they should get their kids.  There are a few things that i have found that hold true for almost all kids with Autism.

  1. They respond well to toys that provide visual or tactile sensory stimulation. Because many kids with Autism lack complex play skills, they find solace in simple things that either enjoy watching or touching.
  2. You may have to try a dozen different things before your find something that interests your child.
  3. Children often get bored of things very quickly.

That’s why I put together a list of 6 stocking stuffers you can order right from this blogpost that cost less than 10 dollars. While I cannot guarantee they will work for your child, I chose them because they are the most common toys that the children I work with enjoy.  Since none of the toys cost much, there is minimal risk. All of the toys selected will provide your child with some sensory input which is demonstrated to reduce stimming behaviors for some children.

References

Allen, A. P., & Smith, A. P. (2011). A review of the evidence that chewing gum affects stress, alertness and cognition. Journal of Behavioral and Neuroscience Research, 9, 1, 7–23.

Foss-Feig, J. H., Tadin, D., Schauder, K. B., & Cascio, C. J. (2013). A substantial and unexpected enhancement of motion perception in autism. Journal of Neuroscience, 33(19), 8243-8249.

Stalvey, S. and Brasell, H. (2006). Using Stress Balls to Focus the Attention of Sixth-Grade Learners. Journal of At-Risk Issues, 12, 2, 7-16

Tips for an Autism Happy Halloween

Halloween is many children’s favorite day of the year. However, for children with Autism it can be more spooky than a treat. They are being forced to communicate with potentially dozens of unknown strangers which can be both challenging and stressful. Children with Autism often like routines, may have sensory preferences that make costumes difficult and may not fully understand why people are dressed in costumes. Many Halloween costumes and decorations can even be scary for neurotypical kids.

The good news is that there are things you can do as a parent to make Halloween a fun and enjoyable experience for any kid, even a kid with Autism. As a parent, you want your child to experience all the joys of childhood and create the same beautiful memories you parents created for you.  For your family, this may include Halloween.

Following these ten steps can help make Halloween a positive experience for your family.  Read this right away, you will want to start a few weeks in advance.

Tip 1: Start having your child try on their costume a few weeks in advance.

Last year, I was working with a four year old child who was very excited for Halloween. He picked out his costume and was talking about going trick or treating for weeks. His mom was very excited since it was the first year he doing well enough to be able to participate.

When Halloween finally came and it was time to put on the costume, he had a complete and total meltdown. He screamed and cried and kicked and absolutely refused to put on the costume. He wouldn’t even try it on.

Mom tried to make it a game,  man handle him in it and bribe him  but it was no use. He was not wearing the costume. Now him and his mother were both frustrated. Hallowen was ruined.

This particular child had a lot of sensory aversions. The costume was a different material and shape of the clothing he was used to wearing. It was more constricting and putting the whole thing on at once was just too much for himl.

Sometimes it takes practice to get your child to try on his costume. I recommend always having your child try on his costume ahead of time so that you can find one that is suitable for your child, especially if they have sensory needs. If you have a hard time having them keep on sunglasses at the beach or hats during the winter, you probably don’t want one with a mask. Keep into account you child’s past preferences with clothing when choosing a costume.  If your child has had any sensory aversions keep it as simple as possible. A shirt with their favorite cartoon character is a perfectly acceptable costume.

If your child wants to dress up in a particular costume but is having difficulty wearing it gradually get them used to it. You may want to start off by simply having the costume out and having them touch it. Then have them put on just part of the costume. You can even have them put in just one arm or leg and then be done for the day. The earlier you start the more time you will have to gradually expose them to the idea.

Some kids will also feel less stressful if other members of your family wear a costume. If you think this would make your more comfortable, have the whole family dress up for dinner for a few days before Halloween! It could be fun!

Tip 2: Practice ahead of time.

Practicing ahead of time is not just for the costume. You should also practice having your child ring a doorbell, wait and say trick or treat. You can rehearse this in your own home. Rehearse it several times a day for at least the week leading up to Halloween.

Initially, give your child a piece of candy,  a new toy or even a penny for a correct response. This will serve as a reinforcer. Anything is fine as long as your child wants it. You will want to continuously reinforce your child’s behavior until they have learned to respond correctly.

Once they have responded correctly at least five times start to practice other  variables such as someone not ringing the door, not having candy or your child getting a candy they don’t want. Let’s face it. Not everyone celebrates Halloween, will answer the door or buys the good candy.

If possible, ask a friend or family member if you can practice at their house too so your child has experience with multiple locations. It is also a good idea to practice with a family that has a dog if you have a friend or family with a dog. Hearing a dog barking and having someone open the door can be stressful for many children that are not used to animals.

The more your child is prepared for what will happen, the more enjoyable Halloween will be.

Tip 3: Use a social story

A great way to convey information to your child about what will happen on Halloween is to use a social story.

