Thursday, June 15, 2017

The Guilt of Active Ignoring and Why You Shouldn’t Feel It

It’s difficult navigating the autistic space when a child does something for attention. On the one hand, it’s hard because you want to give them all the attention in the world; on the other hand, they have a lot less ways than other kids of gaining the attention they need.
As caregivers it can lead our heads in a spin; is ignoring their behavior when it is attention seeking the right thing to do? Are we neglecting their needs? Shouldn’t we be their strength of communication for them by speaking/acting/advocating for them?
With Applied Behavioral Analyses (ABA) therapy a technique called active ignoring is used in certain circumstances, where the child is trying to get attention, or what they want, with socially unacceptable behavior, like spitting, whining, or violence.
We don’t ignore them because we want the child to feel abandoned or unheard, but because it encourages the child to search for new ways to gain the attention. We can’t explain with our words why they shouldn’t spit, so we have to explain with routine and patterns (or basically, in the way an autistic child can understand).
It’s important to not feel guilty when you’re ignoring whining for food, or other things that seem necessary or even neglectful to ignore. Remember, you are actively ignoring inappropriate behavior that won’t serve them, not ignoring their needs. You will meet their needs, just not right that second.
For example, you’re playing with their sibling so they take his toy, this forces you to turn your attention onto them to ask them to give it back. They now have your attention moved from their sibling and onto them. In their minds they’re not worried about the social repercussions, all they know is they have gained the thing they wanted;. You looking at them and talking to them instead of their sibling.
You need to speak the autistic child’s language here. Turning your attention to them to scold them doesn’t teach them anything when they don’t understand a full range of empathy, verbally explaining the situation does nothing when they don’t understand everything you are saying.
However, giving the other child tons of attention, taking the toy back without even looking at them, blocking the snatching, and actively ignoring, teaches: this action doesn’t get a desired result. But (and this is where we as caregivers can breathe a sigh of relief) once the undesired behavior stops, or the child uses a more appropriate way of asking for attention, you can lavish them with praise and affection.
The two should always be used together, otherwise ignoring will be in-effective and seemingly random for the child. This is all about routines and patterns, and giving your child a way to communicate and to latch onto that they understand.
Active ignoring is different from ignoring a child. You actively make a conscious decision to ignore a specific behavior and give attention to other behaviors. It can feel unnatural at first, but once you see your child blossoming into speech, or other appropriate means of asking for your attention, your relationship will be much stronger.

Tuesday, June 6, 2017

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.

Thursday, May 11, 2017

Techniques on how to encourage your child to stick out

The behavior of trying to escape a situation in all children is common, but especially so with autistic children who have a lot going on and little to no attention span.
In applied behavioral analyses therapy (ABA) avoidance techniques are tackled head on, to build up the child’s tolerance to accept and even enjoy certain situations—such as sitting down to read a book.
A child won’t be allowed to escape a situation (since this will re-enforce that escape is preferable to getting through to the other side) so what does the therapist do to make sure the child feels they can make it through that moment?
ABA Techniques: How to Encourage a Child to Stick it Out
A lot of now vs then techniques may be used. Sometimes autistic children have a hard time understanding that this moment won’t be forever. Timers are set up to show this will end and posters explaining now vs then.
Rewards are also great. Rewards such as music, and toys when they finish a task can help a child get excited to finish, instead of unmotivated and blah.
Replacing behaviors is another tool. Instead of your child running away and hiding, the therapist teaches them to ask for a break. If they ask too often, it is lined up with the other techniques and tolerance built up.
For older children the work you are doing together could be too hard, do they understand it or getting too frustrated by how difficult it is? Maybe everyone needs to step back and look at whether this is a reasonable ask.
For older children, help him/her discover their why, what positive thing they will get from learning or ‘surviving’ this task? Talk out the positives and help them view the task from a new light.
If the amount of time it takes is too overwhelming, a therapist may cut the work into parts, doing some now then taking a break and some later.
Our therapist uses awesome token systems, which are Velcro tokens of their favorite characters. Every time they complete one step they get a new token and they love it!
The Therapist Doesn’t Expect Perfection
The effort should get rewarded more than the outcome.
If your little one tried really hard but got the answers wrong, this won’t be penalized. For e.g. If we’re teaching a child to do the dishes, and stick it out, but they leave mess on a couple of cutlery, oh well! The point is they stuck it through and should be rewarded. Everyone makes mistakes and perfection isn’t the outcome we want here, it’s getting through the situation.
The therapist will always praise your child as they take steps through a non-preferred task, they deserve it. It is difficult to do anything when your world is full of noise and distraction, sometimes they just want to do something easy; but as we all know we can’t always do this as adults.
This is Something We All Do
Often ABA is just common sense. I bet you ask for help, know why you want things, take breaks and reward yourself for getting through boring tasks too! For instance,
“This meeting will take 20 minutes, I’ll learn some valuable things and when I go home and take a bubble bath.”
“I would like to be healthier for my family; I can ask my friends for help and have a special meal on the weekend. If I lose 10lbs I can get a new wardrobe.”
The procedures your ABA therapist uses isn’t alien, these are things even non-autistic people need to learn to optimize their days! And they set your child up to conquer the more uncomfortable aspects of later life, like boring work, meetings and chores.

