Applied Behavioral Analysis therapy (ABA) is amazing because it isn’t designed to tackle autism by itself.

Sometimes Autism isn’t the only diagnoses that a child on the spectrum is diagnosed with. A child who has autism may also be diagnosed with Attention Deficit Hyperactivity Disorder, Oppositional Defiance Disorder, Anxiety, Depression and more. There is a 30% chance your child may also have a specific phobia, and a significant number have intellectual disabilities. Autism isn’t as straightforward as some may believe which is why it’s difficult to tackle it with most conventional therapies.  

Applied Behavioral Analysis therapy (ABA) is amazing because it isn’t designed to tackle autism by itself. It is a therapy used in all areas of life, from career, to sports, to businesses and other disorders. When you put your child into an ABA programme, you’re not only providing help with life skills they lack (due to the way their brain functions), but also skills to help with a variety of issues and other disorders.

If you’re concerned your child may have issues outside of autism, such as ADHD, you can ask your DR to refer your child for further testing. Here are some symptoms and behaviors:

ADHD: Aggression, excitable, fidgeting, hyper, impulsive, irritable, no restraint, repetitive words and behaviors, absent-minded, no focus, forgetful, short attention, angry, anxious, bored, excited, mood-swings.

ODD:  Aggressive, antisocial, impulsive, irritable, screams, self-injures, vindictive, argumentative, angry, anxious, depressed, lack of attention.

Anxiety: Tired, restless, sweating, hyperventilates, irritated, racing thoughts, intrusive thoughts, excessive worry, fear, feelings of impending doom, nausea, trembling.

Depression: Apathy, discontent, guilt, hopelessness, not interested in anything, seems bored, mood-swings, tired, insomnia, agitated, cries a lot, no appetite or extreme appetite, slow movements, suicidal thoughts, no concentration, weight gain or loss, repeats thoughts, obsessive thinking.

What kind of therapist will be a good fit for your child?

Not all therapists will have the same style of implementing common ABA therapy techniques. Some may be very gentle, others firm, where some may want to explain situations to a child who works well with logic, and others may want to make simple demands instead. Applied Behavioural Analysis (ABA) is a therapy that is implemented in a way that molds to your child's unique personality and needs.

Because of this, not all Applied Behavioral Analysis (ABA) therapist will be the right fit for your child. When you decide to terminate services, you may consider if you want somebody else. If this is the case, think about what it was about the last analyst that caused issues for you. Understanding what you disliked about the therapist style of teaching, and communicating it to the company, can help them find you a better fit. Making a concrete list of what you are looking for gives the therapist/company a way to meet your needs, and either refer you or find someone like that.

Whether it’s tone of voice, certain techniques you don’t agree with or simply the personality of your therapist, making sure all of those issues are met to your desires are important. Never be afraid to go with a different therapist until you find the right fit for your child. Every therapist practicing ABA will bring their own unique style and personality into the mix. Just like every child will bring their own personalities into the relationship.

Applied Behavioral Analysis (ABA) Therapy has techniques to help teach an Autistic child empathy

People with autism often struggle with empathy; as a parent of a child who shows little empathy, it may be pretty terrifying to wonder what might happen to your child in relationships or how their morals might develop. A child with little empathy may laugh when another is upset, or take a toy from another child and not understand why they should share, or even be violent with little remorse.  

The good news is Applied Behavioral Analysis (ABA) Therapy has techniques to help teach a child empathy and how to respond to situations appropriately. Which is a huge relief when you’re the parent or even child. The other great news is lack of empathy does NOT make someone with autism an awful person who’s choosing not to care. The issue doesn’t lie in choice (typically seen with people who have autism, it’s caused by abnormal neural connectivity), and when given the option to learn and choose to care, a child with autism absolutely can!

First, the ABA therapist will likely teach your child to recognize emotions. Once they can recognize what an emotion actually is in a simple way, it will be way easier to teach them it in everyday interactions, and how to respond to those emotions. This is done through pictures of faces, the therapist demonstrating or even silent clips of facial expressions.

