Tip of the Week: Minimize Tantrums with High and Low-Quality Attention

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Recently I began working with a family who has a six year old boy with autism named Austin (all names and identifying details have been changed to protect confidentiality). His mother was describing Austin’s behaviors when he couldn’t have something he wanted. She told me about him hitting his parents and younger brother, sweeping all materials off tables and shelves, and throwing himself on the floor. She was worried that he might hurt himself or hurt someone else. She told me that when he started this behavior, they would say, “Stop hitting.” They had been doing this for months, but his behavior had not improved.

Later that week, she sent me a video of Austin having one of his “mega-tantrums.” It was exactly as she described, though there was one important detail she had missed. Austin consistently sought out eye contact and physical contact with both of his parents. If they were moving around to pick up an item, he would move his body and face to maintain eye contact. If one of them sat down, he would quickly clamber into their lap while screaming and pounding their arms or the furniture. If one parent walked out of the room, he would immediately run to the other parent. This behavior was clearly maintained by attention. In order to decrease the behavior, his parents had the very difficult task of ignoring it ahead of them.

The next week I went out to their house to help them practice ignoring the behavior. We put in place a three-pronged plan:

  • When Austin wanted something he was not allowed to have, he would be given a choice of options. The options should be for preferred activities. For example, if he wants to watch TV but isn’t allowed to right now, the parent can say, “Austin, you can play with trains or you can do a puzzle.”
  • Once Austin starts hitting or screaming, he does not receive any attention. This includes eye contact, physical contact, and verbal prompts/reminders from his parents.
  • The parents can start one of the motivating activities in another location. For this family, the parents sat with the younger brother at the dining room table and the mother read a book out loud.

As I had forewarned the parents, Austin’s behavior initially intensified as he realized he was getting zero attention. He took a box of toys, turned it upside down, and dumped it all over the floor. His mother kept reading to his brother. He ran over to his father and hit his legs while screaming, the father got up and walked away. Then, Austin did something he had never done before. He climbed up onto the table and started walking around on the edge of it.

His mother looked at me and said, “How do I avoid giving him attention for that?” This is when it’s important to consider high-quality attention and low-quality attention. In order to keep him safe, his mother needed to be more proximal. She walked near where he was on the table, but did not pick him up, did not make eye contact, and did not speak to him. (I let her know that if she felt he was very unsafe, she could pick him up and remove him from the table but quickly letting him go, and withholding eye contact and verbal interaction.) She stayed nearby to catch him if he fell, but she did not provide attention for this dangerous behavior. Her proximity (or if she had chosen to pick him up off the table without eye contact or verbal interaction) constitutes low-quality attention. High-quality attention is only saved for appropriate behavior.

Think about what high-quality attention means for a young child: big facial expressions, expressive tones of voice, big movements, and physical contact. Prior to our intervention, Austin was getting all of those types of high-quality attention for inappropriate behaviors. But now he wasn’t getting any of that type of attention.

However, Austin had been engaging in inappropriate behaviors for attention for 2-3 years now, so changing this behavior takes a little time. For our first day of the intervention, Austin continued to yell and throw items for 40 minutes before he finally went over to where his mom was sitting and reading aloud the story (actually, the third story in a row). When he was near and quiet, his mom started reading in a wonderfully expressive tone, adding voices to the characters. Austin came closer. When a funny part of the story happened, Austin laughed. And then Austin’s mother encouraged him and his brother to imitate the characters in another part of the story. After he imitated the characters, he sat next to his mom and she put her arm around him. All of these high-quality forms of attention were now being given for appropriate interaction.

Sometimes you have to provide some attention in order to keep a child safe, but think to yourself what is high-quality attention for your learner: it may be tickles, silly faces, expressive speaking, or physical contact. Reserve those things for appropriate behaviors.

A few final notes about this intervention: (1) Austin’s inappropriate behaviors will probably still continue for a little bit longer. I’m certain that he will test it out a few more times, and his parents will have to stick to the intervention in order to completely get rid of what they had deemed as “mega-tantrums”; (2) This intervention only works for behaviors maintained by attention. If you’re uncertain about the function of a behavior, confer with a BCBA or an ABA provider for help; and (3) If you’re not certain you can follow through if the behavior persists for a long time (such as 40 minutes in Austin’s case) then give in the first time the learner asks. For more information on this, look back at my tip on Choosing When to Battle.

Pick of the Week: Sensible Pencil

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Save 15%* this week on Sensible Pencil, an easy-to-use handwriting program for both parents and professionals to use with their learners. Children learn to print upper- and lowercase letters and numbers, using eleven basic lines. Use our promo code PENCIL3 this week only to redeem your savings on the Sensible Pencil handwriting workbook.

