See Part I, which is helpful for families needing to know how to prepare the home for ABA services.

I couldn't just leave this topic 1/2 complete. 

Of course, it is important for families to know what to expect of home-based ABA services and general "Do This" & "Don't Do This" guidelines, but it's also important for ABA staff and clinicians to know when home based ABA services are inappropriate, the home setting is unsafe or hazardous, the home setting needs stricter guidelines, or is downright dangerous to staff and/or the client.

I'm not ignoring ABA that occurs in other settings, but for clinic or school based ABA services the environment/facility is typically set up in advance. It is monitored and controlled by management or clinicians, and regularly cleaned and maintained. Certain items are prohibited to be on-site, there may even be security or at the least, janitorial staff. 

The home setting is unique because as the staff going in, we do not have full control over the environment. We don't know what hazards are present unless someone tells us. Sometimes we don't even know how many people (or animals) will be in the home from one session to the next. We may not know what is broken/damaged in the home, or may pose a health concern when we arrive on Day 1, ready to work.

So, this is a pretty big deal. 

To all the company owners and supervisors/BCBAs, this kind of "home safety checklist" needs to be developed with a home inspection occurring before the case starts (during intake/assessment). RBTs should not have to walk blindly into the home of a stranger, with no idea what dangers or challenges may be present.

I recommend that whoever schedules the assessment and makes initial contact with new families explain the company policy related to home safety, make sure to answer any parent questions or address parent concerns, and do a walk-through inspection (this could also occur virtually).

Companies will vary with what is required or expected of the home setting, and sometimes state regulations or funder specifications will apply. 

Unsafe/Inappropriate conditions in the home may negatively affect the client, such as: profuse sweating through the session because sessions occur in the non-ventilated and dusty attic, the parent blaring loud rock music throughout the session, or being unable to let the client play in the backyard due to huge amounts of dog feces.

Unsafe/Inappropriate conditions in the home can also negatively affect staff, such as: excessive and unwanted flirting and sexual jokes from the client's father, having to park in a nearby unsafe area as only street parking is available, or bringing pests into your own home that crawled into your materials bag during the session.

How exactly is learning or teaching supposed to occur under these conditions??

I could fill this post with pages and pages of home-based horror stories, but instead I'll just simply say: Home based ABA won't be possible for every family that wants it, for a variety of reasons. 

And that's ok. 

Services may need to occur at school, at the clinic or center, or in the community (such as at a library) until issues in the home can be adequately and safely addressed both for the benefit of the client, and staff.

**Resources:

Free checklist download to help set policy/establish minimum requirements for home-based ABA services to occur. 

Home Based Employee Safety

Ensuring Safety during In-Home sessions

Firearms & Home-Based ABA: Considerations for Safe Practice

Read more »

Tameika Meadows, BCBA, Blog Author

 

*Recommended Resources:

Helping your ASD child cope with COVID

Strategies for supporting learning at home

Homeschooling special needs children

Mastering Homeschooling

Podcast Episode: "Take Off the Cape"

During this global pandemic, schools have been as impacted as everyone else when it comes to figuring out a New Normal. 

The most recent stats indicate that globally, there are 1.2 billion children learning outside of the classroom due to school closures (source: We Forum) . E-learning has increased dramatically, with parents and caregivers now finding themselves thrust into the role of "Home Education Assistant".  

I have multiple clients who are learning at home this year, and both the parents and the children are struggling to adjust to this unanticipated change. 

For the children, it may be hard to understand why they aren't at school, why the regular routine has been so disrupted, and why they have to sit and learn at a computer all of a sudden.

For the parents, this is an added stressor during an already challenging year, it is hard to navigate a school at home schedule while also working from home (or returning to work on-site), and for parents of ASD children there are added unique challenges to help the child benefit from online learning.

