Tag Archives: autistic spectrum disorder

When Kids Are Just Kids: Avoiding Over-Pathologizing Behaviors of Children with Autism

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A diagnosis of autism can be very challenging for a child and for his/her family. But one of the most difficult aspects of autism is that it is not clear cut what behaviors are related to autism, and what behaviors are related to just being a kid. Every child tantrums sometimes. Every child talks back sometimes. Every child engages in dangerous behavior sometimes.

When I look back on my own childhood, I think of several behaviors I exhibited: in third grade I cut my own hair while my teacher’s back was turned, in fourth grade I got mad at my brother and threw an alarm clock at him, and in seventh grade I loved Agatha Christie books so much that I frequently refused to go outside and sat in my room reading by myself for hours on end. If I had autism, any one of these behaviors may have been pathologized instead of being considered as just a part of growing up.

So how do you parse through all the behaviors your learner is exhibiting and figure out which ones you should actually be worried about? Here are a few questions to ask yourself in determining behaviors to address:

  • First and foremost, is the behavior dangerous?
  • Secondly, how often and for how long does your learner engage in the behavior
  • How different is this behavior from the learner’s same-age peers? For example, does your three year old cry for a couple minutes when told that she can’t have her favorite toy, or does she cry for two hours and refuse to engage with any other toys for the rest of the day?
  • How is this behavior interfering with the learner’s ability to learn?
  • How is this behavior interfering with the learner’s ability to engage with peers and family members?
  • Is the behavior related to a skill? For example, pacing the room and flapping your arms is typically not related to a skill, but building Lego models can be related to a skill. If it is related to a skill, think about ways to provide opportunities for expanding that skill.

The answers to these questions should be able to inform the decisions that you make in intervening with behaviors. And we should remember that above all else, kids with autism are still just kids.

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, she has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

Online Briefs & Learning Modules for Evidence-Based Treatment Strategies

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The National Professional Development Center on Autism Spectrum Disorders holds an impressive wealth of information and resources for evidence-based practices for children with autism. We wanted to share their website as a resource to both parents and providers, since evidence-based strategies are so important in devising a home or school-based program for students with ASD. Specifically, we found the online learning and training modules by the NPDC on ASD to be extremely useful and – even better – accessible to anyone online.

For the following evidence-based practices (EBP), the NPDC on ASD has developed briefs with the following components:

  • Overview of the practice
  • Step-by-step instructions for implementation
  • Checklist to document the degree of implementation
  • References that support the efficacy of the practice

Each brief package comes in downloadable PDF formats for easy saving and printing. Some practices also come with downloadable data collection sheets and supplemental materials for teachers to use.

EBP Briefs 1

Additional resources provided by the NPDC on ASD include Learning Modules to accommodate children in early intervention (birth to 3 years).  The 10 Learning Modules touch upon:

  1. Discrete Trial Training (DTT)
  2. Functional Communication Training (FCT)
  3. Naturalistic Intervention
  4. Parent-Implemented Intervention
  5. Picture Exchange Communication System (PECS)
  6. Pivotal Response Training (PRT)
  7. Prompting
  8. Reinforcement
  9. Structured Work Systems
  10. Time Delay

Each module includes a pre-assessment, objectives, an overview of the evidence-based practice, detailed information about the use of the EBP, step-by-step instructions for implementing the practice, case studies, a summary, a post-assessment, frequently asked questions, and references at the end.

EBP Briefs 2

For more information on the NPDC, visit their website at www.autismpdc.fpg.unc.edu. 

Pick of the Week: NEW! Executive Function Curriculum Books

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How can you help kids with autism be flexible, get organized, and work toward goals – not just in school but in everyday life? It’s all about executive function. This week, we’re offering 15% off* our newest books on teaching executive function: Unstuck & On Target: An Executive Function Curriculum and Solving Executive Function Challenges. Just use our promo code EXECFXN at check out to redeem these savings!

Unstuck_and_On_TargetThese practical resources for parents, teachers, and therapists help high-functioning students with autism improve on these critical skills.

Unstuck & On Target! is a robust classroom-based curriculum book that will help educators and service providers teach these executive function skills to high-functioning students with autism through ready-to-use lessons that promote cognitive and behavioral flexibility. This curriculum gives clear instructions, materials lists, modifications for each lesson, and intervention tips to reinforce lessons throughout the school day. Topics touched upon include flexibility vocabulary, coping strategies, setting goals, and flexibility in friendship, all introduced and reinforced with evidence-based lessons. Lessons will target specific skills, free up the instructor’s time, fit easily into any curriculum, ensure generalization to strengthen home-school connection, and best of all, make learning fun and engaging for students in the classroom.