A social story is a short story written in a specific way that is designed to provide information to your child about how to respond in a social situations. It is one of the most effective and well researched strategies for teaching children with Autism about new situations.

Here is a social story I have written specifically with your family in mind.

HALLOWEEN SOCIAL STORY

Soon it will be Halloween. Halloween is fun.

On Halloween, people wear costumes. Costumes make people look different. But they are still the same person. Wearing a costume is fun!

I can wear a costume on Halloween too! For one day, I can be anything that I want. That’s awesome.

Sometimes costumes can be a little scary. That’s ok. I will remember, under the costume is a person.  If I get scared by a costume, I can tell a parent and they will help me feel better.

On Halloween, I will go trick or treating. Trick or treating is fun.

I will walk to someone’s door and press the doorbell!. Sometimes they will answer. If they answer, I will say trick or treat and they will give me candy. That’s so cool.

Sometimes people won’t answer. That’s ok. I can go to another house.

Halloween is so much fun but sometimes I will need a break. I may hear loud noises like a dog barking, a person yelling or a Halloween decoration that makes sounds,  When I feel too excited or I get scared I can take a break.

It is important to stay safe on Halloween. Kids need to stay with an adult. I will always stay with a parent on Halloween.

I may get lots of treats on Halloween. I can eat ______ number of treats on Halloween. I will save the rest for later.  My ________________ will let me know when I can eat my treat. 

Halloween is fun

Tip 4: If your child can’t say trick or treat bring cards to distribute

Some kids with Autism will be able to say trick or treat and some will not depending on how much language they have.  Let’s face it, not everyone is necessarily very patient. Everyone seems to have an opinion on what you should do and how you should raise them.  I have taken kids with Autism trick or treating who could not say trick or treat only to have people at the door scold them or judge them.

To avoid this I recommend printing up a card and having your child and them to people in lieu or saying trick or treat if they do not have language or get nervous in new social situations.

Not only will this avoid a potentially uncomfortable situation but using pictures is a valid form of communication and it will allow your child to participate more fully in the experience. You should teach your child to do this ahead of time, ideally when you are rehearsing like previously suggested above. The good news is picture exchange is the most common form of communication that children with Autism learn when they do not have language so this may not be too much of  stretch for your child.

I have created a visual that you are free to print and use.

Tip 5: For safety purposes have your child wear a glow stick especially if they elope.

To some putting a glow stick on your child may be silly. Others may think it’s genius! I go camping all of the time. One rule is that everyone wears a glow stick at night, even the dog!

According to the National Safety Council, children are twice as likely to get hit by a car on Halloween than on any other day.

If your child elopes, make sure you put a glow stick around their neck. If for whatever reason they run away and it is dark at night you will be able to see where they went.

Even if you don’t think your child would run, do it anyway! You can get glow sticks in almost any dollar store!  Children get spooked on Halloween! That’s the point!

If an animatronic startles them and they run back towards the street, a glow stick will make sure that drivers see them even on the darkest street.

Tip 6: Visit houses of familiar people

If your child does not do well with meeting new people, one way to make Halloween easier for them would be to visit the house of familiar people. You may not get as many houses in but the good news is candy goes on sale the day after Halloween! You can always get more candy.

Visiting four to five friends houses and having a really good time will create a lot better memories than visiting fifty houses and your child having an epic meltdown.

Depending on where you live, you may also be able to trick or treat at the mall or you might be able to attend a trunk or treat which more and more schools are hosting each year.

Visiting houses of friends and family is also a good idea when you are practicing for Halloween.

Tip 7: If possible drive instead of walk and take breaks between houses

If you can, bring a car with you when trick or treating instead of walking from house to house. Some kids will need a break after walking to a few houses.

Your child will be doing things that may be challenging for them. After 10 times, they may have had enough.

However, simply taking a break in a familiar place for five minutes may be just what they need to regain their composure and continue on.

It is also a good place to warm up when it gets cold! My mom used to always drive us around and give us hot chocolate between houses. It was generally cold by Halloween in New Jersey where I grew up.

This also leads to Tip 8!

Tip 8: Bring calming sensory toys

Bring calming or sensory toys and activities with you so that your child can use them in between houses. This works especially well when you bring the car with you.

Let’s face it, for better or worse, kids are obsessed with electronics. This can be as simple as letting your child watch the iPad for a few minutes in between houses. Just make sure they won’t get upset when it is time to put the iPad away when it is time to go back to trick or treating, Alternatively, you can bring along calming stuffed animals, blankets or sensory balls.

Do whatever works for your child.  Think about what you bring to entertain them while you are out to dinner and they are waiting for their food to come and bring that!

However, listen to your child. If they are done, they are done. If they are communicating to you either with words or with their behavior that they had enough, end the night before a meltdown occurs.

Tip 9: Expose your child to as many costumes as possible before Halloween

Costumes can be scary for all kids. Expose them to costumes and explain to them what kind of costumes they may see.

