Guest Article: Tips on Encouraging Picky Eaters

This week, we’re thrilled to share some exclusive tips from Julia Singer Katz at the Kutest Kids Early Intervention Center on how to deal with picky eaters, from using colors and schedules to modeling good habits.

Don’t let picky eating ruin meal time or divide your family at the dinner table. Encouraging healthy eating habits with a stubborn child requires patience with a firm touch. Here at Kutest Kids Early Intervention Center, our therapists are all too familiar with this phenomenon and would like share some common tips. Begin by setting the stage for healthy choices, thereby helping your child overcome their picky habits with a few key strategies.

Start With a Schedule.  Hungry kids are often less picky than those that have been snacking on junk foods all day. Scheduling snack time – and sticking to it – ensures your kids are hungry when a healthy meal is served. Don’t just schedule snacks, though. Having breakfast, lunch and dinner at regular times further encourages kids to eat only when the food is available.

Skip the Junk.  A pantry or fridge full of unhealthy options further encourages picky eating. What kid is going to fill up on broccoli when they know there are ice cream and chips just a few steps away? If the only options are healthy options, a hungry child is more likely to choose those with few complaints. Keep the healthy snacks accessible – cut up carrot and veggie sticks and keep raw fruit washed and cubed for easy serving.

Add Some Healthy Elements.  Even the most adventurous eater may turn up their nose to a completely unfamiliar food. Instead of making a full change out of the gate, begin by introducing healthier elements to their favorite dishes. Try oven-baked chicken fingers with a whole-meal coating instead of processed and fried nuggets. Mix in some shredded zucchini with their macaroni and cheese. Add fruit to a no-sugar cereal. Small changes can win over a picky eater.

Eat the Colors.  Most kids respond well to games and challenges. Brightly colored foods, such as vegetables and fruits are healthier than most dull and bland-colored foods. Make a game out of eating as many colors in a day as possible! This may encourage an otherwise picky eater to eat more vegetables and to try new foods.

Loosen Up the Rules.  A strict clean-your-plate rule does more harm than good. In the end, it just encourages over-eating while also making the dinner table a place of stress and tears. Allow your kids to decide when they are full. If they want a snack later, it’s not an issue if you have a scheduled after-dinner snack time, and they only have access to healthy snacks.

Model Good Eating Habits.  Often, picky eating is a learned behavior. Only serve foods that you will eat, and don’t complain about any food within the child’s hearing. Have meals at the table, and never encourage mindless snacking while watching television.

Many kids naturally go through phases of picky eating. Keeping unhealthy food to a minimum and only serving it as an occasional treat will help your family weather these finicky moments.

WRITTEN BY JULIA SINGER KATZ, MSS, LSW

Julia Singer Katz MSS, LSW is the Supervisor of Clinical Program Development at the Kutest Kids Early Intervention Agency, an all-inclusive therapy center in Philadelphia. She’s very passionate about helping each child reach his or her fullest potential and making a difference in the community.

Tip of the Week: Use Noncontingent Reinforcement – A Powerful Addition to Your Intervention

Noncontingent reinforcement (NCR) is the presentation of reinforcement independent of behavior, and there are many studies out there that demonstrate it can have a significant impact on behavior.

Before we get to how you can use it with children with autism or other developmental disabilities, it’s important to recognize that noncontingent reinforcement happens all the time with all of us. A few common examples:

  • You’re walking alongside your child. Your child reaches up and grabs your hand. This is a behavior you like, but it did not occur because of any one behavior you exhibited, such as reaching for their hand or requesting their hand. They just did it spontaneously. This probably changes your behavior: you may smile, initiate a conversation, or give their hand a special squeeze.
  • It’s snack time at your preschool. You realize the bag of popcorn you’re giving for snack is almost empty, so you give each student a few extra kernels of popcorn. They did not “earn” it for good behavior, it was just a little extra reinforcement. This may change your students’ behavior: they may sit still a little longer as they eat the additional snack, say thank you, or exclaim, “More popcorn! Yay!”
  • A common example in preschool is placing a child on your lap during story time. They didn’t earn it, but it may change their behavior. For example, instead of calling out to get your attention, they may sit quietly for the duration of the story.
  • You’ve come home from a stressful day at work. You want to just sit down and veg in front of the TV for a few minutes, but discover that your husband has cooked dinner. This may change your behavior: you may sit down at the dining room table or give him a hug. Again, you didn’t exhibit a specific behavior that “earned” you dinner; it was presented independent of your behavior.

