Category Archives: Guest Blog Post

Guest Article: Tackling Tantrums by Bridge Kids of New York

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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.

T-A-N-T-R-U-M-S
by Bridge Kids of New York

Young girl indoors cryingHere 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.

Increasing Play with Unit Blocks – Free Download

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Blocks PileSymbolic play refers to a child’s ability to use one object or action to represent a different object or action within imaginary play. The symbolic play skill that involves object substitution typically begins to emerge around 18 months. For example, you might observe a child using an empty box for a “hat” or an overturned bucket for a “drum.” Blocks are a mainstay in early childhood classrooms because the benefits are innumerable. Block play can help to facilitate cooperation, visuo-spatial skills, problem solving ability, social skills, and language development, and is a good predictor of future mathematical abilities.

One hallmark of the diagnostic criteria for autism spectrum disorder is a presence of “persistent deficits in social communication and social interaction across multiple contexts, as manifested by difficulties in sharing imaginative play or in making friends.” Additionally, rigid thinking patterns may make symbolic play difficult for children with autism as they might view objects in a limited way that makes it difficult to pretend a block is something other than a block. Blocks on ShelfSince unit blocks are a huge component of early childhood classrooms everywhere one could imagine that exposure to them and some level of proficiency opens up huge social opportunities for learners with autism spectrum disorders with their mainstream peers in the classroom.

Some learners will require scaffolding in order to progress from the use of literal props within pretend play to object substitutions. Research suggests that systematic prompting is a common component of successful interventions used for teaching play.  Depending on the learner, various types of prompts will be used as you systematically move from most intrusive to least intrusive prompt levels. Sometimes, a learner begins to respond to natural cues before you have moved through each prompt level. However, for learners that require support froma visual prompt you can attach drawings of objects onto the blocks and then systematically fade them out. Once the learner begins to consistently use the blocks with the attached images you can use stimulus fading procedure to fade out the visual prompt. This can be done by photocopying the image and systematically changing the lightness until eventually the learner is presented with just the block.

Below you will find downloadable images in the shape of unit blocks to help you facilitate symbolic play with a learner who requires visual prompts. The images are to scale and just the tip of the iceberg when it comes to all of the possibilities. It is important to teach various object substitutions for each block shape so that the skill is generalized. In a classroom where the curriculum is organized thematically, you could attach a few visuals to various blocks each time the theme changes to encourage symbolic play for the whole class.

Click here to download our Free Unit Blocks Template!

References

Cook, D. (1996). Mathematics sense making and role play in the nursery school. Early Childhood Development and Care, 121, 55-65.

Wolfgang, C., Stannard, L. & Jones, I. (2001). Block play performance among preschoolers as a predictor of later school achievement in mathematics. Journal of Research in Childhood Education, 15(20): 173-180.

Smilansky, S., & Shefatya, L. (1990). Facilitating play: A medium for promoting cognitive, socioemotional and academic development in young children. Gaithersburg, MD: Psychosocial & Educational Publications.

Christakis, D.A., Zimmerman F.J., & Garrison M.M. (2007). Effect of block play on language acquisition and attention in toddlers: a pilot randomized controlled trial. Arch Pediatr Adolesc Med. 161(10):967-71.

Pepler, D.J., & Ross, H.S. (1981(. The effects of play on convergent and divergent problem solving. Child Development, 52(4): 1202-1210.

Lang, R., O’Reilly, M., Rispoli, M., Shogren, K., et al. (2009). Review of interventions to increase functional and symbolic play in children with autism. Education and Training in Developmental Disabilities, 44(4), 481– 492.

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

Written by Stacy Asay, LMSW

Stacy is a licensed social worker, providing home and school based services to children and their families in the New York City area. With nearly 16 years of experience, her work with special needs children integrates a strengths-based, holistic approach to child and family augmented with the tools of Applied Behavior Analysis, a methodology that allows for reliable measurement, objective evaluation of behaviors, and the systematic teaching of language and learning skills.  This results in an individualized curriculum that equips children with the tools they need for learning and living while honoring their unique spirit.

Guest Article: “Promoting Socialization in Children with Autism Through Play” by Julie Russell

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We’re so pleased to bring you this guest post by Julie Russell, Educational Director at the Brooklyn Autism Center (BAC). BAC is a not-for-profit ABA school serving children aged 5–21. Here, Julie describes specific, simple strategies for promoting socialization in children on the spectrum.

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Promoting Socialization in Children with Autism Through Play
by Julie Russell, Brooklyn Autism Center

Socialization – defined as a continuing process where an individual acquires a personal identity and learns the norms, values, behavior, and appropriate skills – is a vital part of life. It is also a particularly difficult skill for individuals with autism. Children with autism often struggle with initiating conversation, requesting information, making contextual comments, and listening and responding to others. These difficulties can interfere with the development of friendships for children on the spectrum.

The best way to improve socialization in children with autism is to emphasize play. There are several strategies to teach play skills to children on the spectrum that can help them improve socialization and develop friendships.

One method of teaching socialization is to condition the typically-developing peer as a reinforcer by pairing the peer with items and activities that are reinforcing for the child with Autism. The peer can give the child with Autism a preferred edible or join in on a preferred activity for the child with autism. If Ben’s (the child with autism) favorite edible is Twizzlers and his preferred activity is completing a puzzle, Adam (his typically developing peer) can offer Ben a Twizzler and join in on completing the puzzle. The typically developing peer is then associated with both the preferred edible and the preferred activity, making Adam a reinforcer for Ben.