Very few of the clients I serve are able to sit and learn through a device/computer screen for an entire school day. That just isn't happening. So what we are doing instead is helping the caregivers in the home learn how best to support their child's school day with this new format. Especially since none of us really know for sure when schools will be "back to normal".

Below are some tips I share with my client families, I hope they are helpful for you and your children:

• Tip #1 is THE MOST important tip: Talk to your treatment team. By "treatment team", I mean the ABA team/case BCBA, Speech Therapist, Teacher, Counselor, etc. The best person to ask about your child's learning is a professional who already knows and works with your child. Seriously, I have had so many meetings this year with client teachers, and the teachers were all so understanding, accommodating, and willing to work together, because this year is hard for all of us. You will have no idea how much the online school day can be modified until you ask.

• A daily schedule will be your BFF. It will be nearly impossible to adjust to the demands of school at home without a consistent schedule in place. Create a schedule based on when your child needs to log-on/be active in class vs. when they can work on assignments off-screen/off-camera. Be sure to include breaks (Pleeeeeease don't expect your child to sit at a computer screen all day with 0 breaks. That won't end well), meal times, reinforcement time/play, and calming or sensory activities as needed. Just like the rest of us, your child is probably highly stressed from the challenges of 2020. Though they may be unable to communicate that, just depending on ability level.

• Seek help if you are physically unable to supervise your child's online learning. I have some client families where both parents are working from home right now. It is tough, but they are able to adjust their day so at least one parent is always monitoring the child's learning. I have other client families where this is not at all possible. Every household is different. Consider having a neighbor, grandparent, older sibling, or family friend monitor your child during the school day. For some families, "monitoring" may be all that is needed. For other families, see the next tip.....

• DO understand that for some children, sitting at a laptop and attending for more than a few seconds at a time will not be possible. It won't. You are not a bad parent if this is the case. You have not failed, and you should not beat yourself up. This simply means your child will need a high level of support to benefit from schooling at home. I have some clients in this scenario, and it does mean that an adult must sit with the child and help them participate in online school. But guess what? For these types of kids, a 6- hour school day is not the goal. A 4- hour school day isn't even the goal. We work on helping the child participate as much as possible, and then we take breaks. Then we try some more. Then we take breaks....get the picture? Which leads me to my last tip....

• Let's get real. And I mean, really real. We are in the midst of a pandemic. Families are struggling mentally, emotionally, financially, etc. Your child with ASD may not understand what is going on, and why all of a sudden you are acting like a teacher. Stress levels, anxiety, and depression, are sky-high for many people. You have to assess your capacity as a parent to do school at home. It truly is not for everyone. And that's OK! Please re-read tip #1. Talk to the school. Talk to your child's teacher. Explain your situation, and discuss the barriers to teaching your child at home. See what strategies or modifications the school can make. You might be surprised how many options you have that you just don't know about. You are not Superman or Superwoman, and are under no requirement to be perfect. Do the best you can, in the surreal circumstances we all find ourselves in right now. Best of luck to you!

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Tameika Meadows, BCBA, Blog Author

For truly any child, the sibling relationship can be a combination of great/horrible, best friends/worst enemies, play partner/nemesis.
Anyone with a sibling knows this is the truth, especially when you and your sibling(s) were young kids.

BUT, when a child with ASD is tossed into the mix then totally normal sibling hi-jinks can take a more drastic turn.

A big concern of the families I work with is sibling interaction, or lack thereof. Usually, the issues fall into one of these categories:

- The typically developing children ignore the Autistic child, and have learned it's easier to just leave them alone
- The typically developing children fully give in to whatever the Autistic child wants, and have learned that letting their sibling bully them is better than making their sibling upset
- The typically developing child IS the bully, and has learned that their Autistic sibling won't put up much of a fight/won't stick up for themselves


As a professional, I see it as a great benefit when my clients have siblings living in the home because now I have a built-in pool of peers to reach for whenever we are targeting social-emotional or play goals. Win-win!
Usually though, the sibling relationship is so strained and broken that we can't include the brother or sister in the session until we work on sibling interaction first.