My suggestion is to go to your local costume store, buy one of each costume, model them for your child and return them the day after Halloween! JUST KIDDING!  Google is your friend!

Google Halloween costumes and show your child photos of people in costumes. Explain to them that they may see blood, monsters and other scary things but they are not real. I do recommend getting at least one mask and allow your child to take it on and off of you to demonstrate that a mask may look scary but there is a person under the mask. Make it a game and keep it fun.

The more your child understands that Halloween is fun and the scary stuff isn’t real, the more enjoyable that Halloween will be for them.

Trip 10: Bring a visual schedule with you

My final tip is similar to using a social story. Think about it as a our social story cheat sheet. By the time Halloween comes, your child should already be familiar with the steps required to knock on someone’s door, wait, say trick or treat, get candy, say thank you and leave. However, just in case, it is a good idea to have a visual reminder. In all the excitement they may forget.

You can also bring the social story but, it may be more time consuming and your child may be too excited to sit and pay attention to it.   A visual strip with the photos that were used in the social story will likely be enough to quickly go over the necessary steps if they forget.

You can download the photos from this story, put them all into a word document in order and print it up to take with you.

Halloween can be a fun and enjoyable experience even for a child with Autism. It may take some extra work but it is worth it.  Halloween was one of my favorite days of the year as a child. So many parents of kids I work with tell me that they skip Halloween because they are afraid of how their children will react. I am passionate about making sure your family gets to have all the experiences that you dreamed about having with your child.  Autism does not have to take away the memories and events you imagined you would have when you first became a parent. I hope these tips help your family have an amazing Halloween.

If you have any questions about what this blog post says, please comment them below. I will be monitoring this post and will answer any questions you have to help you prepare for Halloween.

References

https://www.nsc.org/home-safety/tools-resources/seasonal-safety/autumn/halloween

http://daddcec.org/Portals/0/CEC/Autism_Disabilities/Research/Publications/Education_Training_Development_Disabilities/Full_Journals/Karal.PDF

Just Freaking Eat It- 5 Steps for Exhausted Parents to get your Sensory Child to Eat!

5 Steps for Frustrated Parents to Get Your Sensory Child to Eat

What is food selectivity disorder?

A child has food selectivity disorder when they have a very limited selection of foods that they are willing to eat. Having food selectivity disorder is not the same as a child being a picky eater. Usually children with food selectivity wind up being underweight and/or malnourished as a result of eating such limited foods.

Food selectivity looks different for all children. Some children will only eat food with specific textures like pureed food or baby food. Other children will avoid textures like wet foods. Some kids will only eat salty foods, some only sweet foods and others only foods of a specific color.

Many times, when kids are presented with new foods, they will become extremely upset and refuse to eat. When you force selective eaters to try something new, they will spit it out or gag and make themselves throw up. Often times, they are unable to express why they are rejecting the food which leaves parents wondering what is going on!  You may be offering them cake, cookies, chips or similar things that it may seem like all kids would want to eat! Either way, it is extremely frustrating and rather than dinner being a fun time for families to spend time together, it becomes one of the most dreaded parts of your day.

Why is my child selective about food?

There is no one answer to why a child is selective about eating particular foods. There is a very high correlation between Autism and Sensory Processing Disorder with food selectivity. The most common reason is that sensory eats avoid specific food textures. Apraxia, a motor speech disorder, also can cause children to reject foods at it makes moving food around the mouth a challenge. The good news is, no matter what the cause of the food selectivity there are five simple steps to overcoming it!

Step 1: Encourage your child to Play with Food Food

Allow your child to play with foods that they do not want to eat without requiring them to eat it. The exposure to the foods without the threat of being required to eat them will create a positive association with the foods and will reduce your child’s stress.

If your child doesn’t like solid foods, you can play with cereals, by dumping them in and out of cups and bowls. You can glue pretzels to paper, string pasta, and even include some of you child’s favorite toys in the games such as putting the food in trucks or feeding the food to stuffed toys or dolls. There are limitless possibilities.  Liquid foods can be a little more messy, but with a little creativity and some rags to clean up the mess, there are also tons of options!

Stay on this step as long as necessary! Feel free to also continue it throughout the rest of the steps.  I would encourage you to use several different foods to help with generalization! No matter what, keep it fun! Remember, the goal is to create a positive association!

Step 2: Require Your Child to Kiss the Food

Children will be reluctant to try new foods. However, if you assure them that they will not have to actually eat the food, they will be far more willing to cooperate. In this step, you have the child kiss the food and then they are done! You can tell them ahead of time how many times they will have to kiss the food but you would never ask them to put the food in their mouth! Praise them for doing a really great job once they kiss the food and give them access to their favorite toy or activity before either having them kiss the food again or to go to the next step.

*You may be able to progress through all five steps in one day or you may stay on each step for days or even weeks. Stay on each step until it becomes effortless for your child. Then, move on!

