Monday, January 26, 2015

Want to Get to “No Man’s Land”? Here’s a Map

I often find myself mulling over how this very circumstance happens a lot in education and parenting. You find yourself in an impossible mess, where every available choice seems wrong. You’re in No Man’s Land. It’s a horrible feeling of helplessness.

But the hard truth is that often we have only ourselves to blame for ending up stranded in the middle of the desert. Let me share with you a situation that illustrates how we get into these dilemmas.
Getting Lost
It was at a school site filling in for the therapist who was on her break when my student decided to throw a tantrum. Bad decision #1 was to tell her to stop and to try to bring her to her desk. I should have just paused and waited for Anny to calm down or try to help her deescalate and choose a better coping strategy, or both. Bad decision #2 was to get upset. If one is determined to manage such behaviors effectively, it is best to stay calm and in control of your own emotions. Every decision later on is made easier by remaining calm.

The student in question became louder and physical (i.e. hitting, pushing, throwing objects at people, etc.). She raised her bet. Everybody, including the teacher, stepped back leaving me alone with the problem and feeling judged by them. I should have joined them and stepped back too. Instead, I called, which in this case means “I’m going to show her who’s the boss.” Bad decision #3. I was now doing what I always advise against: Engaging in a power struggle. Yeah, not smart.
And just like that, I was in “No Man’s Land.”

Fortunately, Anny gave off tell-tales that tipped the balance of my decision when she screamed she wanted the computer. On that basis, I finally found my way out. “First let’s go to your desk to finish your work and then you can play in the computer.” She complied. The magic “First…then…” Or Grandma’s Rule: First you eat your vegetables and then you can have ice-cream. I was saved by her overacting. If not for that, I honestly don’t know what I would have done because I had let myself lose control of the situation from all my bad decisions.

I got lucky to have been shown a way out of the wilderness. That’s not going to happen every time. Usually we just have to make a guess as to which way to go. It’s much, much better to avoid getting lost in the first place.
The Way to No Man’s Land
If you want to get yourself into uncharted territory deep in a behavior management hand, with no idea how to find your way back to safety, I can tell you exactly how to do it. Start by getting upset and losing your cool. Proceed up Bad Position Avenue. Take a left on overreacting and trying to show you are the boss, which quickly turns into Power Struggle Road. Keep going past the flashing yellow warning lights, without pausing to consider what they’re warning you about.

When you get where you were headed, don’t stop, but instead veer off in a new direction, maybe taking Forcing Street or Reckless Boulevard. Keep going past the edge of town, until your car is bogged down by deep desert sand, with no guideposts in sight.
But when you get there, don’t call me asking for directions. I don’t know how to get you out of No Man’s Land. I’m only an expert at how to get there.

Daniel Adatto, BCBA







Sunday, January 11, 2015

Autism and Special Diets

A report released in an issue of Pediatrics states that there is no proof that special diets help or don’t help children with autism.  The study was conducted by a panel of 28 experts made up of professionals from 12 scientific disciplines, including child psychiatry, pediatric allergy, pediatric gastroenterology, and pediatric nutrition. The panel evaluated scientific evidence regarding gastrointestinal disorders in all forms of autism across the spectrum and concluded that there is no evidence that digestive problems are more common in children with autism compared with other children, or that special diets help alleviate some of the behavioral problems associated with autism.

Like any research released about children with autism, the report sparked some intense debate.  One reason for the controversy is that many parents say that restrictive diets have helped their children by combating symptoms and behavior problems of autistic children. What’s important to note however, is that the panel did acknowledge in their report that many parents and medical professionals have reported improvements in autistic behaviors after dietary treatment, but that these observations aren't based on controlled, scientific studies. In other words, they are anecdotal. Many parents try the restrictive diets after hearing anecdotes from other parents but this is not proof enough for scientists and doctors. Additionally, usually these children are receiving other treatments (i.e. special education, speech therapy, behavior intervention, etc.) which only confounds the conclusion that the diets are the sole responsible, or responsible at all for the improvements.

