Transitioning to Adulthood with Aspergers

Individuals diagnosed with Aspergers or another autism spectrum disorder (ASD) may be presented with many challenges throughout their lives—especially during the transitional periods. As the individuals age and learn to use different skills in various environments, families, educators, medical professionals and the individuals themselves begin to anticipate the transition to adolescence and, eventually, to adulthood. Given the differences in abilities and behaviors that many individuals with Aspergers or HFA experience, it can often be overwhelming to plan for tomorrow much less several years later.

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Among the many skills that an individual must learn to successfully transition to adolescence and adulthood, daily living skills are often neglected.

Examples of daily living skills are bathing, grooming, preparing meals, managing finances, using public transportation, etc. These daily skills are necessary for independent functioning in the home and within the community.

A recent study discovered that individuals with ASD improved in daily living skills during adolescence and the early twenties. These skills plateaued around late twenties and began to decline in the early thirties—this shows the importance of honing these skills earlier in life instead of waiting until later.

Some positive findings were that inclusive schooling had a positive influence on adult outcomes. The study also found, “that vocational independence predicts improvements in autism symptoms and significant improvements in behavioral problems.” Daily living skills could also be increased by engaging in some type of work activity.

It is encouraging that daily living skills can continue to be gained at later points in development as other skills plateau. The authors suggest that more research is needed to develop behavioral and pharmacological interventions for older individuals on the autism spectrum.

While individuals with Aspergers or HFA may have challenges with the daily living skills necessary for transitional periods, it is important for their independence and quality of life to begin this journey at an early age to ensure success.

by Lupe Castañeda, M.S., BCBA

Have you thought about or experienced the transitional periods in your or your child’s life?

How did you cope with these experiences? 

Sources:

Smith L.E, Maenner, M.J. & Seltzer, M. (2012). Developmental Trajectories in Adolescents and Adults with Autism: The Case of Daily Living Skills. Journal of American Academy of Child and Adolescent Psychiatry.  51(6): 622–631.

5 Focuses For Creating a Learning Environment in the Home

When it comes to setting the stage for learning, individuals on the Autism Spectrum need to continue their learning experiences even after school. This requires responsibility from therapists, caregivers, and parents. Each must work together to help create a learning environment in the home that continues to provide opportunity to expand the vital skills a child is working on. This includes setting up a home environment, understanding your child’s classroom setup or making suggestions at their after school program.

Child playing at home

Here are five goals to focus on when evaluating a school-related learning environment in the home for children with Aspergers or HFA.

1. Increase Engagement:

It’s ok for kids to take a break after school and have some down time, but preventing total shutout is important. Whether it is a play activity or helping with homework, making this part of the routine will assist with expectations that the child will need to interact for an expected amount of time.

2. Increase Communication:

Asking the question “how was your day?” rarely gets the response desired. To get them to chat, incorporate out of the ordinary or silly situations to spark spontaneous requests or comments. (e.g. carrying an umbrella when it isn’t raining or dressing up the dog before your child gets home). Sometimes a child may need a prompt to take note about the change in environment, but that is ok! It increases the opportunity to communicate either way

3. Promote Independence:

Use visual charts to show the steps expected to follow directions without reminders. This is especially useful for morning and bedtime routines. It may take some time to teach the sequence to complete the task. However, using the visual will allow the child to find the solution on their own rather than get in trouble for not completing the task.

What is ABA Therapy?

Applied Behavioral Analysis

So, what exactly is ABA, or Applied Behavioral Analysis?

Close-up view of pencils and African girl writing

ABA is an intervention therapy that specifically addresses behavior. ABA is one of the proven best practice therapies for children on the autism spectrum, including Aspergers. Thousands of research articles have documented the effectiveness of ABA in individuals with autism across behaviors, settings, and specialists. The behaviors that ABA seeks to address could relate to academics, communication, challenging behaviors, and other daily living skills.

ABA, as a field, seeks to understand and improve human behavior—the goal of many disciplines. What sets ABA apart from other fields is the approach and process. Professionals trained in ABAor behavior analysts—break down each component of interactions to understand this behavior.

In ABA, behaviors are analyzed by looking at antecedents, behaviors, and consequences. These are known as the ABCs of ABA.

  • A = Antecedents (what happened before the behavior)
  • B = Behavior (the behavior targeted for intervention)
  • C = Consequence (what happened after the behavior)

For example, a child sees a box full of cookies on the table that his mother just took out of the pantry (antecedent). He asks her, “Mom, can I have a cookie please” (behavior). His mother tells him that he must eat his omelet before he can have a cookie (consequence).

