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Survive the Holidays: By Ashley Flanders

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Written by: Ashley Flanders, RBT

The holiday season is a time to welcome a break from our day-to-day lives, to get together with families, enjoy gift exchanges, decorate with bright lights, break out those annoying Christmas songs, and partake in rich food…all ways of celebrating that we have come to eagerly await. However, for individuals with autism, especially children, this comes with new expectations and a disruption in routines. The holiday traditions we hold dear may be a source of stress, frustration, or sensory overload for individuals with autism. Provided below is a list of general tips that may help your child feel more comfortable and get through the holidays unscathed (which the holidays are also known for!)

Care to Prepare

Knowing what to look forward for the season and/or on a certain day can help avoid stressors for you and your child, and how much preparation you engage in will depend on your child’s needs. Keep in mind what events have been a source of anxiety for them in the past and what could have helped in that situation. You could find or create a social story to read with your child that discusses what is going to happen during the holidays and what behavior is expected from all parties. You can also review a calendar with them a few days or weeks ahead of time, so they have a physical countdown of when these events are going to happen. Make it exciting and really emphasize the fun parts!

Practice for Success

Whatever your traditions are, roleplaying or using social scripts ahead of time may help the holidays run smoother. Whether opening presents, meeting Santa, or performing religious rituals, practicing can avoid catching your child unprepared and help them have a good time!

Getting to Know You

If you plan on visiting family or friends that your child has not spent a lot of time with, you may want to start easing your child into meeting them ahead of time. You can create a picture book with notes about each person to give to your child. On the other side, speaking to visitors about your child’s potential triggers, what they enjoy, and how they communicate can help visitors get to know your child better. For all parties, it may be helpful to discuss consent before touching others, to let your child know it’s okay to say “no” if they feel uncomfortable with new people and avoid embarrassing visitors if your child does not want to engage with them at first.

Plan B

Have a back-up plan for when you go out on the town, visit loved one’s homes, or are traveling. Carry a bag full of their favorite toys/activities or soothing items. Make sure you bring food that your child will eat. Before heading out, locate a safe area you and your child can go to take a break. Let people that are with you aware that you may take these breaks, and ensure them that  it is so everyone can have a positive experience.

Baby Steps

Ease your child into the season by taking gradual steps for events that may be overwhelming to them. For instance, when you begin decorating (and also taking down decorations) put only a few up every day until you build up to a perfectly merry home!

Sensory Relief

If your child has a history of being hypersensitive to certain stimuli, prepare for this as well by avoiding areas/events that may be agitating to them—for instance, holiday light shows or caroling. You can also use your “baby steps” to get them used to these experiences for the season or bring along appropriate sensory adaptive aids such as noise-reducing earphones or sunglasses.

Communication

This is for you and your kiddo! Encourage your child to communicate their needs through the holiday. Don’t feel afraid to voice to others what kind of supports and your child may require to get through the holidays.

Be safe, have fun, and happy holidays from ABA Connect!

What To Look for in Your Child’s Autism Assessment

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Determining when and where to get an assessment for autism can be a daunting task for parents. Time, money, and finding a clinician trained in autism assessment in your area are all things that have to be considered.

Luckily, experts in autism have devoted extensive time to help determine the best procedures for providing a valid autism diagnosis. Below I have outlined a “best practices” core assessment battery for children when autism is suspected.

An Autism Diagnostic Assessment Should Include:

1.       Parent Interview – The parent interview about the developmental history, family history, and the child’s individual strengths and challenges is the foundation of the assessment.

2.       Direct Observation – The child should be observed engaging in various social interactions. The Autism Diagnostic Observation Schedule – 2nd Edition (ADOS-2) and the Childhood Autism Rating Scales-2nd Edition (CARS-2) are well-researched measures that provide robust information about the child’s behavior as it relates to symptoms of autism. Using the ADOS-2 or the CARS-2 as a direct observation measure is very beneficial to describe the child's social strengths and weaknesses.

3.       Assessment of Cognitive Development – Cognitive functioning and problem-solving are an important part of a child’s development. An assessment of your child’s cognitive development can help inform intervention. It can also provide a baseline of your child’s functioning. Intensive applied behavior analysis (ABA) therapy has been shown to increase cognitive and problem-solving abilities in some children.

