Thursday, December 17, 2015

Getting through the Holidays in One Piece

Holidays are again upon us. This ought to be a time of great joy, sharing and spending time with your love ones. However, for those of us with kids, and more so with special needs kids, the holidays can present unique challenges. Holidays can be overwhelming because they cultivate many stressors that may cause a child to erupt: absence of routine, overstimulation, being away from home, and one important one that many of us may overlook – parents’ stress.   Kids are “sponges”: when they sense you are stressed, they can get extremely overwhelmed. Your stress management skills are put to a test, no doubt about it. And it is paramount you pass the test.

So, mom, dad, it is time to review some crucial tips:

-        Being sensitive to your child’s needs and keeping familiar routines in place as much as possible are the best ways to avoid holiday havoc.

-        Prepare your child for the social event: Explain to your child what is going to happen ahead of time. Be specific about every detail that might occur in any given situation. If part of your holiday itinerary includes flies, prepare your child for the crowds he might encounter and explain him about security procedures. Be sure to include the fact that he might be asked to remove his shoes, walk through a “funny machine” and that someone might look through his things. New or unexpected situations can be very frightening for a child with autism and being prepared can help him cope. It may be helpful to create a picture book that will show the sequence of events and prepare him for the sights, sounds and people he might encounter.

-        Prepare the social event for your child: Avoid long trips whenever possible. Airports, planes and long car rides could be very stressful.

-        Stick to your normal routine as much as possible. Keep sleep and meal times as close to their usual time as possible.

-        Bring your child’s favorite snacks with you. Unfamiliar foods will leave your child hungry, which is literally a recipe for disaster.

-        Bring your child’s favorite movie, video game system, sensory and security toys. Having familiar items will give him a sense of normalcy and comfort.

-        Pre arrange for a quiet space for your child to retreat to when stimulus gets too intense and he needs a break.

-        Don’t give in to social expectations (“People are looking at us”) or worry about insulting your host or family members if you don’t abide by social norms. You are your child’s advocate, she is your priority. This means you don’t need to force your child to hug, kiss, shake hands or play games with anyone if they don’t want to. Try to motivate him instead. This goes for clothing as well. Don’t force your child to wear something or comb his hair if he really doesn’t want to. You have to pick your battles. In general terms, don’t force your child to do anything unless it involves a safety concern or an emergency.

-        Educate your family ahead of time if you feel necessary. You can explain to them possible behaviors that might occur so that you don’t find yourself constantly apologizing for your child’s behavior.

-        Know the triggers and read the precursors of challenging behaviors, such as facial expressions, changes in breathing, body movements, etc. Look for the signs that your child may be unraveling and retreat to your safe place. Preventing a meltdown is always easier than managing a tantrum once it begins.

Finally, relax and enjoy. You are your child’s barometer and if you are stressed out, he will be too.

Daniel Adatto

Monday, December 7, 2015

Behavior management vs. behavior modification

Behavior management and behavior modification are not exactly the same. In behavior modification the focus is on changing behavior by teaching functional equivalent replacement behaviors, while in behavior management the focus is on maintaining order. Hence, behavior modification focus on building functional (socially appropriate and valuable) behavior repertoires.

Behavior management skills are of particular importance to teachers in the educational system. Behavior management include all of the actions and conscious inactions to enhance the probability people, individually and in groups, choose behaviors already in their repertoires, which are personally fulfilling, productive, and socially acceptable.[1]

There is a great deal of research related to "behavior change" and "behavior management". B.F. Skinner's approach says that anyone can manipulate behavior by first identifying what the individual finds rewarding. Once the rewards of an individual are known, then those rewards can be selected and provided in exchange for good behavior. Skinner calls this "Positive Reinforcement Psychology". In order to effectively address behavior problems, individual must be persuaded (motivated) to behave appropriately.

Behavior Management:

Many of the principles and techniques used are the same as behavior modification yet delivered in a less intensively and consistent fashion. Usually, behavior management is applied at the group level by a classroom teacher as a form of behavioral engineering to produce high rates of student work completion and minimize classroom disruption. In addition, greater focus has been placed on building self-control.

