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Category Archives: Early Intervention

Homebound and Vulnerable: What will you do to prevent abuse and neglect?

24 Tuesday Mar 2020

Posted by kolubcbad in adults, Autism, Behavior Analysis, boundaries of competence, children, Community, coronavirus, Covid-19, Early Intervention, Education, Education and Trauma-Informed Behavior Analysis, ethics, mental health, Uncategorized

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behavior analysis, camille parsons, coronavirus, Covid-19, ethics, mane, pandemic, reporting child abuse, telehealth

This is the 19th article in a series on Trauma-Informed Behavior Analysis by Dr. Camille Kolu, BCBA-D. Start by becoming informed; then please read to the end if you’re interested in taking steps with your organization to support therapists and teachers to continue to fulfill their roles as mandatory reporters.

Child abuse, elder abuse, domestic violence, and abuse of people with intellectual disabilities is going on all around you. It may have just become simultaneously more prevalent, invisible, and insidious.

For example, in some areas, there has been a marked decrease in calls to the hotlines that typically lead to welfare checks for vulnerable people in their homes to insure that families have resources they need, children are not being abused or neglected, and appropriate actions can be taken if they are. (See this story from Colorado reporting a drop in calls the 9th and 10th of March as schools began to close).

Across the nation, different states are reporting similar decreases in calls but also a spike in the number of serious child abuse hospitalizations and even deaths.

Reasons for this disturbing increase are numerous. Little annoyances become big ones when there is no possibility of a break and both mental health (e.g., patience) and physical (e.g., food and sleep) resources are running thin. Even a normal battle on whether your kid will eat the peanut butter sandwich becomes a crisis when you’re trying to feed several people a balanced diet with whatever dwindling foodstuff you still have in the cabinet, while money (and outside trips) become scarce.

For many families, the struggle is not only real but getting uglier by the day, by each hour the kids are home from school.

There is conflicting advice, some of it really unhelpful, yet most of it well-intentioned. (I read a recent article about how we should just give in and let kids watch endless videos during this unprecedented time; but for many children, a huge increase in access to media may be accompanied by major behavior challenges (and even injurious and aggressive behavior) when parents try to have them turn it off for meals or bed. Research shows increased screen time can cause impulsivity, hyperactivity, and inattentiveness,

all of which are even more difficult to deal with when you’re cooped up. Of course, you need solutions, and the quick fix is even more appealing right now.

And there are major barriers to resources. Some have said this crisis is leveling the playing field, but really, it’s revealing discrepancies.  

Being quarantined at home doesn’t hurt that much when there’s plenty of food, you already know how to navigate technology to work from a home office, and there is room and time to get away from housemates or family members for a little while.

Being at home with other people who normally require 7 to 9 hours of behavior support and school-provided structure, let alone meals, while you work to make ends meet—that is another story altogether.

So there are the struggles to which we can all relate, and then there is the reality of jumping into these struggles with no help, no end in sight: There is the reality of suddenly not being able to be by oneself for even a minute, and not knowing when it will end; there are children whining or crying (or hurting themselves while other things need their caregiver’s attention; there is behavior, so much behavior, that a parent doesn’t know how to handle and is made worse by a lack of structure, suddenly upended routines, and for some, the complete loss of safety figures.  At the same time, there are abusive people who are now alone with their victims for the next few weeks.

Maintaining a safe environment for a child depends on several behavioral and environmental factors. Right now, those factors are not all present. Instead, we have

-Caregiver behaviors that are really important to keep people safe, but may not be FLUENT (such as giving effective instructions to a child, creating a schedule for several people, or responding to unsafe behavior that you usually don’t have to respond to)

-Caregivers that may physically present, but not AVAILABLE (e.g., an adult who can provide continuous, adequate supervision to every single member of the household who needs it)

-The presence of new circumstances creating unsafe environments (such as having 3 children with special needs home at the same time, for hours and days on end, and without the things (therapies, bus drivers, respite workers, social outings and educational time) that typically provide structure and relief)

-The additional presence of huge stressors (the unending flow of news about the virus; the dwindling of food and resources; the loss of jobs)

