Using Contingency Contracts in the Classroom

As adults, we’re fairly accustomed to contracts for car loans, new employment, or updates to our smartphones. But contracts can also be beneficial in the classroom setting.
A contingency contract is defined as “a mutually agreed upon document between parties (e.g., parent and child) that specifies a contingent relationship between the completion of specified behavior(s) and access to specified reinforcer(s)” (Cooper, Heron, & Heward, 2007). There are several studies that indicate using a contingency classroom can be beneficial in the classroom setting.
Cantrell, Cantrell, Huddleston, & Wooldridge (1969) identified steps in creating contingency contracts:
(1) Interview the parent or guardian of the student. This allows you to work together to identify problem behaviors to be addressed, identify the contingencies currently maintaining these behaviors, determine the child’s current reinforcers, and establish what reinforcement or punishment procedures will be used.
(2) Use this information to create a clear, complete, and simple contract. The authors provide examples of how these contracts might look. You can vary the contract based upon the behaviors you are addressing with your student and the student’s ability to comprehend such contracts.
(3) Build data collection into the contract itself. You can see an example from the article below. For this example, it is clear how points are earned and how the child can utilize those points, and the contract itself is a record of both the points and the child’s behaviors.

BlogPic

There are clear benefits to utilizing such contingency contracting: building relationships across different environments in which the student lives and works, addressing one or more challenging behaviors simultaneously, and providing opportunities for students to come into contact with reinforcement. You can read the entire article here:

Cantrell, R. P., Cantrell, M. L., Huddleston, C. M., & Wooldridge, R. L. (1969). Contingency contracting with school problems. Journal of Applied Behavior Analysis, 2(3), 215-220.

And much more has been written about contingency contracting. If you’d like to learn more, we suggest taking a look at one or more of the following:

Bailey, J. S., Wolf, M. M., & Phillips, E. L. (1970). Home-based reinforcement and the modification of pre-delinquent’s classroom behavior. Journal of Applied Behavior Analysis, 3(3), 223-233.

Barth, R. (1979). Home-based reinforcement of school behavior: A review and analysis. Review of Educational Research, 49(3), 436-458.

Broughton, S. F., Barton, E. S., & Owen, P. R. (1981). Home based contingency systems for school problems. School Psychology Review, 10(1), 26-36.

Miller, D. L., & Kelley, M. L. (1991). Interventions for improving homework performance: A critical review. School Psychology Quarterly, 6(3), 174.


WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-15 in NYC. Working in education for twelve years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently a PhD candidate in Applied Behavior Analysis at Endicott College. She is also a lecturer in the ABA program at The Sage Colleges.

Pick of the Week: Save 20% on select speech and language workbooks!

 

POWSpeechSlide2

These books are perfect for helping young learners strengthen their communications skills!

 

*Promotion is valid until June 26th 2017 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code WORK2017 at checkout.

Strategies for Teaching Games to Young Learners

In this month’s ASAT feature, Maithri Sivaraman and Ruth Donlin offer advice on selecting the best games for children with ASD. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

 

My son is 5 years old and was diagnosed with autism when he was two. He has responded well to early intervention services in terms of his communication and daily living activities. But it is still challenging to for him to play games with his neurotypical peers. When all the kids at a birthday party are playing “Simon Says,” my son prefers to play alone with his toys or just watch the other kids playing. I don’t know how to teach him to play new games or even identify what kind of games he likes. Could you provide some suggestions?

The growing awareness about the early signs of ASD has made it possible for an increasing number of children to be diagnosed by the age of 3 years (Stahmer, 2011). Considering the difficulty in building social relationships and peer play that is often associated with ASD it is important that specific instruction on social behaviors in various play situations is provided.  Research has shown that extensive and planned interaction with peers facilitates social skill development (e.g., Krantz & Mclannahan, 1993; Baker, Koegel & Koegel, 1998). At your son’s age, this interaction primarily occurs during play.

Play has been described as a “child’s workshop” where social rules and consequences are explored (Bruner, 1975). Teaching a game to a child has consequences beyond the game itself: Apart from having fun, it could lead to social engagement, formation of friendships and create abundant opportunities for imitation, negotiation, cooperation, and other skills. However, though important, teaching games to children with autism often involves many challenges, such as the play activity not being motivating to the child, the need for intrusive prompting, having to teach the rules of each game, and managing problem behavior, to name a few.  Some of these challenges can be overcome by using the strategies described below.