So there is the 1st tip: until the sibling relationship is repaired, just tossing the kids together to work on skills will likely not end well.

Need more tips? Okay:

1. Step back from the problems, and focus on what you DO want to see - Are there issues with name-calling and teasing? Then you want to see respect. Are there issues with hitting or kicking? Then you want to see calm bodies. Are there issues with always having to win every game? Then you want to see playing by the rules. When it comes to behavior: focus on what you DO want, rather than what you don't want.
2. Start small- Baby-step your way to success rather than jumping into the deep end. If your children start attacking each other 5 minutes into playing Candyland, then let's play the game for 3 minutes. Or 2 minutes. Start at a level where everyone can be successful, and gradually increase your expectations over time.
3. Teach functional communication - Ensure that your children are able to communicate (vocally or non-vocally) what they do and do not want. Usually when functional communication is lacking, there will be lots of aggression instead. Make sure the children are taught how to communicate "I don't want to play", so there will be no need to hit, punch, or kick. 
4. It's OK to dislike your sibling - Sometimes my clients just don't seem to like their siblings very much. Especially if the sibling is much younger. While we can't force "like", what we can do is maintain an expectation of respect. It is not okay to throw blocks at your baby sister because she's annoying. Nope.  Instead, how about taking a break from the situation, asking to wear headphones, or practicing patience and self-calming? 
5. Remember, relationships evolve over time - This should be good news for someone! As adults, we tend to forget that in our childhood we felt differently about our siblings at different ages. This is completely normal. I have some clients I have worked with for years, and I have seen the ebb and flow in their children's relationships. From "I can't stand you!" to "I want to sit next to Erica!". This will happen. Just because your children have a terrible relationship right now does not mean it will always be that way.

Lastly, any quality ABA provider can include sibling interaction goals into the treatment plan, provide parent training to help you generalize strategies when the therapists are not around, and intentionally plan for play dates or community outings with all the siblings (basically, moving from rehearsal to a live show).

*Resources:

How ABA can Reduce Sibling Rivalry

Playing with Siblings

Strengthen the ASD Sibling Relationship

Sibling Perspectives & ASD

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Tameika Meadows, BCBA, Blog Author

For a variety of reasons (some preference based, some due to circumstances) many parents today are choosing to homeschool their ASD child.

Thanks to technology, if you are a parent considering taking the often scary step into not just being Mom or Dad, but also Teacher, then there are websites, apps, and all sorts of tools that can help you. Which is great.

So is homeschooling all great, ALL the time? Hmmmm.....not really.
Just like any educator, every day will not be sunshine and roses. However there's a huge difference between an occasional rough day, and ending each homeschooling lesson sobbing at your kitchen table. Let's avoid that 2nd scenario, when at all possible.

Many of my clients are homeschooled by one or both parents, so I get an upfront view of the difficulties these parents have when it comes to teaching their own children.

This post isn't about answering the question "to homeschool, or not to homeschool", as that's a decision parents should make. But, I do hope to give some helpful tips for making the homeschool process a bit easier and less frustrating.