Step 3: Require Your Child to Lick the Food

Step 3 is almost identical to step 2 with the exception that in step 3, they are licking and kissing the food. Like with step 2, you should end the demand, praise them and give them access to their favorite toy or activity every time they lick the food. Also, like with step 2, stay on the step until it becomes easy for the child. Then, they are ready to move to step 4.

Step 4: Require Your Child to Put the Food in his Mouth but Allow them to Spit it Out

In this step, for the first time, you are requiring the child to put the food in their mouths. For many kids, this will be the most difficult step. Be prepared to give them a major reward for trying the food, especially the first time they do it!

This is also the most difficult step for many parents because it may seem counterintuitive to allow your child to spit out the food. The main reason for this that knowing that they can spit it out makes children much more likely to try them. The good news is that more often than not, they wind up realizing the food actually tastes good and they don’t spit it out!  You don’t want to repeat this step too many times for the same food! This step is meant to be a transition to step 5. You don’t want to spend a lot of time on it. It is just an option the first few times a child tries a new food. Keep in mind, there may be some food your child just doesn’t like!

Step 5: Require Your Child to Eat the Food

Once your child has completed the prior four steps, they are ready to eat the food! If they are still a little bit apprehensive, there are things you can do to make mealtime less stressful. My recommendation is to allow them a bit of a favorite food for every few bites when eating a challenging food. Or, if you are comfortable with it, allow them to bring a toy or watch a video during dinner as long as they are eating or you can use a token board and allow them to watch a video or play with their toys after a few bites. However, typically, the key is getting kids to try foods! Usually, once they try them, they realize they actually like them!

Starting School With Autism

Congratulations! Your child is about to start school. It is exciting, but it can also be scary. Sending any child to school for the first time is hard for any parent, sending a child with special needs to school, especially one that has a difficult time communicating can be even scarier. 

Fortunately, there are things that you can do to make the transition easier for you and your child. Here are my best 10 tips.

Tip 1–Prepare Your Child Ahead of Time 

Many children with Autism fear change.  The good news is that once school starts, the consistent structure and schedule will be wonderful for you child. However, while it is new, the change in routine can be challenging for many kids to cope with. This is compounded by the fact that children who are starting school for the first time might not fully understand what is going on and what to expect.

There are some things you can do to help ease your child’s anxiety by preparing them ahead of time.

  • For a few weeks before school expose them to books and videos about school. Talk to them frequently about starting school using language they can understand. Even if it seems like your child may not fully understand the books or videos, show them to them anyway. At the very least, they will create visual associations that could ease their comfort in a new environment.
  • Use social stories to help prepare your child to understand that he will start school. Social stories are short stories that are designed to teach a child how to act in a social situation. They were researched and developed by Dr. Carol Gray in 1993 and since then, dozens of studies have demonstrated their effectiveness. I use them all the time in my private practice working with families like yours.
  • Countdown the days until school with your child. Cross off the days until school on a calendar to provide a visual countdown for your child. This will help make sure they know exactly what to expect . 

Tip 2–Know the Goals on Your Child’s Individualized Education Plan (IEP)

I am going to be real for a minute. You may not like what I have to say but it is true. Your child’s teacher is being handed a stack of IEPs for each and every one of their students. They are long, lengthy legal documents that generate verbose and confusing text that all sounds the same. It is not likely many teachers will read it and actually use it to develop your child’s education program. The more you as a parent know about your child’s IEP, the better they will do in school.

Know what your child’s goals are. Ask the teacher what they are working on and make sure the lessons they choose, address the goals you agreed upon at your child’s IEP meeting. If you haven’t already, make sure you participate in the creation of those goals! Know what support services your child is supposed to receive. Make sure if your child is supposed to be pulled out of the classroom for services such as speech therapy, physical therapy, occupational therapy, that those sessions are actually happening as opposed to the therapists being used as an extra set of hands to pass out snack.

Most often, teachers like myself who work with kids with Autism do it because they are really passionate about helping kids but unfortunately this isn’t always true. You are your child’s best advocate and it is ultimately up to you to make sure their needs are being met. Knowing your child’s IEP will help you to have informed conversations with your child’s teachers and ensure they are aware of his goals.

Tip 3— Take a Tour of The School

Ideally, the first time a child visits their new school and classroom shouldn’t be the first day of school. While every school has different policies, most schools are very accommodating and will let you and your child visit. Sometimes they will even let your child spend part of a day in his future classroom. 

Many times, children with Autism will attend contained classrooms that have children in a fairly broad age range. This means that when they enter school, they will likely see some familiar faces. It will also give your child a chance to get comfortable with their new teacher.

Some people think that children with Autism are not interested in people and as a result, they skip this step. This is simply not true. The fact that children with Autism struggle with knowing how to act in social situations does not mean they don’t desire to create bonds with others. Whether or not they are able to express it, they know the difference between friends and strangers and receive the same comfort we do by seeing a familiar face.