Noncontingent reinforcement can be a powerful addition to your interventions. But it looks a bit different when you’re using it as part of your intervention. You want to provide continuous access to the reinforcer maintaining the problem behavior so that the problem behavior becomes unnecessary. The preschooler sitting on the teacher’s lap is an excellent example, because the child has continuous access to the teacher’s attention. This can be faded over time, but can be an effective starting point for reducing problem behaviors when used in conjunction with other strategies.

Research has shown that noncontingent attention can decrease destructive behavior, noncontingent juice can decrease rumination, noncontingent access to preferred items can decrease inappropriate mealtime behavior, and noncontingent social interaction can decrease vocal stereotypy (Hanley, Piazza, & Fisher, 1997; Kliebert & Tiger, 2011; Gonzalez, Rubio, & Taylor, 2014; Enloe & Rapp, 2013). There is much more research out there that demonstrates that noncontingent reinforcement can impact behavior. Here are a few tips for using it:

  1. Make sure it matches the function. If your student is engaging in destructive behavior in order to escape a task, then providing noncontingent attention is unlikely to produce the behavior change you are expecting.
  2. Decide on a method for providing noncontingent reinforcement. Will you provide it continuously (like the preschooler sitting in the teacher’s lap) or provide it on an interval schedule (such as providing verbal attention every 2 minutes)?
  3. Take data! You need to know if the noncontingent reinforcement is actually decreasing the problem behavior or increasing the desired behavior. Define the behavior you want to change and then take data on its frequency, rate, or duration.
  4. Account for other students’ needs. If you are only using noncontingent reinforcement for one student, you need to be prepared to address the needs of other students. For example, if just one preschooler gets to sit in the teacher’s lap every day at story time, you may see an increase in problem behaviors from the other preschoolers in the class.
  5. Plan ahead! Our ultimate goal is that our learners be as independent as possible. Plan for how to fade your intervention over time.
  6. Take a look at the research. There are a few studies cited at the end of this article, but you may be able to find research simply by searching for “noncontingent” and the name of your problem behavior.

Noncontingent reinforcement is much easier to implement than many interventions that are available and can have a huge impact on your learner’s behaviors.

References
Enloe, K., & Rapp, J. (2013). Effects of noncontingent social interaction on immediate and subsequent engagement in vocal and motor stereotypy in children with autism. Behavior Modification , 38(3), 374-391.

Gonzalez, M., Rubio, E., & Taylor, T. (2014). Inappropriate mealtime behavior: The effects of noncontingent access to preferred tangibles on responding in functional analyses. Research in Developmental Disabilities , 35(12), 3655-3664.

Hanley, G. P., Piazza, C. C., & Fisher, W. W. (1997). Noncontingent presentation of attention and alternative stimuli in the treatment of attention-maintained destructive behavior. Journal of Applied Behavior Analysis , 30(2), 229-237.

Kliebert, M. L., & Tiger, J. H. (2011). Direct and distal effects of noncontingent juice on rumination exhibitied by a child with autism. Journal of Applied Behavior Analysis , 44(4), 955-959.


WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

Guest Article: “Speech-Language Pathology and ABA – Can’t We All Just Get Along?” by Danielle McCormick, MA, CCC-SLP

We’re excited to share with you an exclusive article “Speech Language Pathology and Applied Behavior Analysis: Can’t We All Just Get Along?” by co-founder of Bridge Kids of New York, Danielle McCormick, MA, CCC-SLP, with contributions by Ashley Stahl, MSEd. In this article, Danielle shares with us her quirky and humorous opinions on the importance of combining traditional speech-language pathology practices and those of Applied Behavior Analysis.

SLP-ABA

I have vivid memories of a professor in graduate school essentially condemning the field of Applied Behavior Analysis (ABA) as the most “robotic” and “unnatural” way to help a child learn communication skills. As a passionate and dedicated Speech-Language Pathologist (SLP), I took these words to heart and kept them with me as I continued my career. That was until my first job as a Clinical Fellow at an Early Intervention center—that (insert gasp!) followed the principles of ABA. This center was also filled with the most diverse, beautiful children I have ever known, many of whom were diagnosed with Autism Spectrum Disorder—my passion. I had to take this job!