-Competing, sometimes incompatible, needs (like people home from work who need quiet to make money but who also have to provide constant caregiving and supervision; or people who have intellectual and other disabilities and are without their scheduled programs, events, therapies, social opportunities)  

-Therapists and teachers who are working from home or not at all, but who normally document and relay evidence that a child or adult may be being abused, mistreated or neglected

These factors and more combine to produce

-The occasion for more abuse or neglect to occur

-Decreased opportunities for abuse to be reported

-Emotional and physical needs that may make the outcomes of a child being quiet or following directions suddenly much more important or reinforcing, whatever the cost

So, my therapist, day program provider, and educational staff friends- how will you add and document safety checks for all your clients on a reliable schedule to take the place of “having eyes on” the client in your clinic, their home, or your school or program?

There are no hard and fast answers. For instance, some behavior analysts are out of work; could they be repurposed to providing online support of families with children at home? Having eyes on the family is good, but it’s also introducing a risk that we will give advice that we don’t have an assessment to back up, or that is not fully safe to implement. And while I’d like to share ideas for behavior analysts to incorporate safety checks of your clients virtually, it’s most important for me to encourage you to reach out, right now, to your organization—and ask for your TEAM’S plan to do that. This is because different states and areas have different guidelines and requirements for you to follow depending on your local recommendations for HOW you monitor and report unsafe situations. You need to do it, but you should follow your local guidelines and state laws.

  1. Recommit to your role as a mandatory reporter for individuals with disabilities, the elderly, or children, if you are a therapist, teacher, etc.
  2. ACT as an employee: If you work for an organization, act by asking your company what their contingency plan is for all employees to fulfill this role given our emergency situation, and how you can help.
  3. ACT as an employer: If you own or lead an organization, stop right now and generate a brief plan for how you’ll support your team to fulfill their roles as mandatory reporters. Here are some ideas:
    • Write up a plan and email it out. Bonus points if you schedule an online meeting right away to disseminate it and give examples and encouragement.
    • Assign everyone a recommended frequency to make check-ins that specifically deal with the client’s physical well-being and mental health.
    • Give the team an example for what questions they can ask, and what they should avoid (if needed) to maintain everyone’s safety in the home they are looking at.
    • Tell employees to document the outcome of their checks (e.g., if they notice things that typically would indicate possible abuse or neglect; or if they notice something might be wrong that warrants another check-in from a supervisor on your team; if calls are made to CPS or APS)
    • Reinforce and encourage the behavior of employees who follow the plan, including having social support carved out for them so they don’t have to go it alone.

Telehealth provision is already a new skillset for some employees, including teachers, and if they are suddenly without any social support when they used to be able to walk down the hall to the counselor, administrator or psychologist on site, they may freeze and wait when action is important. It’s your job to make the unfamiliar but correct action as easy and supported as possible.

And here’s a notice: Social services haven’t closed down. In Colorado, not only are they still making visits, they are hiring. Hotlines are available and staffed with trained professionals to take your call.

Resources: Read guidance from the Behavior Analysis Certification Board on ethics, safety and more related to Covid-19.

Here’s more on how a few states are monitoring this issue.

Colorado:

Call 1-844-CO-4-KIDS if you suspect abuse or neglect

https://www.coloradocac.org/

For birth to 3 receiving services: http://coloradoofficeofearlychildhood.force.com/eicolorado/EI_QuickLinks?p=Home&s=EI-CO-Response-to-COVID-19&lang=en

Ohio: https://www.cleveland.com/court-justice/2020/03/staying-at-home-amid-the-global-coronavirus-pandemic-creates-new-dangers-for-victims-of-domestic-violence-and-abuse-experts-say.html

And in Texas, use this info:

https://www.allianceforchildren.org/

If you suspect a child is being abused or neglected, please contact the Texas Department of Family and Protective Services toll free at 1-800-252-5400, 24 hours a day, 7 days a week.

You may also file a report using the secure TDFPS website. Reports made through this website take up to 24 hours to process.

The Texas Abuse Hotline is 1-800-252-5400.

Start your fall to-do list: Register now for Paradigm play webinar this Monday (and more)!

