PROMOTING INDEPENDENCY- AUTISM

Hello, Hi, good to see you!!! Another interesting topic in the journey of Autism, highlight demands/needs and work carefully to enjoy success. Our children are in a way capable and all it needs is total encouragement and trust.

“Don’t go where the path may lead to

Go instead where there is no path and

Leave a trail”

thanx to www.autism-essentials.com for the above picture

Independency is a big word to think and implement in the life of children with autism.  Children (with normal development) perform tasks/activities independently at certain stage does not like parents/caregivers intruding their work and they enjoy the feeling of accomplishment and competence. Children with autism do not seem to get the concept of independency though they are equipped to perform the task given. Often times we will be surprised to know that many skills which may seem to be second nature to normally developed children are the skills that still need to be taught to an autistic child. Most of the time children with autism ask for help (what and how abouts) to complete the task and expects reassurance. This is because children with autism have difficulty with organization, initiation and generalization. Children with ASD are too much used to adult prompts and finds difficulty to display target skills without their supervision. I heard parents telling complaints like; does not stay on task with their absence, expect them to say next step, does not do simple and well known activity independently, looking for assurance in each step, sits for long hours to complete simple stuff independently. The moment parents/care givers decide to take back step/ removal of close supervision leads to frustration and tantrums in children with ASD. We have to understand the reasons for lack of independent behavior and the strategies to promote independence in our children. Difficulty with independent functioning impairs the overall development in children.

Reasons behind lack of independent behavior:

Ø  Lack of organizational skills: children with ASD have problems in following instruction because of other associated issues like inattention and auditory processing difficulty. Shows significant difficulty in understanding demands required to complete the task and developing plan of action for successful execution.

Ø  Distractibility:  caused by internal and external factors may also hamper child’s ability to complete the assigned the task. Children finds great difficulty in prioritizing the information required at the same time have issue filtering unnecessary visual and auditory stuff.

Ø  Lack of sequencing skills:  most of the time children get confused with the steps (the first and last step) in order to complete the task. Understanding the beginning middle and end of the task are highly demanding for children with ASD. 

Ø  Initiation:  initiating task on their own is quiet tuff for children with ASD; they expect prompt and assurance in every move they make. They go through hard ships especially planning and initiating lengthy tasks.  Initiation is part of executive function deficit though they get the concept of doing the task.

Ø  Constant adult involvement: prompting works best in the initial acquisition of the skill/ task, but as a parent/ therapist you need to be very cautious to withdraw prompt to make your child total independent. Children with ASD are not able to continue productive and appropriate responding with the removal of close adult supervision. They expect some form of rein forcer’s and contingencies provided by adults without that it’s difficult for children with ASD to maintain the task.  Understand the learning of task in to three stages like acquisition of a task, maintenance of a task and generalization of a task, give opportunities for your child to generalize and carry out the task with ease and total independent execution.

Ø  Prompt dependency: this is very common in children with ASD and other related disabilities and constant adult supervision is one of the reasons for prompt dependency. Children often depend upon adult supervision and assistance to carry out tasks once the intense level of support is provided , it may be difficult to  fade support over time due to an individual resistance to change or insistence on sameness, consequently impacting long term functioning. Staying “on task” is difficult without prompt they thrust for assurance in every move they make. Prompt dependency is seen more in children who participated more in one-on-one instruction/ sessions. Prompt dependency leads to learned helplessness and over all passivity.

Ø  Difficulty in generalization:  children with ASD perform a task independently in one situation/setting, yet finds difficulty to apply the same skills in another novel situation, this acts as a great hindrance for independent behavior.

Strategies to promote independency:

J Start with simple tasks for independent execution and then gradually progress to more difficult tasks. Model the new task and give instructions clearly and help him to practice and gradually fade the prompt. Give him/her enough opportunities to perform on his own. First time your child successes to execute the task with total independency surprise him with his favorite rein forcers to continue further maintenance of the task.  

J Video modeling: is proven to be best technique to teach skills using minimal adult supervision and prompting. !) Choose the target skill need to be taught!) Model performs target skills while being video tapped!) The video is viewed prior to learning!) Once he masters doing task independently video self modeling is done in a natural setting. Video modeling holds a promise as a means to promote independent to independent behavior and it minimizes the need for instruction delivered by a teacher or a parent.