Apart from recognizing emotion, there are two other steps to mastering empathy. Taking someone else's point of view into account and controlling how we respond. This can be done through role-playing situations, using life skill books demonstrating situations where empathy is needed, having the child role play another's emotions through facial expressions, or even asking questions in everyday conversation when an empathetic response is needed.

The other cool thing about empathy is there are actually three types.

Emotional Sharing: Where you feel what another feels

Empathetic concern: Where you want to help others in distress

Perspective taking: Which is when you can see someone else's point of view

Knowing this as parents of autistic children can help us to understand why your child might run to help their sibling up when they’ve fallen down one second, but call them names and laugh the next.

ABA is a fantastic therapy which can help so many children with autism thrive and live a far more high-functioning life than they would have. The vast amount of things the therapists can teach and help your child with is so worth the time investment and bond you will build with both the therapist and your child.

How prompting can help during ABA

Prompting is a wonderful tool in applied behavioral analyses therapy (ABA) and probably the reason some children learn to communicate at all. This simple way of moving a child through the motions of an action/response so he/she can see the consequence is so powerful yet so simple. It really answers the question, how do you teach a child that can’t understand language intuitively, what you are asking of them?

My son was completely non-verbal until his speech therapist used hand-over-hand prompting to show signs and slowly weaned him through the process of prompting until he could mand (request things) for himself.

Here is a list showing some most invasive to the least invasive prompting.

Most invasive: Full Physical Prompting

This is when your therapist will essentially use your child’s hands to carry out a request. For instance, she/he may say, ‘pick up your toys,’ then take the child’s hands and close them around the toy, guiding it to the toy box.

Next Invasive: Partial Physical Prompting

In this case the therapist will put the child’s hand onto the toy to show them what she means and wait to see if the child carries out the rest of the direction. Normally this is the first step taken once the child has mastered full physical prompting.

Next Invasive: Modeling

The therapist will act out what she wants the child to do. For instance, she will pick up the toy and put it in the box after asking them to do it and wait to see the child’s response.

Next Invasive: Gestural

Where the therapist will point at the toy and the toy box to gesture to the child what is needed of them.

Next Invasive: Positional Prompt

The therapist places the object close to your child and tells them to clean it up.

Least Invasive: Simple Direction

The therapist will simply ask your child to clean up their toys and expect that they will do it without further help.

When we move down this chart the child slowly learns what is expected of them, or basically, what you’re asking them to do! Much of the time, just telling them what to do and showing them won’t work for an autistic child. Going from most invasive to least invasive (depending on the specific skill set of your child and what they are asked to do) teaches them in a way that they will actually understand. It’s so simple and effective but works beautifully.

Techniques for Sensory Issues

The other week I discussed reasons for why a child would act out. We then went through techniques an Applied Behavioral Analysis (ABA) therapist uses when a child elopes.

But what about techniques for sensory issues?

Sensory integration is the process of normalizing sensation and making it easier for your autistic child to cope with them.

Occupational Therapy

Alongside ABA your child may benefit from Occupational Therapy if you find they have a lot of physical issues. OT in simple terms helps people do what they want to do in everyday life, be it taking off a t-shirt or using a pen. Sometimes these issues are accompanying sensory problems, like the feel of fabric, or not knowing you are squeezing too hard. An OT’s job is to identify the sensory issues and guide your child through them until they can physically handle the task. They’re a perfect addition to ABA.

Applied Behavioral Analysis Therapy

An ABA therapist identifies why your child is having an issue and either teaches them something new, or reduces it. When a child can’t handle, or process sensory information because of autism they may have extreme reactions to it, such as self harm, violence, or meltdowns. It’s important to identify when your child is behaving this way because they simply don’t want to do something or don’t know how to communicate, and when they truly cannot process what is going on around them.

This is no easy task.

We cannot personally dive inside their minds, so we can only observe, watch and wait until we know the answer. Which is what your ABA therapist or analyst will do before they introduce an intervention.