Tip 4— Create a Visual Schedule for Your Child

Children with Autism are visual learners. As a result, schedules are very helpful in knowing what to expect. Most children have difficulty with transitions because they do not know what will happen before or after an activity. Creating a schedule will show them what happens before and after school. This will make them far more comfortable about going to school and will ease their anxiety about coming home. 

Ideally, put something your child enjoys on the schedule right after school such as eating a favorite snack, going to a fun place or time to play with their favorite toy. This will motivate them and give them something fun to think about.

Tip 5— Make Sure Your Teacher is Aware of Your Child’s Sensory Needs and Send in Sensory Toys

Sensory behaviors are part of Autism. These behaviors, technically called stereotypy, can include hand flapping, mouthing objects, spinning car wheels, lining things up, watching parts of a video repetitively, fixating on one toy, holding things in their hands, rubbing their feet on people and countless other behaviors.  Make your teacher aware of what your child’s sensory behaviors are and send in any toys that will help them be more comfortable and focus in school.

For example, if your child uses a chew tube at home because they mouth objects, send it in! It is important your child has it in school. If your child will drink from one specific cup, send it in! If using sensory balls helps your child focus, pack them! Send whatever you think will help your child be more comfortable and successful. Many parents choose not to send things in because they are afraid teachers will judge them or limit access to them. But, most teachers are grateful to have something that works for your child.

Tip 6–Make Sure Teachers and Support Staff Know about Special Accommodations like an Alternative Augmentative Communication (AAC) System.

Many children with Autism will have received some type of service such as early intervention, speech or applied behavior analysis before starting school. This almost always includes the development of an AAC system. An AAC system is a way for a child to communicate while they are learning to talk. This could include a picture board, a formal program such as Picture Exchange Communication System (PECS) or a voice output system such as a Dynabox or iPad app like Poloquo2go. Make sure to send this in and make sure that you child’s teacher is trained on how to use it.

Insist your child be allowed to have access to his communication system all of the time. This is your child’s way of communicating. Taking it away, even putting it out of your child’s reach for a few moments to make more  room on the table for and art project or snack is equivalent to putting a hand over your child’s mouth so they cannot speak. It is never ok.

Tip 7— Get The Same Toys the School Has Ahead of Time

Do your very best to find out what toys, puzzles and books will be in your child’s classroom. Get the same ones and teach him how to play with them. Most behavior problems occur in school when children do not know how to manage or occupy their downtime. 

There is something to be said about kids liking toys that are new and different. That is true, but kids with Autism usually lack some play skills which means without being taught how to play with new toys, they may not be able to. This will result in them spending more time engaging in sensory behaviors or having tantrums.  It is better to make sure they at least know what to do with the toys that will be in their classroom.

Tip 8— Take Advantage of Community Programs to Practice School Skills 

If your child is new to school they may be new to group activities like circle time and art projects. Do everything you can to make sure your child has lots of practice before school starts and school is not your child’s first exposure. They will likely need a lot of practice before they know how to sit and participate. Almost every public library in the nation has a circle time. Call your town’s library and the library in the towns surrounding you and bring your child to as many of them as possible. This is one of the best ways to prepare your child for school activities.  

Tip 9— Send in Your Child’s Reinforcers

Most children with Autism will receive some form of applied behavior analysis (ABA) in the classroom. ABA works by giving your child reinforcers or rewards when they engage in a desired behavior. It helps to show them what a correct response is and know what is expected of them. 

Many times children with Autism are picky and only like a few things. I don’t need to tell you that! How many times have you bought new foods or toys that your child has rejected? It may be really hard for your teacher to find something your child really enjoys. The more motivating a reinforcer is, the more a child will learn, this is always true. One of the best ways you can help your child learn more effectively at school is to send in what reinforcers have worked at home.

Tip 10— Ensure Your Child Has Identification

Every parent’s  biggest fear is that their child does not talk and that there is a possibility that they will wander out of a classroom. I would love to tell you that could never happen but we are all too keenly aware from watching the news that it does. 

If your child wanders, make sure his teachers know and fight to get him a 1:1 aid. If your child cannot communicate his name, your name and your phone number, make sure they are always wearing an identification bracelet. It should identify that they have Autism, their name, your name and your phone number. 

Some parents fear this will stigmatize their child or that they will have a difficult time keeping them on. These two things may be true but it will help keep them safe and that is the most important thing.

It is my hope and prayer these ten tips ease your fears about sending your child to school.  School will be a fun and safe place for your child. He will learn, grow and explore at a whole new level and you will watch him blossom before your eyes.

As a therapist, I can only imagine what it is like to send a child that can’t speak for themselves to school. But, what I can promise you, is if you follow these ten tips, you can be their voice.

An interesting “spin” on Reinforcement.

Applied behavior analysis (ABA) is the most well researched and scientifically validated methods for teaching children with Autism new skills.  It is based upon the behavior principle that what happens before a behavior and what happens after a behavior will determine if it happens again. If a person engages in a behavior and they do not get what they want, they are far less likely to engage in the same behavior again. Conversely, if a behavior results in a desirable consequence, a person is far more likely to repeat the behavior.