Moving from Amateur to Master

“Adapt” is now your favorite word	If you have spent any amount of time inside a Special Education classroom, or speaking with a Special Education teacher, then you should know that Adaptation is the name of the game. Most purchasable curriculum does allow for  customization (some more than others), but if your child is not progressing well with the curriculum/can't keep up, or isn't understanding the material, the beauty of homeschooling is that you can adapt the material to fit the child. I know some parents who don't even teach certain skills/certain subjects because in the grand scheme of things it just isn't functional for their child. When I say "adapt", I mean the materials, the tests/quizzes, the textbooks, the lesson plans, EVERYTHING! What you are teaching should be functional for your child, and presented in a manner they find interesting, and clear to understand. If it isn't, then you have some adapting to do.
Reinforcement is key	Life is about reinforcement. The quicker you accept that, the easier teaching will become. Using a combination of visual/auditory supports, and tangible rewards, embed frequent, powerful, doses of reinforcement into teaching. Ideally, you want your child to be a willing and compliant learner who enjoys learning, right? Well, the way to get there is by breaking tasks down (see the previous point) and wrapping up demands in a thick layer of reinforcement.
Knowledge is your strongest weapon	Knowledge of subjects? Nope. I mean knowledge of your child. If you have a teaching background that's great, but many parents who choose to homeschool do not. But you definitely do have knowledge of your child :-) Use what you know about your child (temperament, motivation, personality, etc.) to design instruction. I know of a family where the mom created lesson plans focused around the movie "Zootopia", as that was a special interest for her daughter. So they used "Zootopia" to learn about history...math...science....etc. Use what you know about your own child to your advantage.
“Prompting” & “Teaching” are not synonymous	See my Prompting post if you are unfamiliar with this word. Here is a common error I see many parents make when homeschooling: child responds incorrectly, parent delivers prompt, child responds incorrectly, parent delivers prompt...repeat 500 times. The problem with confusing a prompt with teaching, is "What is the child learning"?? A prompt is always intended to be lessened, or fully removed, so we can reach independence. If you stop prompting your child, and they suddenly have no idea what to do, then you have been over- prompting. Which will slow down the rate of acquisition (it will take longer for the child to learn).
Masters seek help when they need it!	The most important tip is not to try and do everything on your own. Educators working for school systems know when to reach out for assistance, and so should educators working around their kitchen table. If your child has significant behavior issues, attention problems, or their academic performance is far below their age (a 7 year old working on Kindergarten level assignments) then you need some professional assistance to design intervention. Reach out to an educator, the support available through the homeschooling curriculum/website, or a qualified BCBA so they can help you learn the best ways to teach your child.

*Resources:

If you aren't already familiar with TPT (Teachers Pay Teachers) it's an awesome site full of resources made by and for educators

"The Value of Homeschooling"

"Homeschooling Your Child with Autism Spectrum Disorder"

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Tameika Meadows, BCBA, Blog Author

Activity schedules are amazing tools that can benefit a household in many different ways:

1. Ease transitions
2. Promote independence/Self-management/Leisure skills
3. Teach play skills (particularly independent play)
4. Prompt behavior without a therapist/adult being present
5. Decrease unsupervised "free time", which is often filled with problem behaviors
6. Teach following a schedule/teach routines
7. Signifies when reinforcement is available
8. Teach choice making

I love, love, love activity schedules. A common recommendation in my behavior plans is to "keep the child engaged". Most of my clients exhibit their worst problem behaviors outside of therapy sessions and school. Why is that? 

It's often because the home environment does not provide the same level of routine and structure as school and therapy sessions. For most of my clients, down time is not their friend. Down time is usually filled with behaviors that Mom or Dad do not want to see increase, like eating carpet lint, dumping out the dog's food bowl, or sitting on top of the refrigerator.

If you are working with an ABA team, ask them if this is something your child could benefit from. If you don't have the support of a team, then keep reading and I'll explain how you can make one yourself.

Firstly, parents often say to me "Is this really necessary? Will he/she always need to have a photo schedule to follow? Won't this be inappropriate when he/she is a teen or adult?". My response to that question is to inquire if the parent ever uses some type of planner (including digital ones) to organize or structure their days. Roughly 80% of the time they tell me they do. I then explain that a planner is a glorified activity schedule. Don't believe me? Okay:

Activity schedule with photos----->Written schedule with no photos----->To Do list----->Organizer/Planner/Scheduling app

Now that you know even adults use a version of an activity schedule, how do you know if your household could benefit from one? If any of these scenarios ring true for you, consider implementing activity schedules:

1. Afterschool/on the weekends/after therapy sessions the child's problem behavior skyrockets
2. Breaks from school/3 day holiday weekends are just the WORST, and your child seems to amp up their problem behaviors day by day
3. The child must be constantly supervised or they will break, climb, or destroy something in the home
4. The child has no leisure skills, and lacks the ability to just "go play" (these words mean nothing to them)
5. Telling the child "stay in here" also means nothing, and they tend to just wander all over the house
6. Mom or Dad cannot do laundry, take a phone call, respond to emails, have company over, or cook dinner unless someone else is home to keep the child entertained/busy
7. Toys sit around gathering dust, because your child only interacts with them for a few seconds before losing interest
8. Other children in the home rarely get their share of parent attention or time 
9. The child will only sit and attend to electronics (TV, iPod, tablet, etc.). Books, toys, puzzles....nope.

Are you starting to love the idea of an activity schedule yet? :-)


Now for the fun part: Making one! *Puh-lease do not buy an activity schedule online. For one, it will not be individualized to your child. For two, it's super easy to make

Decide which part of the day you want to introduce this visual support  (I suggest picking the part of the day that is currently the MOST difficult to keep your child entertained)

Decide what you want the child to do instead of wandering around, being glued to an electronic, or engaging in problem behavior  (Puzzle? Read? String beads? Sensory tub?)

Create a visual display of each step. The schedule can show one activity or multiple activities (On a piece of cardboard or thick paper, tape a photo of each separate activity in the order they should be completed)

Consider the use of a timer and reinforcement  (Timers help ease transitions, and reinforcement is behavior superglue)

Prepare the area (Have all materials organized and nearby, tape the schedule to the wall)

Teach your child to follow the schedule  (You will need to prompt and reinforce)

* More information:

Book: Activity Schedules for Children with Autism-Teaching Independent Behavior 

Research: Use of activity schedule to promote independent performance of individuals with Autism and other Intellectual Disabilities

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Tameika Meadows, BCBA, Blog Author

Photo source: www.ablg.org, http://www.angelfire.com/tx5/autism/abaprogram.html

*Recommend Reading: Common ABA Work Settings


ABA therapy can be provided in any setting where help is needed, but often services take place in the clients most natural environment: the home. Particularly if the client is very young, its usual that they spend all their time at home so that is where its most helpful for the therapy to occur.

This is another one of those topics that will vary across clients or companies, so I'm going to generalize a lot in this post. This information can help both professionals and parents know how to properly prepare the home environment for ABA therapy sessions.

Q) So what can a parent expect when initiating in- home therapy?

A) Once the intake process is completed and there is a treatment plan in place, the ABA team will begin coming to the home on a regular schedule. For example, every M-W-F from 9am-12pm. The ABA team can include 1 or more direct staff, and a Clinical Supervisor who comes out less often than the direct staff (maybe 2-3 times per month). Each therapy session is a mix of play, direct instruction, activities, adaptive skills (utensil use during snack time, toilet training, etc), parent training, and lots of client breaks. The sessions could be loud and boisterous, or quiet and calm, just depending on what skills are being targeted. Therapy may take place in one room or area, or the staff may move all over the house with the client.


For many families who initiate ABA therapy services, they have never had in- home therapy before. Parents may be unsure what to expect or what their role should be ("Do I jump in and get involved, or do I stay out of your way?"), and may be unprepared for how invasive in- home therapy can truly be; particularly if therapy is intensive (20+ hours per week).

During client intake I like to discuss all of this with new clients and help explain to them what it will be like to receive in- home ABA. Even if the family has received in -home therapy before, it may have occurred once a week. In which case, ABA will be a VERY different change of pace. If you want happy clients, talk to them about all this before services start so they are prepared and know what to expect.