4.       Assessment of Language – An assessment of your child’s understanding and use of language is very important. Most cognitive assessments will include an assessment of verbal reasoning and vocabulary knowledge that will provide some information about your child’s language skills. Additionally, direct observation of your child during the assessment can provide an informal assessment of language and communication skills.

5.       Adaptive Behavior Assessment – Adaptive behavior describes what a child is able to do on their own. An adaptive behavior assessment can help determine what level of assistance a child needs when compared to others their age.

The information from each domain above should be integrated into a report by a licensed psychologist (PhD or PsyD) or a physician (MD or DO) that details the diagnostic classification that best describes your child. Recommendations based on the best available research and the priorities for treatment should also be included.

Remember that the above outline is describing the essentials of a “best practices” autism assessment. Additional assessment of other areas of functioning may be needed depending on the concerns for your child. The psychologist or physician will let you know if other areas should be added to the core autism assessment.

For more information about securing a best practices autism assessment at ABA Connect, please call us at 512-900-8116.

The History of Giving Birthday Presents to Kids

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Most parents in western countries celebrate their children’s birthdays by giving gifts, however, birthdays weren’t always celebrated in this way. In this blog post, we take a look at the tradition of giving gifts to celebrate birthdays, how it started, and how it differs in other nations.

Who Started the Tradition of Giving Gifts?

The act of giving gifts goes as far back as the time of cavemen, perhaps even right to the origin of our species. Of course, gifts at this time weren’t the kind of goods we’d like to receive nowadays! Cave people typically gave items from nature, such as animal teeth, perhaps with a hole in to be worn as a necklace.

Over the years, the types of gifts given has changed. Coins and herds of livestock were given as gifts in later years. Nowadays, gifts can be just about anything. For adults, it’s common to receive a household gift such as a candle, flowers or a favorite food item. Teenagers can be difficult to buy for – gifts can range from anything from gadgets and tech to make up or clothes. Great present for boys and girls on their birthday can be anything that suits them. Most commonly given gifts for children are toys and games, although clothes, chocolate and candies and things for their room.

Other Historical Birthday Traditions

In ancient Greek times, gifts were given to those celebrating their birthday as a way to get rid of evil spirits. They also used noisemakers to help scare away the bad spirits – perhaps this is where the use of party poppers to celebrate birthdays came from. In Roman times, gifts were only given to men on their birthday. Women started celebrating their birthday sometime around the 12th century.

Adding candles to a birthday cake is something else we can thank the ancient Greeks for – they started this tradition as a way to honor their gods and goddesses, however, birthday cake as we know it today was developed by Germans towards the end of the 18th century. This was the same time when ‘Kinderfeste’ first started taking place – the 18th century equivalent of a child’s birthday party.

Which Countries don’t Celebrate Birthdays?

Not all cultures celebrate their birthdays the same way. Some people, because of religious beliefs do not celebrate birthdays. Some cultures do celebrate, but with different traditions. In Russia for example, you might be given a personalized pie instead of a cake. Some cultures don’t recognize official birthdays, with many people worldwide not knowing which date or even which year they were born in.

The Future of Birthday Celebrations

Birthday customs and traditions are always changing and adapting, with many popular American customs spreading to other countries. For example, many British parents now choose to do a ‘cake smash’ with their child for their first birthday, a trend which was virtually unheard of just a couple of years ago. One thing’s for sure – birthday celebrations are set to get bigger and better as time goes on.

Behavioral Treatment for Specific Fears and Phobias

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Fears and phobias are increasingly common in children. A fear of needles is a particularly common fear that usually starts in early childhood and can result in significant avoidance of  medical procedures in general. A recent NPR story describes a research study published in 2012. The researchers surveyed over 800 parents and 1000 children. In the study, 24% of the parents and 63% of the children reported a fear of needles! This is concerning because specific fears and phobias can lead to avoidance of health-related procedures. Luckily, there is behavioral treatment for specific fears and phobias.

Behavior therapy or cognitive behavior therapy (CBT) can help children overcome their fears. The most effective behavioral treatment for specific fears and phobias is called graded exposure therapy. In graded exposure therapy the child is introduced to the feared situation or object in small steps until they are able to participate in the situation on their own. For example, if a child has a fear of going to the dentist, the treatment can start out with the child reading a book about the dentist, looking at a picture of a dentist's office, and observing a parent participate in a dental visit. Then the situations are gradually increased until the eventual goal of participating in a dental procedure is achieved.