JWork systems to increase independence: is a strategy by presenting tasks systematic and organized way.  The materials provided in the work stations are visually communicate the information to children. The idea of work system is part of a technique called TEACCH. The system clearly provides the information about the nature of the task, steps need to be completed using concrete cues, giving clear idea of starting and ending of a task( giving visual cue by giving stop sign or finished pouch or box), once he is finished with the task he is been clearly indicated to next activity. A work system provides all of the require information without adult prompting and teaches the student to attend visual/verbal cues when completing task.

JWritten work system: for children who can read and process written information and present the steps in a sequential order. 1) How much work he has to do 2) when the work is finished 3) what is next activity 4) how many steps are required to complete the task 5) to understand first and then 6) reduces adult prompt 7) uses of contingencies and reinforcement. As we know our children process written information to complete the task.

J Restructuring the environment: Always provide specific material required for the specific task, see to that you avoid extra or unnecessary information. Use work system in a variety of setting to increase generalization. Gradually decrease adult prompt for the child to be used to work system. Visual cues should be provided to indicate the end of the task.

J Delayed contingencies: parents/ caregivers tend to give prompt before the child executes the task, children with ASD takes time to process information (processing delay). Slightly delaying the instruction and contingencies can facilitate independency and eventually child get chance to generalize the learnt skill.

JGeneralization: encourage him to execute the learnt skill in variety of settings. I heard parents telling me like: he does it with me or he does beautifully at home, this is because he lacks in generalization. Child should learn to perform the task in multiple settings until then independency is highly demanding goal.

Children with ASD and other related disabilities need to be encouraged to carry out tasks independently, as we understand these children easily become prompt dependent and go through stress when we tend to vein off the prompt. Increasing independency has often been a daunting goal for educators/ parents while working with children with ASD.  No matter what your child level of ability is, he will surely do his/her best when you plan and implement strategies carefully in order to promote independency. I feel as parents of children with ASD your primary and highly demanding goal should be to make your child independent. It may take lot of your thinking and time but I am sure at the end results are worth to celebrate. Cheers!!!!

I AM LEARNING TO WAIT

Hello friends, warm greetings

“Someday everything will make perfect sense

Smile through the tears and keep reminding

Yourself that everything happens for a reason”

thanx to www.easyvectors.com for the above picture

Waiting is a necessary life skill that everyone needs to learn.  We have to display this skill in different events in our life; at home we need to wait for the dinner to be ready or wait for our turn to watch our favorite TV program. Outside home I mean in the community we need to generalize the learnt waiting skills in various situations; in the restaurant we need to wait for the order food to come to our table  and need to wait in the line to pay grocessary bill( now a day’s expect this bill all the other bills are paid in online). For children with autism learning to wait is extremely challenging task, I have experienced children rolling on the floor, screaming, trying to attack, throwing things nearby whenever they are delayed  with their desired object. Most of the time it’s hard for them to understand the concept of wait and for some children they just can’t wait though they get the concept. The Delayed gratification leads in to frustration and the child end up throwing a big tantrum. Wait more, not now but later, after you done are tuff words to take it for children with amazing autism.  As we clearly know this skill needs great focus and consistent approach from our side or whoever working with the child. The approach and strategies to teach the concept of wait differs from child to child. I am happy to mention some of the techniques which works best to bring out concrete change in children with autism and other related disabilities.

·   Show your child  the symbol of wait or Icon  whenever he is needed to wait by placing right hand over the left hand preferably palm facing down

·   If your child in picture level show him/her the picture of the child sitting with quiet hands and say wait

·   Use timer for understand the waiting time by saying waiting time on, timer with auditory signal does great job here. As soon as timer rings give him the requested item immediately by saying that was a good wait

·   Initially start by having your child wait for very short periods of time by setting the timer for short duration

·  Always provide with positive praise with the desired item though the child responded to the request with resistance by saying you tried waiting, good job

·   You can ask your child count numbers up to 10 or you counting during wait time, slowly you can increase wait time by giving long pause between numbers like1….2……3….

