Tag Archives: autism spectrum

Can the principles of ABA be used to toilet train a child with an autism spectrum disorder?

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This month’s ASAT feature comes to us from Dr. Frank Cicero, Ph.D., BCBA, LBA. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

Here is the good news…children with autism can be toilet trained through the exact same methods that are used with typically-developing children. And what are these methods? Applied behavior analysis! If you have ever toilet trained a typically-developing child, you probably used a combination of praise and rewards for going on the toilet, explaining your expectations, removing the child‘s diaper, prompting to the toilet on some type of schedule, rushing him or her to the toilet when they seemed like they needed to go, and teaching how to notify you that he or she needs to use the bathroom. You might or might not have added in some form of punishment or verbal reprimand for accidents. Well…here is my advice for toilet training a child on the spectrum…use exactly the strategies that I just described.

So then, why does it seem so much more difficult? One of the biggest obstacles is simply getting started. Because parents think that toilet training will be very difficult, and something so different than anything else they have taught their child in the past, they delay training. Toilet training for a girl typically is recommended to begin at around two years of age. For a boy it is a little later (about two and a half). When it comes to a child with a developmental disability it is difficult to use these age guidelines. Instead, a child is ready to begin training when they can hold urine in the bladder for at least 1 hour, can remain seated on a toilet for at least three minutes, have an awareness of the relationship between following instructions and getting rewarded, and do not have significantly interfering problem behavior. Another challenge with toilet training a child on the spectrum is the absolute need for consistency and intensity of training once you begin. The more intense you implement a plan, the quicker you will see results. For the most intense procedure, I recommended toilet training for at least 6-8 hours per day. I also usually implement the training directly in a bathroom with the child wearing the least amount of clothing possible (usually underwear, shirt and socks). In this way, he or she can easily get to the toilet when needed and also you, as the trainer, can easily and quickly see when they are beginning to have an accident.

Toilet training consists of four main components: prompting to the toilet on a schedule, rewarding success, teaching how to request, and quickly prompting to the toilet at the start of an accident. For the schedule, I usually recommend starting with 30 minutes. The child sits on the toilet and tries to urinate for 1 minute. If the child is successful, immediately provide him/her with a very powerful reward with verbal praise. If the child is not successful, simply prompt him/her to try again in 30 minutes. In order to teach requests, prompt the child to request the bathroom each time you are about to prompt him/her to the toilet. You can use whatever communication system (i.e., verbal speech, picture exchange, signs, etc.) your child is used to and does best with.

Now, what to do with the accidents? Accidents in toilet training are a good thing. In fact, without accidents, you will only be reinforcing prompted trips to the toilet, thereby resulting in a child that is schedule trained instead of independent. You have two choices here, prompting/reinforcement or punishment. I usually recommend the first choice, prompting/reinforcement instead of punishment, at least in the beginning of training. Try encouraging a lot of drinking during training hours. Within the first second of the child having an accident, produce a loud verbal startle such as “HURRY, HURRY, HURRY.” This is not a reprimand but should be stated in a very loud, surprising, urgent tone of voice. The idea is to temporarily produce a startle response in the child so that urination is reflexively held for a brief moment. In that moment, you physically prompt the child to the toilet, where you instruct him or her (now in a very calm voice) to continue their urination. If they continue (which is likely), you reward the behavior with a reward and verbal praise. In this way, you turned an accident into a positive teachable moment. Continue with these strategies until the child begins to show fewer accidents, goes more on the schedule and begins to independently request. Throughout training it is very important to collect data on accidents and successes, so that you can make data-based decisions along the way. Fade the intensity of the schedule, fade out of the bathroom and ultimately fade the tangible rewards. With this intensive treatment program, I have seen complete training in as little as 1 week; however do not get discouraged if your child takes longer. What about training for bowel movements? Good news….you often get bowel training along with urination training without doing any additional procedures. Bad news…this is not always the case. When a child is trained for urination, but continues to have bowel accidents, you need to figure out the reason behind the problem before you can treat it. Is it simply a lack of knowledge? An ingrained ritual or routine? Noncompliance? A medical problem such as constipation? The nature of the accidents will guide your treatment. Very briefly, if the problem is a lack of knowledge, a reinforcement / punishment procedure should work. This procedure is similar to the procedure that I described for urination training, except that it is rarely implemented for 6-8 hours per day. Instead, you bowel train only when the child is likely to need to have a bowel movement. If the problem is more consistent with a ritual or noncompliance, you need a traditional behavior plan more than a toilet training intervention. And finally, if the problem is medical in nature, follow the recommendations of a physician or dietician.