Brophy (1986) writes:

"Contemporary behavior modification approaches involve students more actively in planning and shaping their own behavior through participation in the negotiation of contracts with their teachers and through exposure to training designed to help them to monitor and evaluate their behavior more actively, to learn techniques of self-control and problem solving, and to set goals and reinforce themselves for meeting these goals." (p. 191) [2]

In general behavior management strategies have been very effective in reducing classroom and home disruption.[3] In addition, recent efforts have focused on incorporating principles of functional assessment into the process.[4] This means understanding the function (needs and wants) of the challenging behavior and developing interventions with the objective of teaching functional equivalent behaviors.

While such programs can come from a variety of behavioral change theories, the most common practices rely on the use of applied behavior analysis principles: positive reinforcement    and mild punishments (such as response cost and time-out). Behavioral practices such as differential reinforcement are commonly used.[5] Sometimes, these are delivered in a token economy or a level system.[6] In general the reward component is considered effective. For example, Cotton (1988) reviewed 37 studies on tokens, praise and other reward systems and found them to be highly effective in managing student classroom behavior.

Behavior Modification:

As parents and teachers we should be aware of the importance of incorporating behavior modification as a crucial component of our approach, especially when working with children with special needs. These kids do not learn from the environment like regular developed ones do. They have to be taught the appropriate behaviors that will replace the challenging behaviors ones. As I said in previous blogs, “We are in the business of building socially appropriate behaviors repertoires. We are behavior teachers.”

Daniel Adatto, BCBA


1.      ^ Baldwin J.D. and Baldwinn J.I. (1986). Behavior principals in everyday life (2nd Edition), Engle Wood Cliffs, New Jersey: Prentice Hall.

2.      ^ Brophy, J. (1986). "Classroom Management Techniques." Education and Urban Society 18/2, 182–194

3.      Brophy, J.E. (1983) "Classroom Organization and Management." The Elementary School Journal 83/4, 265–285.

4.      Angela Waguespack, Terrence Vaccaro & Lauren Continere (2006). Functional Behavioral Assessment and Intervention with Emotional/Behaviorally Disordered Students: In Pursuit of State of the Art. International Journal of Behavioral Consultation and Therapy, 2 (4), 463–474. [1]

Monday, November 16, 2015

Reading to your Kids

Strong language skills are important to success in school and life, and parents are their children first and most important teachers.

Reading is easily defined. But reading with engagement is a different story.

I frequently see parents walking in the park or grocery stores or driving with their kids. But they are talking on the phone, not really engaging their children, stimulating and challenging them.

When reading or just hanging out with your kids, ask them questions, tell them your personal story, tell them they can be anything they want to be, encourage them to imagine the future, make comments, and relate the story to real life situations.
Communication is paramount in the relationship with your children. A lack of communication or deficits in this area can lead to problematic behaviors. Children face a lot of pressure and many emotions. They don’t always know how to express these emotions but the “pressure” has to come out somehow. If they don’t have the right tools to express themselves, problems can arise and it will start to manifest itself in the form of challenging behaviors.

This is even more so when it comes to children with special needs. If children did not learn the necessary skills, they will resort to methods that worked during the time they were babies: crying, screaming, throwing things, etc. As a child gets older and stronger, this can be incredibly problematic.
For this reason teaching and encouraging functional communication should be a key component of any school and parenting program.

An essential component of effective communication is to listen. This helps to make children feel comfortable and secure: you care about their feelings and needs, you respect their point of view, and you are interested in what they have to say.

As teachers and parents we can take important steps to build healthy communication repertoires. Both ways. I mean, you are talking and listening to them and at the same time you are teaching them how to talk and listen. How many times you felt as if they were not listening to you? Well, they felt the same. Every time you feel the other person is not listening to you is because you are not listening as well. Think about the other person as a mirror that reflects your image. So, the best way to get the other to listen, is to start listening.

Listen patiently before disciplining your kids. Instead of asking them to stop, encourage communication, even if they need to scream and cry for a little while. They probably need to vent, let the anger out before they talk about the problem. And do not interrupt or criticize when they are communicating. Keep in mind that communication is not only words. Crying, gestures, facial expressions, breathing patterns are all means of communication as well. 
Encourage your children to express their opinions by just responding “Yes” or “Really?” Ask them open-ended questions such as “How would you feel if that would happened to you?”, or “What is the right thing to do?” If needed provide them with 2-3 choices.