This method is a great way to make the peer more desirable for the child with autism. The items or activities used for conditioning should only consist of items/activities that the child with autism already enjoys. When trying to introduce a new item or activity to the child with autism, peers should not be included right away. Trying to teach how to play with the item and the peer simultaneously can be confusing and over-stimulating for the child with autism. The child with autism should first be taught how to play appropriately with the age-appropriate activity during individual instruction, and then the peer can be included in the activity once mastery of the activity has been demonstrated.

Another way to promote socialization is to engage the child with autism in cooperative games, or any activity that requires interaction where each child has a role that is needed in order to complete the activity. This way, the motivation to engage with the typically developing peer will be higher. When teaching the child with autism how to play cooperative games, such as board games, you can include teaching skills that target turn taking and sharing. Children with autism (or any child) may have difficulties with giving up preferred items/activities, so these may be challenging skills to teach. In order to teach these skills with success, begin by having the child with autism share and take turns with non-preferred items/activities, then gradually fade in more highly preferred items to take turns and share.

Evidence-based practices such as social stories, peer modeling, and video modeling are also excellent methods to promote socialization in children with autism. Reading social stories and watching “expert” peers interact will allow children with autism to view and understand appropriate behavior before interacting with a new peer or practicing skills such as turn-taking, requesting information, and listening and responding to others.

All of the above methods of promoting socialization are used in Brooklyn Autism Center’s after school program BAC Friends, which pairs our students with typically developing peers from neighboring elementary and middle schools. We also provide additional opportunities for our students to practice peer socialization (along with academic work) during our reverse inclusion program with Hannah Senesh Community Day School. These methods combined with enthusiastic peers have helped our students improve their socialization skills and develop meaningful friendships.

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WRITTEN BY JULIE RUSSELL, MS, BCBA

Julie holds an M.S. in Applied Behavior Analysis from Simmons College in Boston, Massachusetts and received her BCBA in 2009. She has over 10 years of experience working with children with autism and related developmental differences in centers, schools, school districts and home-based programs. Julie received her supervision hours for board certification in behavior analysis by Dr. Nathan Blenkush, Ph.D., BCBA from JRC in Boston, Massachusetts. She was a Clinical Supervisor at ACES (Center for Applied Behavior Analysis) in San Diego California and Clinical Supervisor at the ELIJA School in Levittown, NY before joining the Brooklyn Autism Center as Educational Director.

Guest Article: “Seamless Separation: Transitioning to School” by Bridge Kids of New York

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As our kids and students prepare to go back to school, we thought it was the perfect time to share this wonderful guest post on transitioning into a new school or classroom, submitted to us by Bridge Kids of New York. Read on below for exclusive tips on how to best help you and your child have a smooth transition back to school.

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Seamless Separation: Transitioning to School
by Bridge Kids of New York, LLC

When your young child enters into a school or daycare setting for the first time, the transition can be challenging for both you and your child!  This may be the first time your child has had to navigate a new environment without your support and it may be the first time you have had to entrust your little one to someone else.  Of course this has the potential to be stressful for everyone involved!

Here are a few proactive tips to help both you and your child have a smooth transition:

  • Try to meet with your child’s teacher prior to the first day of class.  Discuss your concerns, goals, and values.  Share important information about your child and ask the teacher to fill you in on any key information you should know about the classroom and/or the teacher’s approach. This conversation may help to ease your anxiety and build trust between you and your child’s new teacher.
  • Establish a communication system.  Talk to the teacher and/or the school’s administration to determine the best means of exchanging important information and find out how frequently you can expect communication.  This will help to establish trust, create consistency between home and school, and keep you informed as to all of your child’s triumphs!
  • Have a game plan for the first week of school.  Although we certainly hope you and your child will transition to school without any difficulties, we always advise that you be prepared just in case!  Expect that the separation may initially be challenging for your child.  Talk to the teacher and school administration ahead of time and develop a plan for how you can help your child to be successful.  Rather than waiting for a difficult and emotionally-charged situation to arise and then reacting to it, we suggest that you take proactive measures and develop a plan when both you and your child are calm.  We highly recommend that you consult with a Board Certified Behavior Analyst when developing this plan to ensure its integrity as well as the safety of all involved.
  • Try to remain calm and confident for your child.  Children are often very good at reading our moods, emotions, and energy.  If you enter into the school transition with outward uncertainty and nervousness, you may send your child the message that he should feel the same way.  Instead, try to remain calm and positive about the change—model the behavior you want to see.
  • Prepare your child for the transition to school.  Discuss this new chapter in a way that expresses excitement and positivity.  Provide your child with clear information on what to expect.  Surprises or confusion can make this process more challenging for your child so do your best to help him understand what will happen.
  • Create a “Going to School” storybook.  Consider creating a fun storybook to help your child get ready for this new transition.  Your storybook can include both text and pictures of the school, your child’s teacher, your family, and even some of his classmates (with consent from those parents, of course).  You will want to provide your child with a step-by-step guide for what to expect.  Using actual photographs may help your child to feel familiar with the school environment before the first day.  We suggest reading this storybook to your child for at least 1-2 weeks prior to starting school, in the morning before school, and again after school until he/she is adjusted.  You may even send the storybook to school with him.  These types of books help to provide important information and also serve as a cue to remind us to talk about it!
  • Do a dry run.  Ask the school for permission to bring your child for a visit before school starts.  Allowing your child to see the classroom and meet the school staff may help him to feel more comfortable on the first day.  You may even consider taking pictures of your child in the school building or with her teacher to post in her bedroom or to include in your storybook.  If school is in session and the administration gives you permission, you may even consider trying to walk out of the room for a few minutes during the visit to assess how your child will adapt to you leaving later on.  (As a pointer, try not to make a huge production out of leaving!  A dramatic exit may lead to a dramatic response!)
  • Practice separating from your child in familiar environments.  If separation is very challenging for your child, you may want to consider practicing this separation in a familiar environment.  It may be overwhelming for your child to adjust to separation from you and the introduction of a new environment and new people all at the same time.  In preparation for school, try separating from your child in environments where she already feels safe and secure (e.g. in your home).  Provide your child with lots of praise and reinforcement for separating from you calmly and successfully!
  • Gradually increase the length of separation.  Some children benefit from gradual and systematic separation.  You may initially just try walking out of the room for 10 seconds, then 30 seconds, then 1 minute, and gradually increase from there.
  • Try to engage your child in a favorite activity before separating.  By doing this, you are pairing the separation with something your child enjoys, which may make the separation itself less aversive.  It may also serve as somewhat of a distraction, so your child is less likely to focus on your absence.  Remember to do this proactively, not in response to problematic behavior.

