Tuesday, July 31, 2012

Preparing for back-to-school

Is it back-to-school time already? Where did the summer go? Anyway, let’s get ready for back to school.

Children in general, but especially those with autism spectrum disorders, generally have a difficult time with transitions. It stems from the fact that they have trouble shifting attention from one activity to the next and tend to have a greater need for predictability. As any parent of a child with autism knows, preparation strategies are crucial. These next few days are the perfect time to begin preparing your child for the back-to-school routine. By using this time to slowly transition into the routine, it will help avoid the meltdowns and behavior issues that can occur when a child is not adequately prepared for a new situation. Here are some tips:

·       If your child has trouble waking up in the morning, start putting him to bed earlier, using 15-minute increments to get the time earlier each night. Once he is used to waking up at the expected hour, waking up on the big day will be much easier.

·       Next, you need to establish a consistent morning routine. Using a visual schedule is a great way to show to a child the sequence of events that make up this routine. You can prepare the schedule together with your child using pictures or drawings of familiar activities such as going to the potty, brushing teeth, getting dressed and eating breakfast. The visual schedule will give your child a sense of control and allow him to understand which activity follows which. To help avoid power struggles, it is helpful to have a desired activity follow an undesired activity. For example, if TV is part of your morning routine, make sure that more difficult tasks such as getting dressed come first and TV time can serve as a reward.

·       Give your child a 5 or 10-minute warning before he is expected to move onto the next activity. Never whisk him away from a preferred activity and demand that he gets in the car when it is time to leave. When giving warnings try to make the instructions as clear as possible by breaking them down into simple steps. Sometimes a seemingly simple statement such as “we’re leaving in 5 minutes” can be too difficult for a child to understand. Instead you can say “in 5 minutes we have to walk out the door and get into the car”. 

·       If power struggles over food or clothing are an issue, be sure to offer choices, as in “you can have cereal or oatmeal”. You can even have your child choose his clothe the night before. Choice making will give the child a sense of control and reduce the power struggles.

·       Needless to say, choose your battles. Give up on combing his hair to perfection, for example.

Once you have established your routine stick to it consistently. Having a predictable and consistent daily schedule builds confidence in a child, decreases anxiety, and encourages cooperation. Preparation and consistency are keys to success in back-to-school. Remember, it is not about “begging” or “forcing”; or “hoping” your child will be OK. It is about manipulating environmental variables (routines, visual schedules, rewarding positive behaviors, providing choices instead of directives, etc.) to prevent meltdowns and facilitate desired behaviors, such as compliance. You can be in control, and you should.

Daniel Adatto,
Board Certified Behavior Analyst

Friday, July 20, 2012

Spanking Again?

I can’t believe it. Another article about spanking? This time the title is “Study fuels spanking debate” (http://www.latimes.com/news/local/la-me-banks-spanking-20120714,0,6374260.column)

