Friday, February 21, 2014

Moving from Awareness to Action

Photo Source: http://www.momnivores-dilemma.com



I recently had a conversation with one of my clients (see below for information about her company) about Autism Awareness month. While its not quite April yet, during the month of April it is common to see banners, commercial spots, print ads, blue light-bulbs, parades, etc., all focused on spreading awareness of Autism. Across communities, parents, educators, professionals, and regular Joe’s  join together to help spread the word about Autism. If you’re reading this blog you likely have some connection to Autism, so you’ve probably worn a t-shirt or marched at a rally during Autism Awareness month, or maybe even dyed your hair blue :-)

My client asked me a question about Autism Awareness month that struck a chord with me, and prompted me to write this post.

“When do we move past awareness, and into action?”

Awareness and information are important…absolutely. Awareness of the impact Autism can have on an entire family, not just the individual who actually has Autism, is a necessary 1st step. But after that 1st step, then what? Did you spend last April making your church, co-workers, or neighbors aware of Autism? What impact did that have on your life once the month of April was over?

What I would love to see, is a focus on action in the month of April. So many of the families I work with are super non-impressed with the Autism walks, telethons, and celebrity endorsements of various Autism therapies. They tell me “Tameika I’d love to go downtown and wear a t-shirt for the Autism march, but I’m too busy raising my child with Autism”.

So my small part to add to this conversation is a list of simple action strategies that anyone can implement to improve the life of a family living with Autism.  Maybe you feel you don’t know where to start, or this is too big of an issue for you to tackle. Okay, so then do something that helps 1 family.

Ready for the action strategies? Here they are:

  • Greet individuals with Autism out in the community: I know, you can’t know for certain who has Autism and who does not. But if you are a parent or professional and you see the tell-tale tip-toe walking, hand flapping, or echolalia being exhibited by a child in front of you at the grocery store, take some time to greet that child. Smile or wave, whether the individual responds or not. Make eye contact with the parents and ask a simple question such as “How old is she?” or “What’s this little guys name?”. Parents of children with special needs often experience no attention in public, as people politely avert their gaze and look down, or they experience excessive attention, as everyone turns to stare at their child’s odd behaviors. Just a simple smile and a “How are you guys today?” could go a long way.
  • Offer free services to a family living with Autism: Offer to babysit the kids for an evening, so mom and dad can catch a movie….or offer to cut their lawn…..or do their laundry……or cook dinner…….or (and here’s a big one) invite the individual with Autism out without the parents present. Do you know for some families, no one ever invites their child with Autism out to do things? Yes, some parents may feel uncomfortable letting their child go to a movie or to Six Flags without them present. But some parents would LOVE if a family friend or relative invited their child somewhere, and mom and dad are not implicitly expected to go and play chaperone.
  • If you own a business, pursue Diversity Training on special needs: Whether you own an ice cream parlor, shoe store, or a pet cleaning business, does your staff know how to respect the dignity of individuals with special needs? If a parent walked into your business with a withdrawn and quiet teen who suddenly bounced on his heels and shrieked loudly, would that parent be asked to leave? Would the staff make that family feel welcome? Or whisper and stare at that family? Most of the families I work with are incredibly loyal to the businesses in their neighborhood that “get it”….the dry cleaner who lets their daughter spin in circles until she is dizzy, or the Burger King where the manager puts the ketchup in a cup, because that’s how their daughter likes it. Don’t let your business be a place where families living with Autism feel disrespected or unwanted.
  • Instead of lighting something up blue, consider supporting a cause: It’s great to show your support of Autism Awareness month, but once April is over, families will still need quality treatment for their kiddos. Consider making a donation to an Autism research facility, or start locally: call a school in your city and ask what donation you can make to the Special Education department. You can also donate your time. Volunteer at a respite facility, or visit group homes and play your guitar for the individuals who live there. And speaking of volunteering…….
  • Volunteer to serve in the special needs ministry at your church: If you work with kiddos with Autism, think of a few of the kids you help. Now picture them sitting through a church service. How do you think their parents handle it? Well, in many cases they don’t. Often the child has behavioral issues that make attending church difficult, so the family just doesn’t go. Or the volunteers, even in the special needs room, can’t handle their child so the family feels too embarrassed to take their child to church. If you work with children with Autism for a living, you are full of knowledge and information that many of the other volunteers might not have. Helping the church implement structure, visuals, and reinforcement into the special needs ministry could make all the difference in the world.



*Resource: If you are located in the West Indies and need information, resources, or training related to Applied Behavior Analysis, feel free to check out the Dawn Autism Program.






Sunday, February 9, 2014

Teaching Leisure Skills







Recommended posts: Task Completion, Toy play

A few weeks ago, in my Top 10 post I discussed recommendations I make to families over and over again regarding common issues new clients present with.
A common concern I hear from parents is “my child stims all day long”, “he just wanders around the house putting things in his mouth”, “she just sits in the living room and stares out the window”. What these issues are all describing is a lack of leisure skills.