06 Friday Sep 2019

Posted by kolubcbad in BACB CEU, Behavior Analysis, CASA, CEU, children, Community, continuing education, Court Appointed Special Advocate, Early Intervention, Education, learning, play, resources, Uncategorized

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paradigm behavior, play, webinar, workshop

This summer has been a busy one for Cusp Emergence. Dr. Kolu taught Ethics to University of Colorado Denver students, jumped back into work doing consultation to support businesses and BCBA’s to reach their behavior analytic goals, trained CASA volunteers and more. Next month we will be training Friends of Broomfield and (finally!) putting the finishing touches on the Education and Trauma Informed Behavior Analysis course by Cusp Emergence University.

In the meantime, we just learned about a great low-cost resource for parents! Paradigm Behavior has all kinds of great parent-oriented supports that also help behavior analysts and caregivers. This Monday they are having a sale on an informative webinar!  REGISTER HERE:

https://paradigmbehavior.com/play-registration

You know who would also benefit from this? Foster and adoptive parents, preschool teachers, and church nursery staff would find this super helpful. Our trauma informed teams also love learning how to enrich “time in” with kids who are just learning to have fun with adults in carefree ways after a difficult early life.

And coming up, this fall we’ll register for the APBA (Association for Professional Behavior Analysts) convention coming to Denver 2020, attend COABA (Colorado Association for Behavior Analysts) on November 2,  sign up for 4CABA (Four Corners Association for Behavior Analysis) that meets in Colorado Springs April 2020, and submit proposals for the May 2020 workshops at ABAI (Association for Behavior Analysis International) in DC. We’ll be back shortly to tell you all about the new courses we’re offering this fall. Contact us today if you’d like Cusp Emergence to tailor an online workshop or training for your team. Hope to see you soon at a local event or meet you at one of our webinars (CEU’s offered at all of our events)!

 

Part 9 in Trauma-Informed Behavior Analysis: On intervention for fetal alcohol exposure

18 Monday Sep 2017

Posted by kolubcbad in adults, Behavior Analysis, children, Early Intervention, Education, enriched environment, FAS, FASD, Fetal Alcohol Spectrum Disorders, risk assessment, self injurious behavior, Social Interaction, teaching ethics, trauma, Uncategorized

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aggression, behavior analysis, early intervention, FAS, FASD, Fetal Alcohol Spectrum Disorders, fetal alcohol syndrome

Early intervention after an unfair start in life: Fetal exposure to alcohol

Those of us who work with people who have lived through adverse childhood experiences are familiar with the importance of individualizing treatment. We can do a lot of harm if we don’t consider what someone went through in life, or if we assume that one child’s preferences and needs are similar to those of another person.

Of course, this series about trauma has emphasized that it is the responsibility of ANY behavior analyst to individualize treatment, to consider the history of a client before moving forward with treatment, and to treat more than the “local” functions of behavior. Unfortunately, it is easy to miss the importance of this component of assessment and treatment, especially for new behavior analysts who have gained their “hours” working with highly similar clients, working without supervisors experienced in a diverse clientele, of without any supervisor or instructor who appreciates experimental as well as applied behavior analysis. One of the ways we find out more, is to go to the literature. This may be easier said than done, and an example of successfully data mining for this topic is provided toward the end of the article.

Today’s discussion involves clients who have been affected by what’s known as “Fetal alcohol syndrome”, or exposure to alcohol in the womb.

This is more than adverse childhood experience, for it goes back further in development, perhaps even as early as the neural tube (which will give rise to the spinal cord) and other important structures were being formed. This kind of exposure can affect an individual for their entire lifetime.

So we can consider it an adverse experience, although it happened even earlier than what we think of as “childhood”, and it has long lasting consequences, altering the way someone will learn and interact for the rest of their life.

Can we treat behavior after this condition? Continue reading →

Part 7 in Trauma-informed behavior analysis: When praise doesn’t work

25 Friday Aug 2017

Posted by kolubcbad in Behavior Analysis, Early Intervention, Education, praise, risk assessment, Social Interaction, supervision, teaching behavior analysis, trauma, Uncategorized

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For readers following our ongoing series on treating behavior affected by previous adverse experiences (e.g., trauma) from a behavior analytic perspective, you may have noticed a few key concepts embedded in the articles and stories I have shared so far. One of these key ideas is this:

After trauma was present in a child’s life, their behavior may seem to respond a bit (or a lot) differently to everyday behavior management strategies.