Considerations When Choosing a Game

Choose a game that is a match to the child’s developmental level and one that incorporates his or her interests and facilitates social skill development. Games may provide an appropriate social context to the perseverative interests of children with ASD (Koegel et al., 2012; Baker, Koegel & Koegel, 1998). It is a great idea to modify games to accommodate the child’s interests. For example, if the child has a keen interest in vehicles, the Red Light/Green Light game can be modified to be played with cars rather than people. A perseverative interest with names of washing machine brands can be accommodated in the same game by asking the child to take a step forward each time one brand name is said or stop when a different brand is said. For a child who likes twirling threads, the thread could be at the finish line to motivate the child to “go” during Red Light/Green Light.

Strategies for Teaching Games

Children with ASD are less likely to learn age-appropriate play skills through mere exposure to play materials and peers using those materials. Instead, intervention is often required to teach appropriate play skills directly and explicitly to these children (Lifter, Mason & Barton, 2012; Malone and Langone, 1999). When planning for social interactions and game play with others, the child with autism should understand what to do before being placed in the social play situation and have appropriate supports to avoid failed social experiences that could decrease long-term interest in the activity. Some strategies for teaching games follow.

  • Modeling – Provide your son with opportunities to observe others playing the game. At this stage, the only expectation is that the child stays within the play area for a few minutes and observes others. No other form of participation/engagement is required. Alternatively, providing a video model of a group playing the same game will serve as a form of priming and prepare the child for the actual experience, as long as the child has learned and is competent with observing of others, in vivo or video.

 

  • Shaping – The child could initially engage only in those play actions (relevant to the game) that he can do independently. Subsequently, better performances in these actions can be modeled and expected (Ward, 2011). For example, in a game like Red Light/Green Light, your son may initially just run along with all the other players. It does not matter that he does not stop at the Red Light. But if he/she is successful at this level and shows independent participation, over the course of the next few instances, a play partner could be made to hold hands with your son and have him stop at the Red Light. Gradually, the partner could stop holding hands and independent performance in “red” and “green” can be tested. Prompting – After being given a few opportunities to observe others playing the game, some prompting might be required for the child to improve existing play behaviors. In a least-to-most (LTM) prompting hierarchy, the least intrusive prompts are provided first. More intrusive prompts are provided only if the expected behavior does not occur at the present level of prompting. For example, in the Red light/Green light game, if a child does not start running when the leader says “green,” the teacher might initially say, “What should you do now?” A gesture to move or a gentle push may be provided if the student does not respond to the teacher’s question. One LTM prompt hierarchy that is often used to teach these kinds of skills is indirect verbal, direct verbal, gestural and a physical prompt, in order of increasing intrusiveness (Cooper, Heron & Heward, 2007; Davis-Temple, Jung & Sainato, 2014; Libby, Weiss, Bancroft & Ahearn, 2008). For example, when the leader says green, an indirect verbal prompt could be “What should you do now?” while a direct verbal prompt would be saying, “Run.” An example of gestural prompt for this situation would be a hand gesture indicating the child to move in a certain direction whereas a physical prompt would be to hold the child’s arm and gently push him forward. In contrast, A most-to-least (MTL) prompting hierarchy involves providing the most intrusive prompt initially. The prompt is then faded gradually to facilitate independent performance. Using the previous example, an MTL prompt strategy would begin first with a physical prompt and then fade to a gestural prompt, direct verbal, indirect verbal prompt, and finally allow for independence as the child is successful. The prompting techniques used should be tailored to each learner. Because LTM prompting allows the child to attempt the skill independently first, MTL prompting is recommended if errors (which can be more common with LTM) have been found to impede the child’s learning. LTM can be used for children who show rapid acquisition of skills and are familiar with this prompting strategy (Libby, Weiss, Bancroft & Ahearn, 2008).

 

  • Positive Reinforcement – Try to use naturally occurring reinforcers as much as possible. Exaggeration of facial expressions and emotions, and making funny noises could be a part of the game itself to make the activity more enjoyable. For instance, stopping during the Red Light could be accompanied by exaggerated body postures and funny facial expressions. Also, if the child is familiar with a token system, it could be extended to the game as a “points table” where everyone’s scores in the game are recorded. The winner of the game might then be given a chance to choose the next activity. Reinforcers that are a natural result of play are recommended over edibles/tangible items because they can be easily transferred to the natural environment during play with typically developing peers (Stokes & Baer, 1977). Maximizing the use of activities within the game that can serve as reinforcers will promote generalization. Learning to play a game in one situation and being able to do it flexibly in other similar but different situations requires the events within the game (stopping at “Red Light” with a screeching sound like a car, jumping and saying “Woohoo” at the finish line) to serve as reinforcers as opposed to using edible or tangible items which may not be available everywhere.