How is it that spanking is still a topic of debate?
“If you spank your children, even occasionally, you’re setting them up for a lifetime of mental and emotional distress,” the article reads. There was a study from two Canadian universities published in the journal of the American Academy of Pediatrics and led by Tracie O. Afifi who defines “spanking” as “hitting”. What’s the novelty of this, I asked myself, it IS hitting.
No so fast, Mr. Behaviorist. “I think there is an important distinction”, writes Sandy Banks, the author of the LA Times article, “Hitting, slapping, shoving, grabbing are not the same thing, to my mind, as a parental smack to the behind.”
I don’t agree with that. But I agree with her when she says “The conflict between what we do and what we believe is never tested more than in parenting.” Yes, but that does not make hitting, excuse me, spanking OK. Or yelling, or threatening. Parenting is very rewarding and fulfilling, but it can be very challenging as well, no doubt, and it confronts us with unknown territories of ourselves.
“The point of spanking, after all, is to get kids to behave”, we read in the article. My question is how can we expect them to behave when we don’t? Being able to control ourselves before we request our kids to control themselves is paramount. After all our main job as parents is to teach, not to police. What we teach with hitting? Maybe, just maybe, we teach that conflicts are resolved with violence and aggression, don’t we?
The author of the article finally confessed. “While I would never have called it “hitting”, as Afifi insists, I probably whacked a few backsides when my children were young.” She goes further when she says “Looking back now, I think the spankings of my youth taught me things than lectures and time-outs couldn’t: that my mother’s indulgence had limits. That pain can be a powerful deterrent. That bad choices have bad consequences.”
Seriously?  Are you saying that spanking is the way of teaching all that?
How would you like, Ms. Banks, if someone much bigger than you spanks you every time you do something wrong? What would you say if you know that the teacher spanks your kids? And what if the police officer spanks you for speeding? Problem solved, let’s just spank each other every time we misbehave.
Spanking is not OK under any circumstances. It reflects “parenting ignorance” because there are other ways. Spanking comes out of frustration, anger and lack of resources. If you find yourselves spanking, first apologize to your kids and then ask for help. There are other tools of discipline that build positive behavior repertoires, that teach limits and respect, responsibility and self-control. But through love. Let’s set our kids for success by respecting them at least in the same way we like to be respected.

Daniel Adatto.

Board Certified Behavior Analyst.

Wednesday, July 11, 2012

Common misconceptions about Applied Behavior Analysis

I would like to draw attention to some very common misconceptions about Applied Behavior Analysis (ABA). For example, that ABA is only relevant to the treatment of autism, or that it is synonymous with Discrete Trial Training (DTT). Discrete Trial Training is a teaching procedure that is based on the fundamental principles of Applied Behavior Analysis, but it is only one of the many aspects of ABA.

ABA is a systematic approach to understand and change behaviors and thus, much more than any one particular teaching procedure or intervention. It is based on many years of research into behavior, its causes, and strategies for changing behavior and building functional behavioral repertoires. ABA can be applied in any situation where a behavior change is desired. Other teaching methods included in an Applied Behavior Analytic approach include Incidental Teaching, Pivotal Response Training, Verbal Behavior Training (VB), Behavior Management, and others.

DTT (sometimes referred to as the Lovaas method) is an intensive treatment designed to assist individuals who have developmental disabilities such as autism.  It involves systematically and intensively teaching a variety of skills those individuals with disabilities may not pick up naturally. Because these individuals do not learn the way we teach, we should teach the way they learn.

Programs designed for individuals on the autism spectrum initially teach pre-learning skills (sitting, attending, looking at the therapist, imitation, etc.), social skills, self-help skills, communication skills, safety skills and basic concepts (colors, letters, numbers, etc.).  After these basic skills are mastered, higher-level skills are taught. DTT is conducted using intensive drills of selected materials.  Complex behaviors are broken down into small, reachable components, and taught until mastery before moving to a higher level. A specific behavior is prompted or guided, and the client receives a reward (reinforcement) for proper responses in order to increase motivation. 

Adversaries sometimes suggest that DTT promotes robotic responses in children, but that argument only demonstrates lack of knowledge on ABA. Programs start in very contrived, intensive and repetitive fashion. As progress is achieved, the intervention moves to incidental teaching conducted in natural environments and including all caregivers, thus achieving generalization of gains across settings and maintenance across time. Research has demonstrated a 50% recovery rate for autistic children who participated in discrete trial training 40 hours per week, including parent education, and began treatment during the preschool years. But like any therapeutic program, DTT, as well as ABA, needs to be tailored to meet the needs of the individual client because no two cases are alike. A good behavior analyst will know how to adapt a program to fit the child’s needs because, as all of us working in the field of autism know, “when you know one person with autism, you know one person with autism”.

I fell in love with ABA when I learned all that. The more I learn, the more passionate I am. ABA gives me the answers I need to do my job effectively.  Everybody who jumps in the ABA waters seriously gets hooked. Don’t you wonder why? 

Daniel Adatto, BCBA