Communication Skills

Sometimes, our children have a meltdown when there are bright lights or loud noises because they don’t know how to ask to leave the situation. In this case, the therapist would prompt the question of leaving and the stimulation would stop. For e.g.

Therapist, “Say, turn the light off.”

Child says, “Turn the light off.”

Therapist turns the light off.

This way your child learns that communication is a wonderful way to remove uncomfortable stimulation.

Reducing Stimuli

In other cases we can tell when a certain situation will be triggering in advanced, and know that our child has to go through it and get out the other side; like grocery shopping or school. In these cases tools are used, such as noise blocking headphones and weighted vests. These keep the child grounded and block out sounds, thus reducing the sensory stimuli to begin with.

Sensory Integration

Other times our child has to get through a stimulatory process, but there is no way to reduce it. Like brushing hair, or clipping nails. Either way they have to brush their hair and clip their nails, for health and cleanliness reasons. In this circumstance the child can’t ask to leave the situation and we can’t reduce it, so what does the therapist do?

Sensory integration is teaching the child how to handle sensory input, with breathing techniques, and practice. Just like when we as adults have irrational fears and have learnt how to face them—like public speaking, or roller coaster rides—our children have to learn how to face their fears and remain calm too.

It will be heart wrenching to watch at first as they scream and cry, but guiding them through it slowly, and teaching them how to step over their fears is something all parents should teach their children no matter whether they have autism or not.

The only difference here is that autistic children will often scream and tantrum rather than whine or talk about it, because they either have no other way to communicate or little understanding of the consequences of the tantrum in a social setting. All they know is, if I scream I won’t have to do this.

An Example of Sensory Integration

A child was petrified of nail clippers; he wouldn’t even let you cut your own nails. He would scream, cry, and have meltdowns every time someone used a pair. We would have to hide them and his nails never got clipped. This had the added down-side of learning to use his nails as weapons to cut open people’s skin, when he got mad. We couldn’t reduce the stimuli, and we had to clip his nails, so the therapist slowly introduced the stimulus to him.

At first she showed him videos and clippers.

Next she cut her own nails and the nails of others.

Then she placed the clippers on his skin.

And finally she cut one finger nail.

This took more than a month, and on every step he screamed at the top of his lungs like he felt petrified. He cried and fought and sobbed his eyes out, until he didn’t. Until he barely even noticed what you were doing. As a parent at first though, it was traumatic to watch every new stage brought with it a wrenching feeling in the parent’s gut.

But by the end? Even though he still screamed and cried, he would ask the therapist to do it! He had grown courage, and the ability to see his fear as irrational, despite still feeling it. He had learned something that takes even adults a long time to learn; fear will not kill me. A life lesson that will serve him. So although listening to his fear was uncomfortable for many parents, seeing how this process empowered him makes it all worth it.

Parent Training: Is your child's behavior getting worse?

How do you know whether you’re experiencing an ‘extinction burst’ or if your child’s behavior is just getting worse?

What is an Extinction Burst?

To understand what I mean by this, I’ll give an example. Let's say you ask your child to do something and they start hitting you. You've learned that not allowing escape is a great intervention so you ignore the child hitting you and repeat your request. At this point the child may start hitting more or harder (i.e. behavior just go worse).   

Why does this happen?

Because it used to work for them! This is called an extinction burst.

When you start to ignore the behavior all together they will up the ante and try to go back to the way it was before. Because that was easier for them than listening to you.

This doesn’t make your child a bad person in any way; in fact it makes them pretty smart! They’ve figured out how to get what they want in this world, and it’s wonderful. They can problem solve like this. Increasing the bad behavior is actually a clever thing to do. If you did something one way, and it worked, you would keep doing more of it to get the same reaction too!

When a behavior is done for attention, and we ignore the behavior it will get worse. But then it will start to get better, because your child will realize this is just too much work. Great!

But what happens if it stays the same? And doesn’t get better at all? When do you draw the line in the sand and try a new tactic?

What if an intervention isn’t working?