A consequence that makes a behavior occur again is called a reinforcer. Most people think that reinforcement is a good thing. However, reinforcement is neither good or bad. It simply makes a behavior occur more often. Sometimes this is good and sometimes it is not.

For example, if Joe hits his mom and gets a cookie immediately after doing so, the next time Joe wants a cookie he will likely hit his mom again.  Obviously, in this case, Joe’s mom would not intend to reinforce hitting by giving him a cookie. However, the cookie served as a reinforcer for hitting and made hitting more likely to occur again.

Let’s say Joe is learning to talk and asked mom for a cookie by getting her attention and saying, “cookie.” Let’s assume mom gave Joe a cookie. In this example, mom would want Joe to ask for things using his words in the future. I this example it is likely a good thing the behavior is reinforced.

In the example above, the behaviors were reinforced by Joe getting something, a cookie.

In this example the cookie served as a reinforcer because it was a desirable consequence for Joe.  This is called positive reinforcement. However, sometimes a behavior can be reinforced when something unpleasant is removed. This is called negative reinforcement.  For example, if a person lowers music because it is too loud, the softer music will serve as a reinforcer. The most common example of negative reinforcement in an ABA therapy session is when a child is provided with a break for completing work. During the break the demands from the child are removed. 

ABA therapists typically use positive reinforcement in two different ways. A reinforcer may be used with a young learner to teach them what a correct response is.  For example, a two-year-old with Autism might be learning to follow the instruction, “Find your nose.” The therapist might say, “touch your nose” and prompt the child to touch his nose. After doing so, the teacher may give the child a small favorite snack.

Initially, the child might now know what the therapist is asking him to do. However, he will learn that when he touches his nose after the therapist says, “touch your nose” something good happens– he gets his favorite snack.  Motivated to get a snack, the child will eventually learn that he is rewarded when he touches his nose after the therapist says touch your nose. Eventually the prompts and reinforcement (snack) can be faded and the child will have learned to follow the instruction touch your nose. 

The second way a therapist may use a reinforcer is to encourage a child to comply with a non preferred instruction by providing them with a reward.  Generally, when a therapist is using a reinforcer in this way, the child is rewarded for either engaging in a behavior or not engaging in a behavior. For example, a child may be rewarded for completing his homework all week. Or, a child may be rewarded for not having any bathroom accidents during the day.

Many people look at this type of reinforcement and think it is bribery. Let’s be honest, there is some truth to that. But, whether we realize it or not, reinforcement is part of everyone’s everyday life, even yours.  Just think of how many people run marathons just for the marathon medal! Most people go to the gym because they want great abs, not because they genuinely enjoy sweating and aching muscles! Finally, would you really go to work if you didn’t get paid? That’s right, the marathon medal, your abs and your paycheck are all reinforcers! Reinforcement is a normal part of social interaction and reinforcers can be very effective for helping children with Autism learn.

In order for an object to be a reinforcer, they must want it.  As you already know, what a child wants is always changing. So, it’s important to check every day to see what will qualify as a reinforcer for your child.

Typically to find out what is a reinforcer for a child, you would conduct a preference assessment.  A preference assessment is just a fancy and over complicated way of saying, find out what a child wants.  For a child that can talk, this may be a simple as asking, “What would you like as reward today if you have nice hands in school? Or “We are going to do your homework and when you are finished you can either watch TV or play outside for fifteen minutes. Which do you prefer?” For a child that is non-verbal, you can hold two objects in your hands and assume the one they reach for is the one they want.

It sounds so simple right! It is and it is not! What a child wants is always changing! On day a child wants pretzels and the next day they have no interest in pretzels and have moved onto to gummy snacks.  One day a child can be enamored by a toy car and by the next day they have lost all interest in it. That’s why it is so important to have a variety of reinforcers available and to rotate them as much as possible. This will keep children from getting bored of them.

From my experience, there are three types of kids that make it particularly difficult to find reinforcers for. The first child is the child who is not really interested in anything. Children with Autism often lack play skills, can have food sensitivities and may not be reinforced by social situations. This can make it really hard to find a reinforcer. If this is the case, establishing items as reinforcers by teaching your child how to play with objects is really critical. Searching for reinforcers will be a full time job. There will be a lot of trial and error. However, it is important to take time to expose your child to new stimulus all the time. Eventually, every child will find something they are interested in. I will admit, there are some children who make this a lot more difficult and frustrating for parents than others. 

The second child is difficult  is the child who is interested in everything. This may come as a surprise. Some of the hardest children to reinforce are the children who are most easy going. They are interested in everything. If you show them a puzzle, they will play with it. If you take it away and show them a car, they will play with the car. If you take away the car and give them some toy animals, they will play with those.  

