Sunday, April 28, 2013

The Power of Structure and Routines

Try to imagine your life “unstructured”: you don’t know when you are going to have food again, or where it’s coming from; you don’t know at what time you’re going to be home, or if you are going home at all today; you don’t know when you are going to be done with a non-preferred activity, how long it’s going to last; and you don’t know when you are going to be able to rest, have fun with you preferred activity or see your loved ones again. In sum, your life is unpredictable, uncertain, chaotic.
I don’t know about you, but I’m “freaking out” just by thinking about that possibility.
Your child might be living in that state of confusion and anxiety all the time. So, let’s structure. 
What does "Structure" mean?
A predictable and consistent daily schedule (time-space-people in charge). Lack of predictability increases anxiety, which leads to problematic behaviors. Yes, I’m talking about your kids. Are you with me?
Predictability is what your children need, and something you can implement at home. You don’t need complicated IEPs, or your insurance to approve services, balanced state/federal budgets or lawmakers to pass bills.    
Benefits of "Structure":
q  Builds Confidence
q  Decreases Anxiety and Fears
q  Develops Positive Expectations
q  Encourages Cooperation and Compliance
q  Increases Predictability
q  Increases Motivation (when desired activities follow undesired activities)
q  Increases sense of Control
q  Increases Independence
q  Anticipates future events
Sounds good? Well, it is.

I can hear your question, How to Structure Activities?

--Keep times, places and people in charge as consistent as possible. Start with the “must do”: meals, bed time, etc.

--Adjust the environment to focus on the activity. For example, turn off the TV when it is bed time.

--Present scheduled activities in a positive manner. Do not be overly rigid. Some flexibility is necessary.

--Include free and play time: children need it.

--It is very important to allow time for transitions between activities. For example, when your child comes from school he/she typically will need some free, unstructured time. Or when transitioning between activities. Prepare the child ahead of time. For example: "It is almost dinner time, so you will need to come in soon. Be ready to put your toys away".

--Have preferred activities follow non- preferred activities. In order to be able to do the desired activity, the child has to finish the undesired activity. For example, "homework first, then play"; or "bath first, then video".

Children may not have independent play skills. You may have to set aside time to play with your child.

Choices can be built into the schedule by allowing the child to choose between 2 activities, such as "bath or shower", or "going to the park or to the store", or "video or TV".

In sum, structure and routines do not mean “militaristic”. They mean “predictable”.

Very cost-effective: easy to implement, excellent benefits. Sometimes, the solution is simple.

Daniel Adatto, MA, BCBA



Wednesday, April 10, 2013

Parents with Special Needs

Are you a parent of a child with special needs? If so, you know how challenging it can be. You are a parent with special needs.

Children with special needs are, first and foremost, children, and thus, they share kids’ basic needs: love, acceptance, care, and support and guidance to overcome challenges. Parenting is arguably the most difficult job on earth. However, the emotional toll you pay due to your child’s deficits and excesses can drain you, making it more challenging than raising a non-special needs child. 

But you are not alone. The state health department, social services agencies, parents support groups, schools and health insurers are there to support you.

When parents learn for the first time that their child has special needs, strong emotions such as denial, anger, fear and/or guilt take over. This is common and understandable. Parents feel alone and worry that their child will have an unhappy life. However, you need to learn to manage your emotions. Some helpful recommendations are:

- Communicating with others about how you feel.

- Seeking help from family, friends and other parents who have kids with special needs. Do not hide. Do not feel ashamed. Your worst mistake could be isolating and pretending that nothing is going on.

 - Learning about children with special needs, effective treatments, and educational and legal rights.

- Taking care of yourself (see previous blogs about Stress Management). It is difficult to help your family and your child if you are stressed, depressed and out of energy. Remember to rest, exercise, eat healthy and relax.

- Seeking counseling if your emotions and responsibilities are overwhelming.

And don’t forget to spend quality time with your child. Be sure to have fun!

Yes, having a child with special needs is challenging. Would you believe me if I tell you it can be rewarding too?

Daniel Adatto, BCBA