·   Ask children to complete a simple puzzle or ask them to place pegs in the peg board during wait time by saying first do this then that. The child shows great deal of resistance; initially give physical prompt to complete the task. Select activities which he finishes in very short time/ duration

·  If the child tries to grab the desired item or tend to attack you during wait time, simply say quiet hands and show him/her the symbol of wait.  One of my student attacks whenever there is delay in getting desired item, we tell him hands in the pocket!!! Once we finished counting ten his hands are off from the pocket and he gets item with positive praise. It worked

·   Always Place the desired item in the same place preferably not in child’s reaching level but he could clearly see it, this helps him to understand whenever the item is placed there he needs to wait, this gives him visual cue  or contextual cue and facilitates better learning

·   In the beginning you can expect lot of protest from your child when he denied access to his favorite activity or item, as the child understands the process there is a visible change in intensity of protest as well as increased patience

·   Always remember the wait time has to be highly reinforcing and motivating to the child, by saying you are a good waiter, I see you waiting that makes me happy or its pleasure to see you waiting etc

·   Write a social story about wait for understanding the consequences of learning this skill and to make him understand the projection of others feelings

·  Allow your child access to preferred item for a small increment of time, then stop access to the item

·   As your child learnt to wait for short periods gradually increase the time of wait

·  Never use no if your child request for desired item instead practice to say you have to wait, this is waiting time etc. The word no triggers tantrum always approach in a positive way

·  Maintain very calm voice and don’t show irritation or anger in your face if your child bothers you during wait time

·  Create a natural opportunity for your child to learn the skill of waiting as well as generalize the learnt skill

There is lot of work involved from your side while your child learns to achieve this life skill. The whole procedure sounds very easy to implement, but not that easy as it sounds. You (parents of autistic children, therapists) come across hard times while your children acquire this skill, but all I could tell you is never give up!!! Children with autism may not be able to tell you how much they love learning from you and your presence but I am sure they appreciate all you do. You are amazing

Take care

ENGAGE ME WHEN YOU ARE BUSY

Hi, it’s my pleasure again

Today I happened to listen to sadhguru  Jaggi vasudev, he is a spiritual guru and an amazing speaker. I am enlightened to mention this quote by sadhguru

“Life is not about waiting for the storm to pass

It is about learning to dance in the rain” 

thanx to http://www.heartofthematteronline.com/ for the above picture
 Yesterday I had an appointment with the doctor; to avoid traffic I started early and I ended up reaching there prior to my appointment time. I engaged myself by flipping the magazine, suddenly my attention caught with an incident happen there.  A young boy walked in to the doctor’s office along with his mother as she was busy talking to doctor’s PA, this young cute little boy was wondering the room purposelessly and grabbing stuff from the office desk. I think the PA got little irritated and told him hey you are big boy don’t you think you have to ask permission before touching others stuff, all this happening that boy did not give notice to that PA not even eye contact. His mother seemed to be little annoyed by the situation and told her that he is a child with special needs. I am sure most of you (parents of special children) would have come a crossed these kind of hard ships, May not be in doctor’s office elsewhere.  What do we need to do to make our children: sit in one place, meaningfully explore the new place and asks people permission before they touch others stuff. HmmJJJ you would have given enough thought and I am sure you guys are successfully implementing the strategies you found for your children.  Engage his waiting time by structuring it interestingly of his choice not really making him do home work or accademic work. if you manage to  do so he will surprise you with expected behaviour!!!!!  

Simple tips to go with the situation where your child has to wait:

v  Carry a small mat with his name on and place it on the chair or on a floor (wherever you assigned him to sit) this reminds him of his territory. Initially start this practice at home so he could generalizes wherever he go

v  If he is fond of music carry an I pod or music player with ear phones(some children are sensitive to ear phones be aware), play songs which are of his great interest or you  play selective songs  whenever he has to wait for longer period

v  Take his favorite toy or object to manipulate this will keep him engaged when you are busy doing your work. Remember sometimes obsessions also can work as a reinforcement

v  Provide a wrist band with his favorite characters, I am sure this make him engaged  

v  If your child is fond of reading carry a  new book to read this gives him enormous joy, some children with autism want to read the same book again and again  in that case carry his favorite one

v  Create interest in cross word puzzles and word hunt games, this is the best way to keep your child occupied when you are finishing your work

v  Some children are very fond of play dough let him enjoy by rolling the clay and encourage him to make models with it