If you are new to working in -home with clients, or just looking to streamline the way your agency/company prepares clients for in- home services, I hope this simple checklist is helpful:

Preparing for In-Home Therapy

• Your home is your home. It is also now our work space. This means we may ask to park in your driveway, put up visuals on your walls, store materials, data sheets, and program cards,  plug in a laptop or tablet, and during supervision/training sessions you may have multiple professionals in your home at once. You may feel annoyed, uncomfortable, or like you need to "impress" the direct staff with how immaculate your home is. Please don't do that. We aren't in your home to critique your decorating or housekeeping skills: we are here to provide therapy.
• We may ask you to set aside an area in your home to turn into a "therapy area", especially if early learner skills are being taught using Discrete Trial methodology. We may ask that when no staff is in the home, your children don't have free access to therapy materials, program reinforcers, or the program binder.
• If any of the staff have pet allergies, please respect that. This may mean that your beloved cat Fluffy needs to be put behind a closed door during therapy sessions. Beyond allergies some people just have cat phobias. Please be respectful of that.
• Please ensure we have an adequate working environment. If there are consistent issues with insects/rodents, no heat or air conditioning, strong odors, pet waste on the floor, etc., understand that we may be unable to continue working in these conditions.
• You may be wondering what you, your spouse, and your other children should do during therapy sessions. Don't feel like you have to lock yourselves in a room and stay absolutely quiet until sessions end. While you are always free to quietly observe the therapy session, avoid interrupting or joining the session without discussing with the therapist first. If you see problem behaviors occur, please let the staff handle it. If you have any questions or concerns about any of our techniques or strategies, you are always free to ask us to explain.
• There is no need to offer the staff food or drinks. We are in your home to work, not to socialize.  On a similar note, please do not offer us gifts. We really cannot accept them.
• Promptly let us know if anything about the staff is upsetting to you or anyone in your home. Feel free to talk to the staff directly (they cant fix a problem they don't know you have), and if that doesn't work immediately speak with the Supervisor. Examples can include: strong perfume, staff smells of alcohol, staff doesn't clean up after the session, staff wears low cut tops, staff breaks something in your home, etc.
• If you ever need to cancel or change a session date or time, inform us as soon as you can. Depending on company policy, if we get to your home and you are not ready for the therapy session you may still be charged for the full session. If staff do not extend the same respect to you (let you know when they will be late, or have to cancel) immediately notify the Supervisor.
• Before we arrive for a therapy session, please help us do our job by making sure your child is "therapy ready". This means they are awake, fed, diaper/pull up is dry, and they are not actively engaged with a highly preferred reinforcer or activity. In language your child will understand, let them know when we are coming so they will be prepared.
• Understand that habitually cutting therapy sessions short minimizes both your child's therapy time, and it impacts the staff's pay. Avoid doing this unless its an emergency.
• We need you to be home and "available" during therapy sessions for parent training, and to help incorporate you into therapy. Avoid using therapy time to run errands....we are not babysitters. 
• We understand that you will form positive relationships with all of the ABA team, but that there will be staff you like more than other staff. That is fine. What isn't fine, is gossiping about staff with other staff, telling staff they need to be more like a different staff, or making any staff feel unwanted or uncomfortable in your home. If you do not want any of the staff working with your child, please share these concerns with the Supervisor.

*Resource:

Preparing for in-home services

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Tameika Meadows, BCBA, Blog Author

Self-help skills are those functional skills or tasks that build independence, self esteem, and increase the likelihood that a child will be successful across multiple environments. I think teaching self help skills is incredibly important, yet I often see these programs being skipped or left out of a treatment plan.

For parents of a child with Autism, they are typically very used to helping their child be successful. From an early age Mom or Dad have been prompting their child (even if they don’t know the term “prompting”, they have probably been doing it for years), modifying the environment to help their child, calming emotional outbursts/being a safe haven, etc. So by the time you meet a family, the parents have probably fallen into a habit of doing whatever they can to help their child get through each day. Problems can arise when this loving and caring help goes on for too long, across too many environments, and hinders development. 
Here is a very typical experience for me: During intake, I ask parents lots of questions about what their child can and cannot do. When I get to self help skills (can your child independently brush teeth, bathe, prepare a snack, etc) I usually hear "I don't know...I'm not sure...I do it for him". That is a big red flag for me that the child has little to no independence skills.