Unstuck & On Target! also comes with an accompanying CD-ROM that contains printable game cards, student worksheets, and other materials for each lesson. The curriculum is targeted for students with cognitive ability and language skills ages 8-11.

Solving_Executive_Function_ChallengesSolving Executive Function Challenges is a strategy guide that offers teachers and caretakers various ways to teach EF skills, including setting and achieving goals and being flexible, as well as ideas for accommodations and actions to address common problems (e.g. keeping positive, avoiding overload, coping, etc.).

To be used with or without the robust curriculum Unstuck and On Target!, this strategy guide aims to show how to embed executive function instruction in everyday scenarios with specific examples, samples IEP goals, and scripts and worksheets that break down tasks into manageable chunks. This guide is appropriate for learners in grades K–8.

Don’t forget – you can save 15%* this week only on these new executive function books by applying promo code EXECFXN at check out!

*Offer is valid until 11:59pm EDT on October 7th, 2014. Not compatible with any other offers. Be sure there are no spaces or dashes in your code at check out!

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.

Pilot Study Finds that Parent-led Early Intervention Can Reduce Autism Symptoms in Babies

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Autism symptoms can display in babies as young as 6 months old. A new pilot study at the UC Davis MIND Institute found that parents could reduce symptoms of autism in babies under 12 months by using intervention treatments in the home as detailed in the Early Denver Start Model.

As reported in a recent Huffington Post article, the study involved parents and their babies between 7 and 15 months of age in a 12 week-long treatment conducted by parents in home-like environments. The treatment was based on the Early Denver Start Model and revolved around parent-child interactions, such as bathing, feeding, playing, and reading. Four comparison groups were also included: Those who were at a higher risk for autism because of an affected sibling; those who were at low risk; those who had developed autism by age 3; and those with early symptoms who received treatment at a later age.

At the start of the study, all babies displayed early signs of autism, such as low interest in interactions and repetitive behaviors, which increased by around 9 months. However, by 18 to 36 months of age, the children in the treatment group produced lower autism severity scores than the comparison groups who did not go through the treatment.

The Huffington Post article “Pilot Intervention Eliminates Autism Symptoms In Babies” highlights the importance of early intervention in autism treatment. While this research is highly preliminary, the findings show that therapy and early intervention are key factors in treating infants and children with early signs of autism, and possibly in reducing them altogether. This study offers hope for parents and professionals in helping their children succeed with more tools and resources for the earliest stages of autism.

Read more about the pilot study on Huffington Post here.

Pick of the Week: “The Asperkid’s Secret Book of Social Rules” – A teen’s guide to not-so-obvious social codes

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It’s not easy for any teen or tween to fit in, but it can be especially tough for Asperkids. Jennifer O’Toole knows this first-hand, and has written a book she only wishes she had when she was a teen with Asperger Syndrome.

This week only, save 15%* on The Asperkid’s (Secret) Book of Social Rules by entering promo code ASPERKID at check out!

In The Asperkid’s (Secret) Book of Social Rules, O’Toole doesn’t offer advice on what Asperkids should not do, but on what they should do with witty and wise insights into baffling social codes. With helpful tips, practice scenarios, checklists, and quizzes, Asperkids will learn how to:

  • Thank people, apologize, and offer compliments
  • Build and maintain genuine friendships and how to deal with bullying
  • Actively listen and have a meaningful conversation
  • Step back and see the “big picture” instead of focusing on the details
  • Make a correction and let go of the need to be right

With over 30 social rules and logical explanations, this illustrated handbook offers information that tweens and teens can truly digest. And having been there herself, the author shares her experience and points out the potential pitfalls with humor and sensitivity.

Don’t forget to save 15%* on The Asperkid’s (Secret) Book of Social Rules this week by using our promo code ASPERKID at checkout!

*Offer is valid until 11:59pm EDT on September 16th, 2014. Not compatible with any other offers. Be sure there are no spaces or dashes in your code at check out!

The Power of Music (and Katy Perry)

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What can you say? Imagine this mother’s absolute delight when her 8-year old son, mostly non-verbal, started singing the big pop song of the day? His mother, Carla, said “I was so happy to know something that he liked. I don’t know what his favorite food is, I don’t know what his favorite color is. I know he likes music, but I didn’t know he liked a particular song.” Have a listen and be warned – you may erupt in applause.


