Monday, June 23, 2014

Kids need structure and routine, even in the summer

We are just a few weeks away from summer vacation and already I can see the behavior problems creeping in. Boredom is one of the main culprits of behavior problems in children. The lack of predictability that goes hand in hand with summer and the absence of regular routines can cause stress in children and can in turn cause them to act out.

Parents may overlook this factor. After all, what child doesn’t love being out of school? Adults assume that most children would be happier during the stress-free days of summer. But this isn’t always so. Many children do much better with routines that are more synonymous with the school year. When a child can anticipate what is coming it increases his sense of control and independence and therefore encourages cooperation. Having a familiar routine builds confidence and decreases anxiety.  

But all is not lost just because it is summer. If your child is not attending a summer camp or doesn’t have a daily activity to depend on, it is still possible to build structure and routines into the day. Some useful tips are:

- Try to maintain times and sequence of events as structured as possible. For example, if a child is used to eating breakfast as soon as he wakes up, stick to this routine.

- Since children feel more secure when they know what to expect, it is best to plan the day ahead of time and discuss it your child the day before.

- Build some choices into the day to help your child feel some control and nurture self-esteem.

- Use visual schedules (pictures, drawings, etc.) to cue a child about what is happening. 

- Present scheduled of activities in a positive manner and try not to be overly rigid. Some flexibility is always necessary. If you remain flexible and adjust your expectations, it will be easier to maintain a stress-free environment for your children.

- Plan physical outlets daily. Kids need to burn energy. Sitting in front of the computer or playing video games for hours long is a recipe for disaster. Planning play-dates at the park or at the beach could be good ideas. Going hiking and bike riding is always fun. 

- Watch what they eat. If your child is not overweight some “junk-food” is OK as long as you balance it with healthy food. Food is the main source of energy. Too much sugar and processed food have a direct effect on mood changes. When in doubt, consult with you pediatrician or a nutritionist.

-  Plan some quality one-on-one time with your kids where they are the “boss” and you play with them. 

And finally, always include some free time in the day – children need some down time and it can be exhausting to be overly scheduled.

And have a happy summer!


Daniel Adatto, BCBA

Sunday, June 15, 2014

Can your child recover from autism?

The results of a study on early intervention for children on the autism spectrum, performed by the Center for Autism and Related Disorders (CARD), are very encouraging.  The researchers followed 14 young children receiving intensive Applied Behavior Analysis (ABA) over the course of three years. Although there are many varieties of early intervention, ABA is the method of treatment most often recommended by professionals because it is the only method of autism treatment that is scientifically backed. This means that results achieved utilizing ABA methodology are proven and documented using scientific clinical studies such as this one.
According to their press release, the CARD study showed improvement in all of the children who participated, and claims 43% of participants “no longer display clinical symptoms of autism.” These results are extremely encouraging and send a message of hope to all parents that with the right interventions, children can recover from autism. This type of study were beneficial to the process that led to the bill mandating insurance companies to pay for ABA therapy for constituents diagnosed with autism in California and several other states.  Insurance claims for ABA were often rejected in the past on the basis that ABA therapy was experimental in nature.

Without trying to squash any hope brought about by this study, because it is very positive, we do need to be cautious in the conclusions we draw from it. The sample size of this study, 14 children, is very small and does by no means prove that all children will be able to recover from autism. We also need to be careful on how we define “recovered” or “cured”. It is true that many children grow out of the symptoms of autism and can eventually fall off the spectrum (as measured by standard assessment tools). However, many of these children continue to have a tendency towards problematic behaviors. These behaviors often reappear during times of change or stress. If a child and parents are continuing to receive proper ABA treatment and training, the reoccurrences can be minimized and even prevented.

Since the study was performed on children receiving early intervention, the participants are still very young. By diagnosing them as recovered at such a young age, we may be preventing them from receiving the continued services they need to ensure proper development. So while it is nice to believe that children can recover from autism, we also need to be careful about being overly optimistic.