 

  • Chaining – In the context of simple games with a consistent, predictable sequence of play such as “Hi-Ho-Cherry-O” or “Candy Land”, the game could be broken down into a series of simple steps (task analysis). Teaching one step at a time to mastery before introducing the other steps could simplify the game for the child. For instance, in the game Candy Land, your son might initially be required only to pick up the card and label the color, while the parent or teacher helps him complete all the additional steps on his turn (e.g., finding his piece and moving it to the corresponding color). Following success at this step, he could be expected to pick up the card, label the color and also move his piece on the board. Subsequently, telling a peer to take a turn, waiting appropriately for his turn, setting up the game and cleaning up could be added to the list of expected behaviors.

 

  • Scripting – Playing games provides numerous opportunities to develop or increase communication skills such as imitating words, making comments (“This is fun,” “Your turn”), making requests (“Help”) and initiating communication (“Let’s play”). Visual script interventions have been shown to be effective with children with autism, including those with minimal language (e.g., single spoken words, Krantz & McClannahan, 1998) and those with extensive verbal skills but poor social skills (Krantz & McClannahan, 1993). Scripts typically are a written or pictorial appropriate phrases or sentences presented during play to evoke responding. For example, a script during the Red Light/Green Light game can serve as a prompt for social greetings (“Hi, let’s play”), asking for a turn (“My turn to be the leader”) and making comments (“We’ve all stopped like statues!”).

Assessing motivation – How to tell if the child is interested?

Gauging child motivation for an activity is as important as knowing how to teach a game. Being indifferent to a child’s interest level and focusing only on the process can impede his/her ability to play games (Taylor et al., 2005). The overwhelming urge to teach the child to play by all the rules of the game on the very first opportunity can be truly aversive for the child (and the parent or teacher!) and lead to problem behavior. A closer observation might reveal that problem behavior occurs when the child’s interest in the game starts to wane and continued engagement is expected.

This challenge can be overcome by taking motivation into consideration and choosing games that have components which you know the child enjoys. This increases the likelihood that the learner will exhibit independence in at least one of the expected play behaviors during the game. The Red Light/Green Light game might work well for children who like to run or be outdoors; Simon Says might work for children who have a good imitation repertoire; Hangman may be motivating for children who like letters; and simple board games like Tummy Ache/Pizza Pizza (Orchard Toys) may be enjoyed by children who prefer visual stimuli and matching.

Additionally, here are some ways of measuring motivation during the game (Ward, 2011).

  1. Mands/Requests – Did the child request for the game after a few exposures? Did he/she ask for a turn to hold up the colored cards and say “red” and “green”?
  2. Initiations – did he/she make any initiations during the game? (e.g., asking a partner to “stop” when they didn’t)
  3. Responses to partner initiations – does the child respond to play partners? (e.g., moving forward when a partner asks him to do so)
  4. Affect – Does the child seem happy? Is he/she smiling, jumping, or laughing?
  5. Independent play actions – Does the child run by him/herself during “green”? Or go back to the starting line at the end of one round?

If the game has been broken down into doable steps with appropriate reinforcement and the child is still not initiating or displaying independent play actions, these are clear indications of low motivation in the game, which can be also due to task difficulty. If such situations persist, it is best to choose a different game. Identifying a child’s disinterest and knowing when to stop, or modifying a game in a manner that might enhance motivation, can facilitate success.  Motivation can be fleeting: what was fun yesterday might not be fun today. But being proactive about gauging these variations is what should be lasting.

Summary

We have learned many effective ways to teach games over the years (Jung, 2013; Krantz & McClannahan, 1998; Maurice, Green & Luce, 1996; Stahmer & Schreibman, 1992). Since playing games is an important activity among typically developing children, play activities serve as an opportunity for children with ASD to learn appropriate social behaviors (Davis-Temple, Jung & Sainato, 2014). Whatever the goals associated with each game, adding “having fun” as one of them, and identifying and monitoring observable measures of enjoyment, may be the key to successful game instruction. Being process-oriented and showing our kids that games can be fun is more important than playing the game the right way.

References

Baker, M.J., Koegel, R., & Koegel, L. (1998). Increasing the social behavior of young children with autism using their obsessive behaviors. The Journal of the Association of Persons with Severe Handicaps. 23, 300-308.

Bruner, J. (1975). From communication to language: A psychological perspective. Cognition. 3, 255-287.

Cooper, J.O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis (2nd edition). Upper Saddle River, NJ: Pearson.

Davis-Temple, J., Jung, S., & Sainato, D. M. (2014). Teaching young children with special needs and their peers to play board games: Effects of a least to most prompting procedure to increase independent performance. Behavior Analysis in Practice, 7(1), 21–30.

Jung, S., & Sainato, D. M. (2013). Teaching play skills to children with autism. Journal of Intellectual and Developmental Disabilities. 38(1), 74-90.

Koegel, R., Fredeen, R., Kim, S., Danial, J., Rubinstein, D., & Koegel, L. (2012). Using perseverative interests to improve interactions between adolescents with autism and their typical peers in school settings. Journal of Positive Behavior Interventions, 14(3), 133–141.