Behavior analysts believe that adaptive and maladaptive behaviors are learned, and can be changed.

Basic principles of ABA state that when behavior is followed by something pleasant, it will occur more often in the future. In the same way, when a behavior is followed by something unpleasant, it will occur less often in the future. Behavior analysts utilize these principals of behavior to understand and improve human behavior.

Here is a general process for developing interventions utilizing ABA:

  1. Select the target behavior that is socially significant, observable, and measurable
  2. Clearly and specifically define this behavior
  3. Utilize principles of ABA to develop interventions
  4. Collect data in a way that demonstrates the changes in the target behavior are due to the intervention implemented and determine the impact of the intervention
  5. Make educational/therapeutic decisions based on the data.

It is key that an ABA intervention be effective. Meaning, the changes produced in the behavior are significant enough to make a difference in the person’s life outside of the context in which the intervention was implemented.

Now you know a little bit about the basics of ABA as a field. Do you think this process would apply to your child?

By Berenice de la Cruz, Director of Training and Research at Autism Community Network

Sources

Baer, D. M., Wolf, M. M., & Risley, T R.(1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1, 91-98.

Cooper, J. O., Heron, T. E., & Heward, W. L. (1987). Applied Behavior Analysis. Prentice-Hall: New Jersey.

Treatment for Sensory Processing Disorder

Sensory processing disorder (SPD) can make participation in life activities—what occupational therapists refer to as occupations—very difficult. Luckily, there are options and strategies to help improve sensory processing and make life much smoother and more enjoyable.

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Sensory-based occupational therapy (OT), may look like play to adults, but to the child it is their work and necessary for improving overall abilities to process sensory information more appropriately. Jumping, swinging, climbing and playing in multisensory mediums—such as shaving cream, beans, rice, or play dough—all have a place in their growth and the development of sensory processing abilities.

As the child plays and learns more about their body and how to use it through treatment for sensory processing disorder, their brain improves its ability to process sensory information more efficiently. These children are then able to handle situations more appropriately and participate in everyday activities including self-care, fine motor and social skills.

This process can take months for long lasting effects, but parents often see a difference after the first few visits.

Occupational therapists that specialize in SPD and autism are especially adept at helping individuals on the spectrum succeed. These therapists are skilled in testing and providing treatment, compiling strategies to modify the environment, developing home programs, and giving suggestions to schools and vocational programs to improve participation in life’s activities.

When looking for an occupational therapist, it is important they have advanced training in sensory integration or SPD and, if possible, are SIPT (Sensory Integration and Praxis Test) certified.

Though occupational therapy services may be provided in a variety of settings—including home and school—the clinical setting is much more conducive to treating SPD and the underlying causes of the child’s difficulties. This is because a clinic will have specific equipment designed to promote engagement in therapy and develop skills necessary to overcome sensory difficulties.

You also want to make sure they have an OT gym that is well equipped to treat SPD.  A phone call and an interview with the therapist may be beneficial.

Find a SIPT Certified Therapist

by Dr. Gayla A. Aguilar, OTR, OTD

Does your child have a sensory processing disorder? How does your occupational therapist help?

How to Expand A Picky Eater’s Diet: Feeding and Food Chaining

Since feeding involves all sensory systems (sight, smell, sound, touch, and taste), eating is the most difficult sensory task that children face. Feeding issues are especially common in children with autism, including those with Aspergers, because of difficulties with sensory processing. In many cases, this leads to eating challenges at mealtimes.

Little girl eating

“Food chaining,” from the book by the same name, is based on the child’s natural preferences and successful eating experiences—specifically the idea that we eat what we like. Food chaining introduces new foods that have the same flavors or sensory features as foods that are already preferred by the child, increasing the likelihood that the child will like the food.

A food chain consists of four levels that build upon one another. By following the levels of the food chain, the child will be able to build upon success with small changes.