Please use the following format to cite this article:

Cicero, F. (2009). Clinical corner: Toilet training. Science in Autism Treatment, 6(1), 3-4.

About The Author

Dr. Frank Cicero, Ph.D., BCBA, LBA is a New York State licensed psychologist, licensed behavior analyst and board certified behavior analyst with over 20 experience working in the fields of applied behavior analysis and autism spectrum disorders. He received his master’s degree in school psychology from St. John’s University and his doctoral degree in educational psychology from the City University of New York Graduate Center. Dr. Cicero is currently an assistant professor and aba program director for Seton Hall University, New Jersey. Prior to this position, he served as the Director of Psychological Services for the Eden II Programs, an applied behavior analysis agency in the New York City area serving children and adults on the autism spectrum. Dr. Cicero continues a private practice for child/adolescent psychology and aba as well as conducts program consultations in best practice treatment for autism, developmental disabilities and problem behavior. Dr. Cicero frequently conducts workshops and trainings nationally on a variety of topics within his fields of expertise. He also has several publications including peer reviewed articles, book chapters and a training book titled “Toilet Training Success.”

Build and Generalize: Strategies for Systematic Language Instruction

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This week’s blog comes to us from Rosemarie Griffin, MA, CCC/SLP BCBA, creator of the Action Builder Cards! Head to our site to check out some of Rosemarie’s favorite supports for language instruction! 

 

Helping students with autism and other communication disorders increase their expressive language skills can be overwhelming. It can be difficult to know what targets are the most important to start with. Every situation is so very individualized but following a general framework has made these decisions easier for me and has helped my students make progress in this area.

If we were to focus on the skill of labeling, for example, I would start with labeling items, people or places that are preferred for the student. If you have a student who really loves bubbles, chips and basketball – these would make wonderful first targets. Working on labeling can be difficult for students, so we want to make sure we make the programming fun and engaging. We should also include a plan for generalization at the start of this programming. Showing the student multiple pictures of bubbles, chips and basketball will allow for us to plan for the generalization of materials. This helps to build a bridge between the therapy environment and novel exemplars they may see in the natural environment.

When we start to work on labeling actions, the same framework can be implemented. Starting with preferred actions when available is a great idea. If the student is more motivated by the action or seeing the action, this may help to keep the student engaged in the task of labeling. We could choose targets that are related to the nouns chosen above: blowing, eating and playing. If the student enjoys these actions we could work on engaging in these actions and labeling them as they take place in real time, or we could show them pictures of these actions taking place.

When a student is able to label a variety of nouns and actions, it is time to combine these into action object or agent action phrases. To keep language instruction systematic, we start by combining previously mastered nouns and actions. Using the example from before, we would show the student pictures of the above action and nouns combined: blowing bubbles, eating chips and playing basketball. After the student has worked on creating these phrases with his/her words, pictures or device we can work on multiple exemplars to help plan for generalization. These could include blowing candles, blowing a kiss, eating pizza, eating an apple, playing soccer, playing tennis, etc.

Using a framework can help us plan for systematic language instruction for learners. This framework can help our learners have fun while learning, increase their expressive language, and help them generalize skills along the way.

About the Author

Rosemarie Griffin, MA, CCC/SLP BCBA, is an ASHA certified Speech-Language Pathologist and a Board Certified Behavior Analyst. She divides her time between a public school and a private school for students with autism in Ohio. She’s presented at the national, state and local level about systematic and collaborative language instruction for students with autism. Her professional mission is to help all students expand their communication step by step. She can be reached at www.abaspeech.org, on Facebook or Instagram. 