Krantz, P. J., & McClannahan, L. E. (1993). Teaching children with autism to initiate to peers: Effects of a script-fading procedure. Journal of Applied Behavior Analysis, 26(1), 121–132.

Krantz, P. J., & McClannahan, L. E. (1998). Social interaction skills for children with autism: A script-fading procedure for beginning readers. Journal of Applied Behavior Analysis, 31(2), 191–202.

Libby, M. E., Weiss, J. S., Bancroft, S., & Ahearn, W. H. (2008). A comparison of most-to-least and least-to-most prompting on the acquisition of solitary play skills. Behavior Analysis in Practice, 1(1), 37–43.

Lifter, K., Mason, E. J., & Barton E. E. (2012). Children’s play: Where we have been and where we could go. Journal of Early Intervention33,281–297.

Malone, D. M., & Langone, J. (1999). Teaching object-related play skills to preschool children with developmental concerns. International Journal of Disability, Development and Education. 46, 325-336.

Maurice, C., Green, G., & Luce, S.C. (1996). Behavioral intervention for young children with autism: A manual for parents and professionals. Austin, TX, US: PRO-ED.

Stahmer, A. C., Akshoomoff, N., & Cunningham, A. B. (2011). Inclusion for toddlers with autism spectrum disorders: The first ten years of a community program. Autism: The International Journal of Research and Practice, 15(5), 625–641.

Stahmer, A. C., & Schreibman, L. (1992). Teaching children with autism appropriate play in unsupervised environments using a self-management treatment package. Journal of Applied Behavior Analysis, 25(2), 447–459.

Stokes, T. F., & Baer, D. M. (1977). An implicit technology of generalization. Journal of Applied Behavior Analysis, 10(2), 349–367.

Taylor, B.A., Hoch, H., Potter, B., Rodriguez, A., Spinnato, D., & Kalaigian, M. (2005). Manipulating establishing operations to promote initiations toward peers in children with autism. Research in Developmental Disabilities. 26, 385-392.

Ward, S. (2011). What you need to know about motivation and teaching games: An in-depth analysis. Lulu.


About The Authors

Maithri Sivaraman is a BCBA with a Masters in Psychology from the University of Madras and holds a Graduate Certificate in ABA from the University of North Texas. She currently runs ‘Tendrils Centre for Autism Research and Intervention’ which is a registered resource center providing behavior analytic services to families in Chennai, India, conducting workshops, and supervising students pursuing certification. She has presented papers at international conferences, published articles  in peer-reviewed journals and has been authoring a column for the ‘Autism Network’, India’s quarterly autism journal. As an Extern at the Association for Science in Autism Treatment she has been involved in the international dissemination of evidence-based treatments writing articles for their newsletter and responding to media reports that highlight treatments for autism.

Ruth Donlin, M.S., is a Board Member of ASAT since 2010 and on the Public Relations Committee. She is a consultant in private practice based in New York, and has provided consultation to schools, agencies, and home programs for children and adults on the autism spectrum for 20 years. She presents on a variety of topics such as managing challenging behaviors, using visual supports, team dynamics, and social skill development at conferences regionally, nationally, and internationally. Ruth is Past-President of the Autism Special Interest Group (SIG) of the Association of Behavior Analysis International.

Introducing Smart Kidz Club!

6ada225d-7c24-42a6-b662-91bf7d9b0032

Different Roads is proud to introduce you to Smart Kidz Club, a digital library of educational resources for young readers, available on web & mobile devices. Smart Kidz Club’s collection of more than 450 eBooks, interactive resources, play activities, and comprehension quizzes can be accessed safely off-line on mobile devices for anytime, anywhere learning. There’s even a special category dedicated to teaching children with ASD!

You can access a no-risk, two week free trial here!

 

Outlaw Fidget Spinners???

This week,  Linda Hodgdon, M.Ed., CCC-SLP shares her thoughts on the rising popularity of fidget spinners. This piece originally appeared on her blog at  www.usevisualstrategies.com


OK. . .so I got 5 fidget spinners for 5 grandchildren. Amazingly, there were 5 colors available so there would be no confusion over which spinner belonged to which child.

Then BAM. . .

School banned them!

No fidget spinners in school!

Well. . . .can you guess my immediate reaction?

Why not teach the students the correct way to use them? My logic says that would be a good goal. But obviously that school staff didn’t look at it with my logic.

Are fidget spinners a distraction or a learning tool?
I guess that depends on how you use them. It’s just like technology. Tech tools can be a huge helper for students or they can become an obsession for games and activities that cause students to hyper focus so they miss what’s important to pay attention to.

This is not just an autism thing. It’s also an ADHD thing. And a typically developing young child thing. Older kids, too. And don’t forget adults.