Because this is such an important idea, I want to say it a few different ways to help you identify with different audiences and members of your collaborative team.

A parent might say, “I don’t know why, but in my 20 years of parenting kids, many who had disabilities and many who were typically developing, I’ve never had a child who just didn’t respond to my regular parenting skills – this child doesn’t respond the same, and not only does my normal parenting seem to not work, but it feels like I’m actually making it worse when I try to help.”

(Empathy red flag: Remember my suggestion to go to parenting or adoption or foster care groups and to listen hard before you try to help? Any behavior analyst knows to first “do no harm”, and it gets real, right here, when we try to help first by “doing only what we normally do” after someone experienced certain kinds of aversive and “traumatic” experiences.)

A special educator getting his behavior analytic certification new to “kids who have been through abuse or neglect” might say, “it’s so weird how the PBS (positive behavior support) and class-wide token system techniques work on my whole class, but they just don’t seem to impact this student at all; I feel like he doesn’t care, and I can’t seem to get through to him”.

A law enforcement professional new to this population might say, “It’s strange how the mother who called us seemed like she was in crisis and the child was about to commit murder, but when we got there the child seemed super calm and talked to us like nothing was wrong; I’m thinking it might be the parent who has mental health issues.”

(Above, this law enforcement example is a red flag for indicators of possible “Reactive attachment” issues that will be discussed in some upcoming articles. It might sound strange to a behavior analyst, but “attachment” is an idea that can be translated and discussed with social workers and caregivers to make sure that the client is receiving appropriate support. Responding oddly to praise is just one  of the indicators of a past challenging history, and telling vastly different stories to different adults can be another.)

A behavior analyst might say, or at least agree, that someone’s behavior responds differently to social stimuli after a series of difficult, life-changing and aversive experiences that occurred with previous caregivers.

And a behavior analyst familiar with using preventative schedules and comprehensive historical assessments to support a client after serious aversive experiences might say, “We need to document what stimuli the person was exposed to in their conditioning history, and how socially delivered stimuli affect their current behavior stream. We need to prioritize the teaching agenda for the caregivers, parents, and teachers, to make sure they know how to deliver preventative schedules [instead of doing the everyday adult training agenda like teaching people to praise appropriate behavior; we know that because of this person’s history, praise may not function as a reinforcer, and may result in worsening behavior over time, if we are not careful about how and when it is delivered].”

It’s important to point out that this article is not about how praise is not a good idea.

In fact, praise is just a social interaction that involves pointing out what was great about someone’s behavior, and it can be as simple as calling out a behavior when a child tries it for the first time (“Hey, you helped out without asking when we cleaned up the room; I bet Ms. Tilly was super happy to get some help. Did you notice how she smiled at you when we left? You’re a part of this school family and we’re so glad you’re here.”)

It’s also not about how to deliver praise effectively or why we praise or how to fade out praise. (If you’re interested in that, check out research on the subject in the Journal of Applied Behavior Analysis or our Why we praise handout).

It’s really about how something—a parenting practice, a behavior management strategy, an educational plan—works, given someone’s history. Often this is in addition to how a behavior functions in the moment.

It’s about individualizing our strategies (which can only occur after appropriate assessment). Praise should be a tool that waters the flowers you want in your garden. If you accidentally dump fertilizer on something you don’t want to grow, what happens? What if praise isn’t like water to a flower, but a weed-killer that will stunt its growth, because of the person’s history, and how it was paired with other stimuli in their repertoire?poppies.jpg

Sometimes we jump in before assessing the history.

Clients exposed to disruption in their early learning histories just don’t respond “typically” to praise.

Praise is not magic.

It’s just another stimulus that occurs in a social context.

By definition, it is delivered by a person, meaning it has a social conditioning history.

For some of us, it was just a signal or pre-condition for bad things about to happen.

Unlike in happy homes, for people who have been through abuse, the history of hearing praise (or hearing adults talk to a child) might not be pleasant, or predictable.