Important Note:  The tips outlined in this post are proactive measures only.  We hope that applying this advice will help to prevent or reduce interfering behavior and set your child up for success.  However, despite these proactive measures, some children may engage in interfering behavior that is dangerous to themselves and/or to others.  We do not recommend implementing a procedure that may result in an unsafe situation.  For this reason, we highly suggest you consult with a Board Certified Behavior Analyst (BCBA) prior to implementing intervention procedures.  A properly trained professional can assist you in keeping the situation safe while helping your child to be successful.

We hope these pointers will help to make the school transition smooth for both you and your child!  Of course this list of tips is not comprehensive and our behavior team is full of other suggestions, so feel free to contact us for support!  You may find our upcoming Seamless Separation Workshop to be helpful!  Click here to register for this FREE workshop.  We understand that every child and family is unique and that successful transitioning may need to be individualized based on your unique needs.  We are always here to help!

For more information about Bridge Kids of New York, please email info@bridgekidsny.com or visit www.bridgekidsny.com.

Tip of the Week: Use Technology to Promote Social Interactions Between You and Your Child

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Last month I had the privilege to speak in New Jersey at the 2014 Statewide Conference for Fathers of Children with Special Needs. I love the opportunity to speak with parents, and this conference allowed for lots of small group discussion that centered on the individual needs of each of the families represented there.

My focus was on utilizing technology, and one of the fathers said, “You know, I see what you’re saying about how I can use the iPad to increase social interaction, but my son won’t do that with me. When I try to work with him on the iPad, he just wants to go to Temple Run. He won’t play with it the same way he does with his teachers.” This question highlights the differences between the home environment and other environments. This is a common problem that parents face, not because they’re doing anything wrong, but because they have a different relationship with the child than the teachers do.

Go back to when you were in middle school. Imagine that you’re at home with your parents, you’re in your room engaged in one of your favorite activities, and your mother comes in and says, “Let’s watch a movie about how the solar system was created.” It is highly unlikely that you are going to leap at that opportunity. At home, you like to have your own space and free time, you have lots of choices for what you can do, and there are options that are more motivating than watching that movie.

Now think of the exact same situation, except you’re in your middle school science classroom and the teacher says, “Let’s watch a movie about how the solar system was created.” You never get to watch movies in that science class, you usually have to take notes and worry about when the teacher might call on you to answer a difficult question. It is much more likely that you are going to want to watch a movie in this scenario. Compared to the options you usually have during science class, watching this movie is highly motivating.

The same thing happens at home when you try to introduce an educational or challenging activity, and for learners with special needs, an activity we think of as fun may in fact be highly challenging. It’s important to acknowledge that parents are working with the child in a different environment so that we can create strategies that are feasible for creating success in the home. There are some things you can do to make it a bit easier on yourself when introducing iPad or tablet activities.

My biggest tip is to offer choices. For example, instead of saying “Let’s play on the iPad,” say, “Do you want to play Animal Race on the iPad or go outside and jump on the trampoline together?” This way, you’re labeling a specific app instead of providing free access and you’re creating an opportunity for interaction no matter what the child chooses.

My second tip is to utilize built-in accessibility tools. Use Guided Access to lock the app. This way, the choice really is to just play that app or select the other option presented. If the child selects the other option, that’s fine! You can let them know when they have free time on the iPad and when they only have the option of playing with a particular app. You can also limit the amount of time they play quite easily by going to your “Clock” app on the iPad or iPhone. Look at the menu of ringtones, scroll down to the bottom and select “Stop Playing.” Set the time, and when time is up, whatever app your child is playing with will automatically close. If you have a passcode set for your phone, then the passcode has to be typed in before access to the app is available again.

Some learners also respond very well to visual cues to signal when they have free time on the iPad versus structured time. This can be accomplished by changing the color of the iPad cover (my students know that the “orange iPad” is for structured time) or by placing a reusable sticker on the edge of the screen.