There will be plenty of data and charts to show whether your child is going through an extinction burst, or the behavior hasn’t changed at all. If the behavior hasn’t changed at all the reason your child is doing the behavior may need to be looked at again. Maybe the therapist was wrong, and they did it for another reason. If this is the case, the charts will show it and the data will help them change tactics. Some other ways the therapist could change the intervention to the behavior is;

-        Changing the length of time they ignore the behavior/child

-        Expand the plan to other places where the behavior may occur more

-        Have someone else also back up the intervention

If you feel a part of therapy isn’t working for your child, you can always speak to your therapist about it. They will have the data and charts to confirm or deny your experiences. They should work with you, not against you, to help your child better function, learn more and live a more productive life.

ABA therapy steers autistic children to work through sensory overload until it's no longer an issue

Many children with autism suffer from sensory overload. This could be sensitivity to noises, sensations, lights, textures, temperature and more. The issue with these sensory problems is they impede things your child needs to do.

We work with a boy who has autism and he hates people touching his finger-tips. Therefore, it is almost impossible for parents to cut his nails because he will scream and thrash around. But he also uses his nails as weapons to hurt himself, so cutting them is necessary. It’s a catch 22 and there are a lot of times this happens for our autistic children.

Take for example a potty; if they are scared of how it sounds or how it feels to sit on one, they won’t want to relieve themselves. It will be impossible for them to learn how to potty train. They may not like the way a hairbrush feels or a shower sounds. It hinders their life in a way you don’t always expect; sensory issues can stop your child from being able to care for them self.

That is why Applied Behavior Analyses (ABA) is so important. The therapist can use ABA as a way to run programs that eradicate this sensory issue for good. The name of one technique is systematic desensitization. This is where, a child is exposed to the stimulus on purpose and taught relaxation techniques.

For my son and his nail clipper issue it looked like this:

-        -Nail clippers were used on other people

-        -Nail clippers were brought close to him

-        -They brushed the nail clippers over his fingers

-        -They used the nail clippers to cut one nail

At every step this boy screamed and cried and fought, but eventually he could cope with that step. It became normal to him and he calmed himself.

Dealing with things like that alone is scary, especially seeing your own child in that level of fear or pain. An ABA therapist helps to steer them through these issues until they are no longer a big deal.

How your child can wait in a structured way

It’s hard for our children on the spectrum to control impulse control and emotions related to frustration. Because of this, asking them to wait is akin to asking them to stop their world from spinning. The end result? It gets frustrating quickly; they may explode, tantrum, lash out, whine, repeatedly ask, and destroy property, or any number of things to stop the waiting period.

This is why with applied behavioral analyses (ABA) your therapist teaches your child how to wait in a structured way.  First the therapist may start by reducing the waiting period to a miniscule amount of time; usually 5 seconds.

The therapist will hold a toy, and when the child asks for it, they will say wait, and count to 5. If the child can wait those 5 seconds, great! They receive the toy and all is good with the world again. If this happens regularly, the time will increase from 5 seconds to 10 and so forth.

But if your child throws themselves into ‘negative’ behaviors, the therapist will stop the program until the child has calmed down, and try again. If the child continues to engage in problem behavior that’s no issue! The therapist will simply stop trying and move the situation to something else.

As long as the adults teach the child to wait, eventually this hard lesson will sink in, tolerance for this situation will be built, and you will have a child able to wait. Teaching a child how to wait has so many long term benefits. As an adult we have to wait for many things, lines in stores, for a package to arrive, for somebody to finish using what we need, etc. If an adult couldn’t wait it would severely impact their relationships and happiness later on. Which is why therapies like ABA are so important.

How your child can perform tasks successfully

Sometimes your child doesn’t have a skill that his peers have. Recently we’ve had problems getting an (almost 4-year-old child) to remove his shirt. This is obviously a skill he should be able to do by now if he was developmentally normal but alas Autism has him behind others his age in many ways.

There could be plenty of skills that your child has yet to achieve too! Such as; washing their hands, putting on clothes or brushing their teeth, etc. But that doesn’t mean there is no hope. Applied Behavioral Analyses (ABA) therapists have a specific technique for teaching skills like this and it’s called chaining.

