Thursday, December 27, 2012

Quote of The Day

"The intuitive mind is a sacred gift and the rational mind is a faithful servant. We have created a society that honors the servant and has forgotten the gift"
Albert Einstein


 Intuition is the ability to acquire knowledge through perception or inference. Intuition is directly related to creativity and innovation. Some of the most creative people who think outside the box are also intuitive people.
Parents, be wary of close minded or small thinking professionals who can't be open minded and receptive. This could include your child's teacher, ABA therapist, OT, etc. When teaching or caring for a child with Autism, creativity, flexibility, inference, and imagination are key. I regularly listen to my intuition when working with my kiddos, as I strive to make a personal connection with each child.
 To parents I would remind you that YOU are the expert on your child, and your instinct is a valuable tool when evaluating any therapeutic method, company, program, or professional. Trust your instincts and seek ABA professionals who are passionate and creative. 
A closed mind can't open minds.

 


To all my wonderful blog readers, see you in 2013!
Saturday, December 15, 2012

Quote of The Day




“If you treat an individual as he is, he will remain how he is. But if you treat him as if he were what he ought to be and could be, he will become what he ought to be and could be.”
― Johann Wolfgang von Goethe, 1749- 1832



Kids will live up (or down) to the expectations we have of them, so have high expectations!
Saturday, December 8, 2012

How to Write a Social Story








A Social Story is a teaching tool often used in ABA therapy to help teach a child about a desired behavior. A social story is a short story designed to teach a specific concept. The story should be individualized to the child, tailored to their interests, and have a specific goal (or goals) that you are trying to teach, reinforce, or generalize.  It may take repeated presentations of the social story for the child to apply the information described in the story to their own life and change their own behavior. 
* The research on the effectiveness of Social Stories supports its use when part of a comprehensive treatment package, and when certain pre-requisite skills are in place, such as listening comprehension. A review of current literature is recommended before implementing Social Stories with a client.

Examples of social story topics could include: Privacy, Lining Up in the Classroom, Flapping My Hands, I Have a New Sister, Flying On an Airplane, Going to Burger King, When Grandma Comes to Visit, Riding in The Car, Is That a Stranger?, We’re Moving To a New House, When I Feel Angry, etc.

 I will typically write a social story for a child who needs to know the unspoken or implicit rules of a particular social skill, such as a child who has learned to play board games but acts very rude and obnoxious when he wins. That’s a situation that is ideal for a social story because the child can perform the skill (playing a board game with a peer), but the child isn’t picking up on the implicit skill of good sportsmanship.

Social stories are another one of those ABA materials that you could purchase, but it isn’t necessary to because:
-Social stories are super easy to create
-Social stories should be individualized to the situation and child, and be incredibly specific

A good social story should include the four basic sentence types recommended by Carol Gray: Descriptive, Perspective, Affirmative, and Directive.
Descriptive sentence: “My name is Josiah and tomorrow is my first day of school”
Perspective sentence: “When I listen to the teacher and follow directions that makes my teacher feel happy”
Affirmative: “When I want to answer a question, I will raise my hand until the teacher calls on me. This is the right thing to do”
Directive: “I will try to remember to raise my hand to answer a question, and not to yell out the answer”


Here is an example of a social story I wrote for a client a few months ago. This social story was for an adolescent girl who had a behavior of stripping off her clothing in public or on the school bus. The specific social behavior we wanted to teach was privacy.



Privacy



When I need to change my clothes I do it in private. Private means that I am alone or with my family, and not in a public place where lots of people can see me. 


Everyone likes having privacy sometimes, like when they use the bathroom, or change their clothing





When I need to change my clothes I should:



1.       Get my clothes and go into the bathroom or my room

2.     Close the door

3.     Close the curtains on my windows






I can change my clothes in front of Mom or Dad. That is okay. I cannot change my clothes on the bus, or at the store. That is not okay.





When I go into my room or into the bathroom to change my clothes that makes my Mom and Dad feel happy, and they say “I'm proud of you!” 