Part of typical childhood development includes a separation from Mom and Dad and learning to care for yourself, learning to calm yourself, and problem solving, e.g. “I’m in a new public setting and I have to use the bathroom. What do I do?” Emotionally, it can be difficult for a parent to start to separate from a special needs child, and to begin teaching the child skills that will lead to independence. It can be difficult for parents to let their “baby” start learning big girl/big boy skills. So understand that even if you have sound and reasonable reasons for wanting to teach self-help skills to a client, the parents may push back a little bit.

When first meeting a new client, problem behaviors and lack of language can overshadow any other goals. Parents usually express frustration and fear over their child’s lack of communication, or aggressive outbursts occurring multiple times a day. As the professional, even if the parent does not express a concern about self-help skills you should be the one to address it.

Don’t think teaching self-help skills is that big of a deal? If a child is lacking self-help skills they can have a developmental age that is years below their chronological age. Just think about a 9 year old who yells “Wipe me!” from the bathroom, because he still can’t wipe himself after bowel movements. Or a 4 year old who is still spoon fed by Mom. Or an 11 year old who cannot button or zip up his clothing.

The VB-MAPP, Vineland, and ABLLS-R assessments all include some type of self-help/adaptive skill domain. This is an important area of teaching; don’t skip it.

The first step in determining self-help deficits will be the assessment process, and observation. I wouldn’t advise just asking the parents about self-help skills, because parents can over or under estimate the independence level of their child. Always observe the child in the natural environment to make sure the information you were given about their level of independence was correct. 

Think about self-help skills that are developmentally appropriate, will make the child more successful in social settings or across environments (the biggest example of this is Toilet Training), and any self-help deficits that are placing undue burden on the parents. For example, do the parents have to bathe their 13 year old son each night because he is incapable of taking a bath? If so, that is a self-help deficit that should be targeted for intervention. Think about how much it will help that family, and empower that child, if he can start to bathe himself.

If you still are doubting the importance of self-help skills, here is my advice for you: Spend some time with a typically developing toddler. Toddlers are standing right in the gap of “babydom” and being a big girl/big boy. They typically want to do things independently even if they don’t have the skill yet. They don’t want you to pour their cereal or pick them up and put them on the couch: they want to do it by themselves. 
Compare a typical toddler to the child or client you care for, and prepare to be amazed at the difference in independence. Just because a child has Autism does not mean they don’t need to learn independence. I’m not going to wipe the nose of a typically developing 3 year old, and I’m not going to wipe the nose of a 7 year old client just because he has Autism. Hand him a tissue, and tell him to blow! 

I have never met a parent who told me their goal for their child was to be as dependent as possible. So help these kiddos be more independent, by deciding today to stop doing things for them that they can do themselves.

Self-Help Skills Checklist

• Dressing Skills (tying shoes, putting on shirt, matching tops to pants, etc)
•  Bathing Skills (washes face, uses soap, dries with towel, etc)
• Grooming Skills (uses comb or brush, brushes teeth, can apply Chapstick, etc)
•  Feeding Skills (uses utensils, sucks using a straw, chews with mouth closed, etc)
•  Toileting Skills (wipes after BM’s, stays dry through the night, requests toilet if in a new public setting)
• Independence/Autonomy Skills (chores, making choices, polite refusal, e.g. "No Thanks")

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Tameika Meadows, BCBA, Blog Author

“I can’t even talk on the phone/take a shower/ visit with guests because my child gets into everything.”

“She spends all day moving from toy to toy, and I’m constantly cleaning the house and picking up.”

“She doesn’t have any hobbies.”