It is important to teach your children that it is okay to disagree or be upset, as long as they express their opinions and feelings in an appropriate manner. Emotions are always okay, behaviors can be problematic. Validate their feelings by saying “You seem very upset”, or “You are mad, and I understand why”, for example.
Healthy and rich communication is paramount.

Oh, your phone is ringing.

Daniel Adatto, BCBA




Monday, November 2, 2015

ABA is not restricted to autism

I recently had a discussion about ABA (Applied Behavior Analysis) with a friend. His argument was that ABA can only be applied to children with autism.

In previous blogs I wrote about some of the real life applications of Applied Behavior Analysis (ABA) and specifically its use with autism. I also emphasized that ABA is not synonymous with treatment for autism. In fact, ABA can be applied to any situation where a behavior change is desired. That’s the meaning of “applied” in Applied Behavior Analysis. And of course, the principles and strategies can be implemented when it comes to every day parenting. Picky eating, doing homework, cleaning up their room, doing chores are great examples of this. 

Furthermore, the same systematic techniques can be used to teach skills. Actually when we target a behavior for reduction or elimination we teach appropriate behaviors to replace it. The problematic behavior is functional for the child because it gets his needs and wants met. Just eliminating it is leaving the child in the vacuum, which he will likely fill with another challenging behaviors. The solutions to this problem is teaching the skills that will allow this child to address his wants and needs in functional and socially appropriate ways.

Let’s take the example of a child who screams and cries when he needs something or is denied a request. In this case access to desired objective should not be allowed following the child’s misbehaviors. Once the child is calm and able to listen, acceptable alternatives ways to obtain what he wants should be model to him. He should be rewarded for engaging in those functional ways to obtain access. During the training process ample opportunities to request wants and needs should be provided.  

Another example can be a child who is picky eater. If your child has a severe aversion to a certain 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.

These are just a few examples that show that ABA principles and techniques can be applied at everyday life situations and are not restricted to autism.

However, I’m not quite sure I was able to convince my friend.

 Daniel Adatto, BCBA



Tuesday, October 20, 2015

Prevention can go a loooong way

Rest before you’re tired, eat before you’re hungry, and drink before you’re thirsty. LAFD spokesman Brian Humphrey said “people overestimate their ability and underestimate the danger.” This advice is especially relevant when it comes down to parenting. Once you’re tired or overwhelmed it is too late. And the same happens to your child. A lot of meltdowns can be avoided by just establishing a routine that includes eating and sleeping times, and sticking to it. Prevention can go a long way, and is the most cost-effective strategy. As we discussed previously in these blogs, once meltdowns occur it is too late and more challenging.

Downtime, unexpected changes, too many or too little activities, lack of physical outlets, are a recipe for disaster. Lack of predictability increases anxiety, which leads to problematic behaviors.

I know, sometimes it is difficult putting them in bed or having kids come to the dinner table. And because you want to avoid a struggle, they get their way. But this only makes it more difficult for you because they learn how to obtain their objectives.

As it happens at school, children get used to predictable schedules and respond to it automatically. You have them on “cruise-control.”
Some tips worth to remember:  

-        Keep times, places and people in charge as consistent as possible. Start with the “must do’s”: meals, bed time,homework, 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". First “must do’s”, then “can do’s.” It can be helpful to present it in a visual schedule format. Here is a link where you can find tons of creative ideas: 

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".

And make some time to spend quality time with your kids where they can choose the activity and be the boss. In plain English, have some fun with them.

Daniel Adatto, BCBA

Tuesday, September 29, 2015

Measurement of Behaviors

When asked what had been his main contribution, Skinner, the father of applied behavior analysis, used to say the measurement of behaviors.

ABA is a scientific approach to understanding and changing behaviors. Science relies on direct and objective observation, measurement and experimentation of phenomena, which leads to effective interventions.
We start by taking baseline data: the behaviors are measured in the absence of the treatment variable. This gives us a measurement of the behavior before intervention is applied and allows for comparison further on for evaluation of treatment purposes. In other words baseline data is used to measure effectiveness of the intervention plan.