The internet has information
I’ve read a number of internet articles telling how wonderful fidget spinners are, but there seems to be more information about what’s bad.  Here are examples.

  1. A young child took the fidget spinner apart and accidentally swallowed pieces when he put them in his mouth. Surgery needed.
  2. Some adults are concerned because spinner parts may have mercury or lead. Health hazard.
  3. Teachers react to how disruptive spinners are in class.

But this complaint is most interesting
It’s written by young woman on the spectrum. She shares how students who need to stim in order to concentrate have endured years of training to have “Quiet Hands” or demonstrate other “normal” behaviors. Now, all of a sudden, a businessman writes about being able to concentrate better at staff meetings with a fidget toy. She concludes,

“Something that was considered entirely pathological and in dire need of correction when done by disabled people is now perfectly acceptable because it is being done by non-disabled people.”

Good point
Makes me think how some describe autism “behaviors” as meaningful and typical, but just occurring more frequently or intensely than those without autism might do.

One point worth considering
In defense of the teachers out there, I’m thinking of the “criteria” for a good fidget toy. I’ve listed them out in my speaking programs.  For example:

  • Small enough to fit in your hand or pocket
  • Doesn’t make noise
  • Not distracting to others
  • Doesn’t bounce
  • Has movement or texture or something that will engage the hand of the individual

Fidget spinners fall short for some of my criteria even though they rate very high on social interest.

Are there other options?
The problem with fads is that they go out as fast as they come in.  I’ll bet that by the time the new school year starts in the fall, fidget spinners will be lying in the bottom of a drawer somewhere and there will be a new fad for a new school year.


What is your experience with fidget spinners or other fidget toys?  I’d love to hear.  Just click below or comment on my Facebook page.

https://www.facebook.com/lindahodgdon.autism


About The Author

Linda Hodgdon, M.Ed., CCC-SLP is a Speech-Language Pathologist who is internationally known as a pioneer in developing the use of visual strategies to support communication for students with the communication, behavior or social skill challenges that are common in Autism Spectrum Disorders (ASD).

As an author, speaker and consultant, she has become well known world wide for her very practical information and strategies that guide communication partners to develop effective communication relationships with their children with autism.

With a focus on communication, Linda’s books and training programs are packed with “best-practices” and proven strategies for helping individuals from young children with autism through adults with Asperger’s participate more effectively in their life opportunities.

COPING WITH CHANGE: ADHD, Autism Spectrum Disorders, and Other “Issues”

This week, we’re pleased to present a piece from Dr. Eric Nach, Ph.D., M.Ed., A.S.D. Cert on supporting children through times of change. 

“Our children” are often identified as being “creatures of habit”, they tend to be highly regimented and rigid in their ways of thinking and acting. Virtually any type of change in environment and routine can become a massive dilemma for all children and teens, especially “our children” with “varied needs”.

Our children will have many new experiences to encounter as the school year winds down, summer vacation begins, and then the summer winds down and the school year begins again. Many parents experience either “selective forgetting” or feelings of “dread” as our children transition through these changes year after year.

So what’s a parent to do to help their child transition through times of change? Here are some suggestions based on my decades of teaching, training, and counseling children, teens, young adults and their families with special needs

  1. Parents can and should use “modeling and role-playing” to help their child prepare for the ending or beginning of a new routine.
  2. Parents can spend time, along with siblings “training” their child how to create new routines and especially how to have some level of flexibility in these time of transitioning.
  3. Parents can develop a clear-cut timetable for the transition so their child will know what to expect and how they will still be able to have time to do preferred tasks. Even though little occurs perfectly, knowing what to expect will bring comfort to our children.
  4. Parents typically get best results by explaining Who, What, When, Where, and How factors play into the transitioning events and activities their child will experience. How this information is presented is just as important as when and where. During times of stress and turmoil is NOT the time to discuss potential changes, wait until our child and their environment are at peace to have these discussions.
  5. Parents need to have their child be part of the decision making process to establish better buy-in.
  6. Parents who create a “reward schedule” for a relatively smooth transition are most likely to see a less traumatic transition period.
  7. Parents who understand that it will take time and work for their children to get acclimated to a new routine and that they will likely experience some struggles as they go tend to be happiest. We are looking for “progress not perfection”.
  8. Parents who keep routine as times of change occur tend to be happiest. Parents who continue with light academics and various types of therapies that the child typically experiences throughout the school year tend to have a smoother time at transitioning and experience the least amount of regression of skills throughout the summer months. Social skills groups, camps, and activities where our children can experience successes lead to better social, academic, and behavioral development.

This piece originally appeared on the Support for Students Growth Center website and at www.nachacademy.com


About The Author

Dr. Eric Nach has nearly 25 years experience working with children with special needs and their families.

