Thursday, April 26, 2012

Applied Behavior Analysis in every day parenting

Many kids are picky eaters. Picky eating is one of those parenting challenges almost every parent faces. And while picky eating is not unique to autism, it can be exacerbated by it because of the heightened sensitivity to texture and taste that many children with special needs experience.
 In previous blogs I talked about some of the applications of Applied Behavior Analysis (ABA) and its use with autism. But I also tried to emphasize that ABA is not synonymous with treatment for autism. In fact, ABA can be applied in any situation where a behavior change is desired. And of course, the principles and strategies can be applied in every day parenting. Picky eating is a great example of this.  The same systematic techniques combined with positive reinforcement used to teach any skill can be used to address picky eating. If your child has a severe aversion to a food, start with baby steps, breaking down each task into very small reachable goals. For example, you can start by just having the undesired food on the table. Get the child used to having it there next to his other food and seeing other people eat it. Once he accepts the food on the table, you can move on to having him smell it, bringing it closer to his mouth. Remember that every successful step needs to be rewarded with, for example, a bite of a food that the child likes. Possible next steps can be to have the child lick the food, getting him used to the taste. After that, move on to taking a bite. He may not even chew or swallow the food, just take a bite and spit it out. Remember, we are breaking this down into tiny achievable steps. After the child agrees to take a bite, you can move on to swallowing and so on and so forth until the child agrees to eat the new food.

 The same principles and strategies can be implemented with problems such as brushing teeth, sleep in own bed, toilet training, etc.  

 These baby steps may not be necessary with a typically developing child. Most of the smaller steps can be bypassed and the idea is simply to convey to the child that he at least needs to try the food before saying he doesn’t like it. If the child tries and does not like it, he can have a reward of something else to eat, then slowly move up towards eating more than one bite of the food the child refuses to eat. Eventually, you will be able to say to your child “you can’t have your dessert until you eat dinner” and the child will get the point.  Most children will usually give in to eating something over going hungry.

Always keep in mind that some food aversions can be related to allergies and should be checked with a doctor. Also, even adults have food preferences so if your child really does not like a certain vegetable there is no reason to ever force a food on a child. Be realistic with your expectations and relax.

 Good parenting almost always involves offering choices and a loving approach that focuses on “the good” rather than “the bad”. Love is the most powerful tool of discipline.    

Daniel Adatto, BCBA

Friday, April 13, 2012

Can a child be “a little” autistic?

Parents often ask us if their child can be “a little” autistic. The truth is there really is not a clear answer. There are many terms used for children who do not have a full-blown diagnosis of autism. Some examples of these are autistic-like, on the autism spectrum, displaying autistic-like symptoms. These often refer to children who may exhibit some of the symptoms on the autism checklist but not all. Displaying one or two autism symptoms is not always cause for concern but does raise a red flag and should be checked by a professional.
One can infer that for every kid who receives an actual autism diagnosis, there is another who has autistic traits - including repetitive behaviors and communication problems – but is not found to have autism spectrum disorder. For a diagnosis to be made, a child must exhibit a certain number and severity-level of these characteristics. In other words, not every child with social impairment can be characterized as autistic. But on the flip side, many children can suffer from autistic traits on a level that is in fact impairing even though they may not meet the full criteria. The good news is that Applied Behavior Analysis treatment, which is proven to be the most effective intervention for children with autism spectrum disorder, can also be used to effectively treat any behavior disorder as well as to teach critical skills that a child may be lacking.

A parent’s gut feeling is often the best indication. Parents should follow their instincts and talk to a professional if they have trouble in any of the following symptoms:

·        Impaired social interaction or difficulty forming relationships

·        Trouble responding to social cues

·        Inability to understand give and take activities like sharing

·        Shows extreme distress over minor changes in routine

·        Problems with verbal and non-verbal communication

·        Failure to respond to name

·        Avoidance of eye contact with other people

·        Repetitive movements such as rocking, hands flapping or twirling

·        Self-abusive behavior such as biting or head-banging

 Applied Behavior Analysis is a scientific system of principles and techniques aimed at understanding and changing behavior. Any behavior: eating disorders, addictions, outbursts, domestic violence, relationship problems, crime, stress, etc., etc.

Also, and probably more important, is a system to teach skills. Any skill: learning skills, social interactions, stress management, anger management, productivity and motivation in the work place, etc., etc.

Challenging behaviors are means of communication: your son is telling you something when he throws a tantrum. By understanding what he needs, we teach functional skills (replacement behaviors) that are socially appropriate, thus eliminating the need for crying and screaming.

If you mom or dad are concerned about your child’s behaviors, we can help. We know how. There is a light at the end of the tunnel, even though you may not be able to see it now.

Daniel Adatto, BCBA