As if starting my first job in New York City was not daunting enough, here I was surrounded by the enemy—the big, bad ABA therapists! As a newbie who was still building confidence in my field, and having been trained to always respect other professionals (especially those who are above you in the pecking order), I took a backseat and opened my ears and eyes to the ABA that was happening all around me. The voice of my graduate professor was ringing still in my ears, so in my sessions, I made sure there was to be absolutely no ABA (at least I thought at the time!). If they wanted to “do ABA” in the classrooms, that was their business, but I wanted nothing to do with it!

Except—wait a minute—how did they teach that child to start pointing so quickly?

As time went on, I started to notice that some of my children were exhibiting extreme interfering behavior that I had not been trained to deal with. I was lost and did not know how to support these learners. Much to my relief, in came my super hero colleagues wearing ABA capes, telling me exactly what to do and why to do it.

 

Tip of the Week: Stop Behavior Early in the Behavior Chain

Recently I was working with a family to toilet train their son Jonathan, a six-year-old with autism. (Names and identifying characteristics have been changed to protect confidentiality.) When he eliminated in the toilet, part of his reinforcement was getting to watch the water go down the toilet after flushing. At some point, he developed the behavior of putting his hands into the toilet water as it was flushing.

When I went in to observe the behavior, one of my goals was to identify the steps in the behavior chain. Pretty much everything we do can be viewed as part of a behavior chain, in which one action is a cue for the following action. For Jonathan, each time he placed his hands in the toilet water, the behavior chain looked like this:

Pulled up pants
Stepped towards toilet
Pressed button to flush toilet
Stepped back
Watched water as it flushed
Stepped forward again
Leaned down
Put hands in water

Behavior chains can be even more detailed than the one above, depending on the needs of your learner. Identifying the steps in the behavior chain for an undesirable behavior can have a huge impact on your interventions. For Jonathan, we were able to stop the behavior of putting his hands in the toilet water by interrupting the behavior early in the behavior chain. It’s too late and unsafe to stop him once he’s leaning forward to put his hands in the water. Through prompting, which we faded as quickly as possible, we changed his behavior chain to this:

Pulled up pants
Stepped towards toilet
Pressed button to flush toilet
Stepped back
Watched water as it flushed for 3-5 seconds
Stepped towards sink
Leaned forward
Turned on water
Put hands in water

Instead of waiting for him to engage in the inappropriate behavior, we redirected him several steps earlier in the chain, providing a gestural prompt toward the sink and had him start washing his hands 3-5 seconds after he had started watching the water flush. This was ideal for two reasons: first, it was the expected step in an appropriate toileting behavior chain and second, it provided an appropriate and similar replacement behavior since Jonathan was still able to put his hands in water.

This behavior chain was relatively easy to change. While it may not be as easy in some interventions you may try, it’s essential to remember to stop the behavior early in the behavior chain. It’s much easier to give a child an activity that requires use of their hands as soon as you see them lift their hands out of their lap than it is to remove their hand from their mouth if they’re biting it. And it’s much easier to redirect a child to put their feet back under their desk than it is to get them to stop once they’re sprinting out of the classroom. Looking at the behavior chain and considering when to intervene as a part of your intervention plan is quite possibly the extra step that will make your plan successful.


WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

Tip of the Week: Using Activity Schedules to Improve Bedtime Routine

Many of the families I work with struggle to get their child with autism through the bedtime routine. An activity schedule can help your child independently manage the routine.

You should select 3-5 tasks that your child can complete independently. The final task should be something that your child finds reinforcing, preferably something that can be done in or near the bed, such as being read to or listening to music. Based on your child’s reading skills, you can use pictures or text for the schedule.

You can arrange the activity schedule as a picture schedule or a checklist. Below are two samples. For the picture schedule sample shown below, I did an online search for the appropriate images, but when possible, I prefer to actually take a picture of the item or the learner engaged in the activity.

PICTURE SCHEDULE: I use self-adhesive laminating paper (which you can purchase at any office supply store) and laminate all pieces. Each task on the schedule has Velcro so the learner can arrange items in the order he/she wishes and can remove them once that activity is complete.