My final tip is to consider motivation. There are apps out there that I think are great, but I have to start with what my particular learner will be interested in and build from there. Find apps that have a characteristic that should appeal to your learner, such as specific cartoon characters, animals, or music.

Using these simple tips can provide some success in using technology to promote social interaction between you and your child, or between your child and his/her siblings and peers. If you’ve used other strategies successfully, please share them with us on Facebook.

On the Need for Crisis Intervention Training: A Guest Article by Bobby Newman, PhD, BCBA

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Last week, we discussed a comprehensive checklist for parents in placing their children in the right school environment. Service providers in special education programs play a vital role in students’ daily lives at school and are expected to understand certain protocols when behavioral difficulties arise. We couldn’t think of a more appropriate article than that of Bobby Newman, PhD, BCBA to shed light on this need for crisis intervention training in order to ensure the best learning environment for students.

On the Need for Crisis Intervention Training
by Bobby Newman, PhD, BCBA-D

It was one of those moments in life that seemed scripted. A colleague and I were being given a tour of a public school, a prospective placement for a student of my colleagues. The student in question had a history of aggressive behavior towards staff and bolting from the classroom towards the street. How such physical crises were going to be addressed was thus a major concern of mine. I asked the tour guide, the principal of the school, how such matters were handled and whether staff were formally trained in any crisis intervention philosophy and techniques. She informed me that they were not, but that there were “informal things that staff had taught one another.”

As if on cue, at that very moment a student came sprinting past us, with a staff member in pursuit. The staff member reached out and grabbed the sprinting student by the back of the collar, effectively stopping him by choking him with his shirt. My usual flimsy professionalism couldn’t survive this seemingly scripted moment, not to mention the loud choking noise, and I asked, “Is that one of the things staff have shown each other?”

Further questioning revealed that when students had serious outbursts, 911 was called. My mind went to Chicago where in 2012, police were called to the home of a child with autism during a behavioral crisis with tragic results. Very little else needed to be known to determine that the student’s parents would never agree to this school placement, and I couldn’t say that I blamed them.

Crisis intervention is one of those very sensitive issues in the field of developmental disabilities. There are people who want to ban the physical portion of crisis intervention training, either due to liability concerns or perhaps due to abuse concerns. I will agree that the potential for abuse exists if staff are allowed to put their hands on students/consumers. I will argue, however, that the possibility of abuse is much greater if we do not train and if we do not have formalized systems in place, or at least for mass exclusions of people from less restrictive settings due to the inability to maintain them there safely in such environments. Let me develop my argument:

  • Due to the nature of some developmental disabilities (e.g., difficulty in developing communication skills or sensory defensiveness), behavior that is not typical of same age peers can occur.
  • This behavior may sometimes take forms that can be dangerous to the person engaging in them (e.g., running into hazards or self-injurious behavior) or dangerous to those around them (e.g., aggression towards others or environmentally dangerous behavior such as object destruction).
  • At such times, we may be facing a “crisis,” when injury to self or others is imminent and probable and “crisis intervention” (verbal and possibly eventually physical) may be necessary to keep everyone physically safe. The guiding idea behind crisis intervention is to keep everyone safe. This includes the person engaging in the behavior, peers, and staff.

I wish to emphasize that a crisis is NOT an everyday occurrence. A crisis should not be routine, it should arise as a relatively infrequent occurrence that needs to be dealt with via crisis intervention protocols at that moment. I wish to distinguish crisis intervention from “behavior treatment plans,” which must be in place for behavior we often see from the individual in question. If you’re doing crisis intervention frequently, then this a matter for discussion of alterations to behavior management plans or resource allocation/availability. Crisis intervention is not a consequence meant to change the probability of behavior via a punishment contingency, and any physical interventions where one must put their hands on a student should be a last resort.

Even with this caveat in place, some would make the argument that crisis intervention training should not be provided, that it gives staff permission to be overly physical with students. While I will grant such a possibility exists, as I always tell my ethics classes, the argument about what you are not willing to do is not enough. One must be prepare to answer, “and then what?” Suppose staff were not trained. When a crisis occurred, they would be left with “doing the best they can” or otherwise improvising in the moment. Given this set of circumstances, staff would respond in their own ways to crises and injuries and abuse become probable, not just possible, as staff panic or lash out with whatever self-defense techniques they can think of or act in keeping with a faulty knowledge of body mechanics or physical hazards (witness the “choke stop” described above).

To summarize, the implications of the “do not train” argument are:

  • I know there will be crises due to the behavioral history and repertoires of the students in the program
  • I’m concerned about liability or staff becoming heavy-handed, so I’d rather not train people to safely deal with the crisis, I’d rather trust to their natural impulses or an “unofficial” policy/procedure that has grown up within the program.

What must be appreciated is that good crisis intervention training systems are based on sound behavioral principles, providing the supports the individual needs, rather than on controlling the behavior of the individual physically. The vast majority of crisis intervention training is based upon preventative measures that aim to teach the individual self-control and alternate behaviors, and to create settings that are not likely to create crises in the first place, rather than sheer physical intervention. Should a physical intervention be needed, safety is a foremost concern. Techniques are performed in such a way as to attempt to minimize injury. No technique, for example, is meant to cause pain, is meant to scare, uses impact for behavior control, or moves a limb beyond its normal range of motion.