Ten tips to prevent autism-related shopping meltdowns

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This week’s blog comes to us from Lucia Murillo, Autism Speaks’ assistant director of education research. and was originally posted on Autism Speaks as part of their Got Questions? series.

“How can I help my child avoid meltdowns at the store? Everything is okay with him until he gets into the store.”

Thanks so much for your question. You are far from alone in this challenge. For good reason, outings such as shopping can be particularly challenging for families who have children with autism.

The abundance of sights, sounds, crowds and other sensory stimuli can easily trigger challenging behaviors that seem near-impossible to handle in a public place. Unfortunately, this prompts many families to avoid taking children with autism to public places unless absolutely necessary. This, in turn, can contribute to isolation for the whole family.

So I’m so pleased for this opportunity to share a few meltdown-prevention strategies that, when practiced ahead of time, can help promote a calmer shopping experience.

But when I say “ahead of time,” I don’t mean right before you head to the store. These strategies involve time and patience. Ideally, you’ll also have the guidance of a behavioral therapist skilled in working with children who have autism.

#1 Give fair warning
Research and experience tells us that “knowing what to expect” helps children with autism cope with potentially stressful situations. This means resisting the understandable temptation to try to sneak a quick shopping trip into your son’s day. Whenever possible, I strongly recommend letting him know ahead of time where he is going and what he can expect.

#2 Take a virtual tour 
You and your son may be able to take a virtual tour of the store on the store’s website. If that’s not available, consider visiting the store on your own to take pictures and/or a cell-phone video.

This approach is particularly useful for preparing your child to accompany you to a new store. Sit down and look at the pictures and/or watch the video together so your son can become familiar with the new environment.

You might even take a virtual drive to the store using Google Maps.

#3 Practice and build tolerance

When you feel your child is ready to make an actual trip to the store, I suggest starting with a short trip and small purchase. Reward any degree of success with praise and perhaps a small prize or favorite activity.

As you sense your child is getting more comfortable with the short trips, gradually increase the length of time that the two of you are in the store. At this point, try to incorporate these trips into a regular routine – but always with fair warning – so your child can learn to expect them.

Repetition is important. And occasional reversals are likely. So don’t give up!

#4 Prepare a schedule 
Many children – and adults – on the autism spectrum greatly benefit from having a clear schedule for the day ahead. Visual schedules are particularly helpful, and the Autism Speaks visual supports guide can help you make one.

A morning review of the day’s activities can help your child gain a sense of where he’s going and what he’ll be doing. So on the morning of a shopping trip – or even the night before – sit down with your child as you add a shopping trip to the schedule. Or invite him to add it at the specified time.

It can help to schedule one of your child’s favorite activities following the shopping trip and together enter it on the day’s schedule. This can be as simple as time to play with a favorite toy or game with you.

#5 Remember: Rest is best
It can greatly increase your son’s chances of success if you make sure he’s well rested before the outing. In fact, the same goes for you! Being tired tends to shorten everyone’s tolerance.

#6 Identify triggers 
You know your child best. Are there certain sights, sounds or situations that tend to produce to a meltdown? You might try visiting the store without your son with an eye for such triggers. For some people with autism, fluorescent lighting is a trigger. Others are bothered by the loud hum of air conditioners or the blare of clerks calling to each other over the intercom.

#7 Provide personalized “armor”
Identifying triggers enables you to provide personalized support. For example, if loud sounds provoke anxiety in your son, he might be helped by headphones. If overhead lighting is a problem, he might be willing to wear sunglasses or a baseball cap. Many parents find these strategies make a world of difference for their kids.

#8 Getting ready to shop …
Before leaving the house, consider prompting your son with a finer breakdown of what you’re going to do on this shopping trip. For instance:

* We will drive to the store.

* We will park in the lot.

* We will walk into the store.

* We will find the items we want.

* We will pay for them at the register.

* We will walk back to the car.

* We will drive home.

* And we will play a game of Uno.

If, like many people with autism, your child responds best to visual information, try making a personalized story with pictures about the above steps. Autism Speaks has partnered with the University of Washington READI Lab to provide a series of personalized story templates that include Going to the Store. Learn more and download them for free here.