Kids with specific phobias and fears benefit from parent participation in the treatment process. Practice at home will provide faster progress. Depending on the age and learning history with the feared object or situation, treatment can progress quickly or may take more time to break down the situation into smaller steps. Either way, behavior therapy or cognitive behavior therapy can help a child overcome their fears and phobias.

ABA Connect can offer this behavioral treatment as a part of a child's ABA therapy program or with an individual CBT program with a psychologist.

My Child Just Got Diagnosed with Autism, Now What Do I Do?

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A diagnosis of autism can be an uncertain time for a family. Many parents are sent into a whirlwind of emotions and left wondering unanswerable questions: Why is this happening? How did this happen? What will their future look like? What do I do now?

Some questions are easier to answer than others. First, knowing which specialists are available to help can bring peace of mind. Some services are evidence-based, versus “fad treatments” or experimental treatments with no research supporting their use or effectiveness. Evidence-based treatments are interventions that have been supported by peer reviewed studies that have been replicated, often through years of research. When a provider tells you they can help your child with autism, don’t be afraid to ask them, “Can you tell me about the research supporting your services?” and “Is your treatment recommended by the National Institutes of Health for treating people with autism?”

Children with autism often receive a variety of support from different sources; evidence-based services include ABA therapy from a Board Certified Behavior Analyst (BCBA), speech therapy from a Speech Language Pathologist (SLP), ongoing care from a pediatric neurologist, and possible treatment with a doctoral psychologist or psychiatrist.

Wow, that’s a long list! Does my child need all of those services?

The answer is each child is different, and your child’s needs will change over time so it’s best to know what options are out there! Some services may require more time than others. ABA therapy, or applied behavior analysis therapy, typically ranges from 10 to 40 hours per week depending on a child’s needs. The programs are intensive, which requires a higher number of therapy hours. Research indicates a lower number of therapy hours does not produce meaningful outcomes, hence the greater time requirement (Granpeesheh et al, 2009).

Search for ABA centers in your area to learn more.

Speech therapy with a private SLP typically ranges from 1 to 2 hours per week. Many provide in-clinic and in-home services. To find a private speech therapist, search for speech language pathology clinics in your area. Public schools in Texas also offer speech therapy, typically about 30 minutes per week. Contact your child’s teacher and school psychologist to see if they are eligible to receive services at school. If they are currently not eligible, inquire if the school can evaluate them to see if they need support (they can!).

Pediatric neurologists provide initial diagnoses and ongoing screenings or check-ups one to two times per year. If additional diagnoses are warranted, they can evaluate your child and refer you to recommended specialists if need be. Neurologists can diagnose developmental disorders, seizure disorders, brain injuries, and nerve-muscle disorders.

Psychiatrists and licensed psychologists can also provide a diagnosis of autism. Psychiatrists can provide treatment through medication if severe behavioral issues (such as severe self-injury or aggression) persist in spite of intensive ongoing behavior therapy. Licensed psychologists can provide a variety of therapy options, including PCIT, or Parent-Child Interaction Therapy. PCIT is a type of evidence-based therapy that teaches parents effective ways to engage their children to produce meaningful behavior change and skill acquisition.

Collaboration is Key

Hands down, collaboration among all specialists will result in better outcomes for your child. Encourage your child’s team to communicate on a regular basis! For example, BCBAs or speech pathologists can attend doctor visits with the neurologist or psychiatrist to discuss specific behaviors that are observed during day-to-day therapy. Doing so will give doctors more complete information and allow them to make the most informed decisions. Also, BCBAs can include recommendations from a psychologist in their skill acquisitions programs and individualized behavior plans. The two specialists can also discuss if other evidence-based treatments are needed, for instance in a child has multiple diagnoses that require a variety of behavior therapies.

Moving Forward

In addition to knowing how to navigate through the sea of specialists, many families benefit from reaching out to one another. Parent support groups that connect parents of children with special needs are a great place to find compassion and understanding for a process that can be emotionally taxing. Further, many states have conferences, such as Texas Parent to Parent Conferences that provide parents with information and foster connections with other families. You’re not alone, don’t be afraid to reach out!

Learn more about reducing stress in your life with these simple techniques and tips.