To sum up the basic argument:

  • We know behavioral crises that can lead to serious injury may occur
  • If we do not train people, we are trusting the staff member’s individual reactions or “unofficial policy’ that cannot be traced or analyzed as it is unofficial.
  • If we do train people, however, we can create standards of conduct and accountability and we can aim at program design that avoids the need for physical intervention.

This seems to me to be our best bet for creating programs that are humane, not emotionally reactive, and encourage the development of effective problem solving strategies that rely on behavioral interventions, rather than relying on physical intervention by staff to keep everyone safe. This seems to me to be most consistent with ethical practice of Applied Behavior Analysis.

About the Author

Bobby Newman is a doctoral level Board Certified Behavior Analyst and Licensed Psychologist. Bobby is the first author on twelve books and has published over two dozen articles in professional journals, as well as numerous popular magazine articles and has hosted two series of radio call-in shows. Bobby is the Past-President of the Association for Science in Autism Treatment and the New York State Association for Behavior Analysis. A popular speaker, Bobby also provides direct treatment, staff training and consultation around the world, and has been honored for this work by several parents and professional groups. Bobby is a SCIP-R (Strategies for Crisis Intervention and Prevention, Revised) instructor and has published a manual to accompany crisis intervention training (Gentle Redirection of Aggressive and Destructive Behavior). In addition to his other clinical work, Bobby teaches non-violent crisis intervention philosophy and techniques for schools, agencies and families.

Safety, Wandering and Emergency Planning for Individuals with Autism: An Interview with Gary Weitzen of POAC and the Autism Shield Program

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The safety of individuals with autism is an enormous concern for parents and caregivers across the country. POAC Autism Services consulted with Dennis Debbaudt to pioneer The Autism Shield Program providing safety training for police, fire fighters, and EMTs. More recently, POAC has developed a companion workshop designed for caregivers, teachers, and child study team members.

Sam had a chance to talk with Gary Weitzen, Executive Director of POAC Autism Services. Gary is an excellent source of information and has been incredibly generous and proactive in sharing his experiences and knowledge with the community. POAC has now trained more than 15,000 police officers and first responders on autism recognition and safety. We’re sure you will find Gary’s insight and suggestions exceedingly helpful and applicable to children and adults of all ages.

***

Fifteen years ago, Gary Weitzen’s five-year-old son with autism went missing. The first place his parents looked was the lake, because like many children with autism, they knew he was drawn to water. Fortunate to find him in time to save him, this experience and many similar stories Gary would hear over the years, were the impetus for creating the Autism Shield Program. Gary is now the Executive Director at POAC, an organization in New Jersey that provides free resources for the autism community.

“The Autism Shield Program is a comprehensive program really designed to keep our children safe in their schools, homes, and communities,” Gary said. “It originally started training police officers. Multiple FBI studies have shown that if you have autism or any other developmental disability you’re seven times more likely to encounter police than if you don’t have autism.  We’ve expanded it to the current program which also includes firefighters, EMTs, emergency first responders, school nurses, prison guards, and parents.”

One thing that Gary stresses repeatedly is the need for children with autism to learn how to swim.

“I lived with the fact that my son almost drowned. [Fifteen years ago] it was just huge numbers of children with autism drowning. Like every week another child with autism died, another child with autism died. It was overwhelming,” Gary said. “We thought, we have to do something here. We have to let parents and police know exactly what’s going on here.”

Eight years ago, POAC started training police departments on how to respond to emergency situations that involved individuals with autism.

Wandering Child

“I always tell the first responders the same thing: individuals with autism are never lost. Ever. They’re always going somewhere. They didn’t wander out of the house like someone with Alzheimer’s would or even a small child would. Our guys are going somewhere so you want to try to get the information right away about where you think they might be going from the caregiver. If you get that information beforehand, you can try to search there. Always start a search with bodies of water. Always. If the child is missing from a specific location, start with concentric circles out and hit every body of water,” Gary said.

Two more suggestions have been extremely beneficial for law enforcement and first responders in dealing effectively with individuals with autism. The first is to speak in short, direct sentences telling the individual what TO DO instead of what NOT to do. The second is to provide a prompt if the individual is without identification and not giving contact information upon request.

“Let’s say, you ask Charlie his phone number, he doesn’t give you a phone number. Ask his phone number again, but this time prompt it with the area code for that area. ‘Charlie, what’s your phone number, 9-7-3…’ Ninety-nine times out of 100 our guys with autism will finish their phone number.”

Gary also suggests families complete an Emergency Planner and to register with 911 in order to assist with improving safety and emergency response efforts. He urges families to utilize services such as Project Lifesaver.

“[Project Lifesaver] has been in existence for over 15 years. It’s LoJack for our kids who wander off. It was designed for Alzheimer’s patients and expanded to individuals with autism. There are now more individuals with autism that are on it than people with Alzheimer’s,” Gary said. “The success rate in 15 years nationwide: 100%. There’s never been a case of an individual on the program not being found alive ever, ever, ever. Hundred percent success rate. And the average time it takes from the time mom calls up ‘My child is missing’ until the sheriff’s officer has their child in their hands: 14 minutes.”

For individuals who may not tolerate the Project Lifesaver bracelet, Gary recommends creating a rule about cell phones and using the cell phone to ensure the individual is safe.