#9 Have a signal
Make sure there’s a way for your child to communicate to you when he begins to feel overwhelmed. We know that children who have autism vary widely in their ability to communicate. So one child might be able to simply say “I need a break.” Another might need to learn a sign – such as hands over ears. Picture communication systems are yet another option. (See the Autism Speaks visual supports guide mentioned above.)

Even if you child can’t reliably communicate when he’s getting overwhelmed, there are often behavioral cues that you can learn to recognize in time to leave the store or otherwise provide support before the meltdown.

#10 Bring “cool down” items
Meltdowns happen. Sometimes, having a favorite comfort item on hand can help ease the crisis.Despite all the best plans, meltdowns happen. You can ease the crisis by bringing an object or activity that you know will soothe. This could be a favorite toy or blanket. It could be a special little song.

All these strategies have the same goal: To provide optimal conditions for your child when taking him into an overly stimulating environment. By preparing ahead of time, you can increase the chances that the shopping trip – or any outing – will be more tolerable for your child and entire family.

 

Teaching Safety Skills to Adolescents

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This month’s ASAT feature comes to us from Shannon Wilkinson, M.ADS, BCBA. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

I am a Special Education Teacher at the high school level. A young man with autism is transitioning to my caseload from our middle school. Although there is much talk about “safety skills” amongst my colleagues, I would like to target this skill area effectively and comprehensively. Any suggestions?

Safety skills are important for learners with autism and should be addressed comprehensively over the course of the learner’s schooling and across the lifespan. The type of safety skills taught at any given time will vary depending on the learner’s age and functioning level. For example, younger learners can be taught to walk appropriately with an adult so they do not run into the street while older learners can be taught to cross the street independently. Regardless of age, safety skills should be included on the learner’s Individualized Education Plan (IEP) and reflect the goals of the individual and their families. In addition, data collection on the targeted skills is essential to ensure the learner is acquiring the skill and that the skill maintains over time.

An effective method to teach safety skills is Behavioral Skills Training (BST). BST is a comprehensive teaching method which includes delivering instructions to the learner, modeling the correct response, rehearsing the correct response in both pretend and more naturalistic environments, and delivering feedback to the participant regarding their actions. If the learner is having difficulty acquiring the skill, an additional teaching component known as In Situ Training (IST) can be added. In IST, the trainer provides immediate and direct training in the learner’s environment and allows for additional practice of the skill. Within the literature, BST and IST have been shown to be effective for teaching a wide range of safety skills such as abduction prevention skills (Beck & Miltenberger, 2009; Gunby, Carr & LeBlanc, 2010; Johnson et al., 2006) and how to seek assistance when lost (Pan-Skadden et al., 2009).

There are a number of safety skills that that could be targeted for an adolescent with autism. Targeting those that also increase independence should be a priority if appropriate, based on the adolescent’s level of functioning. Teaching him to use a cell phone is one such skill, as it can be used to improve his safety and overall independence (Hoch, Taylor, & Rodriguez, 2009; Taber, Alberto, Seltzer & Hughes, 2003). First, you will want to ensure the learner has the basic skills associated with cell phone use including: answering the phone, following directions on the phone, answering questions on the phone and negotiating all of the mechanisms associated with initiating a call. Once these basic skills are mastered, specific safety skills involving the phone can be taught. For example, a learner can be taught to answer his cell phone and provide a description of his location in the event he is separated from his caregiver or group. He could also be taught to follow instructions to seek assistance from a community member if lost (Hoch, Taylor, & Rodriguez, 2009; Taylor, Hughes, Richard, Hoch & Coello, 2004) or to call a trusted adult.