For parents of children in the spectrum, the road is not easy. Receiving direct in-home intervention services, usually daily, can be intrusive. Parents (at least one of them) are recommended to participate in session in order to receive the hands-on training necessary to carry on the intervention when the clinical team is not present, thus providing their child with the necessary treatment for most of his/her waking hours. President Barack Obama just urged fathers to get more involved in their kids' lives in his weekly radio and Internet address this Father’s day weekend. Obama said “being able to have a child doesn't make you a man, but having the courage to raise one does.”  To read the entire article click on

Also, identifying the right provider requires education and experience. Families usually receive services from different companies until they learn the process and are equipped to choose.

It is definitely challenging. However, it is currently the only way. Consider it an investment, a sacrifice that parents make for the family’s quality of life.

The good news are that there is hope. And that is what matters.

Daniel Adatto, BCBA

Tuesday, June 3, 2014

Does punishment work?

We discussed punishment in previous blogs. The LA Times bring the issue back, this time in school settings.

“School administrators typically have handled misbehavior problems by suspending students. But this year Markham and Gompers middle schools have reported marked reductions in that form of discipline — as has the L.A. Unified School District overall, where the suspension rate dropped to 1.5% last year from 8% in 2008.”

In this article ( alternative discipline strategies in school settings are discussed. 

“The drop came after the Los Angeles Board of Education and L.A. schools chief John Deasy called for fewer suspensions as concern grew nationwide that removing students from school imperils their academic achievement.”

Kudos to the chief. I understand that schools may suspend problematic students for safety reasons. Aggression (physical and verbal, including cursing), property destruction, class disruption, threats (including bringing weapons to school), are all safety concerns.

However, from a discipline point of view sending problematic students home not only doesn’t address the real problem but often times rewards bad behaviors. Students who don’t want to go to school get to be home playing videogames, or something worse, frequently unsupervised because their parents need to work.

I’m aware of the fact that teachers and school administrators have a hard time dealing with misbehaviors, especially since years of tight budgets have left limited funding for the critical extra staff and training. 
“Principal Traci Gholar said she readily suspended disruptive students in 2011-12, her first year at the helm, to drive home to families that she was intent on building a safe, orderly and positive school climate. When superiors questioned her high suspension rate, Gholar asked for new resources that would support alternative disciplinary approaches: a conflict resolution specialist, a restorative justice coordinator, more campus aides, performing arts events and other activities.”

Alternative disciplinary approaches, interesting. Since I know you are a fervent follower of our blogs, you are familiar with alternative forms of discipline, positive ones aimed at building behavior repertoires, including life skills.

“The extra help appears to have made a difference. According to school data, incidents involving student misbehavior declined from 1,035 in the last school year to 663 as of May of this year. And although most of the misbehavior was serious enough to warrant suspensions, Gompers made a greater effort to address it in alternative ways, reducing the suspension rate to 3% from 30% last year.”

“Markham has also reported significant progress. Student incidents have declined from 1,732 in the last school year to 1,463 this year and the suspension rate has fallen to 7% from 12%. Like Gompers, Markham has received extra help, including a restorative justice coordinator.”

 Wow! These alternative strategies not only sound good but they work.

“As Gompers students celebrated "peace week," featuring games and banners decrying violence and bullying, eighth-graders Wesley Price, Cindy Birrueta and Maria Gomez said the atmosphere on campus has improved greatly. Gomez said that "community building circles," in which students share experiences, build trust and forge friendships, have helped reduce tensions.”

In other words, proactive strategies to foster and encourage appropriate behaviors and create a positive atmosphere (“peace week”, visual reminders, support groups, special activities to increase motivation, etc.), address the real problem. As we always say, behaviors are communication. When an individual misbehaves he/she is expressing a need. By punishing, the needs remain unresolved.   

Often times I hear the statement “there are no real and consistent consequences in school settings,” meaning punishment.

I think the problem is that there are no real and consistent rewards, making learning fun, teachers that know how to get the attention of their students by motivating them rather than policing or forcing.  

Let’s stop the madness and start training and educating parents and teachers on effective ways of teaching and fostering appropriate, functional, social significant behaviors. It would be cost-effective by rising and nurturing productive members of society. It is the right thing to do. 


Daniel Adatto, BCBA