Wednesday, May 10, 2017

Why your child is acting a certain way

Every child, anywhere, regardless of autism, acts a certain way for a reason. We don’t do things out of nowhere. Honing down those reasons are the key to helping a child overcome a behavior that won’t serve them in their adult years.
Let’s look at some common reasons people engage in certain behaviors so you notice what makes your child act the way they do!
Sensory
Sometimes we do things because it feels good to do them. Even though soda is bad for us, when we drink it the taste feels worth it, or the energy it gives us feels good. Sometimes we know we shouldn’t do something but we do it anyway because it makes us feel something we crave.
For an autistic child they may involve themselves in sensory stimulation, like flapping, rubbing their hands on things and spitting. This behavior is self soothing; they do it because it feels good! You may see it occur more when the child is frustrated, bored or even excited.
Escape
If you could escape from a painful situation without consequence, instead of facing it head on, would you? Most of us would!
Autistic children are known to bolt (they call it eloping now, officially) they run from situations, they hide under tables and do anything they can to escape doing something. Sometimes that something could be as simple as putting their plate in the sink. It’s not always because of doom and gloom circumstances.
A client of ours loves to use this behavior, he has several places in the house he knows is hard for adults to get to and as soon as you ask him to do something unpleasant (like chores) off he runs to hide under the bed.
There are other ways to escape situations like violence and yelling.
Children do this when they don’t want to engage in something. Maybe that something is boring, scary, annoying or too hard for them.
Attention
Yup, people do things for attention. This is a difficult one for some people to understand because it has such negative connotations wrapped around it. It shouldn’t, ‘attention seeking’ is just communicating that you want someone’s attention in the wrong way.
This is probably my middle child’s favorite reason to act out. He is a show star, he is loving, cute and by golly if he can be center of attention he will find a way! His autism (low empathy) means he often pushes children, hits them or bullies them so he can take their attention from them. It’s not about the child being a ‘bad kid’, this is just a child that doesn’t know how to say, “Hey I want a connection with you right now but I don’t know how to do it.”
Children do this when they want social interaction, or they want you to connect with them.
Tangibles
A few of our clients are obsessed with electronics. When it comes to trying to take them away the term ‘out of my cold dead hands,’ comes to mind. Sometimes children act out because they want something, plain and simple. They just don’t know how to communicate that want or they are terrified if you take it away they will never see it again.
This is the way that an ABA therapist looks at your child’s behavior, and a great thing to do for yourself as a parent. Sometimes putting meaning to situations helps us cope, and also gives us insight into how we can help our child in that moment.

Friday, May 5, 2017

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.

Wednesday, May 3, 2017

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.

Tuesday, May 2, 2017

Parenting Styles: Techniques can influence an autistic child in many ways

When it comes to Applied Behavioral Analyses (ABA) therapy consistency is key. This is true for all parenting styles; Autistic children are no different from every other child in the world. If they can find a way to get what they want, then they will utilize it.
For instance, if a toddler wants a lolly-pop and you say no, then they ask somebody else and they say yes, they may ask different people until they get candy because it worked before. It’s important that all parents and those raising a child (because it takes a village) are on the same page.
An ABA therapist in effect helps you to raise and teach a child who doesn’t respond as well to traditional teaching methods we as caregivers see in our own families and mainstream media. Because consistency is paramount, it’s imperative you keep constant communication with your therapist. Moreover, all parents involved are on the same page. I say this because one parent, one caregiver, or one daycare/school can undermine an entire week of ABA therapy if they aren’t clued in to how everyone is reacting to a behavior in a child.
It’s the two steps forward one step back issue. If you want ABA to run smoothly and quickly, allowing anyone to take the child a step back will make the process much longer.
If your child attends a daycare, goes to school, has separate households and more than one set of parents, every single person needs information on what techniques are used in certain situations.
ABA is a very effective but easily undermined therapy. This is why having a therapist you trust enough to implement all of their ideas, will make your ABA journey smoother. This is why communication across all platforms will ensure ABA works as well as it should.
If you ever feel that ABA isn’t getting the results you expect, you need to investigate and ensure that everyone is on the same page, and has followed through with the techniques correctly before changing them up or ending ABA all together.