v  Prepare your child before taking him to any place. Social stories will be of magical help in understanding the what’s where’s and who’s he has to deal with the situation

v  If your child knows time concept explain him how much wait time by making him read the clock, allows him for preparation and meaningful engagement or sometimes stop clock also serve the purpose 

v  Tell him it’s ok to rock himself sitting in the same place, this gives him vestibular movement/movement gratification

v  Contingency contracting works best most of the times,  by explaining terms and conditions like; mama will buy you stickers when you sit and read your book until mummy finishes her work

v  Coloring books are sometimes a great savior provided your child should have interest

v  Reinforce immediately and consistently

As we know every child is unique and strategies should be tailor made and your child will show you which works best for him. All it needs is trial and error and consistency in using the approach.  All the best, I bet your kitty has much more ideas which are  already serving the purpose

Take care, see you soon

BEHAVIOUR - A MODE OF COMMUNICATION

              
Hello friends

Good see you and I wish this New Year brings you lots and loads of great joy and success

Believe that all things are possible

Never give up!!! Try, Try Try

thanx to http://www.artandcritique.com/ for the above picture

Most of the behaviors children with Autism exhibit are a child’s response to a disturbance in his internal or external environment. Consider that a child’s behavior is his/her means of expressing his emotional feelings of need or discomfort. Trying to control or negative response on a behavior often makes things worse and it tends to increase in nature. Always as a parent /therapist make sure you identify or resolve the stimulus or trigger factor. If the stimulus (factor that triggered the behavior) is not addressed, the behavior can escalate or new intense behavior can take place. Give it a try to understand that the exhibit behavior is a mode of communication. Let us analyze the reasons for escalation of undesired behavior.

ü  Identify the behavior pattern: this step need to answer couple of WH questions like when the behavior is happening( I mean it is related to calendar time, days etc), where it is happening( the location or place of exhibition) and with whom the behavior taken place etc

ü  Changes taken place in the recent past: changes which are happened in the child’s environment has considerably affected child’s mental health or triggered emotional issues. For ex; moving to a new residence, child’s favorite TV program has stopped, he lost his favorite toy, his care taker has been changed in the classroom.

ü  Changes in the sensory environment: new arrangements in and around him (school, house), basically it talks about infrastructure. For ex; new lights arrangement, changing the door bell, changing ring tone of the phone, rearrangement of furniture.

ü  Developmental spurt: adolescence plays a major role influencing behaviors and there are sudden changes in child’s personality and the way he interacts or responds to environment. We can clearly make note of aggression frustration and increased tantrums in children with autism. Increased challenges and the fear of facing these issues shapes up in to an undesirable behavior.

ü  Illness: if you find any sudden changes in your child’s behavior give a great notice to his health, sometimes pain and discomfort in the body influences behavior. Child lacks receptive vocabulary to explain the health issues instead he show it as a form of behavior.

ü  Attention seeking: top it of some of the behaviors exhibited by the child is purely to seek attention from people.

Measures to be taken to address these issues:

J Always understand behavior is a form of communication

J Talk to him about alternative ways of showing his needs. For ex; if he is not happy with the dinner choice instead of screaming the child can say it as I would like to include cookies in the provided menu

J Extinction or total ignoring works best in greatly reducing the attention seeking behaviors

J Relaxation techniques helps your child in reducing anxiety and calms him in a great extent, one such relaxation technique is Jacobson’s progressive muscular relaxation. It works best in some children with ASD and all it needs is practice, practice only practice

J Do frequent health checkups for your child and educate him to identify and inform you about his aches and pains. Give him visual cards to indicate his type of discomfort or pain

J as a parent you need to calm down and be positive when you responding to these behaviors, all it means is be patient and give time while your child working on deescalating the negative behaviors

J Prepare your child for adolescence in advance; it will help him to adjust with the changes happening in him. Social stories is a great resource here

J Prepare your child for transitions (changes) well in advance, helps him in better adjustment. This should takes care of sensory issues as well

Your child’s behaviors are an opportunity to learn or get to know more about him is n’t it amazing. Count on your trust and use the strength of your relationship with him to make things best for him. All it needs is belief yes the magical word belief.

Wish you a very happy and fantastic new year

2012