What is Chaining?

Well, we can break it down like this. Almost every skill has a series of steps attached. For example, when you’re learning how to make a salad, you don’t go from someone who’s never seen a salad bowl to a bowl full of salad. First you have to look up a recipe, and then set out your ingredients, cut them up, put them in a bowl and add dressing. This example had five different steps involved that we don’t even think about, but for a child learning a new skill those are all the steps they have to learn to get the result of a salad for dinner.

A therapist can’t show an Autistic child how to do something and expect that they’ve understood their complex language, have the motor skill available, remember every single step, then execute it perfectly. Because of this they use chaining.

Chaining starts by teaching a child how to do something either backwards or forwards (depending on what is easiest). Take the example washing hands, this can be placed into steps like so;

1.     Pull the stool up to the sink

2.     Find the soap

3.     Turn on the tap

4.     Get your hands wet

5.     Apply the soap

6.     Rub your hands together under the water

7.     Rinse the soap

8.     Put away the soap

9.     Turn off the tap

10.  Get down from the sink

When chaining forwards a therapist will prompt step 1, then re-enforce it until the child can perform this task perfectly three times. They then move on to the next step, and so on and so on, until the child can perform all ten steps without prompts.

When chaining backwards the therapist completes all nine steps for the child, then prompts the final step. When the child completes it on their own, they get positive re-enforcement. They then complete steps 1-8 and prompt 9, and so forth.

 This technique is not only fun for the child, with lots of praise and very few errors, but it can teach a child how to perform almost any task successfully. This way they can lead a more independent life. Using this technique my son went from not even caring if he could take off his own shirt, to removing his own shit just by asking him to, within a week in an excited happy manner.

Terms that can be useful during ABA therapy

As a parent Applied Behavioral Analyses (ABA) uses a lot of jargon words that leave us confused and wondering what the heck the therapist just told us! Arming yourself with the professional language of ABA will help you understand what the analyst or therapist may be saying when discussing your child with you (or even each other).

ABA – Applied Behavioral Analyses.

ABC – A three step behavior process that stands for, antecedent, behavior and consequence.

ASD – Autism spectrum disorder

Abscissa – The horizontal line graph that measures the time a behavior occurs.

Active Behavior – A behavior which can change, such as running, jumping etc, sitting still is not an active behavior.

Active Responding – When a child is expected to behave by solving problems, speaking, writing etc rather than just listening.

Advocate – Somebody who speaks out on behalf of a person.

Americans with Disabilities Act – Federal civil rights law protecting those with disabilities.

Annual Goal – A goal that you wish your child to reach within a set time period.

Antecedent – What happened before a behavior.

Approach – Choosing which form of treatment will be used, ‘the approach used’.

Augmentative Communication – Any communication made without using speech, such as pictures, sign, or electronic devices.

BCBA – People with this qualification are able to oversee and supervise programmes.

Behavior – Not always something bad, this is when a child does a behavior that is measurable, such as a meltdown or manding.

Chaining – This is the word used to describe when a therapist teaches a child a task using multiple steps. These can be taught backwards or forwards and still be successful.

Chronological age – How old the child is biologically.

Cognitive – Referring to thinking skills, which includes receiving and understanding information. This could be done by placing a square in a square shaped slot by understanding where the square needed to go.

Consequence – What happens after a behavior occurs.

Consultant – Anyone your therapist consults with/creates plans with, or a person who trains people.

DSM – Diagnostic manual for all mental disorders. This let’s a therapist know the criteria for each diagnoses.

DTT – Discrete trial training. This is when a skill is taught multiple times, usually by giving a demand and expecting a specific response, followed by praise.

Deprivation – When a motivator is removed/lessened so it is very desirable.

Development age – How old the child is ‘developmentally’, measured by tasks and skills they can complete based on the neurologically typical age range for those skills.

Developmentally Delayed – When a child is delayed compared to their peers.

Echoic – When you ask a child to repeat something and they repeat it on demand.

Echolalia – Where a child repeats what is said back to you almost compulsively. So instead of answering a question they repeat parts of the question, or the entire sentence.