In order to measure behaviors operational definitions are a “must.” We need an accurate, observable and objective description of behaviors, including data on events that precede and follow the occurrences of the behaviors, and the frequency, duration and intensity of the problem behavior. It is a count of the present (i.e., pre-treatment) level of performance.

        Allows all team members to identify and discuss the same behavior

        Ensures consistency when implementing behavior plans

Direct and frequent measurement enables a dynamic, data-based decision making process concerning the continuation, modification or termination of treatment. Without this information, an ineffective treatment could be continued or an effective treatment could be discontinued based on subjective judgment. Continuous evaluation of success and failures in the treatment allows us to make the necessary changes in the behavior modification plan. Through measurement we “hear” our clients’ messages.
Additionally, measurement enables practitioners to be accountable to clients, employers and referral agencies.  

Because behaviors occur within and across time, they have three dimensional quantities:

       Frequency: Instances of a behavior. Behaviors can be counted. (i.e. Johnny engages in 7 tantrums per day)
       Duration: Behaviors occur during time. Therefore, the duration of behaviors can be measured (i.e. each tantrum episode lasts 5 to 7 minutes)
       Magnitude: The intensity of the behavior. One standard way is to define the intensity as followed:
       Severe: the behavior may be harmful or dangerous to self and/or others.

       Moderate: the behavior is disruptive to the life of the individual and/or others.

       Mild: the behavior is bothersome to others.

Usually a simple tally of number of occurrences is enough. For example, the number of times a student raises his hand. The behavior must have a clear onset and offset (beginning and end). The observation period must be reported (i.e. 10 times per hour, day, week, etc.)
When the behavior does not present a clear beginning and end, percentage of responses per unit of time is used (i.e. students engages in eye contact 20% of the time per session) 

Comparing measures without referencing to units of time can lead to faulty interpretations. For example, stating that Will reads 100 correct words is not enough. Time must be reported. For example, 100 correct words per hour, session, etc.

Oftentimes data isn’t taken correctly because practitioners don’t know how to take the data or track the wrong behavior. This is one of the reasons why interventions have to be supervised by knowledgeable professionals. Board Certified Behavior Analyst are the gold standard in the field.   
Once I heard the phrase “What gets measured can be improved.” And this applies to our practice.

As a parent or teacher, be sure the professionals working with your child are experienced and knowledgeable enough to ensure the effectiveness of their treatments. And monitor regularly, at least monthly, the data. The answer is usually there.

Daniel Adatto, BCBA


Monday, September 14, 2015

Dealing with GOOD behaviors

We usually spend a lot of time discussing dealing with challenging behaviors and not nearly enough about good behaviors. However, mastering the skill of not ignoring desired behaviors is a key component in any behavior management program.

Kids don’t misbehave all the time. Even those children with intense problem behaviors. Every once in a while they are calm and quiet, or they comply with a direction. And when they do, adults interacting with them feel it is their break and more often than not ignore those desired behaviors. They shouldn’t.

“Catch them being good.” You probably heard this statement numerous times. But, what it means?
-        Reward: make a big deal, praise, provide attention, offer rewards. Do not ignore good behaviors.

-        Identify those variables conducive to the appropriate behaviors and replicate them as much as possible. On the same token that you want to change the variables conducive to problematic behaviors, you want to recreate those ones that facilitate good behaviors. For example, if you were able to do groceries with your child in peace, ask yourself “Why?” What happened?” Pay attention at the time of the day and identify patterns. Was your child rested or tired? Did you feed him before leaving home? Was the store not crowed? Did you promise him a treat if he behaved?

-        Ask other people in your child’s life (teachers, grandparents, speech therapist, etc.) what helps your child behave. There are aspects of his/her personality you don’t know. How they give directions? Do they yell “No” at the first misbehavior? How they motivate your child to engage in non-preferred activities? Do they reward her or praise is enough? How do they manage to stay calm when problems arise?

This and other information is gold. Do not leave it on the table. 
Be sure you and the other people interacting with your child are consistent in reproducing those appropriate situations. The more you do it, the more they become second nature and thus, it becomes easier and easier.