The reason this presents a challenge is that when you withhold an item they are interested in until they complete a difficult task, they usually just find something else to do. Since all things have an equal value to them, there is no one specific item that will motivate them to put in effort to do something that find challenging or unpleasant.  In this case, it is best to limit access to toys. All toys other than the ones you are using should be out away and out of the reach of the child.

The third child that is difficult to reinforce is the child satiated with, the technical term for getting bored of reinforcers rather quickly.  This was the case for a client recently who was the motivation for writing this blog post.

Her son has learned to use the toilet but he often has accidents especially at home. His mom tried several different reinforcers. They will work for a day or two but then they totally stopped working. After having access to the reward, even for a short period of time, he was bored by it and he no longer was motivated enough to go to the bathroom.

She mentioned he is more motivated to go to the bathroom out of the house then he is in the house. She stated that she thinks that when he is in a public place, he is excited since it is new and different. At home, he is usually engaged with his toys, which are highly preferred activities and as a result, he doesn’t want to take the time to stop playing and use the restroom.

The more she described her son, the more I started to realize that he seems to be reinforced by something new or different. That’s when I suggested she put a different spin on a reinforcer — quite literally!

My initial recommendation was to allow him to select a prize out  of a prize box with several reinforcer options. This worked for about a week. But eventually, he got bored of his choices and had a regression.

I started to wrack my head about how we could make going to the bathroom at home exciting. In the past, I had suggested she use a reinforcer box. Her son was able to pick a prize out of a box every time that he went to the bathroom. However, he would select the same thing over and over and it quickly lost its effectiveness.

That’s when I suggested she try a prize wheel. Every time her son went to the bathroom, he could spin the wheel to see what his prize would be.  This wouldn’t totally solve the problem of reinforcers becoming satiated. But, it added an element of excitement and surprise. The wheel itself could also serve as a reinforcer which will increase the probability of a child complying.

Using a prize wheel is not limited to just potty training. It can have any application. If your child has a hard time keeping his hands to himself in school, you can have him spin the prize wheel when he gets home if you get a good report from the teacher. If you have a hard time motivating your child to try new foods, you can reward them with spinning the prize wheel if he tries new food.The possibilities are endless.

She has ordered her spin wheel and I will report back soon how it goes for him. I did some research on which spin wheels I thought would be the best and I think this one will work really well for you. It is small, only 12 inches so it can easily fit in most homes.  It also is a dry erase spin wheel so you could easily change what is on the wheel based on the time of day, what your child is currently motivated by and what things you have at home. I have included a link to it below. In full disclosure, this is an affiliate link. You are under no obligation to purchase a spinning wheel. However, if you decide to, and use this link, it will cost you the same amount and help me offset the cost of providing this free training for you.

I hope the suggestions in this blog post help you have a better understanding of reinforcement is and why it is such an important part of your child’s education plan. If you decide to try a spin wheel, I would love it if you would comment how well it worked for you on this blog posts.

Why Kids With Autism Often Have Behavior Regressions Right After They Acquire More Language

Does it feel like every time your child takes a step forward in one area, he takes a step backwards in another? Do you find yourself time and time again being confronted with old behavior problems you thought you had gotten past?  Have the strategies that were effective before seemed to stop working? Are you wondering what you are doing wrong? The answer may be both frustrating and a relief — Nothing– This is a common experience that is reported by most parents of children with Autism.

Although the degree may cary, all children with Autism have delayed language.  The number one priority of almost every parent I have ever worked with is that their child is able to learn and and use language. The number one fear that almost any parent has is that they won’t be able to.  

Watching a child be able to get something they want for the first time is one of my favorite parts of working with kids with Autism. The first time it happens, their eyes light up and you can see them experiencing joy. For the first time, they have learned a way of getting what they want without crying or tantruming.

For kids who can’t talk, their world is very limited. Some kids are able to use gestures or take their parents to objects that they want. But, still they are limited to only asking for things they can see.

Have you ever wondered why your child start crying at as restaurant when you gave him a food you know he likes? It is really frustrating, especially if you don’t know why.  As frustrating as it is for parent or teacher, it is even more frustrating for a child.

Imagine you went to your favorite burger joint! You ordered a bacon cheese burger.  You could taste the mouth water meat in your mouth as you waited for it. But when they brought it, they brought you a black bean veggie burger on ice burg lettuce instead of a bun … Now unless you are a vegetarian, you would probably be pretty frustrated. The good news is, you would know how to tell the waiter, that he brought you the wrong thing and your delicious burger would soon be on its way.

Well your child can’t do that. They walk into a restaurant super excited to eat chicken nuggets and pizza shows up.  They would love to be able to say, “No, mom I wanted chicken nuggets.” You would love to be able to ask your child, “What do you want and have them respond.” But that may not be possible. So you gave him what you thought he would want and he cried when he wanted something else.