CHECKLIST SAMPLE: I use self-adhesive laminating paper for checklists as well. This way the learner can use a dry erase marker or crayon and reuse the same page each day. For many learners, I attach this to a clipboard and the clipboard hangs in an easy-to-reach spot.

What I like about the activity schedule beyond the fact that it promotes independence is that it also allows for some choice. The reinforcing activity must always come last, but the learner can choose what they want to have for that reinforcing activity. The learner can also have some flexibility for what order to place the items on the schedule. For example, your learner might prefer to pack his lunch before taking a shower. When implemented correctly, it’s a win-win for both parents and children.

For more information on implementing activity schedules, I highly recommend the book Activity Schedules for Children with Autism by McClanahan & Krantz.

Note: if you decide to use the iPad as the final item on the activity schedule, you should set the timer so the iPad turns itself off. To do this:

1) open the Clock app
2) click “Timer” on the bottom right of the screen
3) click “When Timer Ends”
4) scroll all the way to the bottom of that menu and click “Stop Playing”
5) set the timer for the appropriate amount of time,
6) hit “Start”


WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

Pick of the Week: Sensory Tubes – Reinforcers filled with endless possibilities of stimuli!

We love these Sensory Tubes here at Different Roads to Learning! This set of 4 clear and sturdy Sensory Tubes is remarkably versatile.
What we love about them is that you can fill each one with assorted visual or auditory stimuli that a particular student finds reinforcing, completely individualizing them. This week, take 15% off* your order of the Sensory Tubes by applying promo code TUBES15 at checkout!

Each tube features dual openings with 2 solid lids along with four vented lids that let children explore their sense of smell or even observe little critters.

The lids easily twist off and on, and the solid lids hold liquid securely inside. The tubes measure 12 inches in height and 2.5 inches in diameter. These Sensory Tubes will make your student’s reinforcement possibilities endless!

Don’t forget to save 15%* this week on your set of Sensory Tubes by applying promo code TUBES15 at checkout!

 

*Offer is valid until 11:59pm EST on December 23rd, 2014. Not compatible with any other offers. Be sure there are no spaces or dashes in your code at check out!

Tip of the Week: Consider Response Effort in Your Intervention

Several previous posts have discussed how important it is to have a multi-pronged approach to behavior interventions, including definitions for how caregivers will respond to undesirable behavior, the replacement behavior, and reinforcement. One thing I have not shared is considering response effort when choosing a replacement behavior.

Response effort describes how easy or difficult it is to engage in a behavior. For example, I frequently check my e-mail on my phone. Occasionally, I get an e-mail that requires a lengthy reply. The response effort for typing on the tiny touchpad is much greater than sitting down at my laptop and using the keyboard, so I wait until I can go to my computer to reply to that e-mail. Typing on the keyboard requires less response effort.

In general, when we make choices about how to behave, whether we are aware of it or not, we choose the behavior that gets the best results with the least response effort. But if a low response effort achieves poor results, we’re probably not going to engage in that behavior. Let’s look at an example of choosing a higher response effort. Let’s say I live down the street from a hair salon, and I go there once but hate my hair cut. I’ll engage in the higher response effort to drive 30 minutes to a salon that gives me a great cut. I want the lowest response effort, but not if it achieves poor results.

So how does this apply to interventions in your environment? When you’re choosing a replacement behavior, you should try to make it require less response effort than the undesirable behavior. Here are a couple of examples:

  • Every time you teach a math lesson, your learner breaks his pencil and throws it across the room. You’ve identified that the behavior of breaking the pencil functions as escape, meaning that in the past, when he broke his pencil, his consequence was a break, a walk to “calm down,” or a trip to see the dean. You’ve provided a replacement behavior of holding up a stop sign that stays on his desk. When he holds up the stop sign, he is provided with a break. Holding up the stop sign requires much less response effort than breaking a pencil.
  • You are the director of a center for learners with autism. Many of your students are being toilet trained during the day. It is important that the providers working with the students wear gloves during the toilet training process. The gloves are on the wall when you enter the bathroom, but you’ve noticed that several providers are still not wearing gloves. One provider tells you that if she forgets to grab the gloves as she’s coming in and the child is already in the stall, it’s too difficult to backtrack and keep an eye on the child. You decrease the response effort by placing a box of gloves inside each stall in the bathroom.