A major safety concern for most parents is abduction. Although abduction may be more likely with a young child, adolescents with autism should still be taught to identify “safe people” such as police officers, fire fighters and security guards, in the community. Many learners with autism are not able to distinguish safe or familiar people from unsafe or unfamiliar people. As a result, they cannot determine whom they can speak to or make a request for help. Learners can first learn to identify safe people, such as those noted above, in pictures. Once they can reliably do so, they should be taught what to do if a stranger approaches them. Multiple scenarios should be practiced so the learner becomes familiar with potential lures such as a stranger offering candy to get in a car or telling the student that his mom told the stranger to pick him up. Behavioral skills training and In Situ Training may be beneficial in teaching these skills (Beck & Miltenberger, 2009; Gunby, Carr & Leblanc, 2010; Mechling, 2008). In this scenario, the learner would first be provided instructions on what to do in each stranger situation. The learner should then model the correct response. If he does so successfully, a mock scenario can then be set up whereby a confederate approaches the learner and the learner has the opportunity to demonstrate the skills he has learned (i.e., do not go with the stranger, run away and tell an adult). If the learner performs the correct actions, he receives praise. If the learner does not demonstrate the correct response, the instructor immediately provides him with additional training.

Additional safety skills to target could include:

  • navigating and using community resources appropriately and independently;
  • exiting a car and crossing a parking lot or busy street safely;
  • responding appropriately in emergency situations such as a fire or earthquake;
  • addressing potential household hazards such as responding safely to cleaning chemicals, using appliances properly, or answering the doorbell when it rings;
  • identifying a need to dial 911;
  • using basic first aid procedures;
  • interacting appropriately with pets and other animals;
  • using the internet safely; and
  • managing teasing and bullying

 

There are many others that can be addressed based on the learner, his individualized goals and his future educational, vocational and residential placements. Involving the learner’s parents in the planning process will help you to identify which safety skills are most important and relevant for the individual to learn, particularly if the parents have specific concerns or if there has been a history of unsafe behavior. Finally, as you go through this program planning process, it’s helpful to keep in mind that the essential goal in teaching these skills is to promote greater independence by ensuring the learner has the tools he needs to be safe and to protect himself in his environment.

References

Beck, K. V., & Miltenberger, R. (2009). Evaluation of a commercially available program and in situ training by parents to teach abduction-prevention skills to children. Journal of Applied Behavior Analysis, 42, 761-772.

Gunby, K. V., Carr, J. E., & Leblanc, L. A. (2010). Teaching abduction-prevention skills to children with autism. Journal of Applied Behavior Analysis, 43, 107-112.

Hoch, H., Taylor, B. A., & Rodriguez, A. (2009). Teaching teenagers with autism to answer cell phones and seek assistance when lost. Behavior Analysis in Practice, 2, 14-20.

Mechling, L. C. (2008). Thirty year review of safety skill instruction for persons with intellectual disabilities. Education and Training in Developmental Disabilities, 43, 311-323.

Pan-Skadden, J., Wilder, D. A., Sparling, J., Stevenson, E., Donaldson, J., Postma, N., et al.(2009). The use of behavioral skills training and in-situ training to teach children to solicit help when lost: A preliminary investigation. Education and Treatment of Children, 32, 359-370.

Taber, T. A., Alberto, P. A., Seltzer, A., & Hughes, M. (2003). Obtaining assistance when lost in the community using cell phones. Research and Practice for Persons with Severe Disabilities, 28, 105-116.

Taylor, B. A., Hughes, C. E., Richard, E., Hoch, H., & Rodriquez-Coello, A. (2004). Teaching teenagers with autism to seek assistance when lost. Journal of Applied Behavior Analysis, 37, 79-82.

About The Author 

Shannon Wilkinson, M.ADS, BCBA is a Supervising Therapist with TRE-ADD program at Surrey Place Centre in Toronto, which is a comprehensive day treatment program that provides services for children and youth with autism and related developmental disorders and their families. Shannon has worked in the field of autism for 13 years, starting as an Instructor Therapist. She is particularly passionate about working with adolescents and has taught many vocational and life skills over the years. Shannon has a Masters in Applied Disability Studies from Brock University and is a Board Certified Behaviour Analyst.

Pick of the Week: Books for HFA Learners!

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How Can Parents Find Effective Reinforcers?

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This week, Leanne Page M.Ed, BCBA, answers a parent’s question on creating effective token economies.  

This piece originally appeared on bsci21.org.

“Dear Behavior BFF, I’ve tried using a token economy and it helped for a little while. But lately my son has told me that he doesn’t want to earn stickers and he doesn’t care about the new toy he can get from his sticker chart. What do I do?”