And when that happens the quality of your family life will improve dramatically.

Daniel Adatto, BCBA


Saturday, August 29, 2015

Problems with Transitions

Difficulty with transitions from one activity to the next is a common problem for some children with special needs. If you struggle when is time to turn the TV off or going to bed, you are not alone.

A variety of antecedent-based interventions have been evaluated to address problem behavior that occurs during transitions. For example, providing advance notice of an upcoming change in tasks (i.e., a 2-min warning) decreased transition related challenging behaviors.

Visual prompts, often in the form of visual schedules, are commonly recommended to aid with transitions for children with autism. However, studies suggest that if the behavior is maintained by avoidance of non-preferred activities, access to preferred activities/items, or escape from the transition, visual schedules alone, a commonly recommended intervention, may not produce decreases in transition-related problem behavior unless extinction (not allowing access to reinforcement) is also used.

The importance of identifying the function of problem behavior that is occasioned by transitions and developing treatments based on these results is commonly overlooked in recommendations to parents and teachers regarding the use of visual schedules.

The combination of visual schedules and a function-based intervention for problem behavior that occurred during transitions appear to be the most effective intervention.

Try this at home. When is time to turn off the TV, to stop playing in the computer or to go to bed use a visual schedule before the preferred and when you prime your child (“Remember, in 5 minutes…., in 3 minutes…, etc.). Also, make the preferred activities contingent on preferred ones. “When you finish your homework, you can watch TV.”

Another recommendation is to make the non-preferred activity motivating by adding some fun (i.e. make it a race, include motivating items and activities, sing a song).

And be consistent. Follow the same routine, like teachers do in the classrooms. Not only the activities, but times and the way the activity is performed. For example, standing in line before going to recess, or cleaning up desks before free time. Kids do much better when they follow a predictable routine. We all do.


Daniel Adatto




Tuesday, August 25, 2015

The Five Most Common Parenting Mistakes That Are Easily Avoided:

Making positive behavioral changes can help every parent avoid these common parenting mistakes.

  1. Giving attention to bad behaviors   
  2. Ignoring good behavior
  3. Placating the whining or crying request
  4. Saying No when you can say Yes
  5. Using time-out as a punishment
1. We parents devote far too much time attention when our children misbehave. In a child’s mind, negative attention is better than no attention so by eliciting a negative reaction (yelling, punishing etc.), the child has in essence won the battle. By rewarding the bad behavior with attention, you are teaching your child that crying, hitting, disobeying, etc., is the way to get your attention and you are perpetuating the bad behavior.

2. This brings us to common mistake no. 2. We punish the bad behaviors, but do we take notice of the good ones? Reverse your negative patterns by catching your child doing something good and reward him/her for behaving. Is your child playing nicely? Don’t run away to make a phone call. Commend that behavior first, reward your child with a positive interaction and you will increase good behaviors while reducing the undesired ones.

3. Placate now – pay later. And pay dearly you will! We parents are so irritated by the crying or whining child that we so often give into the request just to make it stop. Children are very clever. They know that this works.  But ask yourself, is the price worth it? By giving into the request, we are teaching the child to cry or whine to get whatever he wants. I can not stress this enough - Never ever give in to a crying, whining or tantrum request! If your child requests something while crying, you must demand that he/she stops crying and asks nicely before you give him whatever he/she wants. If you are consistent, the crying and whining will decrease over time.

4. We say “NO” 100 times a day and I can almost guarantee that 75% of those NO’s could be Yesses. If we rephrase our response to a more positive alternative and redirect the child instead of just saying no, we can reduce the child’s frustration in being told NO.
  • Instead of saying just NO, what he CAN’T do, tell the child what he CAN do. “Can I have a cookie mom?” Instead of immediately saying no, you can say “you can have a cookie when you finish your dinner”.
  • Do not forget to give at least two Yesses for each NO. “I want to play outside” Try “It’s too cold right now but we CAN play blocks or dance inside”.
By the way, when you say “NO” to your child, you are teaching him/her to say “NO” to you when you place a request on him/her. So, save the NO’s for when it is necessary. If you child is running to the street or playing with a knife, that’s a NO.