For example, if your child’s accepted food is chicken nuggets, a sample food chain might look like this:

Level I Level II Level III Level IV
Maintain & Expand Current Taste & Texture Vary Taste & Maintain Texture Maintain Taste & Vary Texture Vary Taste & Texture
Other brands and sizes of chicken nuggets (i.e., strips/popcorn/bites, both fast food & home-prepared); fried chicken patties cut into pieces (fast food & home prepared) Different flavored chicken nuggets (barbeque, honey mustard, hickory smoked, etc.) Use sauces/dips to vary tastes. Chicken strips (not breaded); chicken leg/drumstick; chicken breast; ground chicken patties Breaded seafood (scallops, shrimp); breaded fish (fast food & home-prepared); breaded turkey breast; breaded vegetables; breaded baked chicken; crusted/breaded pork tenderloin; ground meats

Here are some other food chaining tips:

To Change Unwanted Behavior in ASD Children You Have to Find its Purpose

When a child with Aspergers or High-Functioning Autism demonstrates challenging behaviors, we tend to blame the child’s autism. However, these challenging behaviors are not a byproduct of autism, rather learned due to ineffective means to get needs met—especially when there are barriers to communication.

functions of behavior

Bottom line: if an individual does not have a way to communicate appropriately, he or she will find a way to communicate in another way (e.g. screaming or hitting).

Keeping in mind the ABCs of behavior from our previous post, let’s discuss the key to changing behavior.

Behavior is changed when we know the function—or purpose—of the behavior.

Social (Pragmatic) Communication Disorder

Social Communication Disorder is marked by difficulties with pragmatics—aka practical everyday use—or the social use of language and communication. Therefore, SCD is concerned with an individual’s use of verbal and nonverbal social communication in everyday life.

The condition is of particular interest to individuals with Aspergers or HFA.

In the DSM-V, it specifically states that individuals who have marked deficits in social communication but whose symptoms do not otherwise meet the criteria for autism spectrum disorder (ASD) should be evaluated for social (pragmatic) communication disorder.

Punishment in ABA for Individuals with ASD

While the word “punish” often conjures up bad thoughts for parents and professionals, punishment and reinforcement are key when looking at behavior change through ABA. Punishment in ABA decreases the chances that a particular behavior will occur again, as opposed to reinforcement which increases the likelihood of behavior.

punishment

Let’s look at the behavior analytic definitions of punishment specifically:

Positive Punisher

  • Positive punishers may occur naturally in one’s environment. A child pets a strange dog and gets bit on the finger causing pain. After this occurs, the child does not pet strange dogs. That is considered a positive punisher because the bite/pain (presented stimulus) decreased petting strange dogs (outcome).
  • A parent can use positive punishment as well: siblings are fighting; mom yells “stop it right now!” and the kid’s reaction is to end the fighting. Mom provides the stimulus of yelling, which decreases future occurrence of fighting.

Negative Punisher

  • A negative punisher would be when the removal of a toy ends the fighting between two children. This removal decreases chance of it happening in future.
  • “Time out” is also considered a negative punishment. When used correctly, it removes all reinforcement from the immediate environment resulting in a decrease in future occurrence of the punished behavior.

What is Sensory Processing Disorder?

Sensory processing disorder is a condition in which the brain has trouble receiving and responding to information that comes in through the senses.

Some people with sensory processing disorder are over sensitive to things in their environment. Common sounds may be painful or overwhelming. For young children entering school, they may find the fluorescent lighting, ticking of the clock, polyester in their clothing or smells from the cafeteria may prove overwhelming to the point of outbursts. Trying to identify the challenge and then accommodate will allow the ASD child to focus on classroom work rather than the irritant.

Others with sensory processing disorder may:

  • Be uncoordinated
  • Bump into things
  • Be unable to tell where their limbs are in space
  • Be hard to engage in conversation or play

Adrienne Gaither, OTR, C-SIPT with the Autism Community Network in San Antonio Texas, addresses questions on Sensory Processing and how the disorder may apply to your child diagnosed with an Autism Spectrum Disorder.

What is Sensory Processing Disorder (SPD)?

Watch the rest of this medical vlog series:

The Pathways to Diagnosis

Interdisciplinary Autism Assessments

For individuals on the autism spectrum, a diagnosis from a medical professional is necessary in order to qualify for medical services. One main difference in the assessment is in how the child is evaluated and whether the evaluation is done by an individual or a team.

Interdisciplinary Autism Assessments at ACN

At ACN, we conduct interdisciplinary autism assessments where a number of specialists participate in the evaluation and all of them are present at the same time from start to end.

The team consists of a developmental pediatrician or psychologist, a behavior analyst, a speech-language pathologist, and an occupational therapist. We believe that a comprehensive evaluation gives parents a clearer sense of the skills and deficits in their child and a clearer direction for seeking therapies.

The following is an illustration of the pathway to a diagnosis at ACN:

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