Tip of the Week: Avoid Prompt Dependence When Teaching New Skills

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“She won’t say hi unless I say ‘Say Hello.’” “He will only wash his hands if I put his hand on the knob to turn on the water.” “He won’t use his fork until I put it in his hand.”

I hear statements like this all the time from both parents and providers working with learners what autism. What they are describing is “prompt dependence,” which is when a learner requires a prompt from a teacher or parent in order to complete a task. So how do you avoid prompt dependence with your own learners?

Let’s start with the prompt itself. There are many different ways to prompt which can be divided into levels by how intrusive the prompt is. Below is a sample of a prompt hierarchy, with the least intrusive prompt at the top and the most intrusive prompt at the bottom. Your goal is to quickly move through the prompt levels to move your learner to independence.

Prompting Hierarchy

Now let’s look at two different examples to show these prompt levels. In the first example, the goal is for the learner to greet a person who walks into the room. In the second example, the goal is for the learner to pull up his/her pants after using the bathroom as a part of a toileting routine.

Prompt Chart

Research shows that least-to-most prompting increases potential for errors and slows down rate of acquisition for new skills. Therefore, most-to-least prompting is preferred for teaching new skills. This means that you would start at a full physical prompt, then move your way up the prompt heirarchy until your learner achieves independence with the task.

In the past, when working with discrete trials, it has been common practice to have a learner master a skill at a certain prompt level, then move to a less intrusive prompt and have the learner master the skill at that prompt level, steadily moving towards independence. This can actually encourage prompt dependence because the learner remains on the same prompt level for too long.

Instead, you should try to quickly move up the prompt hierarchy in a way that makes sense for the skill you are trying to teach. Below are some tips to help you help your learners achieve independence.

  • Follow the rule of three: Whether you are teaching with discrete trials or in the natural environment, once your learner has successfully responded to a demand three times consecutively, move to a less intrusive prompt.
  • If you are taking data, make a notation of what prompt level you are using at each step. (And remember, that only independent responses should be counted towards the learner’s percentage of correct responses.)
  • At the end of a session or group of trials, note what prompt level you were at by the end of the session. Then start at that level during the next session.
  • If your learner does not respond correctly when you move to a less intrusive prompt, then move back to the most recent prompt level. Once they respond again correctly at that prompt level three times consecutively, move again to a less restrictive prompt.
  • Remember that verbal prompts are very difficult to fade. Though they are less instrusive, you should avoid using them when possible.
  • You can pair prompts and then fade out the more intrusive prompts. For example, with the sample of pulling up pants described above, you can pair a visual prompt with a gestural prompt by showing the symbol for pulling up pants while pointing at the pants. Over time, you stop using the symbol and just use the gestural prompt. The gestural prompt can be faded by moving your point further and further away from the pants.
  • Write down what the prompt levels will look like for the specific task you are teaching. This way you will be fully prepared to quickly move your learner towards independence.
  • Differentiate your reinforcement! If you move to a less intrusive prompt and the learner responds correctly, then you should immediately provide a stronger reinforcer than you did for previous responses. If a learner spontaneously responds without a prompt, you should do what I call “throwing them a party” by combining reinforcers (such as tickles and high fives) or providing a highly desirable reinforcer.

Prompting can be very difficult to do well, but following these tips should help set your learner on the path to independence.

Tip of the Week: Always Be Pairing

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Yesterday, we introduced you to Sam Blanco, BCBA-extraordinaire and Different Roads’ wonderful new consultant. Today, we’re thrilled to commence her new weekly segment, the “Tip of the Week.” We’re sure you’ll find them to be as interesting and insightful as we do.

TeacherStudentHighFiveAlways Be Pairing

If you are familiar with ABA, you have probably heard of the term pairing. The idea behind pairing is that you will establish and maintain a positive relationship with the child by pairing yourself with preferred items or activities. Pairing is important not only in establishing a relationship with a learner; but also in maintaining the relationship, preventing boredom, and increasing motivation throughout your relationship with the child.

Below we address four common misconceptions with pairing.

Common misconception #1: Pairing only takes place when you are building a relationship with the child.

Many therapists I’ve supervised tell me that they pair for the first 1-4 weeks, then start teaching. But pairing shouldn’t end there (nor should it necessarily take so long as we’ll see with common misconception 2.)