“I can’t sit down/watch TV/talk to my spouse, because I have to entertain my child.”

“How do I stop my son from hitting and annoying his siblings all day long.”

“His teacher says he’s fine at school, but here at home he is just climbing the walls!”

These are just a few of the questions/comments I hear from parents who have no routine inside of their home. I personally feel this is bigger than an ABA issue and is really just an organization issue. I think most parents could benefit from incorporating structure into the household, but especially parents raising children with Autism.

Many parents raising children with Autism see that there is order and routine inside of their child’s classroom, but for some reason don’t see a need to generalize this same type of structure into the home environment. Any teacher of small children can tell you that without a schedule and routine, chaos would ensue.

Households without structure and order tend to have all kinds of problems:

*        Transitioning issues

*        Compliance issues

*        The children don’t initiate activities (if bored, they just bother their parents instead of finding something to do)

*        The kids fight and aggravate each other all day

*        The house is hard to keep clean; toys, puzzles, games are scattered everywhere

*        Keeping the kids entertained is placed on Mom and Dads shoulders

A red flag for me is when I am meeting with parents and we can’t hold a conversation because they keep stopping every few seconds to tell their child to get down…to be quiet….to stop hitting their sister…..to put the cat down…..to get off the table….or  to “Go Play” (the words “Go Play” mean very little to a child with no play skills).

If your household sounds anything like this, then you and your family could benefit from creating a schedule to put structure and routine into your home.

So where do you start?

1.      Write out the schedule for your home divided up by time increments, starting with what already happens everyday (such as dinner). Be sure to add in structured activities for your child, such as Water Play, Fine Motor Activities, or Art.

2.      Decide how you want your child to transition through the activities. Do you want to use timers? Sound cues, such as playing a specific song? Giving the child a directive, such as “Its time for Art”? Each activity needs a clear start and stop, so the child can easily transition.

3.      Modify your home to accommodate the schedule. For example, you may need to set up areas of the home for different activities, section off large rooms so multiple activities can happen in that room, put items and objects away in cabinets or drawers when they aren’t needed for an activity, and label areas so the child knows where to go to do the activity. If the schedule says your son is to do homework everyday after school, then there should be 1 designated homework area, and any needed supplies (paper, pens, calculator, etc.) should be kept nearby.

4.      Create a visual schedule, or write out the schedule and display it in a central location in the home.

5.      Explain the new schedule and routine to your child in simple language he/she can understand.

6.      Teach your child to follow the schedule. This is a step many families skip. It isn’t enough to make a routine and hang it up in the living room. The routine must be taught, and will take your child time to learn. Be firm, use lots of prompts and reminders, and do not allow your child to deviate from the schedule. If the schedule says its time for Reading & Vocabulary, then it doesn't matter if the washing machine breaks, the cat gets sick, or the new neighbors drop by unexpectedly: stick to the schedule.

Creating a schedule for the home will bring order, quiet, and structure into your household. Parents have consistently told me that they have more free time after implementing a schedule. The reason why is simple: when the children are appropriately engaged, it is no longer up to Mom and Dad to constantly put out behavioral fires or keep the kids entertained. 

 Below is a sample schedule for the home:

SAMPLE DAILY SCHEDULE

6:00 Wake up, Morning routine, Get dressed

6:30 Morning chores: Make bed, Feed dog

7:00 Breakfast

7:30 Leave for School

3:30 Arrive at home, Afternoon chores: Take out trash, Put book bag away, Take out homework

3:50 Snack time

4:00 Homework

4:30 Outside Play

5:00 Quiet Reading

5:30 Computer Time      

6:00 Cooperative play with siblings

6:30 Prepare for dinner, Wash hands, Help set table

7:00 Dinner

7:30 Bathtime, Brush teeth, Put pajamas on

8:00 Bedtime routine

8:15 Bedtime, Goodnight!

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Tameika Meadows, BCBA, Blog Author