Elopement – The official term for a child running away, or bolting.

Environmental Modification – Where the environment is changed to reduce barriers affecting instruction, behavior and teaching.

Expressive language – The use of language to convey meaning.

Extinction burst – When a child suddenly starts doing the behavior more often, or at a higher level, once a re-enforcer is removed.

Extinction – Removing what re-enforced your child to do something, such as giving attention to whining, which results in the child doing this less.

Fine motor – The small movements you perform with your body. With Autism you may see that a child has a hard time picking things up with his/her fingers or writing.

Floor-time – When a child moves away from table-learning, this is often child led learning.

Generalization – Being able to apply what you have learned to all situations. Such as learning how to ask for juice in therapy, then asking the same way at home.

Gross Motor Skills – Large muscles in the body perform gross motor skills. This could be jumping or running.

Hand-Over-Hand – When a therapist will literally move your child’s body to show them what they mean by a demand. For example, they may ask them to pick up a block and when the child doesn’t understand or refuses, they will take their hands and help them pick up the block with plenty of praise.

High functioning Autism – A child with Autism who has a great grasp of age appropriate skills but is unable to socialize with ease.

Hypersensitive – Very sensitive to outside stimulation.

Hyposensitive – Not at all sensitive to outside stimulation.

IEP – Individualized education plan. A legal document outlining the educational plan for your child when they are considered to have special needs.

Intervention – Using a plan of action to change an undesired behavior.

Intraverbals – When a child uses speech without visual prompts, such as being able to tell you what they did at school that day.

Level, 1, 2, 3 – Under the DSM criteria each level requires more and more support, with 1 being minimal and 3 being substantial.

Low Functioning Autism – A child who is quite delayed, may not speak etc.

Mand – This is a verbal criterion, and is when a child uses words to ask for something or make a demand. This is usually the first form of language that children learn. Juice, when asking for juice, would be an example of manding.

Mouthing – When a child puts things in their mouth.

NET – Natural environment training is child led therapy or learning from the current environment.

Neurologically-typical – Another way to say ‘normal’. This is when a child develops at a normal rate.

Normal – When a child develops normally. Some people may find this term offensive.

Peer-Mediated – When a child a similar age to yours is trained to interact with your child and teach social skills.

Perseverative Behavior – When a child engages in excessive, repetitive behavior that is not stimming such as asking for an object several times in a row.

Picture Exchange Communication System – Or PECS is used when a child has limited verbal skills, often they are given pictures to exchange with you in order to communicate.

Pivotal Response Training – Where a child is taught pivotal areas of development which are targeted to affect several areas of development at once.

Prompt dependant – When a child has gotten to the point where they consistently need to be prompted to do a specific task and won’t do the task independently.

Prompt – When a therapist prompts a specific response they are looking for, this could be verbally, physically, visually etc.

Punisher – This does not refer to punishing the child, but rather a consequence of an action which reduces a behavior. This could mean having a child move away from a situation where they are being disruptive and being allowed to re-join once they behave appropriately, in this case it could both protect the child and other children/objects involved.

Re-enforcer – When a child is given a motivation to complete a task, such as a favorite toy.

Receptive Language – This is ‘good listening skills’ where a child can follow directions that are non-verbal.

Recovered – When a child no longer fits the diagnostic criteria for ASD.

Regression – Where a skill a child previously knew has reduced or vanished from their repertoire. Or when a behavior eradicated many years ago, comes back.

SLP/OT/PT – Professionals who help with areas of the child’s development. Speech and language therapists (SLP) help with speech delays, OT helps with occupational therapy issues (play), Physical therapists help with fine and gross motor skills.

Satiation – When a re-enforcer no longer works because it has been over-used.

Scripting – A verbal stim of some sort, such as a song that’s repeated over and over.

Scrolling – When a child is asked a question and they go through several responses before reaching the correct response. As in; if they are shown a circle and they say, square, rectangle, circle!

Self-Injurious Behavior – When a child hurts themselves purposefully.