First of all- good job using some behavior analysis to help increase desired behaviors in your family! A token economy is a great tool.

Now- a token economy is a great tool when it is combined with great positive reinforcement. What your message is telling me is that it’s not the token economy that is the problem. The rewards you are offering your son are not reinforcing. It sounds like they were super reinforcing and effective for a while, but your son is just not that into these rewards anymore.

So what do you do? Throw out the whole token economy system? No! Let’s find some more effective reinforcers to help you be successful again.

As parents, we assume we know what our kiddos like. We know what they are into, what they want, and what their preferred items are. But sometimes the things they will work to earn may surprise us.

Our kids may become satiated or habituated to the rewards we are offering them. This means they have had enough and it’s no longer piquing their interest. No matter what the cause, what we do know is that our children’s preferences change. To use effective positive reinforcement, we must identify what is reinforcing to our child at this point in time.

Enter preference assessments.

A preference assessment encapsultes “a variety of procedures used to determine the stimuli that the person prefers, the relative preference values of those stimuli, and the conditions under which those preference values change when task demands, deprivation states, or schedules of reinforcement are modified” (Cooper, Heron, & Heward, 2014).

As parents, we can do this in a number of ways.

  1. Observe your child and see what they choose to play with. This can take place at home but also outside your home. If you go to a friend or family member’s house, what things does your child choose to interact with? If you go to a museum, bookstore, other outings, what interests does your child show?
  2. Make a list of things/activities you think would be good reinforcers and ask your child how he feels about them. Depending on age and ability you could have him rate them on a scale of 1-10 or have them choose a happy face for each one. You could read each item and have your child give thumbs up, thumb sideways, or thumbs down to indicate preference. If you can’t think of ideas, google it. There are many reinforcer surveys or preference assessment checklists floating around on the internet.
  3. Let your child generate the list. Ask “What do you want to earn?” Let them say the big things that are unlikely and help to identify ones that are reasonable.
  4. If you are going to use new items- let your son choose. Take your child shopping. I let me daughter pick one or two things from the dollar spot every time we go to Target. She doesn’t get to keep them that day. She puts them in her prize bag to earn with good behavior or reaching goals on a token economy.

Any time we have a valid system of positive behavior supports in place, such as your token economy, and it stops working- it’s not the system. It’s the reinforcement. The reinforcement you are offering is simply not strong enough.

Up the ante. Give better options for rewards. Identify potential reinforcers by conducting a preference assessment. Let your son choose his reinforcer.

Whenever there is a new problem behavior, or a behavior management system not working- my first response is increase the positive reinforcement for appropriate behaviors.

Be prepared to continue to do preference assessments every once in a while. Our children’s interests and preferences change, so if we stay in the know we can have effective reinforcers at hand.

References

Carr, J. E., Nicolson, A. C., & Higbee, T. S. (2000). Evaluation of a brief multiple‐stimulus preference assessment in a naturalistic context. Journal of Applied Behavior Analysis, 33(3), 353-357.

Cooper, J.O, Heron, T.E., & Heward, W. L. (2014). Applied behavior analysis. Pearson Education International.

DeLeon, I. G., Fisher, W. W., Rodriguez‐Catter, V., Maglieri, K., Herman, K., & Marhefka, J. M. (2001). Examination of relative reinforcement effects of stimuli identified through pretreatment and daily brief preference assessments. Journal of Applied Behavior Analysis, 34(4), 463-473.

Leanne Page, MEd, BCBA, is the author of Parenting with Science: Behavior Analysis Saves Mom’s Sanity. As a Behavior Analyst and a mom of two little girls, she wanted to share behavior analysis with a population who could really use it- parents!

Leanne’s writing can be found in Parenting with Science and Parenting with ABA as well as a few other sites. She is a monthly contributor to bSci21.com , guest host for the Dr. Kim Live show, and has contributed to other websites as well.