5. A Time-Out should be used to remove a child from an environment where he is receiving attention for a bad behavior, and place him/her in an environment where he/she receives NO attention for the behavior. If you are in the grocery store and your child throws a tantrum, be ready to leave the cart full of groceries and remove your child from that environment where he is getting a lot of attention from you and the rest of the customers, and take him to the car, where you are able to ignore the crying and screaming, thus placing the behavior on extinction: no attention.
Be sure that the tantrum is your child’s way to get attention. If your child is over stimulated by the environment, in pain, scared, hungry or tired, do not use time-out, do not ignore the behavior. Your child needs your help.

And remember, you are there to help your child, not the other way around.

Daniel Adatto, BCBA

Friday, July 31, 2015

Don’t fight lost battles

It’s very inspiring when I see a good teacher focusing on his/her skills rather on students’ deficits. It makes a world of difference when we pay attention on what can we do, instead of what the kids do or don’t do.

Ok, let me give you a real life example.

I was supervising a school case when the class was at PE (Physical Education). An excellent and experienced teacher was conducting the class. The activity was manipulating one of those big parachutes that everybody holds by the edges and lift up. Every time the parachute was lifted the teachers named two kids to go inside. As you can imagine, seven or eight kids went inside ignoring the teacher and aides’ directions. After a couple of times, the PE teachers whispers to herself “this is a lost battle” and instructs everybody to go inside. The kids get very excited and start running in and out, or staying inside when they were supposed to go out. 

At that point the PE teacher says to herself “I lost control” and ends the activity instructing all the kids to sit down. Once everybody was calm. She moved to another activity soon regaining control.
What a great and clever teacher! She didn’t have to yell or get upset.

How many times we as parents or teachers lose control and keep fighting lost battles insisting in forcing our kids to comply instead of rethinking our strategies and switching to an effective plan?
So the advice is simple:

“Don’t fight a lost battle,” be aware when you lost control and have to change gears because what you’re doing is not working. This could mean leaving the cart full of groceries and walking out the store, or leaving a social gathering and going home. It could be that homework is not done that day, or is broken down into short segments, allowing your child for breaks instead of demanding him to work for two hours in arrow.
Another example could be letting your child eat in front of the TV instead of sitting at the dinner table.

As I always say in my blogs, you change kids’ behaviors by changing the behaviors of the adults who deal with those kids. Pure and simple.

Keep this in mind, and have a great summer.

Daniel Adatto, BCBA


Wednesday, July 8, 2015

The Crying Game

As we discussed repeatedly in previous blogs, one of the primary principles of applied behavior analysis (aba) is reinforcement, a system that creates desired behaviors by breaking them down into small, teachable steps and rewarding them with positive interaction and desired objectives. Keep in mind that you want to reinforce direction, not perfection.

You reinforce a behavior based on the kind of reaction the behavior elicits. You can increase desired behaviors by rewarding a child when he does something good. The flip side of that is that you can also increase undesired behaviors by rewarding them with attention, so we want to be careful of this. Parents have a tendency to notice misbehavior more often than good behavior. To a child, negative attention is better than no attention so even though we think we are disciplining or trying to teach them the right way, we inadvertently end up reinforcing a bad behavior.

From the time an infant is born, parents instinctively respond when their baby cries.  This is completely natural and appropriate because crying is a baby’s only way of communicating his needs. Problems arise when babies mature into toddlers and continue to use crying and whining as a way of getting something they want while parents, out of habit, continue to respond. Your child cries “I’m hungry”, you give him food.

If you want to eliminate the crying and whining, you need to insist that your child repeat his request without crying or whining and only then attend to his need. You might need to model the appropriate way of communicating wants and needs. You are then rewarding him for communicating his request in an appropriate manner. Over time, the child will learn that his needs will be responded to only when his requests are made without crying. It is difficult at first but if you are consistent over time, the crying and whining will diminish and eventually disappear.  You can further reinforce this by “catching” him being good and offering praise when he does communicate appropriately. Remember, do not ignore desired behaviors. Give your child a strong reason to repeat them.