Dr. Nach is the CEO and primary facilitator of the “Support For The Autism Spectrum Group Inc.” dba “Support for Students Growth Center” located in Boca Raton, FL. At the “learning and counseling center” he and his team of professionals provide *Therapeutic Social Skills Groups, *Learning Strategies and Organizational Strategies Groups, *Behavior Modification Programs, *Individual and Family Coaching and Counseling, *Therapeutic Summer/Winter Camps and *Post-Transitioning Groups for people with special needs, including Autism Spectrum Disorders, Learning Disabilities, Communication Challenges, Behavioral Disorders and Varying Exceptionalities.

Dr Nach is in the final stages of publishing a book to assist parents, educators, administrators, and other professionals to be successful in educating, training and counseling children and adolescents with ASD’s as they navigate the secondary school maze.

Pick of the Week: Schedules and Calendars!

Summer17

School’s out! This week only, take 20% off items to keep kids on schedule all summer long!

*Promotion is valid until June 5th 2017 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code SUMMER17 at checkout.

 

Tip Of The Week: Food Selectivity

In this month’s ASAT feature, Jill K Belchic-Schwartz PhD offers helpful hints for assessing and treating food selectivity. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

I am a behavior analyst working with a 6-year-old child with a very limited food repertoire. Do you have any assessment and treatment recommendations that can guide my efforts to address this area?

Food selectivity is a fairly common issue with children who have an autism spectrum disorder (ASD). Many children who have been diagnosed with an ASD have difficulties with rigidity and a need for sameness, and this holds true for their food preferences as well. This can be very distressing for parents and caregivers.

Prior to initiating a feeding intervention, it is important to rule out any underlying medical conditions that may be perpetuating the child’s feeding difficulties. Common medical concerns include gastroesophageal reflux disease (GERD) and/or food allergies or intolerances. Any underlying medical issues should be treated prior to implementing a feeding program. Once any medical treatment is underway, you can begin to tackle the child’s food selectivity from a behavioral standpoint. If a multidisciplinary feeding clinic is nearby, encourage the parents of the child with whom you are working to consider scheduling an appointment for him/her to be evaluated.

When treating any child with food selectivity, the first step is to take a very detailed feeding history. Ask about the child’s first experiences with breast or bottle feeding, transitioning to baby food and how they handled the transition to more highly textured foods. Get a current detailed feeding diary. It is also very important to gather information about the setting in which the child eats. Does he sit at the kitchen table for all meals or is he allowed to graze throughout the day? Are mealtimes predictable and do they occur at regularly scheduled intervals and at the same time each day? Is the child “brand specific” and eat only a specific brand of food? Will the child eat only one flavor (e.g., strawberry/banana yogurt)? How is the food presented? How long is a typical meal? What are the child’s refusal behaviors? The more specific the information the better!

There are a variety of techniques available that can be helpful in expanding a child’s food repertoire. However, in order to identify the most appropriate treatment, you must first understand the etiology of the selectivity. For instance, is the child’s food selectivity due to a frank refusal to try all new foods or is it due to a failure to progress to more advanced food textures? The food refusal behavior may look the same (e.g., screaming, hitting, spitting out food, etc.), but the treatment would be quite different based on this information.

Once you are satisfied with your assessment, treatment can begin. Try to stick to a daily predictable schedule of meals and snacks and eliminate grazing/snacking in between meals. Hunger can be a powerful motivator! It is also important to limit the child’s access to liquids in between meals, as some children prefer to drink rather than eat. Set a 15-20 minute time limit for meals. When introducing new foods for the first time, it is usually helpful to start with a “formerly preferred food,” that is, a food that the child used to eat or a food that is similar in taste/texture to something he currently eats.

When presenting the “new” food to the child, start with a very small bite of the new food (e.g., sometimes as small as a pencil point) so as not to overwhelm the child and to ensure a greater likelihood of success. Some feeding therapists use the child’s preferred food as a “reward” for eating the “non-preferred” food, while others use toys/activities as a reward for tasting the new food. What works for one child may not necessarily work for another. Therefore, in order to find the most salient motivators, several different options will likely need to be explored. Additionally, reward systems may need to be changed periodically in order to maintain their effectiveness.

When introducing new foods to a child, it is often easier to start with naturally occurring pureed or smooth foods first (e.g., yogurt, applesauce). The reasoning behind this suggestion is that once the child accepts a bite of pureed food into his mouth, swallowing it is almost guaranteed. With a piece of chopped food, the child may accept the bite into his mouth, but chewing and swallowing may not necessarily occur, and the child may expel the food. For instance, suppose you are introducing fruits and/or vegetables to a child who eats only carbohydrates. The child is more likely to demonstrate success with a one-fourth teaspoon of applesauce than he or she would with a bite of an actual apple. Once the child is accepting a ¼ teaspoon of applesauce consistently (e.g., nine out of ten opportunities), you can begin to increase the bite size to ½ teaspoon. Moving along in a systematic and stepwise fashion ensures a greater likelihood of success. Additional foods can be introduced in a similar fashion once the child is eating a reasonable volume of the new food.

