What To Look for in Your Child’s Autism Assessment

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.

Decrease Autism-Related Shopping Meltdowns

Meltdowns happen. But, there are ways to decrease the likelihood your child will have a shopping meltdown. In my previous blog I discuss tips to understand shopping meltdowns. In this blog, I outline simple ways to decrease autism-related shopping meltdowns.

Tend to basic needs first

Before a shopping trip, tend to your child’s basic needs. Make sure they are not hungry, they are rested, and they have received positive interactions with others such as play time with parents, peers, or siblings. Hunger and fatigue make children (and adults) more irritable. Before shopping, you could have a snack with your child and ensure you are attending to and delighting in their positive behaviors. From your child’s point of view, shopping likely means a lot of difficult to manage sensory experiences (sights, sounds, and smells) and adult correction. Therefore, it is important to ensure positive interactions (even for 5 minutes) before a potentially stressful shopping trip.

Use a visual schedule and list

As much as possible, let your child know about the shopping trip before it happens. Visual schedules are incredibly useful for children with autism. Add shopping trips to your child’s schedule, and better yet, try to have a routine grocery shopping or errand day each week. This will help increase predictability for your child. A visual shopping list with smart phone apps, pictures, or clip art can also help your child actively participate in shopping.

Identify meltdown triggers

Identifying meltdown triggers can help caregivers stay one step ahead of potential meltdowns. Some caregivers find that headphones, sunglasses, a soft object to hold, or the child’s favorite foods can help reduce meltdowns. If you observe your child is becoming upset, take a moment to help them calm down before the frustration builds. This may require a pause in shopping so a full meltdown does not occur.

Teach calm shopping behaviors

Children need to learn what behaviors are expected. Some children need explicit teaching and modeling. Social stories and video modeling can help children learn appropriate social behaviors. Video modeling can include having your child watch a video of another child successfully shopping with an adult or a short clip of themselves engaging in calm behavior while shopping. Children may need specific reminders and prompts at different points of the video to ensure understanding. Parents can also attend to calm behaviors during the shopping trip with praise (“Nice inside voice!”) and positive gestures such as a high five, or introducing small portions of food for the child’s “calm” behaviors.

Plan

Planning can help prevent meltdowns. Make a shopping list, decide what shopping items are most important so you can get those items first, and try to reduce the total shopping time. If you ensure you have plenty of planned strategies to help your child stay calm, your child can learn how to manage the stresses of shopping.

Understanding Autism-Related Shopping Meltdowns

Children do not always go along with the shopping plan easily. Autism-related meltdowns can make shopping even more difficult. Understanding autism-related shopping meltdowns can help you and your child experience less stress during a shopping trip.

Carefully observe your child’s triggers

Observe what happens before your child has difficulties. Most children are more likely to have a meltdown if they are hungry or tired. A common trigger for children with autism also includes sensory overload. The lights, sounds, smells, and crowds from a shopping trip can trigger a meltdown. Shopping at the popular grocery store on a Saturday may be more stressful for your child because it is loud and chaotic. You might observe that the smaller, less-crowded grocery store does not trigger a meltdown.

Understand the difference between meltdowns and tantrums

Both meltdowns and tantrums can include screaming, crying, falling on the floor, self-injury, and destruction. But, meltdowns and tantrums happen for different reasons. I define a meltdown as the visual display of a child becoming overwhelmed in response to a trigger. Meltdowns do not immediately stop when a child is given what they want or when they are taken out of an unpleasant situation. The intensity of emotion during a meltdown may take a minute (or more) to decrease.

Children throw tantrums to gain access to something (attention, food, toy,  etc.). Children also throw tantrums to avoid something (unpleasant activity, ending play, bedtime, mealtime, etc.). You can usually stop a tantrum by giving the child what they want (leaving the store, that special toy, attention, etc.). A child having a tantrum may also watch for your reaction to see if the tantrum is working.

Conduct an experiment

Parents can carefully observe and implement systematic changes to decrease the likelihood of a meltdown. If you know your child’s triggers, you may be able to modify the trigger. For example, if a change in your child’s drive home from school triggers a meltdown, plan to give him or her ample notice (verbally or visually) that a shopping trip will occur. If the grocery store’s fluorescent lights are too bright, consider ways to reduce the child’s exposure to the lights.