Designed to help new writers achieve success quickly, this carefully structured program contains sequential worksheets that move ahead in short easy to achieve steps. The child can start with simple horizontal and vertical lines that are presented as fun, and then moves on to the other basic lines needed for handwriting skills. Sensible Pencil includes 200 worksheets, a progress chart, and a manual. Worksheets can also be copied so children can master the tasks at their own pace.

Don’t forget to apply our promo code PENCIL3 at checkout to save 15%* on your copy of Sensible Pencil this week only!

*Offer is valid until 11:59pm EDT on August 5, 2014. Not compatible with any other offers. Be sure there are no spaces or dashes in your code at check out!

Simplifying the Science: Are You Giving Your Student Enough Freedom?

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One of my favorite research papers was published in the Journal of Applied Behavior Analysis in 1990 by Diane J. Bannerman, Jan B. Sheldon, James A. Sherman, and Alan E. Harchik. The title is Balancing the Right to Habilitation with the Right to Personal Liberties: The Rights of People with Developmental Disabilities to Eat Too Many Doughnuts and Take a Nap. It’s an in-depth look at the level of control practitioners can exert over the individuals they serve, and the implications of that control.

It’s important to consider the ethical implications of requiring the individuals we work with to complete specified exercises at scheduled times, eat a healthy diet for all meals, and limit TV. I have seen situations in which the practitioner is holding the individual with developmental disabilities to a higher standard than they hold themselves! Most of you reading this can probably quickly rattle off the name of the last TV show you “binge-watched” or the delicious ice cream you enjoyed too much of.

So how do we teach making appropriate choices to individuals with developmental disabilities without denying the personal freedoms we all value?

One quote from the paper states, “Not only do people strive for freedom in a broad sense they also enjoy making simple choices, such as whether to engage in unproductive, though harmless, activities, like watching sitcoms on television, eating too many doughnuts, taking time off from work, or taking a nap before dinner.” In an effort to teach our learners independent skills, we often neglect to teach meaningful decision-making that reflects the types of decisions neurotypical adults make every day. Since the paper was originally published, there has been more work done on promoting decision-making skills for learners with developmental disabilities, but the issues described in the paper are still relevant today.

Here are a few key considerations described:

  • We need to consider client preference when creating daily schedules, goals, and access to preferred activities.
  • A client’s refusal to participate in an activity may not be a failure to teach appropriately but an expression of preference.
  • It is important for practitioners to teach choice-making. The paper states, “Many people require teaching to help them discover their own preferences and learn to make responsible choices.” We should consider this as an essential step towards promoting independence in our clients.
  • Inflexible schedules for clients can sometimes be obstacles to opportunities for choice-making.

The paper goes on to cite multiple research articles and laws for both sides of the argument about the right to choice for those with developmental disabilities. You can read the full text here.  Overall, I consider this article to be essential reading for anyone working with clients with disabilities. It provides a lot of information to support its final conclusion that “all people have the right to eat too many doughnuts and take a nap” and we have the responsibility to teach clients how to exercise such freedoms.

WRITTEN BY SAM BLANCO, msed, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals.

Pick of the Week: Following Auditory Directions—Improve Auditory Processing of Visual & Spatial Information

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Improve auditory attention, processing, and memory of visual and spatial information with Following Auditory Directions by SLP Jean Gilliam DeGaetano, and save 15%* on it when you apply our promo code FAD15 at checkout!

With 33 different cartoon illustrations and accompanying instructor directions, this unit will help your students stay engaged and attentive, as they listen carefully and translate auditory directions onto their picture pages. Each instructor’s page also has directions so that parents may review lessons at home as needed. Example directions include: Circle the picture that shows Fido in front of the front door; Find the picture where Fido is in front of the dog house, and color Fido brown; and Put dots on the hippopotamus that has painted toenails and is wearing a bow.

Spatial concepts include: front, top, in, on, behind, next to, close to, long, short, most, different, none, almost, beginning, end, few, dirty, clean, inside, under, near, tall, medium, between, middle, over, center, closed and open.

Don’t forget! You can take 15% off* your order of Following Auditory Directions this week only when you mention or enter promo code FAD15 at checkout!

*Offer is valid until 11:59pm EDT on July 29, 2014. Not compatible with any other offers. Be sure there are no spaces or dashes in your code at check out!

Tip of the Week: 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.

Pick of the Week: I Can Do That! – Learn prepositions and self-awareness with a Dr. Seuss classic!