Food selectivity is just one example of feeding problems that may be experienced by children on the autism spectrum. These difficulties often pose a significant challenge to parents, as nourishing our children is expected to be one of the easier, and more enjoyable, tasks of parenthood. Help is available for parents experiencing this challenge, and behavior analysts are a great resource for assessing and treating these disorders because of their specific skill sets in understanding behavior and motivation. For more detailed information, a great resource is, “Treating Eating Problems of Children with Autism Spectrum Disorders and Developmental Disabilities” by Keith E. Williams and Richard M. Foxx.

References

Williams, K. E. & Foxx, R. M. (2007). Treating Eating Problems of Children with Autism Spectrum Disorders and Developmental Disabilities. New York, New York: Pro-Ed Inc.

Please use the following format to cite this article:

Belchic-Schwartz, J. (2011). Clinical corner: Food selectivity. Science in Autism Treatment, 8(3), 11-12.


About The Author

Jill K. Belchic-Schwartz, PhD is a Licensed Psychologist who received her Doctorate in Clinical Psychology from Rutgers University in 1995. Dr. Belchic completed her pre-doctoral internship in pediatric psychology at The Children’s Hospital of Philadelphia (CHOP), where she remained on staff­ for seven years. While at CHOP, she co-directed the Regional Autism Center and was a Program Manager in The Feeding and Swallowing Center. Dr. Belchic’s specialty areas include early assessment of developmental diff­erences, including language delay and diagnosis of autism spectrum disorders (ASD). She also provides psychoeducational assessments for children/adolescents who are struggling in school. She provides community-based consultation and treatment for kids with a variety of psychosocial issues. Dr. Belchic has been in private practice since 2004 and is a partner in Childhood Solutions, PC.

Pick of the Week: Take 20% off products from Stages Learning Materials!

STAGESpromoSlide

Stages has a new look! To celebrate, we’re offering 20% off our entire line of Stages products through May 22nd!

*Promotion is valid until May 22nd, 2017 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code STAGES20 at checkout.

Guest Article: Tackling Tantrums by Bridge Kids of New York

For parents, it can be difficult and frustrating to help their children through tantrums. We’re pleased to share with you a second guest post by Bridge Kids of New York (BKNY), who shares with us a few (humorous) words of advice on tackling tantrums.


Here at BKNY, parents reach out to us for support in a variety of areas. Not surprisingly, one of the most popular reasons we hear from parents is for support in managing tantrums! Why is this not surprising? Well, it’s not surprising because very few of us will make it through life without ever throwing a tantrum! We’ve all been there, right? Whether you were 5 or 35, you’ve most likely engaged in a tantrum. For our little ones, who are still learning about rules, expectations, effective behavior, and self-control, it makes sense that we will periodically see a tantrum—it’s often part of the learning process. So, for all of our parents out there who are tackling tantrums, here are a few words of advice for you:

Take a deep breath
Analyze why the tantrum is occurring and Avoid reinforcing it
Neutral tone and affect
Tune out the bystanders
Remember the big picture
Understand that this is a learning moment for your child
Make objective decisions rather than emotional ones
Stop beating yourself up

Take a deep breath.
Tantrums can be stressful for everyone involved! As a parent, it may be emotionally difficult, frustrating, or potentially embarrassing to work through a massive tantrum with your child–these are common emotions! But here’s the thing: when your child is mid-tantrum and about as far away from calm as possible, that’s when it’s the most important for us to be calm. After all, someone has to be! Whatever emotions you feel in these moments are perfectly valid—acknowledge them—then take a deep breath and try to release them. One of the most important things you can do for your child during a tantrum is to remain calm

Analyze why the tantrum is occurring and Avoid reinforcing it.
All behavior occurs for a reason. Whether or not you fully understand your child’s tantrum, rest assured that there is a function behind it. In order to handle it appropriately and use proactive measures in the future, we need to analyze what is going on. We need you to become a tantrum detective! Think about what happened right before your child’s tantrum (i.e. the antecedent). Were you talking on the phone instead of paying attention to her? Did he have to share a favorite toy with another child? Did you ask him to do something challenging? Looking at what happened right before will probably give you some information about why the tantrum is happening. Thinking about (and potentially reconsidering) how you typically respond in these situations may also help. Once you determine why the tantrum is occurring, the next step is to not give into it. So, if your child is tantrumming in the middle of the grocery store because you said “no” to the box of over-processed chocolate cereal, you want to make sure that you do not give in and buy the cereal. If you cave during a tantrum, you will likely reinforce that behavior and see it again in the future. So do your best to stay strong!