“If the rule is I always have to have my smartphone with me, in my pants pocket, guess what, they will always have that smartphone with them in their pants pocket. And it doesn’t have to be turned on,” Gary said. “It just has to have power and with iPhones and Androids you can get free apps like the Find My iPhone. There’s also programs out there with Verizon, AT&T, and other providers for $10 a month to put a family locator on the phone, set up a location, so if the phone moves 50 feet away from wherever the location, work, school, home, mom or dad gets a text instantly. The phone is on the move. And you can track it in real time. So there are so many things that are out there that people need to take advantage of and could take advantage of. They just have to be told about them.”

Beyond wandering and encounters with police, POAC also works with fire departments and with parents to increase safety during house fires.

“Very often, individuals with Asperger’s will hide in a house fire. And look, regardless of their age—face it—our guys and girls will re-enter a burning building. This happens all the time. All the time, firefighters come, they save the child, the child’s with mom, with other kids, and in the confusion of the fire, especially if there’s somebody still in the house they’re trying to save, we’ve had so many individuals with autism walk right back into the burning house in front of the police, firefighters, and their family and burn alive and die in the house.”

Gary recommends running fire drills at home with clear rules, such as, “Stand by Mrs. Smith’s mailbox.” It’s also important to identify who will be responsible for the individual with autism during an emergency. But Gary cautions that even with supervision, an individual with autism may be dangerously insistent about re-entering a burning building.

“So, where’s the best place to put a child at the scene of a house fire? Locked in the back of a police car. They’ll potentially scream, bang their head, maybe hurt themselves, but they’re alive. They’re alive,” Gary said. “We have videos of a child wandering off and the firefighter actually trying to hold them and the kid just runs across the street back toward the building.”

POAC has also provided many trainings for both parents and professionals about sexual education for individuals with autism. Gary describes sexual abuse as a major problem for individuals with developmental disabilities that people are afraid to address.

“Unfortunately, the sexual abuse rate with our guys to sexual predators is through the roof. The numbers for females are, close to 70% of females with autism were sexually assaulted by predators. Seventy percent. Seven out of ten of our girls are sexually assaulted before age 18. And the number’s around 40% for males. And I go into why that is, they’re the perfect victim. They don’t understand intent, they don’t understand the social rules.”

“You have to start sexual education with our guys in preschool,” Gary said. “That shocks people when I say that, but Sex Ed in preschool is, ‘What a bathing suit covers no one’s allowed to touch.’ That’s Sex Ed in preschool. So it’s not as scary as people think. But you know when most Sex Ed is taught to individuals with developmental disabilities? After something happens. After someone gets assaulted or after someone masturbated in class or someone touched someone inappropriately. You know, we better do something! No, they’re fifteen! Start early.”

“A big problem for parents of children with autism, and I say this as a parent of a child with autism, is that you’re thinking it’s not your kid. Parents on the lower end of the scale always think, ‘Nothing’s ever going to happen to my child because somebody’s always with them—it’s them kids with Asperger’s who are running willy-nilly off by themselves all the time—those are the ones getting into trouble.’ And then right across the room, the parents with the higher functioning kids think, ‘Well nothing’s ever going to happen to my son because my son tells me everything, it’s those low-functioning kids who can’t speak that everything’s happening to.’ But, it’s happening to all of our kids equally, wherever they fall on the spectrum, and the problem is the parents always think ‘Well, not my kid, it’s somebody else’s.’  No, you’ve got to think, this definitely could be my child so what do I have to do to increase his safety?”

POAC continues to provide free workshops and resources to residents in New Jersey. And Gary will continue with that effort for a long time yet. “I always joke that the Irish in me wants stuff to be meat and potatoes. I want it to be real. I want it to be real for the families. I want it to be real for the officers. Any one of our trainings, I want the person to walk away with something that they can use that day to make a child safer.”

TipsForParents_4.16.14

If this story has touched you or you feel you can use it, Gary asks that you please consider making a tax-deductible donation to POAC.

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Our Autism Journey: One Family’s Story

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April is Autism Awareness Month.  We couldn’t think of a more appropriate way to kick things off than by sharing the personal story of someone who inspires and motivates us: Debora Thivierge.  Deb is now a BCaBA, executive director and founder of The Elija Foundation.  But most importantly, she is Jason’s mom.  Her story about her journey and the steps she has taken to not only help her son but support parents and families all over is a real inspiration to all of us in the autism community.  We’re so very proud to share this exclusive article by Deb and hope it resonates with all of you who love someone on the spectrum.

Our Autism Journey

by Debora Thivierge, BCaBA


When my son Jason was diagnosed with autism at twenty months old, I was lucky enough to discover the book “Let Me Hear Your Voice” by Catherine Maurice. Her story became a beacon of hope for me; a light through the early darkness of Jason’s diagnosis. She inspired me and set me on a path to help my son, myself, my family and others on this autism journey.

Hope was a critical component of my family’s survival. The word hope is defined as “the emotional state which promotes the belief in a positive outcome related to events and circumstances in one’s life.” The opposite of hope is despair. I was determined that despair would not define my emotional state, as it would most certainly lead to detrimental outcomes for Jason.

Not only did Dr. Maurice’s personal story give me the hope I needed, but it also gave me scaffolding upon which to build my son’s treatment plan. After reading the book, I realized that there could and would be significant progress if I utilized applied behavior analysis (ABA) as my main course of treatment.

In 2002, my goal as a parent was to educate myself about autism. The more I learned, the more I recognized the need to educate other parents facing the challenges of autism. I decided to start a foundation that would provide information and resources to families and professionals on Long Island focusing on ABA and its efficacy for children with autism.