Leanne has worked with children with disabilities for over 10 years. She earned both her Bachelor’s and Master’s degrees from Texas A&M University.  She also completed ABA coursework through the University of North Texas before earning her BCBA certification in 2011. Leanne has worked as a special educator of both elementary and high school self-contained, inclusion, general education, and resource settings.

Leanne also has managed a center providing ABA services to children in 1:1 and small group settings. She has  extensive experience in school and teacher training, therapist training, parent training, and providing direct services to children and families in a center-based or in-home therapy setting.

Leanne is now located in Dallas, Texas and is available for: distance BCBA and BCaBA supervision, parent training, speaking opportunities, and consultation. She can be reached via Facebook or at Lpagebcba@gmail.com.

10 Common Mistakes Parents Make In Playing With Their Children With ASD

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This week’s post comes to us from Stephanny Freeman, PhD and Kristen Hayashida, MEd, BCBA, and Dr. Tanya Paparella, our partners on the Play Idea Cards app. Play Idea Cards is a full curriculum on teaching play – right in the palm of your hand! Check it out on the Apple App Store! 

Parents of young children with developmental disabilities are truly tireless. At times when one would think a break could be had – the time when they get to enjoy watching their children play, enjoy a conversation with another adult while their children play, or even relaxing by playing and having fun with their children – instead they are working with and teaching their children…and rightly so!

 
I’ve spent a good part of my career watching parents play with their young children with a variety of developmental disabilities (severe intellectual delay, Down syndrome, and autism spectrum disorder). Across the board, parents are remarkable. In a beautiful coordination of grace and direction, they work on controlling behavior, developing language, teaching concepts, maintaining attention, and building fun and relationships. Parents of children with disabilities are more directive and more instructional – yielding evidence of tremendous benefits for their children’s development as a result of these tireless warriors.

 
Children with autism in particular, have a significant and very specialized deficit in their ability to play with toys. Sometimes it can be in the functional domain but it is always difficult for them to think symbolically and abstractly about play. Teaching play to children with ASD is incredibly important and parents know this – they try!
For parents of children with ASD, here are 10 mistakes that are commonly made during play that can really disrupt their child’s growth in play.

 
1. Thinking that play develops on its own and randomly. Play in neurotypical children develops generally in a sequence and children with ASD do not naturally follow or progress through that sequence. Most books you find on children’s play show a fairly consistent developmental pathway for play. Skills build upon skills. Children start with very functional and constructional acts and develop into symbolic and creative play.

 
2. Forgetting to use play to actually teach play. Parents often use play to teach other skills (e.g. language or early concepts). Children with ASD have a core deficit in play so take time during your play with your child to actually teach them how to play with the toys regularly.

 
3. Thinking that your child will love play right away. For children with ASD, symbolic play is very difficult and likely your child would rather do other things than play. For example, a child with ASD may rather roll a car down a ramp repetitively then have the car “feel hungry” and go to the gas station for some “food.” It actually falls on the parent, at first, to convince the child that play is fun! This means you must have high positive affect (e.g., show excitement in your body language and in your words), work through difficulties with a huge smile, and laugh and enjoy using positive language.

 
4. Playing at a level that is way too difficult. Knowing what your child can do will help you teach them what comes next. If you child is just starting to put puzzles together, asking them to pretend to be Buzz Lightyear and talk like him is much too difficult.
5. Forgetting to imitate. It is critical for engagement building to imitate your child’s appropriate play behavior. Directiveness is still great but integrate imitation in your play. You should have a good balance of both. If your child is building blocks, grab a few and copy your child.

 
6. Constantly shifting your child’s attention. Sometimes it is necessary to move your child away from something that is a perseveration or a repetitive interest but in general, try to stick with what your child is doing. Sustained engagement with toys and people in coordination is a great skill and something children with ASD need to work on. It’s not a race to see how many different things you can do during a play time. Be patient and tolerant and build off of their interests rather than shifting their attention. Enjoy playing similar routines every time you play – just slowly build off of them.

 
7. Prompting intrusively. Starting off by hand-over-hand prompting or being very verbally directive (“put that block here and the train here”) your child is forced to shifts their attention without their own consideration. Instead, focus on what they pick up or are interested in, then move them forward by showing them something related to what they are doing, or general verbal comments (“Boy, that doll is super hungry!” as your child is holding a piece of play food).