Similar to how the history of caregiving was not necessarily predictable or always pleasant, so we can’t expect that learning to trust a new caregiver, teacher or adoptive parent, or starting to enjoy their praise, or follow their helpful suggestions and instructions, will be easy or predictable.

How can we help?

When we’re lucky, sometimes clients use their words to tell us. My 20y old client who had been through abuse (and was living in a jail setting where she felt “safer” than going home to live with people who had abused her in the past) reminded me, “Dr. K, you already know I don’t respond well to compliments.”

When they’re not able to use words, even if they can sometimes speak, clients use their behavior to tell us that they don’t feel safe, or that praise is uncomfortable or that adults are historically not reliable signals of good things.

Let’s listen.

P.S. Why is “risk assessment” checked as a category or tag for this article? If we don’t assess the risks for using interventions in a case that involves “trauma”, we risk using or recommending a strategy that would work in 90% of your other cases but might increase challenging behavior in this one. If you’re a behavior analyst, you’re already concerned with following our field’s ethics guidelines related to risk assessment.

Resource Wednesday: Paradigm Behavior, for family-supportive resources beautifully designed by a friendly BCBA

09 Wednesday Aug 2017

Posted by kolubcbad in Autism, Behavior Analysis, children, Early Intervention, Education, enriched environment, play, resources, Social Interaction, teaching behavior analysis, Uncategorized

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behavior analysis, children, community, paradigm behavior, parents, play, resources, teaching behavior analysis

At CuspEmergence, we love finding resources or information we can share with our families and community. Imagine our excitement when we discovered this close-to-home resource, an entire website devoted to helping parents become even more amazing at playing, communicating, and connecting with their children! Paradigm Behavior maintains a website and resource library where families can learn, with the support of a Board Certified Behavior Analyst who is a parent herself. Christina posts blogs, resources for supporting play, and online coaching for families interested in developing play skills, language, and more. Paradigm Behavior maintains a well-stocked Playroom, which could teach students and supervisees cutting their teeth in behavior analysts a thing or about connecting with families and using materials in effective ways.

The resources we found were helpful even to seasoned behavior analysts, taking much of the work out of connecting parents with individualized resources that were at once friendly and helpful. We think you’ll love them as much as we do

Check out ParadigmBehavior.com.

Trauma-informed behavior analysis, Part 4: On terms (Is “trauma” behavioral?)

08 Tuesday Aug 2017

Posted by kolubcbad in adults, Behavior Analysis, children, Early Intervention, ethics, supervision, teaching behavior analysis, teaching ethics, trauma, Uncategorized

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This article is the fourth installment in a series on trauma-informed behavior analysis, by Dr. Teresa Camille Kolu, Ph.D., BCBA-D.

Is “trauma” a behavioral term?

“Trauma” is a buzzword lately. As several people recently noted on behavior analytic forums, it seems as though schools and other entities are requiring “trauma-informed care” from people tasked with providing behavioral interventions, yet it isn’t clear whether trauma actually presents as anything different than the reinforcement history, or a client’s past, that would be explored routinely in any old behavior assessment.

On a recent facebook post in a behavior analytic group, one person posted, “Trauma”, “trauma-informed”, etc, is [just] the new buzzword to get grant funding and sell product”. Another poster chimed in, “Trauma? What’s the behaviors [sic] of concern? What’s the function?” This seems to imply that if we know the current function of behavior, what more do we need to know? It suggests that the resulting treatment path is likely to be no different than that for a “typically developing child” of the same age and an apparently similar behavioral repertoire.

The implication in the social media posts above seems to be, “what’s the big deal?” In other words, trauma is thought of as some in the behavior analysis community as simply another sexy concept that is meant to sell and sound good, rather than being something critical to appreciate (and to suggest differential treatment based on its presence or absence).

As a behavior analyst who has treated children and adults exposed to serious and adverse childhood experiences, I have come to appreciate that the current function is NOT the only important thing to know before treating someone’s challenging behavior patterns, or helping an adoptive parent cope with challenges a mental health therapist might call “reactive attachment”.

So what’s a BCBA to do? Continue reading →

What does hope sound like?