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Practice motor skills, learn prepositions, and develop self-confidence with the award-winning Cat in the Hat I Can Do That! Game. This week only, save 15%* on your order of the I Can Do That! Game by entering or mentioning promo code CATHAT4 at check-out!

This wacky, fun-filled game will have young players moving all about as the Cat in the Hat comes to play. Flip over three cards to create a new challenge. Can you slide under the Trick-a-ma-stick with the toy boat on your head, or jump up and down with the cake between your elbows? Players will have a blast as they practice early reading skills and develop motor skills, understanding of prepositions, and self-confidence.

The game comes with: 1 Trick-a-ma-stick, 9 game pieces of objects straight from the Cat in the Hat story (e.g. cake, fish, boat, ball, book, gown, fan, toy man, rake), 1 sand timer, 33 game cards, and 1 manual.

Remember to redeem your 15% savings* on the Cat in the Hat I Can Do That! Game this week by using promo code CATHAT4 at check-out!

*Offer is valid until 11:59pm EDT on July 22, 2014. Not compatible with any other offers. Be sure there are no spaces or dashes in your code at check out!

Tip of the Week: Teaching Language—Focus on the Stage, Not the Age

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Teaching language skills is one of the most frequent needs for children with autism, but also one of the most misunderstood skillsets amongst both parents and practitioners. The desire to hear your learner speak in full sentences can be overwhelming, making it especially difficult to take a step back and consider what it means to communicate and how communication skills develop in neurotypical children. Many times we get hung up on what a child should be capable of communicating at a certain age, rather than focusing on what they are capable of communicating at this stage of development.

Many practitioners and curricula utilize Brown’s Stages of Language Development.* Brown described the first five stages of language development in terms of the child’s “mean length of utterance” (or MLU) as well as the structure of their utterances.


From aacinstitute.org

Sometimes it is necessary to compare a child to his or her same-age peers in order to receive services or measure progress, but it can be detrimental to focus on what a child should be doing at a specific age instead of supporting them and reinforcing them for progress within their current stage.

Research has suggested that teaching beyond the child’s current stage results in errors, lack of comprehension, and difficulty with retention. Here are some common errors you may have witnessed:

  • The child learns the phrase “I want _____ please.” This phrase is fine for “I want juice, please” or “I want Brobee, please,” but it loses meaning when overgeneralized to “I want jump, please” or “I want play, please.” It’s better to allow your learner to acquire hundreds of 1-2 word mands (or requests) before expecting them to speak in simple noun+verb mands.
  • The child learns to imitate only when the word “say” is used. Then the child makes statements such as “say how are you today,” as a greeting or “say I’m sorry,” when they bump into someone accidentally. Here, the child clearly has some understanding of when the phrases should be used without understanding the meanings of the individual words within each phrase.
  • The child learns easily overgeneralized words such as “more.” This is useful at times, but the child can start using it for everything. Instead of saying “cookie” he’ll say “more.” Instead of saying “train,” he’ll say “more.” And he may say “more” when the desired item is not present, leaving the caregiver frustrated as he/she tries to guess what the child is requesting. Moreover, as language begins to develop, he may misuse it by saying things such as “more up, please.”
  • The child learns to say “Hello, how are you today?” upon seeing a person entering a room. A child comes into the classroom and the learner looks up, says “Hello, how are you today?” The child responds, “Great! Look at the cool sticker I got!” Your learner then doesn’t respond at all, or may say “fine,” as he has practiced conversations of greeting.

These are only a few of the common language errors you may see. While you may want your learner to speak in longer sentences, your goal should be to have them communicate effectively. With this goal in mind, it becomes essential to support them at their current stage, which means it’s essential to assess them and understand how to help them make progress.

This is why I always use the VB-MAPP to assess each child and make decisions about language instruction. I need to have a full understanding of how the learner is using language, and then move them through each stage in a clear progression. I may want the child to say “Hello, how are you today?” But when I teach them that, do they understand those individual words? Do they comprehend what today means as opposed to yesterday or tomorrow? Do they generalize the use of “how” to other questions?

As you make treatment decisions for your learner, think about their current stage and talk about how to support your child with both a Speech Language Pathologist and an ABA therapist.

*Brown, R. (1973). A first language: The early stages. London: George Allen & Unwin Ltd.

WRITTEN BY SAM BLANCO, MSEd, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals.

Pick of the Week: Auditory Timer – ONLY $5 This Week!

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DRT207Keep your student on schedule with our popular Auditory Timer, and get yours for $7.95 only $5 this week (37% savings)! Enter promo code TIMER5 to redeem your savings at check out!