**Quick Tips:

  • As much as possible include actual photos of the child in the social story. I have found its much more effective and intriguing to the child to read a social story that has pictures of their family, home, school, and own face inside of it.
  •  Tailor the story to the child’s likes and interests. I wrote a social story a few weeks ago for an ASD teenager who loves Ariel from The Little Mermaid. This teen was having break outs on her face due to not properly washing her face every day. So her social story talked about how Ariel always washes her face twice a day, and always listens to her mom. Very quickly after the social story was introduced, this teen is now happily complying with washing her face daily.
  •   Use positive language. Focus on what the child should be doing, and avoid overemphasizing their current social deficits. Especially for older and higher functioning children, they can take criticism very hard and often hyper-focus in on negative statements. Instead of saying “If I like a girl, I cant follow her around or she will think Im weird”, the social story could say “If I like a girl, I can ask her about her interests or give her a compliment”.
  •   Keep it short and sweet. Most of the social stories I write are 1-2 pages. I have seen some multi-page social stories that bored the poor child to tears. If the child wont sit and attend long enough to hear the whole social story, how can they benefit from it? 
  •  Write from the perspective of the child. Its important to use language and explanations that will make sense to the child based on their cognitive functioning level. If the child is older and higher functioning its okay to say “When I do my homework, that makes my teacher feel happy and proud of me”. If the child is younger or lower functioning you may need to focus on outward behaviors and not internal emotions or thoughts, such as “When I do my homework, my teacher smiles and says: Good job, Josiah. Then I get a sticker on my token chart”.


Great website with lots of social stories:


Saturday, December 1, 2012

Older Kids & ABA







Most of the individuals receiving intensive ABA treatment in the home, school, or clinic setting are young children between the ages of 2-8. This is the typical age range for an ABA client. Many individualized ABA treatment plans are focused on early intervention  or school readiness. 
It can be difficult to find an ABA provider who will work with adolescents. If you live in a rural area or small town, you may find that the local ABA companies only work with small children. Even in school systems that provide ABA, the ABA classrooms may be for younger children. So does all this mean that ABA is only for toddlers or school-aged children? Definitely not.

It’s important to understand that ABA is a broad science that can include a variety of methodologies, different teaching styles, or ways to manage behavior. Doing DTT with a small child to teach her to communicate is ABA. Implementing a visual schedule in my home to increase my time management is ABA. A mother using positive reinforcement to get her son to clean his room is ABA. ABA can be a strategy, a technique, or a curriculum. Once you understand what ABA really is, it’s easy to see how placing an age cutoff on ABA treatment is ridiculous. Particularly if the adolescent, teen, or adult has Autism, it’s amazing the progress that can be made regardless of the age.


Two big barriers to securing ABA treatment for an older child or adult include safety concerns and lack of funding. A 15 year old with Autism will likely have more serious and potentially dangerous problem behaviors than a small child with Autism. Not all ABA professionals are equipped or trained in handling aggressive behaviors, especially when the person aggressing is 6 feet tall and 200 pounds. A company might tell you they don’t serve older clients simply because the staff is unqualified to work with teens/adults. If the company can’t find staff for your child, then they won’t accept you as a client.
ABA funding varies from state to state, and funding will always affect what services are available. Some insurance companies have age cutoffs (e.g., up to age 9), or will only pay for ABA treatment before the child enters school.

In some states, teens or adults may qualify for ABA services with restrictions. Intensive, in- home treatment may not be covered but behavior reduction services may be available.  In other words the ABA professional can come in for a short time to extinguish a challenging problem behavior. Unfortunately funding sources often don’t understand that without a systematic plan to modify the environment and train caregivers, behavior plans can have temporary effects.

If you are the parent of an adolescent, teen, or adult with Autism, I encourage you to see what ABA services or professionals are available in your local area. ABA therapy doesn’t have to stop just because your child has entered middle or high school. If you are caring for an adult with Autism, you do not just have to accept severe, dangerous, problem behaviors. ABA has the potential to manage behaviors at any age, no matter how chronic the behavior is.

Here are some helpful tips to help you locate quality ABA treatment for an older child with Autism:

  • The company or the ABA professional should have direct experience working with older children or adults (however this may be difficult to find depending on where you live).
  • The staff who will be working directly with your child should have Physical Management Training. PMT includes specific training techniques that teach professionals what to do in the event that a client becomes physically aggressive or dangerous. If the staff are unsure what to do in a dangerous situation then they may unintentionally harm your child, or the staff could get injured.
  • The format of the ABA therapy sessions should be less structured and more naturalistic.
  • Program goals must be realistic and practical--think "What does this individual need to learn to function as independently as possible in society?
  •  Agencies that do serve older clientele often have wide ranging and comprehensive curriculum that can address academic, community instruction, social-emotional needs, and much more.  These may include skills such as: Humor/Telling Jokes, Body Language, Theory of Mind, Using Money, Empathy, and Current Events. A quality ABA program for older individuals should include some of these higher level cognitive skills that will really help the client interact more meaningfully with society.



** Resource: Articles about what ABA can do for older children:

 http://www.asatonline.org/resources/faq/older_children

 http://www.lovaas.com/blog/archives/13-ABA-Treatment-for-Older-Children-with-Autism.html

http://rsaffran.tripod.com/McEachin.html#top 


* Video Clip explaining why it can be difficult to locate ABA providers who work with teens/adults