Neutral tone and affect.
We’re all human and it’s natural to lose our cool from time to time under stressful circumstances. Tantrums can get the best of you sometimes! In these moments, try to remind yourself to use a neutral tone and affect. Let your face and your voice send the message that you are unphased by the tantrum (even if you don’t totally feel that way on the inside!). Channel your inner actor (we’re in NYC after all!) and put on your game face!

 

Tune out the bystanders.
Let’s be honest, a tantrum that occurs in your home feels very different than a tantrum that occurs in public. When you are out in the community, there may be additional safety concerns (e.g. running into the street), worries about disturbing others (e.g. crying in a restaurant or movie theater), and, perhaps the most challenging of all, those darn judgmental bystanders! You know the ones we’re talking about. Those people who either can’t relate to what you and your child are going through, or the ones who pretend like they can’t relate because, after all, their children NEVER, EVER, EVER had tantrums (read: sarcasm). Then, there are also the people who get involved, thinking they’re helping you, but are actually making the situation worse. You know these people too—the sweet older lady who tells your child that Mommy will buy him a candy bar if he stops crying—you’ve met her, right? Unfortunately, you cannot always control what other people will say, do, or think. But, fortunately, you can control what YOU will say, do, and think! In these moments, do your best to turn OFF your listening ears and do what you know is right for your child.

Remember the big picture.
Okay, so here were are in the middle of a huge tantrum. Could you make that tantrum stop in a matter of minutes or even seconds? Yes, in many cases you probably could. All you have to do is give in. If your child is tantrumming because you told her you would not buy that candy bar in the checkout line, you could probably put a quick end to it by just caving and giving her the candy. And that option can be pretty tempting sometimes! This is where we urge you to remember the big picture and think long-term. The goal is not to stop that particular tantrum in that particular moment—the goal is to reduce those tantrums from happening in the long-run. We want to decrease the behavior that interferes with your child’s success and increase the behavior that supports it—that’s not going to happen by giving in. Caving in the middle of a tantrum may stop it in the moment, but ultimately it will teach your child that throwing a tantrum is an effective way to get what he wants. So the next time he wants something, he’s likely to resort to that behavior again. As you can imagine, this may easily turn into a cycle of increasing tantrums. Although it’s easier said than done, try to remember the big picture—you’ll thank yourself later!

Understand that this is a learning moment for your child.
Every moment of every day is a learning moment. This applies to all of us, by the way, not only our children! Believe it or not, your child is actually learning during those tantrums. He is learning all kinds of things, in fact! Your child is learning whether or not Mommy really means the things she says. She’s learning whether or not you are consistent. He’s learning about rules and limits, or lack thereof. She’s learning what behaviors are going to be effective and what behaviors are not. He’s learning how to respond to undesired situations, like not getting what he wants. The list could go on and on! So remember this when your child is having a tantrum and focus on teaching the things you actually WANT to teach! Furthermore, remember that learning is hard sometimes. It’s okay for your child to struggle a little bit in the learning process—you (and we!) are there to be his teachers.

Make objective decisions rather than emotional ones.
We’ll start this one by acknowledging that it can sometimes feel nearly impossible to be objective during a massive tantrum, especially when in public. To the best of your ability, set your emotions aside and try not to take it personally. Your child’s tantrum is happening for a reason and that reason is most likely not about trying to hurt your feelings. So, take a moment to have a mini out-of-body experience, away from your emotions, and try to look at the situation as an outsider. Remember, you want to analyze what is really happening—unfortunately, those pesky emotions can really cloud your judgment. Try to let your choices and reactions be based on facts rather than on feelings.

Stop beating yourself up!
You are not a bad parent. Your child is not a bad kid. You are not the only parent whose child has tantrums (despite those ridiculous people who make you feel like you are!) In fact, your child’s tantrum may actually be the result of you being a good parent and setting limits. You do not have to be perfect every second of every day. You can make mistakes and so can your child. It’s okay. This is a part of the process. Chin up, thumbs up, you got this!

Note: If your child engages in behavior that is dangerous to himself or others, we suggest that you consult an appropriate medical professional as well a Board Certified Behavior Analyst (BCBA) immediately. Safety should always be the first priority. Feel free to reach out to our behavior team and/or attend one of our Tackling Tantrums workshops for more information on understanding and changing behavior!

WRITTEN BY BRIDGE KIDS OF NEW YORK, LLC

Bridge Kids of New York, LLC is a multidisciplinary team of professionals who strive to improve the quality of everyday living for the children and families they serve, providing each family with progressive services that merge evidence-based practices with play-based and social instruction. To find out more, contact them here or email info@bridgekidsny.com.