There is some disagreement about what age a baby stops being a baby and when he is mature enough to understand that mom or dad is not going to respond to crying. Sometimes parents underestimate how smart their little ones really are. But if you have any doubts that even toddlers are clever enough to understand how to manipulate their parents, watch this:

Daniel Adatto, BCBA

Thursday, June 25, 2015

Structure and routine during the summer

“Your daughter officially finished 7th grade,” said my wife.

“Iujuuuu,” said I.

“No iujuuuu, it means my peace is gone.”

“Oh, oh.”

We are already there. It’s summer and there is no school. Parents’ peace, at least for part of the day, is gone. Behavior problems are creeping in. So it is a good time to review some “summer behavior management strategies.”

Remember: 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.

Parents usually 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 not all is 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:

- Maintain times and sequence of events as structured as possible. For example, stick to sleeping and eating routines.

- 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.

- If necessary, 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

Monday, June 8, 2015

A new take on Autism

I came across an interesting video on YouTube called “In My Language”, written by an Autistic adult. It depicts a very interesting angle on Autism and may answer some questions to those of us who have looked at autistic individuals and wondered what must be going through their heads. It also paints a picture of this father’s perseverance and determination while her daughter struggles with the isolating challenges of autism.

Overall it is an inspiring story that is dramatic but at the same time encouraging and offers a good glimpse into the mind of someone with autism. It shows how communication is paramount in the relationship with your children, and especially at this level of autism. For most behavior difficulties, communication emerges as part of the problem and is an essential part of the solution. If the behavior problem is related to the child’s communication needs, then teaching more effective communication skills needs to be a major part of the solution.

For this reason teaching and encouraging functional communication should be a key component of any intervention program. As teachers and parents we should take every possible steps to build healthy communication repertoires. And as the video shows, communication is not limited to talking. There is plenty of technology to compensate the lack of verbal communication. Pictures, signing, visual clues are some other ways you can help your child to communicate.

The first part of the video is in her "native language," and depicts a typical perspective of someone disabled, unable to communicate, weird hand flailing and repetitive movements. But then the second part provides a translation, or at least an explanation of how the autistic individual’s mind works. It is a wonderful statement about what gets considered intelligence, personhood, language, and communication, and what does not.

I think the point she very effectively communicates is that the fact that we don’t understand them, in their language, does not mean that they are the disabled ones. 

Let’s understand them. We should not give up. They are there, we just need to find them.

This is the link to the video.

Daniel Adatto, BCBA

Saturday, May 30, 2015

Urine test to screen for Autism

Women have been doing it for over a decade: Pee on a stick in the privacy of your own home and moments later, find out if you are pregnant. Two lines or one, positive or negative, pregnant or not pregnant. It’s as simple as that. Could it now be this simple to diagnose Autism?

According to a research published a couple of years ago, children with autism have a different chemical fingerprint in their urine than non-autistic children. The researchers behind the study, from Imperial College London and the University of South Australia, suggest that their findings could ultimately lead to a simple urine test to determine whether or not a young child has autism.

According to the CDC, Autism affects an estimated one in every 100 people in the US. People with autism have a range of different symptoms, but they commonly experience problems with communication and social skills, such as understanding other people's emotions and making conversation and eye contact. Currently, diagnosing a child with Autism can be a very subjective process. Parents often notice something is not right about their child between the ages of 12-18 months. At present, the only way to assess a child for autism is through a lengthy process involving a range of tests that explore the child's social interaction, communication and imaginative skills. Many children don’t get diagnosed until even later, missing a critical window of opportunity for early intervention.

People with autism are also known to suffer from gastrointestinal disorders and they have a different makeup of bacteria in their guts from non-autistic people.

This research shows that it is possible to distinguish between autistic and non-autistic children by looking at the by-products of gut bacteria and the body's metabolic processes in the children's urine. The exact biological significance of gastrointestinal disorders in the development of autism is unknown.

The distinctive urinary metabolic fingerprint for autism identified in this new study could form the basis of a non-invasive test that might help diagnose autism earlier.

This would enable autistic children to begin treatment for autism, such as advanced behavioral therapy, earlier in their development than is currently possible.

Early intervention using the methods of Applied Behavior Analysis (ABA) can greatly improve the progress of children with autism. The earlier the better.