Sensory Integration – Tools used to help a child reach internal sensory needs, this could be a weighted vest or blanket.

Shadow – Somebody who follows your child around in the classroom as a helper.

Stereotypic/Repetitive Behaviors – Also called stimming, this could be repetitive motions such as spinning and flapping.

Tact – A tactile is a verbal term, this is where a child can name objects they can see.

Target Behavior – A behavior the therapist is interested in increasing or decreasing.

Task Reduction – In some cases a child is frustrated by the amount of demands put on them so they are reduced to help increase success levels.

Transitions – A lot of children with Autism have transition issues, this is issues with moving from one location to another or one activity to another.

VB – Or verbal behavior; a branch of ABA that concentrates on speech behavior.

Variable Ratio – When a child is given a demand, or is expected to make a response and is given a re-enforcer every set amount of times. For example, 3-5, the child receives a re-enforcer every time they complete a task 3-5 times.

Vocal/Verbal vs Non-Verbal/Vocal – When a child can use language or not.

 

Asking questions about your therapist being too hard or too soft on your child can be a learning experience

Applied Behavioral Analyses (ABA) therapy is about teaching your child life skills, academics, and positive behaviors in a fun environment. Sometimes that means your therapist may do something you don’t always understand. It’s always best to ask why, often, as once you understand you too can apply it at home.

One common question parents often ask is why the therapist is, or isn’t placing demands on a child, especially if the parent has done something entirely different regarding a behavior.

Is the Therapist being too hard?

Sometimes when a therapists places lot of demands, a child with Autism tantrums. However, this does not mean that the therapist should punish or spank.

 Many times you will see an ABA therapist holding a child still, forcing them to do things, or to sit still until they stop tantrumming instead of typical punishments like removing a toy, or time out. As a parent, this can be uncomfortable as we often go into survival mode and try to stop whatever has upset the child. Or bargain with them, or put them in time out, or any myriad of techniques that seem appropriate at the time.

An ABA therapist is unafraid of the meltdowns. They place the same demands that anyone would place on a child and hold them to it, sometimes literally, in a safe place.  

Is the Therapist being too soft?

However, on the other end of the spectrum you could ask, why is my therapist not jumping on the bad behavior enough?

Sometimes this is a legitimate concern and perhaps your therapist needs to consult with their team better if they are encouraging certain behaviors to continue. If you notice your child has started a new behavior because of what a therapist is doing, always consult the analyst or therapist. Sometimes therapists get it wrong too.

For example: Our child once started purposefully engaging in ‘bad’ behavior to find opportunities to get a demand. This was because, during therapy time when given a demand, he got a piece of candy for performing it correctly.  Of course, 40 minute long tantrums ensued as he stole items, gave them back, and then demanded candy for his confused version of good behavior. Looking back, it was a little funny to watch a child run with glee through the house as he stole his sisters night shirt, only to immediately bring it back, then head to the candy jar all proud of himself…as I stood there completely baffled. But at the time it was a confusing experience for everyone involved. We fixed this by speaking to the analyst who banned candy as a re-enforcer. The issue was remedied in less than a day.

But there are other reasons a therapist may not be addressing the behavior. Some techniques involve ignoring a behavior altogether until it naturally falls out of the child’s tool-box. Perhaps they’re licking the table and making silly noises because they think it’s funny, but actually this could be totally unhygienic if they were to do it outside of the home. Here, the therapist may ignore it until the child forgets about doing it because they’re not getting any fun out of it.

Another reason your therapist may not be addressing behaviors yet, is when therapy first begins. Therapists will go through a ‘honeymoon’ stage with the child when they meet. This is where they play, get the child to love them, teach them they’re a fun person and everything will be great. If they come down too hard to begin with, your child won’t want to be around them since they haven’t learnt this person is a fun person to play with. And ABA therapists believe a child HAS to have fun to learn.

 

It’s always best to ask questions that come to mind with your therapist— it can be a great learning experience for everyone involved, not just your child. This is somebody who will be working with your child for perhaps years to come, and being on the same page with their nuances will make everything run a little more smoothly.