Before each session, you should engage in “pre-session” pairing. This means that you are providing free reinforcers without placing demands. For early learners you might start off a session with blowing bubbles or playing with a parachute. For older learners you might start off a session with a game or sharing a book the child enjoys. Usually, it’s a good idea to present the learner with options during pre-session pairing. Involving choice frequently increases motivation, and it also increases the likelihood of delivering a more highly reinforcing item.

Some people feel that pairing every session eats up valuable instructional time. However, pre-session pairing increases motivation and cuts down on maladaptive behavior, which actually increases the amount and the quality of your instructional time for a given session.

Common misconception #2: Pairing takes a long time, and a provider or teacher should not start placing demands until the pairing process is complete.

In some cases, pairing may take a long time. However, in many cases, you are able to start placing demands during the first session. This does not mean that you’ll necessarily start doing discrete trials on the first day, but you can begin placing simple demands to build instructional control while you are pairing. It’s helpful for gaining instructional control to incrementally increase the number of demands placed across sessions, while always starting with a pre-session pairing session.

Unfortunately, pairing is not an activity that can be measured, and it’s important to recognize that the pairing process is never complete.

Common misconception #3: Pairing should involve sensory toys because all children with autism are highly motivated by such toys.

For some learners, sensory toys are highly motivating. However, a common error is using the same pre-session pairing with every learner. What you believe is reinforcing in general may not be reinforcing for your learner in particular. If the learner is not engaging with the item, ignoring it, putting it down, or displaying maladaptive behaviors when the item is presented; then the item is not reinforcing.

Another consideration is that big aspect of pairing is that the learner associates these motivating items and activities with you. While it is beneficial to be the purveyor of fun sensory items; it may be even more beneficial to engage in activities with the learner, such as cause and effect toys or games or physical activity that requires your involvement.

Common misconception #4: A learner will always be motivated by the same items.

Several times when a provider calls me to come in and assist with behavior problems, I discover that there is not enough novelty within their pairing sessions. A learner may love a marble run one session (which happens to be one of my all-time favorite toys) then have no interest the next session. Or, what I see much more often, is that the learner loves the marble run for two months, then suddenly has no interest in it. The provider or teacher is uncertain about what happened and depended too heavily on that reinforcer. Then, without a powerful reinforcer to use throughout the session, the learner displays a drop in motivation and sometimes an increase in maladaptive behaviors.

There’s a word for this: satiation. Learners display a wide range of satiation levels. Some learners you work with may satiate on reinforcers within minutes, while other may prefer to see the same items over and over from session to session. A learner’s satiation can vary based on many different variables, so you should be prepared to address it.

One way to address this is to choose not to bring the same reinforcers to each session. This way, if a battery dies, you forget to bring a favorite toy, or something breaks you have not set yourself and your learner up for failure. A second way to address satiation is to remove the item while the child is still motivated to engage with it, instead of waiting until he/she has lost interest before introducing other choices.           

When pairing is consistent, specific to the child’s interests, and involves a variety of items and activities learners will maintain motivation and you will be more easily able to maintain instructional control.

Music for Autism: A Guest Post by Nancy Amigron

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Music for Autism

Music for Autism is a 501(c)3 organization dedicated to enhancing quality of life and raising public awareness through autism-friendly, interactive concerts developed specifically for individuals with autism and their families.

The concerts, held in the United States and the United Kingdom, feature professional musicians, including Tony Award winners, Grammy-nominated classical artists, and Pulitzer Prize winners.

To ensure equal access for all, every Music for Autism concert is fully subsidized. Families note that the concerts help fill a major psychosocial void, enabling them to enjoy enriching activities that are inclusive and to experience the joy and power of music as a family.

Each concert consists of “Concert time”, in which guest artists perform their favorite pieces for audiences who are encouraged to express their reactions to the music howsoever they choose; “Conducting time” in which audiences are encouraged to literally “conduct” the music themselves; and “Percussion time” during which instruments and small percussion instruments are distributed to allow the audience their own experience creating music!

Before each concert, we provide each family a social story to help prepare their friend or loved one for the fun that is to come, and to ensure that everyone has the best time possible! Our concerts take place in the five boroughs of New York, in Washington, DC, in Houston and in LA. The next upcoming concert we are holding will be on September 28 at the McCarton School (331 West 25th St, NYC) and will feature John Arthur Greene of Broadway’s smash hit, Matilda!

Further information on Music for Autism can be found at https://musicforautism.org/

Upcoming concert information can be found at https://musicforautism.org/concerts.php

For questions of any sort, please contact Nancy at nancy@musicforautism.org

We look forward to seeing you at a concert soon!

The Music for Autism Team