Daniel Adatto, BCBA



Wednesday, May 13, 2015

Twins and Autism Spectrum Disorders

For years, scientists, parents, and doctors have debated the causes of autism. According to certain studies, there is a higher rate of autism among identical twins and although not as high, fraternal twins. Twin studies may seemingly point to a genetic cause for the autism spectrum disorder; however, the increased risk amongst fraternal twins seems to indicate that environmental factors also play a role.

While there is still much to be studied on this topic, documentation of twins development where one twin suffers from autism and the other is typically developing can help researchers tremendously.

I came across a series of videos released by the National Autism Awareness Month, Rethink Autism a while ago which help to raise awareness of autism among parents. Through the powerful story of Trina McField, a mother who recognized early signs of autism in one of her twin boys, these videos educate viewers on how to spot the early signs of autism, highlighting the contrast in behavior between a child with autism and his typically developing twin brother. The videos also suggest evidenced-based treatment options available to parents and show the dramatic improvement in a two-year-old boy with autism after just five months of treatment at home. Behind the video footage is an incredible story of a mother who perseveres through doubt and uncertainty to bring hope to and create a future for her son with autism. The story inspires and empowers parents to start early intervention treatment using an Applied Behavior Analysis (ABA)-based curriculum. Recommended by the US Surgeon General and the American Academy of Pediatrics, ABA is the only treatment for autism that has been consistently validated by independent scientific research.

When in doubt consult with your pediatrician. And give us a call. We, who devoted our professional lives to this field, are here to help.  
Daniel Adatto, BCBA

Thursday, April 30, 2015

Let’s teach our kids how to be happy

I recently overheard one teacher’s assistant say “They don’t know how to be happy”, after one of her students responded in a grumpy way for no clear reason. Interesting statement, I thought, why I don’t write a blog about it.

Happiness, being happy, is a subjective state. What is “happy” for one person might not be for another one. But for the sake of this discussion I think we can agree that when we are happy we feel good, we are more in control of our behaviors, and we enjoy ourselves. Most people know how to be happy for the most part because they know what makes them happy. An activity they enjoy doing, a favorite restaurant, time with loved ones, success at work, the satisfaction of fulfilling responsibilities, etc. In behavioral terms, most people know how to meet natural contingencies of reinforcement, or how to obtain rewards. 

For kids with special needs this doesn’t come naturally. They often live in a state of confusion and anxiety.  Not only is it difficult for them to understand what’s going on around, they don’t know how to meet natural contingencies of reinforcement. In plain English, they don’t know how to achieve positive experiences. The chaotic organization of their behaviors can make them feel in a constant state of discontent.  This can cause frustration, anger, disappointment to the people around them who then react with aversive methods of discipline. Which then feeds the cycle.

Therefore, it is our job as teachers and parents to rescue them. We need to teach them how to be happy. In the process, we can also manage their behaviors.
How do we do this?

As explained in my blog post titled “What’s your talent?” we do so by exposing them to experiences where they can feel a sense of success and achievement:

1.      Contrived rewards and praise have to be built into their daily schedule of activities, at home and at school. Instead of waiting for them to fail to reprimand them, let’s create the environment and provide them with the necessary support to succeed.

2.      Catch them being good. Even during challenging situations make an effort to praise them for something. Do not focus exclusively on the “bad.”

3.      As we discussed in a previous blog (See “Fun can change behaviors”), something as simple as fun is the easiest way to change people’s behavior for the better. For example, if a child is resisting brushing teeth, going into the bathroom together and singing a funny song may be motivation enough. If getting dressed is a struggle, initiate a game of tickle, act silly and turn getting dressed into something fun.  Instead of demanding that a child clean up the toys, turn on some music, dance around and turn it into a game.  Make it fun and you will make it easier.

4.      Another way to help them be happy is to teach the child a more effective and appropriate way to get her needs met. If your child is having a hard time doing homework, for example, teach her to ask for breaks, or help.

Disciplining our kids is part of our job description as a parents and teachers. I know I’m doing my job right when I make them laugh/smile. I do that best when I’m enjoying my time with them. You need to have “fun” in your toolbox because fun is one of the most powerful tools of discipline.
Daniel Adatto, BCBA