 
8. Being concrete. If your child wants to do something a little imaginative, don’t bring them back to the concrete. If a child grabs a block and starts to eat it like a burger, please don’t tell them “It’s not food it’s a block!” Instead, imitate and say, “You have a burger, I have a hot dog!”

 
9. Missing the surprise factor. Every play session, even if it’s pretty routine and organized, should include something surprising by the parent. Parents should throw in a fun “wrench” and make a huge facial expression that indicates surprise. It’s called “violating” a routine or a play scheme. So if Mickey Mouse always goes to his top bunk in the play house, make sure one day the top bunk has cats in it! Your child will laugh and you can laugh too. This makes for enjoyment and further eye contact and engagement. It also facilitates problems solving.

 
10. Allowing your child to get away from play. Although the prior points suggest to following your child’s lead and imitate, the line should be drawn when your child doesn’t follow through with play. So if you are playing with your child’s interest (e.g. play food) and you make the suggestion of showing him dolls or plates or cups, then you verbally request his participation, he must follow through. Don’t allow your child to not follow through on play. Remember it’s a core problem for them so it’s hard!

 
Although play is still a “work” time for parents, hopefully these tips will help make it smoother and more enjoyable for everyone. This builds interest, sustained engagement, longer schemes and ideas for play, and positive practice of play skills. Ready Set PLAY!

About The Authors

Dr. Stephanny Freeman is a clinical professor at UCLA, a licensed clinical psychologist, and Co-Directs the Early Childhood Partial Hospitalization Program (ECPHP).  For 20 years, she has educated children with ASD and other exceptionalities as a teacher, studied interventions for social emotional development, and designed curriculum and behavior plans in school and clinic settings.

Kristen Hayashida is a Board Certified Behavior Analyst at the UCLA Early Childhood Partial Hospitalization Program (ECPHP).  For the last 10 years she has served as a therapist, researcher and educator of children and families living with autism spectrum disorder through the treatment of problem behavior.

Dr. Tanya Paparella is a specialist in the field of autism having spent more than 20 years in intervention and research in autism. She is an Associate Clinical Professor in the Division of Child Psychiatry at UCLA, a licensed clinical psychologist, and Co-Director of UCLA’s Early Childhood Partial Hospitalization Program (ECPHP), an internationally recognized model treatment program for young children on the autism spectrum.

Pick of the Week: Games!

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Now through 10/30!

*Promotion is valid until October 30th, 2017 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at difflearn.com, enter promo code GAMES2017 at checkout.

Sam’s Hints for the Holidays: 6 Tips for Success on Halloween

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

For Preschool & Elementary Children

  • Practice – Invite your neighbors to have a “rehearsal” for Halloween so your learner can practice the steps. If this isn’t a possibility for you, it may be helpful to watch youtube videos of trick-or-treating.
  • Prepare – Let your child know the trick-or-treating route in advance. In the days leading up to Halloween, make yourself aware of houses to avoid based on decorations that are gory, include excessive lighting, have strobes, or any other aspects that you know will make your learner uncomfortable.

For Teenagers

  • Consider alternatives – You may want to join with other parents to throw a Halloween party that is autism-friendly based on the needs of your learner and the needs of other party guests. Another suggestion would be to celebrate with a themed activity, such as Halloween activities at local museums or art institutions.
  • Give a task – Let your child have a job such as giving out the treats at the door, managing an activity for younger children, or helping with decorating your home.

For All Children

  • Be flexible – Think about what is necessary for your learner, what your learner is interested in, and what success looks like in terms of Halloween. Maybe success means you visit three houses, or maybe success means your learner chose a costume. The idea is to keep it fun.
  • Remember it’s okay to stay at home! – You can create your own Halloween tradition that fits your family’s needs. This could include a special movie night, creating Halloween-inspired foods together, or anything that is fun for the whole family.

WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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

Pick of the Week: Prepositions!

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Now through 10/23!

*Promotion is valid until October 23rd, 2017 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at difflearn.com, enter promo code LEARN2017 at checkout.