Our versatile white Auditory Timer can count both forwards and backwards, up to 99 minutes. The timer also counts seconds, and beeps when time has elapsed. You can also set it to go off in increments, such as every 5 minutes, with the simple push of one button. Press “START/STOP” to begin or stop timing. Then press both the “MIN” and “SEC” buttons simultaneously to reset the time. The personal timer also has a magnetized clip on the back so that it can be attached to pockets, belts, or the refrigerator. Only 1 AAA battery required.

Don’t forget—you can get your Auditory Timer for only $5 this week (37% savings) by using promo code TIMER5 at check out!

*Offer is valid until 11:59pm EDT on July 15, 2014. Not compatible with any other offers. Be sure there are no spaces or dashes in your code at check out!

Happy Fourth of July!

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Happy 4th of July!

The Fourth of July is a time of celebration for families and friends to enjoy the summer with barbecues, fireworks, and patriotic music. We hope that you will be enjoying the long weekend this year with your loved ones, whether you will be staying at home or going away.

The displays of fireworks are beautiful and inspiring. But we know that these displays do not always bring smiles and wonder to children with autism. Here are a few helpful tips we found by ABPathfinder on making your Fourth of July evening more enjoyable for you and your children:

Prepare your child. If they’re old enough to understand, tell them about the fireworks. Let them understand what will happen and emphasize that it is a safe, fun way to see some beautiful displays.

Let them in on the planning. Let the child take part in the planning. Have a picnic, determine what you’ll bring, where you’ll go. Try to provide a set time for each activity, including bringing a timer. If the child is enjoying the display, you can always turn the timer off. If the child is not enjoying the display, you can help them refocus by telling them “Look. Just 3 more minutes on the timer!”

Show them videos of displays. Help the child prepare for what they’ll see by watching videos of past firework celebrations. There are some great sources on YouTube, and it will allow the child to see the beauty of the fireworks while still in their controlled setting.

Fingerpaint some fireworks. Let the child explore the beauty of the fireworks by helping them fingerpaint their own display. Use black construction paper for the night sky and colorful paint for the exploding colors!

Provide ear plugs. Obviously, if your child has auditory sensitivity, you’ve already got this covered. But the report from some of today’s fireworks can be overwhelming. Be prepared up front for it.

View displays from a distance. There’s no reason you have to be right under the displays. Most fireworks displays are better viewed from a distance. Find out what displays are occurring in your town, then scope out some parks or parking lots where you can get a good view of the event.

Provide comfort items. Taking along a favorite blanket or teddy bear can be just the thing the child needs to keep calm. Simply holding it can provide the child with comfort and control over their environment.

Let them explore child-safe fireworks. There are a number of child-safe fireworks available that can give your child an opportunity to participate in the fun. Champagne poppers and snaps are a good way for your child to join in. Be careful with sparklers and smoke bombs, in case your child has an urge to grab the flames.

Join another special needs peer. Joining with another special needs family can also be helpful. Not only does it give your child someone to play with, but it also provides your child with a peer that can model appropriate behavior for the celebration.

Have fun. Last but not least, be sure to have fun. Showing you child that you’re not worried can be the first indicator on how they should react. Hopefully, they’ll join you in the fun!

The Fourth of July can be one of the most challenging holidays for families with Autism, but we hope that these tips can make it a fun, safe event for the whole family.

Modified Instructions for Laundry Jumble Game

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We’re excited to bring you the fifth installment of our series of Modified Instructions, created by Sam Blanco, BCBA. In this installment, we’re introducing Sam’s Modified Instructions for Laundry Jumble Game, one of our favorite matching and sorting games. Laundry Jumble is an adorable matching and sorting game that also develops tactile and fine motor skills.

Beautifully illustrated cards display various animals that tell users which article of clothing they need to find. Reach into the dryer to find the piece of clothing that matches the card using only your sense of touch. Make a match and you can keep your card. Watch out for the Skunk’s undies, though! Draw that and you lose a card. This is a fun and engaging game that encourages tactile exploration and fine motor skills with laughter.

Included in the game are 11 pieces of washable doll–size clothing, 30 game cards featuring full–color illustrations, and a fabric dryer measuring 8″L x 6.5″W x 10″H. Don’t forget to download our free Modified Instructions for Laundry Jumble Game today!

Sam’s Modified Instructions present 3-4 additional ways to play a mainstream game to make it most useful and accessible for our students with special needs.  These alternative instructions break down each adapted game by:

  • Age/Skill Level
  • Number of Players
  • Object
  • Skills Required
  • Materials Needed
  • Prep
  • Instructions
  • Considerations