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Tag Archives: individualized

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!

Social Emotional Support: Part 3 (How does it work?)

15 Thursday Nov 2012

Posted by kolubcbad in Autism, Behavior Analysis, Behavioral Cusp, Community, Early Intervention, Social Interaction, Uncategorized

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autism, early intervention, individualized, intensity, S/E, social emotional support

Social Emotional Support should be practical, and fit into a child’s family routine or team involvement.

How does Social Emotional Support work with other therapies? Does it replace Speech Therapy?
Social Emotional Support can complement, but does not usually replace, therapy by an experienced, licensed and trained speech therapist, especially if the child is diagnosed with an issue that would benefit from Speech Therapy. Instead, S/E can facilitate other therapies the child is already receiving, and brings a therapeutic perspective that can enhance the benefit of Speech, Occupational, Physical, or other supports. For example, some children may use dangerous or unsafe behaviors, or escape from unbearable or undesirable situations after inappropriate behavior. Other children benefit from learning how to “turn down” or “turn up” sensory stimulation, without using unsafe behavior. They can learn safe ways to express that there is too much, too little, or uncomfortable stimulation. We can help other therapists to integrate behavioral wellness into their sessions, and how to incorporate motivation and timing and behavior techniques into their strategies. Note: Some of the most powerful technologies in teaching children with autism (and diverse learners worldwide) have been generated by behavior analysts who collaborate with, or have backgrounds in, speech and language therapy. (PECS, or the Picture Exchange Communication System, is a good example of this.)

How do we do it?
Step 1: Assessment
A behavior analyst as S/E provider can assess a child’s strengths, challenging behavior, and family’s concerns, then generate individualized strategies to support the child’s growth. Often an assessment called an FBA, or Functional Behavior Assessment, is conducted over a couple of weeks to understand the reasons and ways that the environment is contributing to the child’s challenges. We learn what situations are most difficult and how to address them by strengthening more appropriate and successful alternative ways for learners to meet their needs.

Step 2: Collaborate
Next, we team with the child’s family and other providers or community members. We use a collaborative strength-based service model to determine measurable goals the child will meet by learning new skills, behaviors, and new ways to use their strengths. Then we discuss ways (strategies) that will be used to get there.

Step 3: Teach family and therapists to use consistent strategies; monitor strategy effectiveness
Collaboration results in setting measurable goals and developing a plan listing specific strategies families will use to meet the goal.

Families often ask whether we use individualized strategies or apply the same kind of support to every child.
We use individualized support. There are also many core “evidence-based” strategies that we use because research and practical application consistently shows they benefit children with autism and related challenges. Read more about the EI Colorado recommended strategies here.

Step 4: Support the child’s transition out of early intervention.
This step involves thoughtful planning for how the child and family will move to the next steps and environments as needed. Local agencies partner with schools to provide families with options for continued therapies in preschool if needed. Social emotional support providers can work with families to put the currently effective strategies in writing to share with important new people in the child’s life. Some families benefit from continued consultation from a BCBA, who can help teach preschool teachers and therapists how to keep making progress by providing continued individualized support based on the child’s needs. (Check out a previous related post on supporting a child’s transition).

Social Emotional Support and Intensity of Behavior Analytic Intervention
Although intensive intervention is recommended and effective for building skills and relationships with children with autism, the intensive aspect of intervention is not characteristic of the time-limited S/E support under Early Intervention Colorado’s guidelines. Instead, this model provides a brief assessment as needed followed by an hour or so of weekly therapy with the child that consistently includes caregiver education. By focusing on engineering change in families and team members, we set caregivers up to learn preventative successful techniques to support their child’s speech, motor, play, self-help and social skills.

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