 

Tips for Potty Training

Autism can cause a host of issues when it comes to potty training and there are many reasons. Some of these issues stem from a general development delay, communication issues and anxieties that accompany toileting.

The Trouble with Communication

There may be some problems with communication where the child is unable to express that they need the potty, or do not understand the line of questions associated with the potty such as: “Do you need the bathroom?”

Even body language can be a problem with children who have Autism; you may notice that your child has no warning signs before an accident, such as playing with their underwear or jumping up and down.

With Applied Behavioral Analyses (ABA) techniques like Verbal behavior methods or PECs can teach a child to understand and communicate more efficiently so fewer accidents happen. Specifically a visual schedule or social story can help a child who has trouble understanding language; this is several pictures showing what will happen when a child goes potty, from sitting on the toilette, to wiping, to washing their hands.

Sensory Issues and Potty Training

Another common issue for Autistic children is the sensory side of using a potty or diapers. Sometimes the bathroom is colder than other rooms in the house, the floor could be cold, the potty hole could be too intimidating, the diaper could comfort, the child may need a stool to stabilize their feet and may detest the sound of the toilette flushing. These are all things that spike anxiety and make potty time unpleasant. Most of these things can be adjusted, explained, and worked through together.

Make Potty Time Fun Again

As with many classic ABA methods, re-enforcers encourage a child to enjoy their potty time. This could be rewarding them with stickers, candy, or a special toy every time they successfully use the potty. Some parents use a special toy area that the child has access to after they have successfully used the bathroom. You can set this up in the corner of the room or in the bathtub.

Transitioning to the Potty

Finally, children with Autism often have transitional problems. This too may impact your potty training in a way that ‘typically developing’ children may not have to deal with. Moving straight from an activity or location can be traumatic for a child with Autism and they may have accidents to try to avoid potty time all together. Giving plenty of warning and being consistent can help.

 

ABA therapists have strategies for every situation that occurs, and they have probably seen it all before, or at least heard about it. This will make potty training so much easier on the parent and guarantee a greater chance of success.

A tool that can help to reduce your child's anxiety

Children who have Autism often have trouble with transitions. A transition is just a fancy way of saying, going from one activity to the next, or one place to the next. Applied Behavioral Analyses (ABA) has plenty of tools in its toolbox to help your child overcome the meltdowns, or negative behaviors that occur after or during the transition.

This article talks about visual schedules…

Autistic children love routine and love knowing what’s going to happen next. Think about it this way:

A friend says they’re taking you away for the weekend. They want you to pack everything you need within 2 minutes so you can leave right away. If you don’t pack in time, you’re leaving any way and can’t gather what you need. You aren’t allowed to know the location, who is going to be there, or any clues to what you might need with you.

The scenario is a little exciting sure, but incredibly stressful. Do you pack jeans? Something formal? Hiking gear? Will you need soap? Will you need a towel? Can you gather your tools to be successful on this trip fast enough?

Springing a transition on an Autistic child is a lot like the above scenario. Without a schedule there is no walk-through, your child doesn’t know what to prepare for, what tools they might need from their coping toolbox, who might be there or how they’re expected to act socially. When a new activity is dropped on them out of nowhere, it’s akin to trying to pack a suitcase in 30 seconds flat…Oh and listen to what your parent tells you to do and do it right away! It is horribly overwhelming.

Knowing this, it’s a little wonder your child might be tantrumming, throwing their toys, or just plain sulking and refusing to go. After all, they probably don’t have the same tools an adult would, to navigate the situation.

A visual schedule is essentially pictures of all the locations your child will be visiting that day. Perhaps it’s different classes, or Grandma’s house. Whatever it is, take a picture and put it up on an hour by hour schedule and talk to your child about what you will be doing that day. Warn your child 30 minutes before you have a transition, and use the picture during a transition, to explain what is happening next. 

Once your child becomes familiar with the routine, and locations, things may get better. This is just a quick explanation, your ABA therapist can use these tools and more to help reduce your child’s anxiety.