I decided to name the foundation ELIJA, an acronym for “Empowering Long Island’s Journey through Autism.” ELIJA’s mission is to bring top experts in the field of autism/applied behavior analysis here to Long Island, to give workshops and presentations where they can share their knowledge of current research and treatments, and to help families and professionals advance their skills in implementing ABA programs.

Having these presenters come from all over the country gives parents, professionals and caregivers direct access to information that they might not otherwise have access to. It also gives them the ability to become fluent in the many different tools and techniques of ABA and how to work with their children on a day-to-day basis. Over the past eleven years, the workshops have educated, inspired and instilled hope in thousands of people, including myself. It was and still is so important to me to help parents understand that their role as educator is one of the most crucial components in research outcome data.

I quickly discovered that parents were desperate for information and this kind of support. Having the ELIJA Foundation as a resource gave them an opportunity they wouldn’t have had otherwise – to obtain information directly from autism professionals actively involved in research and education.

The workshops gave parents and professionals the opportunity to network with each other informally. The setting was comfortable and inviting. We would provide lunch, so that participants could focus on meeting, talking, sharing information and experiences and, most importantly, creating lasting connections.

Parents of children with autism often feel extremely isolated, from family and friends who may not understand autism and the challenges they are facing, and from the community at large. ELIJA’s workshops gave opportunities for families to feel connected, to feel not so alone and to find shared interests with other families. When professionals, families and educators feel connected, they tend to be more effective in their implementation of plans and advocacy for the children they work with. These connections bring some measure of relief to parents, who are often exhausted due to lack of feedback and support in the community and in educational settings.

In retrospect, I look back and wonder where Jason would be today, had I not done all this intensive instructional training, and kept on top of his curriculum, especially the goals and the skills that we were teaching him. I knew his long-term outcome would be affected by our choices of what to teach him, and what not to teach him. These choices were sometimes challenging, but I was able to look at the data tables to determine that his biggest deficit was language.

I learned to change my expectations, and give and take in terms of Jason’s progress. I accepted the fact that he may never write neatly or clearly, or be able to complete a 500 piece puzzle or climb a jungle gym or run a marathon. That’s okay. Twelve years after Jason’s diagnosis, he still has autism, but I can’t even imagine where he would be today without our hope, determination, and the intensive interventions we have painstakingly implemented. Our family’s journey through autism continues.

Debora Thivierge, BCaBA, received her BA in Sociology from Hofstra University and is a Board Certified Assistant Behavior Analyst. She serves as the Executive Director and Founder of The ELIJA School and Founder of The ELIJA Foundation. Debora has volunteered her time to numerous Autism groups such as Nassau County’s Department of Health Early Intervention Coordinating Council, New York State Association of Behavior Analysis, Nassau County Autism Coalition run by the County Executive and currently serves as a board member of The Behavior Analyst Certification Board® (BACB®). For the past 13 years, she has been providing advocacy to families and conducted training workshops to promote evidence based instruction for families and educators who have been touched by Autism. She has a 15-year-old son with Autism.
 
Contact
ELIJA
11 Laurel Lane
Levittown NY 11756
(516) 216-5270
www.elija.org 
deb@elija.org

Helpful Holiday Tips for Children with Autism Spectrum Disorders

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Kelly McKinnon, co-author of the invaluable book Social Skills Solutions, put this helpful post together for the Children’s Hospital of Orange County. Kelly is currently the Director of Behavior Intervention at The Center for Autism & Neurodevelopmental Disorders in Santa Ana, California.

Helpful Holiday Tips for Children with Autism Spectrum Disorders

The holiday season is a joyful time of the year, but it also can be stressful for kids with autism spectrum disorders (ASD). Preparing and planning early for the holidays can help you relieve some of the holiday stress. Here are a few helpful tips.

Provide concrete information for your child
• Provide a visual schedule of each day’s expectations. Include start times and end times.
• Use your smart phone or iPad when possible to find free apps including visual timers, “First This Then This” schedules, and personalized “social stories.”
• Explain what is both expected of your child and not expected.
• Provide opportunities to reward your child for expected behavior.

Provide information visually
• Take pictures of relatives and friends you will visit, and practice names.
• Video modeling is considered an evidenced-based way to teach your child. Take videos of how to unwrap a gift the right way, thank a family member, or greet new people. Role play with your child and practice ahead of time.
• Use pictures to help your child communicate or make choices of what they would like to have or say.

Reduce anxiety
• Compile a list of activities that can help your child fill his or her time wherever you go.
• Use rehearsal and role play to give children practice ahead of time in dealing with new social situations, or work together to write a “social story” that incorporates all the elements of an upcoming event or visit to better prepare them for that situation.
• If you are going to visit family or friends, make sure there is a quiet, calm place for retreat.
• Try to relax and have a good time. If you are tense, your child may sense that something isn’t right.
• Don’t shield your child from the extended family. Family members need to understand the challenges you face.

Introducing a New Support for the Child with Autism: The Acoustical Support

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This week, we bring you a guest post from Martha Gabler. She’s going to share her experience with using an acoustical support to mark desired behaviors known as Teaching with Acoustical Guidance (TAGteach). The sound made by the acoustical marker (the click or ping) is sometimes referred to as a “tag.” TAGteach is based on the scientific principles of Applied Behavior Analysis and uses positive reinforcement and reinforcement schedules to build functional behaviors.