07 Monday Aug 2017

Posted by kolubcbad in adults, Autism, Behavior Analysis, Early Intervention, Uncategorized

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What does hope look like?

The behavioral doctor sat between house calls in her car with amazed tears streaming down her face.

Was this viral story true?bird.jpg

Intuitively, she knew that it must be, for she instantly recognized the chubby little face she saw on the screen. She suddenly recalled the clear little voice asking for “music!”, and a couple of weeks later, “music, please!”. She remembered when his list of words included about five. She recalled singing songs (“Way up in the sky, the little birds fly….”) to a toddler who had needed early intervention desperately.

But the story she read on facebook was also hard to believe, because this young man wrote so confidently and was about to graduate. He also sang so beautifully, as links posted by his mother—and his scholarships to prestigious programs—confirmed. It had been at least 15 years since she saw the toddler’s face, or said “do this” and prompted him to carefully stack one block on top of the other, painstakingly teaching play skills that other children seemed to learn so naturally. At the time she had worked for an early intervention program, providing or supervising up to 7 hours per day of behavior therapy to children whose tantrums often overwhelmed and injured their parents, teachers and skilled therapists—but communicated their wants and needs before they had words. And at the time, she did not know that behavior analysis would become her fulfilling career and that she would go on to study neuroscience and learn how the brain really does change with the hundreds and in some cases, thousands of hours of careful social input that certified behavior analysts are trained to provide.

But this was definitely the same little guy, except he was all grown up. Continue reading →

I’m done with this; now where do I put it?

13 Wednesday Feb 2013

Posted by kolubcbad in Behavior Analysis, Behavioral Cusp, Early Intervention, Education

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behavioral cusp, clean up, family empowerment coaching, give clear instructions

This is a story about a little girl, about five years old. Before she learned where things went, she learned where they DIDN’T go.

(First, a note to the teacher or student in all of us: Do you notice that adults often tell us what NOT to do? Sometimes it’s easier for adults to think about what NOT to do than what TO do.

But do you also notice that when little children hear what NOT to do, they don’t automatically understand what TO do?

This makes sense!

If it’s hard for US to articulate, it’s even more difficult for children or students to understand.

It takes practice, but you can learn to give almost ALL instructions or requests, in a way that lets the person know exactly what to do.

It’s the first lesson of being a great therapist, and it’s better than wishing a significant other could read your mind.

And you can do it. These stories show two different ways this strategy could be used.)

Carlie was a little artist and avid reader, and with alone time, loved nothing better than taking out ALL the art supplies, all the stuffed animals who needed to watch, and surrounding herself in the bedroom with piles and piles of STUFF. She changed clothes often, and changed shoes just as often, and the piles grew every afternoon.

Often at night, before getting tucked into bed, she scrambled to push the piles to the corners, and artfully arranged pillows over the piles. Other piles she pushed under her bed, where a perfectly positioned bedskirt hid them from mama’s eyes during a bedtime story or conversation about kids at kindergarten that day.

And it worked for a while. But one rainy Saturday morning, her other chores were all finished, and Mama said the dreaded phrase: “Why don’t you clean your room? I can help if you need me to.”

No! Not the offer to help! And sure enough, the little girl sat sobbing on the floor for what seemed like hours, as Mama lay on the bed, sometimes only her feet showing, as she pulled out pile after pile of clothing, moldy bowls and cups, ruined art projects and half-eaten cereal science projects. And the little girl was embarrassed, for now Mama knew her messy (somewhat naughty) secret.

But wait!

Now that Mama knew the secret, Mama could solve the problem. Now she knew that the REAL secret was this: The little girl, even after all this time, had no idea where to put things! At least, it hadn’t “stuck”. Now, Mama and the little girl organized the room TOGETHER. The little girl decided where everything went. Mama helped her make places for things: they hung up a net for stuffed animals, Carlie made colorful signs labeling spots for books, art supplies, and even “things to take to the kitchen”! Now she had a place to put everything. And Mama had a much more specific way to help. Saying “clean up your room” hadn’t usually resulted in a clean room. Instead, saying “put everything back where it goes” somehow made a huge difference for Carlie.

It’s not that hard, unusual, or impressive. 