Leisure skills are those skills, interests, and hobbies, most of us have that serve the function of unwinding, relaxation, or simple enjoyment. This is an important life skill. In an ABA program it can sometimes be easy to focus on skill acquisition and filling in gaps in development and miss the big picture. Why does a 3 year old need to know how to entertain themselves without adult involvement or engagement? Because one day he will be 19. What will he do then when he is bored, or mom and dad are busy? Spin in circles? Stand on the kitchen counter? Or, will he be able to go to the game closet, pull out the Scrabble game, and make sentences using the letter tiles?
For me, my main “go -to” leisure skills are cooking, video games, or chatting with friends online. If I am alone, bored, frustrated, agitated, or finish an activity, I don’t need someone to give me something to do or pull me out of my funk. I have the ability to think of an activity, engage in that activity, and independently complete the activity.

So question time: Can you say the same for your child with Autism? When your child is bored, what do they do? When you are not able to give your child attention, can they entertain themselves? When your child finishes one activity, can they independently start another?

Another reason I often recommend teaching leisure skills is for kiddos who spend their time engaging in repetitive behaviors all day long, such as pacing, running up and down the stairs, spinning in chairs, lining up toys, chewing on their fingers, etc. I recently completed an observation of a new client who spent my entire 2 hour observation completing laps around the family dining room table. She would circle the table on her tiptoes, stop and look at me, jump a few times, and repeat. Her parents stated if left unattended she would engage in this ritual all day long. I look at a situation like that, and to me it’s like a huge neon blinking sign that reads “Teach me leisure skills!

So before we jump into exactly how to teach leisure skills, allow me to clear up a few misconceptions. Firstly, just because you think a game/activity/toy will be enjoyable for your child does not mean they will agree. Understand that leisure skills will likely need to be repetitively taught and reinforced before you see your child begin to spontaneously and independently select a game or toy to interact with. Secondly, the inappropriate behaviors need to be placed on Extinction or a DRA in order to teach the child leisure skills. Do not try to compete with the handflapping, toewalking, or pacing behaviors and get your child to play Monopoly with you—you will lose. Instead, reinforce what you want them to do (sit down and play the game) and ignore, block, or redirect what you don’t want them to do (pace up and down the hallway). Lastly, systematic prompting is your friend. If I am working with a child who is used to spending her days playing in the kitchen sink and humming, I cant expect her to immediately be able to play a 30 minute game of Apples to Apples with me. That’s completely unrealistic. Start at a level of expectation where your child can experience some success. Perhaps bring out the Apples to Apples game, reinforce sitting and a quiet mouth, and then set a timer for 5-10 seconds. Prompt the child to play the game with you and when the timer goes off, they are all done. Gradually increase the amount of time the child must engage with the game, and gradually reduce the prompts you provide.

Here are some strategies to teach appropriate leisure skills to replace inappropriate problem behaviors:





        -Begin teaching this concept by using simple Work Boxes, or “Busy Boxes” consisting of easy or mastered targets. For example, have a busy box filled with crayons and cut outs of shapes. Set a timer and prompt the child to color the shapes. When the timer goes off, put the busy box away. Gradually increase the length of time, and introduce new or unknown tasks. Eventually it will be helpful to set up an area in your home where your child can sit and engage with leisure activities, such as books, puzzles, bubbles, board games, card games, etc.

       - Use a First/Then visual to help the child understand that they must complete the non-preferred task to access the preferred item/ task. Or, “First you sit down and  color, then you can go play”. Once the child understands the concept of first/ then, create a visual schedule of preferred and non -preferred activities. For example: “Eat snack. Leisure Time, 2 minutes. Play Outside. Leisure Time, 4 minutes. Play on Ipad.”

       - Teach independence with this skill from the very start. Reduce your prompting and involvement as soon as you can. Try to prompt through silent gestures only, or prompt standing behind the child. Remember that eventually you want the child to complete these leisure activities independently.

     -   Use a visual choice board to allow the child to select what activity they want to complete. Particularly for non compliant children, embedding choice into leisure time activities will make the process go much smoother.


       - Provide excessive reinforcement for engagement in appropriate leisure skill activities, such as looking at a book or completing a puzzle. Provide no attention combined with redirection when the child engages in self stimulatory or repetitive  behaviors.

    -    Provide multiple opportunities per hour for the child to select a leisure activity, and modify the environment if you need to. If your childs favorite activity is the Ipad, then now access to the Ipad is restricted until they complete 2 leisure activities. Put the Ipad away or lock it with a password, and use visuals to help the child understand when they can have the Ipad. (e.g. “First, Leisure Time. Then, Ipad).




*Tip- Resources for creating visual schedules:

Saturday, February 1, 2014

Quote of The Day





"It is not what you do for your children, but what you have taught them to do for themselves, that will make them successful human beings." 
 Ann Landers