Hello. My name is Martha Gabler and I am the parent of a nonverbal teenage boy with autism. The purpose of this article is to introduce you to another type of support for children with autism that is coming into practice, and to ask you to consider it. There are many “supports” available nowadays for children with special needs. Most people are familiar with the adaptive equipment for children with physical disabilities: special chairs, grips, work platforms. In the autism community, most people are familiar with visual supports: picture systems, schedules, token boards, and so forth. These visual supports play a crucial role in educating children with autism and have proven to be extremely useful in both home and school settings.

Introducing Acoustical Support

Box ClickersI would like to introduce you to another type of support: the “acoustical” support. An acoustical support is a neutral sound: a tap, click or ping. The acoustical support plays a crucial role in delivering positive reinforcement to a learner. The purpose of the sound is to inform a learner that he has done something right. The sound says, “YES, you did it.” The instructor, therapist or parent makes the sound at the exact moment that the child has performed a desired behavior. This behavior may be pointing to a picture of a cat, putting a puzzle piece into place, or, one of those rare beautiful flashes of meaningful eye contact or comprehension. As soon as the child has performed the task and the instructor has produced the sound, the child receives a treat (reinforcer). After a few trials, the neutral sound becomes a “conditioned reinforcer.”

Why is the Conditioned Reinforcer Important?

“A conditioned reinforcer is some initially meaningless signal—a sound, a light, a motion—that is deliberately presented before or during the delivery of a reinforcer,” explains behavior scientist, Karen Pryor. After a few experiences of hearing the sound and receiving a treat (reinforcer), the sound itself becomes meaningful for the child, and he starts to watch out for it. After the child is paying attention to the sound, he starts to pay attention to the behaviors that produced the sound. When he realizes that his own behaviors are producing the sound and the reinforcer, he learns to produce those desired behaviors more often. At that point, you have learning and communication. This use of a sound to signal success to the learner is called Teaching with Acoustical Guidance or TAGteach.

As a parent, when I started using a neutral sound (a click) to indicate to my son which behaviors of his would earn treats, he started doing more of those behaviors. My son was loud, chaotic and wild in the early years. He had self-stimulatory and aggressive behaviors. With my conditioned reinforcer (sometimes referred to as an “event marker” or a “tag”), I was able to tag my child every time he did something good. “Good” things were behaviors like Quiet Mouth, Both Feet On The Floor, Hands Still, or Eye Contact. The procedure is: Observe child, press clicker (tag) when child performs the desired behavior, then reinforce child (give a treat or token).

Tantrum Busting

The first time I ever used TAGteach (acoustical support), my son had just erupted into a tantrum, complete with shrieking, stomping and storming about. I tagged every split second that he had “Quiet Mouth” or “Both Feet On The Ground, and handed him a tiny piece of candy with each click. Twelve minutes later he was sitting quietly and calmly on the sofa, and we were able to go about our day. It was an incredibly empowering experience for me, compared to all the previous tantrums when I always felt panicky, demoralized and helpless. I never feared a tantrum or meltdown again because I had a powerful tool to help him calm down.

My Son Became More Skilled and Happier the More I Tagged

The more I communicated with my son via tags and positive reinforcement, the more skills he gained and the happier and better behaved he became. Despite the lack of speech, despite the sensory issues, the click rang loud and clear and told him he had done something good. He loved it and responded beautifully. He had many difficult behaviors, but I was able to tag a split second of a good behavior whenever it occurred, with the result that the split second became two seconds, then three seconds, then four seconds of the desired behavior, plus it occurred more often. Gradually I was able to “shape” disruptive behaviors into positive learning behaviors, and he gained many useful skills.

The Tag is Clear and Precise with No Emotional Baggage

The reason the tag (conditioned reinforcer) works so well is because of the precise information it provides to the child. It tells the child, in real time, exactly what he did that was right, at exactly the moment he did it. From the viewpoint of a child with autism, he receives precise, timely information from a neutral sound; there is no emotional burden, language processing or sensory issue to deal with. Thus the child is free to focus on the priceless information he is receiving: the wonderful knowledge that he has done something right.

The Time has Come for TAGteach

The time has come for the use of acoustical supports in the autism community. There are many reasons: this methodology is based on the scientific principles of Applied Behavior Analysis; it is effective, easy to learn, easy to do and low cost. It is flexible, portable and wonderful for teaching in the natural environment. It is an invaluable tool for weary, dispirited parents, and for over-burdened instructors in the classroom.

Thank you for reading to the end of this article! In the beginning of the article I asked you to consider this method. I hope you are now interested in learning more about using acoustical supports for a child with autism. There are links below with more information. If you have questions, please contact me via the website below. Best wishes to you all.

Martha Gabler and her husband are the parents of two sons. When the younger son turned three, autism entered their lives. The method described above, using an acoustical support to mark desired behaviors, is known as Teaching with Acoustical Guidance (TAGteach). The sound made by the acoustical marker (the click or ping) is sometimes referred to as a “tag.” TAGteach is based on the scientific principles of Applied Behavior Analysis and uses positive reinforcement and reinforcement schedules to build functional behaviors. Martha’s book describing how she used TAGteach with her son is entitled Chaos to Calm: Discovering Solutions to the Everyday Problems of Living with Autism.

For more information about using acoustical supports with autism, see www.autismchaostocalm.com.

For more information about Teaching with Acoustical Guidance, see www.tagteach.com.