Based on the research, the panel concluded that there is still no proof that special diets help or don't help autistic kids -- or that food allergies, food sensitivities, or gut problems cause autism. Harvard's Timothy Buie, MD and chair of the panel noted "Anecdotal reports that restricted diets may ameliorate symptoms of ASDs in some children have not been supported or refuted in the scientific literature, but these data do not address the possibility that there exists a subgroup of individuals who may respond to such diets."

Bottom line? Because of the anecdotal evidence, a parent with a child with autism may be inclined to try a special diet. But as with any alternative treatment, we strongly recommended that a child following a restricted diet be carefully monitored by a nutritionist and a medical professional.


Daniel Adatto, BCBA

Friday, January 2, 2015

What are some of the common signs of Autism?

Scientists aren’t certain what causes autism, but it’s likely that both genetics and environment play a role. Many parents ask how they will know if their child is autistic. More often than not, parents may suspect that something is “off” about their child but ignore the warning signs out of fear or denial.  Better safe than sorry is the best philosophy if you have any concerns. Early intervention is crucial when it comes to treating autism so don’t feel ashamed to ask your pediatrician for a second opinion sooner rather than later.

Sometimes a speech delay is just a speech delay but if your toddler is displaying one or more of these early warning signs it is important to seek help as soon as possible:
·       Impaired social interaction
·       Problems with verbal and non-verbal communication
·       Failure to respond to name
·       Avoidance of eye contact with other people
·       Repetitive movements such as rocking or twirling
·       Self-abusive behavior such as biting or head-banging

 Watching the baby’s behaviors is the best way to recognize whether something seems “off.” If you are a new parents, asking around and observing other babies in the family (look for videos if they already grew up), or in the community (the park, the grocery store, etc.) is the best way to go.

Do not jump to the conclusion that if your baby is displaying odd behaviors she necessarily has the disorder. Once again, when in doubt ask your pediatrician.

Here is a great video about how to recognize the early signs of Autism:

Getting informed is the best advice I can give you. And keep in mind that having the disorder does not mean a sentence of unhappiness for life. There are effective ways to help your child to be a happy and productive member of society.

We are here to help you, you are not alone.

Daniel Adatto, BCBA






What’s your talent?

The special education teacher is asking her students “What’s your talent?” Which made me think that children with special needs may not have a talent. With some exemptions they can’t really excel at anything. And I couldn’t help but wonder how one would feel in that situation. It’s not that everybody is especially talented, but regular developed people are able to experience and savor success, at least from time to time.

As parents we rejoice on our kids talents. They are good at sports, singing, mathematic or arts. How is it to be a parent of a special needs child who is good at nothing?

And this made me realize that our job as parents, teachers, therapists, is to teach our special needs kids to be good at something. Teaching skills where there is lack of, developing abilities where there is disability, fostering success where there is chronic failure.

These kids give up before trying. They stop playing. They might not even get in the game. It’s painful to watch. It requires a lot of patience and energy to motivate them to keep going, or even to make them try to play.

Learning, socializing, trying new experiences, meeting new contingencies of reinforcement (fancy terms we behaviorist use which simply means obtaining rewards from the environment) require motivation, understanding success and failure, visualizing how great it would feel to win or get an A. It requires the ability to connect past experiences with possibilities in the future. All processes very difficult or impossible for people with special needs.

Lack of motivation to learn and get better at something is arguably one of the main features of individuals in the autism spectrum.  Some of them do not to like anything. Others, perseverate in dysfunctional use of objects.  

Therefore, I think it is our job to expose them to success. 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 set the environment and provide them with the necessary support to succeed. In some cases the task requires a great deal of work and patience. How you keep your “cool” when they are throwing a tantrum in the grocery store, screaming to the top of their lungs, hitting and kicking you? Realizing that they are suffering and it’s our job to help them and not the other way around can be a very effective shift of perspective. 

Another important factor to consider is the need to teach them social skills, especially how to play with others. What regular developed kids learn by themselves has to be taught to these children. Spending some time playing with them, coaching them through the turn taking/sharing/following-the-rules/winning-losing processes can be a challenging but crucial task to support special needs children achieved success.   

Let’s help them win and we’ll be winners.

Daniel Adatto, BCBA