Decreasing the response effort for the desired behavior while simultaneously increasing the response effort for the undesirable behavior can produce even better results. There have been several studies related to increasing response effort for self-injurious behavior such as hand-biting while providing replacement behaviors with a lower response effort.

As you’re developing behavior intervention plans or thinking of ways to improve your teaching environment, you should think through the possibilities of using response effort to encourage appropriate behaviors.


WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

6 Tips for Preparing for a Smooth Thanksgiving Celebration

Holidays can be challenging for everyone in the family. Your to-do lists get longer, your routines are switched around, and all the little stresses can be especially difficult for your child with autism. Here are a few tips to ease the difficulties related to Thanksgiving.

Tell. Prepare your child for who and what they will see at Thanksgiving. This may include creating a social story or showing photos of people your child does not know or see often.

Help. When possible, have your child help out. This may include prep activities such as helping with decorations or measuring ingredients for a recipe, but it could also include giving your child a job, such as answering the front door or setting the table.

Access. Be sure your child has access to foods he or she will eat and to a designated quiet space for breaks. It’s helpful if other guests or family members understand where this space is and its purpose.

Notify. Inform guests who aren’t familiar with your child or with autism about what to expect and how to best interact with your child.

Keep it fun. Add in a couple of activities during the day that you know your child really knows. This may include family games or traditions.

Schedule. Provide a schedule of the day’s events for your child so they will know what to expect. This can include a visual schedule or a written schedule.

Lastly, remind your child why you are thankful for them and enjoy your holiday!

Join us at the Long Island Behavior Analysis Conference with Keynotes Dr. Mark Sundberg and Dr. Patrick Friman: December 5, 2015

December 5th, 2014

We are so excited to be a part of this upcoming Long Island Behavior Analysis Conference! The conference will be held at the Long Island Marriott in Uniondale, New York. Registration information can be found here.

With keynote speakers Mark Sundberg, PhD, BCBA-D and Patrick Friman, PhD, ABPP, this 2-day conference will be a great opportunity to hear about what is going on in the field of ABA. Sessions include “Teaching Language and Social Skills in a Child’s Natural Environment”, “The Role of Play in ABA Programs: Analysis, Assessment, and Intervention” and “That’s Not What I Recommended! Merging Treatment Integrity with Reality to Support Caregivers with Behavioral Recommendations in the Home.”

Come say hi! We will have a table at the conference, where we will be selling the VB-MAPP, Teaching Language to Children With Autism, ABA Curriculum for the Common Core: Kindergarten, and a number of our other favorite titles and products – all at discounted prices!

This conference is geared towards ABA professionals, with Type 2 CEU’s available. There is also an alternative track for parents interested in attending.

For more information, visit the ELIJA website here.

Pick of the Week: “I Feel Angry When…” – A Social Skills Game to Teach How to Express & Respond to Anger

I Feel Angry When… teaches children the important skills of learning how to express their anger in a nonthreatening way, and to respond in positive ways when they feel angry. This week, we’re giving you 15% off* your order of the I Feel Angry When… game by applying our promo code IFEEL at checkout!

With this game, kids learn how to use I-Messages – a verbal template that offers a way to communicate how you feel and what you want without offending others. This method, when combined with basic anger control strategies, gives children an opportunity to express their anger in a calm way without resorting to aggression.

As they respond to anger-provoking situations described on game cards, players learn how to use I-Messages to communicate their feelings. They also learn 12 anger control strategies that help them retain their composure in the moment anger erupts. Simple and straightforward, this game gives children the skills they need to keep their cool. The game comes with 2 Anger Control Spinners (one for ages 6–9 and one for 10–12), 1 I-Message Guide Cards, 200 Reward Chips, 54 Situation Cards, and 6 “Tell Me About It” Cards. This game is recommended for children ages 6 to 12.

Don’t forget to use promo code IFEEL at checkout this week to save 15%* on your set of I Feel Angry When…!

*Offer is valid until 11:59pm EST on November 25th, 2014. Not compatible with any other offers. Be sure there are no spaces or dashes in your code at check out!