Understanding autism-related shopping meltdowns gets us one step closer to improving your errand-running experience! On my next blog, I will provide tips to prevent meltdowns.

Stress Reduction for Parents of Children with ASD

Your well-being as a parent of a child with ASD is critical to your child’s functioning. I have listed some simple stress reduction strategies to help improve your emotional well-being as a parent of a child with ASD.

Social Support

Connecting with friends, family and others in the ASD community is a simple stress reduction activity. When you connect with others, it reduces loneliness and helps you feel supported. If you connect with other parents in the ASD community it can allow you to share triumphs as well as discuss challenges with others who have shared experiences. For social support within the ASD community, check out ABA Connect’s Facebook page and the Autism Society of Central Texas Calendar. Both of these sites are updated regularly and are full of events just for you!  Also, reference our Resources page to find organizations who design programs for persons with ASD and their families.

Schedule Time To Be “Mindful”

Take some time each day to focus on the present through a practice called mindfulness. Resist the urge to think about your child’s therapies, what’s for dinner, or anything else competing for your attention. Take some time, even if it is 10 minutes, just for you. Sit with your thoughts without judging them and focus on your surroundings, feelings, and any sensations you may feel without trying to change them. Mindfulness can include meditation or it can just be a specific focus on what you are doing in the moment. To learn more about mindfulness and how it promotes well-being and reduces stress, see the University of Berkeley Greater Good Science Center website. 

Delight In Your Child

Parent optimism has been associated with stress reduction, better parenting, and positive well-being. That does not mean parents walk around with rose-colored glasses. But, an increased focus on your child’s positive qualities and strengths can increase hope and optimism. Think of a cute thing your child did, a tender touch, or anything your child does that makes your heart melt. Reflect on those moments to boost your mood. If these moments do not readily come to mind, start today by looking out for things that make you smile about your child. One mother did this through an Autism Speaks blog that outlines five of her child’s personal gifts.

Foster Gratitude

Research in positive psychology shows that regular gratitude can improve happiness and life satisfaction. One way to do this is to write down three things that went well during the day before going to bed. You may start by doing this for just a week or you may try practicing it consistently. Once you develop the well-being habit of noticing the small things that go well during your day, it can increase positive feelings and decrease stress.

Ask For Help When Needed

Know if you are experiencing “caregiver fatigue.”  Caregiver fatigue can interfere with your ability to enjoy your child and engage in positive interactions.  Respite care for your child or help from family and friends can decrease stress and enhance caregiver well-being. If you feel you need additional help, consider joining a parent group led by someone experienced in children with developmental disabilities or consider individual therapy. HelpGuide.org offers good information about the signs of caregiver burnout and caregiver fatigue.

If you feel you need professional assistance, consider contacting our separate, but affiliated practice, ApaCenter. ApaCenter offers therapy and consultations for individuals, parents, and couples who want to improve their emotional and relational well-being.

Transitioning Back to School: Tips for Parents

Beginning a new school year is both exciting and nerve-racking for parents and children. The transition is especially challenging for families with children on the autism spectrum. While transitions are difficult, there are things families can do to help prepare their children for the new school year. Keep these tips in mind to make the transition back to school a success:

  • Prepare your child for change. The beginning of a new school year brings many changes at once. Familiarize your child with anything new related to school as much as possible. This may mean bringing your child into their school or classroom, showing your child a picture of their teacher and any classmates, or even meeting the teacher before the first day of school.
  • Resume routines. Over summer vacation your child’s morning and evening routines may have changed. They may be waking up and going to bed at different times. Start adjusting your child to the school year schedule and routine well before the school year actually begins.
  • Prepare your child’s teacher. When it comes to your children, you are the expert! Just as your child may need some preparation for a new teacher, your child’s teacher will benefit from getting to know your child ahead of time. Make sure to share any tips or tricks you have learned about your child, including strengths and challenges, what motivates him/her, and how to respond when he/she is upset.
  • Review the “hidden curriculum.” While many children switch easily between the social demands of summer and those required in a classroom, children on the autism spectrum may need more explicit reminders. The hidden curriculum refers to social information that is not directly taught, but is assumed that everyone knows. Go over the “dos and don’ts” of acceptable school behavior. More information regarding the hidden curriculum can be found here.