But if you’re not already helping kids figure out where they CAN put things, try it: it’s a lot easier to clean up when you do!

It’s true for their behavior too.

A couple of years ago, three year old Carlie had just graduated to a “big girl seat” but was kicking at the breakfast table. Every day mom threatened to put her back in her “little girl”seat and every breakfast ended in tears with Carlie back in her “little girl” seat.

But wait, thought Carlie’s mom. She’d just enrolled in a parenting course, and remembered to apply a strategy from class. “Where CAN Carlie kick? When can she kick? Who will play with her? And most importantly… what can Carlie do at breakfast, INSTEAD?”

Fast forward 1 day. Carlie’s mom has purchased a tiny stool. Carlie’s feet rest there. Each breakfast begins with a happy discussion of what she can do with her feet. She can put them on the stool! Then they discuss what they can do after breakfast. We can go outside in the yard and play ball! We can practice our kicks, we can bring our dolls, and we can have fun!

Fast forward 2 minutes. Usually, Carlie starts kicking about 3 minutes after breakfast started. So today, Mom said “Wow, Carlie! Your feet are safe on the stool! I love it. It’s fun having breakfast with you in our big girl chairs!”

Now, this was just one example, with a minor behavior. The behaviors some parents think are problematic are not priorities to other parents. Find what will work for YOUR family or team. Cusp Emergence offers family empowerment coaching. Contact us for more information or to share your story!

Bottom Line: Give clear instructions and involve learners in creating and enjoying supportive structure or alternative behaviors, the way Carlie learned to enjoy active playtime after her breakfast, or participated in creating her bedroom’s “places to put things”.

Note: Did you wonder why this post is in the “behavior cusp” category? Giving clear instructions is so important a skill for caregivers and teachers, that I have often observed them able to access new levels of teaching and instruction when they learn how. Mastering a strategy like this can be a “cusp” for teachers and parents, making it easier to promote appropriate behavior and engagement in their families and teams.

HELP- There’s a monster in my toybox!

06 Wednesday Feb 2013

Posted by kolubcbad in Autism, Behavior Analysis, Community, Early Intervention, Education, play, Rett's, Social Interaction

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autism, behavior support, early intervention, individualized, play, social emotional support

Part 1 of Series: Helping caregivers and teachers support children to meet fearful challenges

Shannon’s Story

Shannon and Gina sat in a free play area near their preschool teacher. “SQUAWK!” came the loud animal sound when Gina pushed the button on a new toy. As the toy noise grew louder, Shannon’s eyes opened wider and wider until she froze, a look of sheer terror on her face. She started to back away and wailed, sinking onto the floor and crying.”Oh no,” gasped her teacher. “Put that toy away!” While Shannon cried, their teacher pulled Gina aside and said “I’m sorry, but Shannon is afraid of that toy. Next time we will remember to play with it when she’s in another room.”

Devon’s Mom’s Dilemma

Devon and his mom Jenny walked down the sidewalk with their next door neighbors. As they neared the playground, Devon suddenly grabbed his mother’s skirt tightly and shrieked. “NO BIRDIES! NO DOGGIES!” At this, Jenny’s face grew red as she picked up Devon and held him tightly. She looked at her neighbor helplessly and apologized: “I’m just so sorry… We can’t go any further with you. He’s been doing this every time. He has this issue with ducks and dogs and birds now. I think even if we don’t see one he’ll be afraid one might get him.”

Toward more supportive, long term strategies

At first, it may seem supportive to shield a child from their fears.

But both teachers and parents want and need solutions that will ultimately help children face and overcome challenges. So when there is a question, especially when a particular strategy feels good or soothing or produces relief in the short term, it’s a good idea to ask ourselves, “is this procedure also supportive in the long term?”

If not, how can Shannon’s teacher and Devon’s mom learn a more therapeutic approach? And why is that important? Let’s review these scenarios again, to better understand why and how to take a supportive long term approach. What might Shannon’s interaction with the toy, and Devon’s interaction with park creatures, have in common?

First, these scenarios are similar in how they are resolved.

In both interactions, a pattern is being established: the child first encounters a fear, or “fear inducing stimulus”, and then others respond by helping the child to escape or avoid it.