Since your child can’t talk, they try to use behaviors like a tantrum as a form of communication. Tantrums are frustrating for everyone — teachers, parents and even more importantly children. I have witnessed thousands of tantrums in my life. I have seen hundreds of kids so frustrated that they are not able to get what they want and so many parents just like you ready to pull their hair out because their child just wouldn’t stop.

That’s why one of the first thing that any behavior therapist will work on is reducing tantrums. Simply, your therapist teaches your child- this is not a form of communication. As long as the behavior plan is always carried out in your child’s life and he never gets what he wants as a result of having a tantrum (which is easier said than done), the tantrum will stop.

You will think as a parent you have gotten past the behavior. Really, what you did is teach your child that tantrum is not a form of communication or sometimes it won’t work in a specific situation..

The good news is, most children with Autism will eventually be able to tell us what they want. Whether it is pointing to pictures on a choice board, using PECS, and iPad program such as Proloquo2go or Touch Chat to help them talk or tell us vocally, they will be able to make their needs met.

When this happens initially everyone gets so excited, they give the child exactly what he wants every time they ask. If you ask your child what he wants for a dinner and he replies vocally, “A donut!” You get so excited he answered you for the first time you jump up and down and clap for him and drive to Dunkin Donuts in a blizzard. I have personally spent two hour long sessions doing nothing but having a child come to the table and ask for a break the first time he has learned to say, “I need a break.” instead of running away from the table or having a tantrum.

For a few days, nothing could possibly get your family down. Your child is happy because he is getting exactly what he wants. You are happy because the months or years of sacrifice and running to see therapist has paid off. You literally feel like you just landed a spaceship on the moon and found potable drinking water! But, as exciting as it when your child learns to say words, it quickly becomes an expectation and the thrills wears off.

The fourteenth time your child asks for donut, and the baker’s dozen you bought has run out you say — No!

That moment turns your child’s world completely and utterly upside down.  They have learned that they ask and they get. Your and your therapists have spent years teaching them if they ask they can have what they want and suddenly- the rules have changed!

They asked and they didn’t get! Prior to this moment, your child has never conceived this as possible. This is not how the asking game is supposed to work. They have no idea what to do. Their new communication system is broken. In panic and desperation they try something that has worked in the past — a tantrum!

Does this sound familiar?  At this point, I get a call from every parent– frustrated and in tears. They don’t know what they did wrong. Their child was doing so well. He was communicating and using his words and then suddenly out of nowhere he just stopped and went back to tantrums.

There is good news. You are not alone. This is not uncommon. It is not your fault and most importantly — it will NOT last forever. It will likely last a few days- maybe a week.

Use the exact same procedures to eradicate the tantrum that worked in the past. EXACTLY THE SAME ONES. Let me repeat that to make it clear — EXACTLY — EXACTLY– EXACTLY– the sames ones! They worked in the past and they will work again. Five out of ten parents will tell me at this point- they don’t want to go back to the token board or rewarding good behavior with stickers because they are taking a step backward.

To be blunt, if you do it, in a couple of days your child will realize once again tantrum is not communication and the misbehavior will stop. If you don’t this problem can be drawn out for months and it will create a lot of unnecessary frustration for you and your child.

At this point your child will learn- Sometimes asking me will get what me I want. This is called and intermittent schedule of reinforcement in the made up behavior language that I personally find unnecessarily complicated. But– if you hear the term- that is what your therapist means.

The bottom line kids have to learn to hear no. Read that again — They have to learn it — The implication of this is that they don’t necessarily no how to do it.

Rest assured — they will learn.

So, when your child takes a few steps forward and soon after it feels like you are taking a giant step back- don’t worry and don’t blame yourself. It is an annoying and frustrating but necessary and short lived part of the process.

Unlock the Code of Enjoying Dining Out as an Autism Family!: Featuring Lenard Zohn

Going to a family restaurant should be an enjoyable experience. A time to relax, enjoy good food and spend time with your family. Let someone else do the cooking and cleaning. Unfortunately, for those of us who have a child with autism dining out can be anxiety provoking and stressful. As parents, we may feel that “all eyes are on us” when our kids exhibit certain behaviors, have outbursts or refuse to sit still. Other diners may be disturbed and the well intentioned wait staff doesn’t really know the best way to help out. Many of us decide it is just not worth the effort and that is unfortunate. We created Autism Eats to bring the fun back to eating out. Our dinner parties are held in private rooms of restaurants or function facilities. Food is served buffet or family style so there is no waiting. Music and lighting are adjusted to accommodate those with sensory sensitivity. These are family dinners and all attending have a loved one on the spectrum so there is no need to apologize, explain or feel uncomfortable. It is an opportunity to enjoy a night out and socialize with others who have many of the same joys and challenges in common.

Here’s What to Do if Your Child Keeps Getting Bored of Their Reinforcers!

Does it feel like every time your child learns a new skill, it is not long before you take a step backwards and the strategies you were using stops working? Are you wondering what you are doing wrong or even if you are the problem? I promise, the problem is not you. In this video I share what the problem is and how to fix it!

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