Second, these scenarios are similar in how they affect other people.

From the perspective of Shannon’s peers, her inability to play with that toy meant that they couldn’t either, at least not when she was around. From the perspective of Devon’s neighbor, the neighborhood kids couldn’t play with Devon in a park. This concept, the idea that Devon can’t play in the park, and that Shannon can’t play with toys that make animal sounds, limits interaction opportunities. It also risks changing the way peers think about approaching Shannon and Devon.

Third, these scenarios have similar “reductive” effects on the children’s “repertoire” or world. Have you ever met a family member or caregiver who says, “we used to love to do ___” but we can’t anymore”? Perhaps a family used to go to the movies, or out to dinner, or have friends over, or go to museums, or go hiking. During the initial conversation with families, that blank is filled in by all the things they need to avoid now because of fears of how people will react, fears that it won’t go well, fears that it will be too difficult, embarrassing, or noisy. Often those fears are REAL at the time! Perhaps people DID stare and talk at church when a family’s child loudly refused to stop standing on the pew. Perhaps all the teachers and mothers DID stare and talk in the parking lot as a child disrobed in public and threw a tantrum before leaving the store. Perhaps it WILL be difficult, embarrassing, or noisy. But keep reading. We can do this together.

Fourth, understand it’s a cycle: handling scenarios by allowing “fear habits” to persist, allows learners to skip learning opportunities and continue to repeat old harmful habits instead.

If Shannon and Devon can’t play with certain toys or in certain places, they have reduced opportunities to learn about those things and places, and no opportunity to learn that they are NOT scary.

Fifth, if these scenarios become habits, they make it more difficult for the child to handle or face similar or other fears in the future. These situations do not teach the child how to be more successful in coping with scary, new or different events.

Bottom Line: Instead of stopping or thwarting learning opportunities, we can expand them.

Come back Friday to learn how!

School of Play

04 Tuesday Dec 2012

Posted by kolubcbad in Autism, Behavior Analysis, Early Intervention, Education, play, Social Interaction, Uncategorized

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Tags

autism, behavior management, language, leisure skills, play, school of play, social emotional support

School of Play ©
Our school of play division provides one-time, brief, or long-term play or leisure skill-based individualized client supports, training, and education.

WHO can benefit?
Groups: Schools, classes, churches, businesses (gyms, pediatric doctors or dentist groups, therapists)
Families: Families affected by behavioral, developmental, social, emotional, or other challenges
Individuals: Children, staff, teachers, administrators

WHEN?
Our clients can benefit from School of Play © services whenever:

-A child gym owner sees staff struggling to help young mothers engage their children in play, interaction, or language, and enjoy the gym activities at the same time
-A community or church member runs a play group in a church or gym, and is not sure what to do differently to support new students with autism
-A community or church play group is not sure how to support children with language delays
-A parent needs the babysitter to manage behavior more effectively when supporting the family’s children
-A parent’s child with autism doesn’t know how to play with his siblings
-A family’s two year old with autism doesn’t like to play with his parents
-A family’s or organization’s group of therapists is great at 1:1 instruction, but they need help getting children to interact with each other
-An organization’s therapists are highly skilled at discrete teaching, but provide less effective naturalistic teaching

WHY does it work?
Cusp Emergence provides play and leisure skill support that is:
-Compatible with IFSP or IEP goals
-In some cases, able to be funded by a state’s early intervention services if the client qualifies
able to improve family or team interaction
-supportive of social, emotional, or behavioral wellness
-provided in the community or home setting
-consistent with research proven methods with demonstrated effectiveness
-administered by qualified, educated, trainers with extensive experience collaborating with parents, educators, therapists and community members

HOW can clients benefit?
-Learn to arrange environments to make appropriate effective language and communication more likely
-Learn to arrange environments to support play
-Learn to teach staff, babysitters, community, or family members to provide supportive environments
-Learn to arrange environments that prevent behavior challenges
-Receive support from our School of Play division in your group or home

HOW does it work?
-An initial consultation takes place to discuss the family’s or group’s needs
-Next, a workshop or future education is planned based on individual needs
-Follow up support is available for families or groups on a schedule determined together with the client

(click here to check out Building Your Workshop)

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