Anxiety-related symptoms are frequent concerns in children, adolescents and adults with Aspergers and HFA, which may be treatable with Cognitive Behavioral Therapy.

the pain

Anxiety is commonly found in high functioning individuals on the spectrum in particular because they have an increased awareness of their own social difficulties. This cognitive awareness may intensify their anxiety toward social interaction and promote isolation.

Recent numbers found that 11-84% of children on the autism spectrum experience impairing anxiety, while only 4.7% of all children aged 3-17 years have experienced anxiety.

Cognitive Behavioral Therapy (CBT) is a type of psychotherapeutic treatment that helps individuals recognize how thoughts and feelings influence behavior and cope with these challenges.

CBT is used to treat a wide range of issues, in addition to anxiety, including:Continue Reading

Many school students carrying the diagnosis of Asperger’s Syndrome exhibit challenges in the area of social interactions and social skills. These social difficulties are worrisome for parents and family members who look for supports to address these challenges. Struggles in the school setting often center on their child’s inability to “fit in” with other students or an inability to grasp social expectations from their teachers and peers. Additionally, their child’s feelings of high anxiety and stress can make the learning environment challenging for them and the people around.

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Over time, I’ve listened to concerns from parents and teachers regarding a student’s lack of understanding when it comes to social situations in the classroom environment. This often leads to isolation and the need for behavior support.

There is information in the literature that suggests both adult and peer mediated techniques to teach and build social skills in children with autism.

Strategies that are directed by an adult include reinforcement of shaped social skills. This is a technique where the child is reinforced when they demonstrate closer and closer approximations of a desired behavior. Peer mediated strategies incorporate the use of proximity, prompts with reinforcement, and teaching peer initiation. The literature also supports using social scripts to capitalize on visual learning methods (Krantz and McClannahan 1993).

In my experience, I’ve observed how visual supports can be very beneficial in producing non-transient messages for the student to follow and use during social situations. When paired with direct instruction using ABA techniques like shaping and reinforcement, social skills training can be accomplished.

When you set out to develop visual supports, first perform an internet search to get some ideas.

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Reinforcement in Applied Behavior Analysis (ABA) focuses on the outcome of the behavior and increasing the likelihood of certain behaviors occurring in the future. There are two types of reinforcement: positive reinforcement and negative reinforcement. Positive reinforcement is when a response is followed immediately by the presentation of a stimulus and, as a result, similar responses occur more frequently in the future.

In other words, positive reinforcement means when a behavior has an increased likelihood of occurring again if something is given after it occurs.

reinforcement

An example of positive reinforcement:

You tell a child if he or she cleans up their room, they can play for 30 minutes on the Wii, an activity they enjoy. The likelihood of the individual cleaning up the room is more likely to occur in the future because they received 30 minutes of playing with something they enjoy. In order for reinforcement to work, you need to make sure that what you are giving them is something that they value.

However, let’s change the reinforcement premise–

You instead tell the child if they clean the room you will go the movies. Your child is sensitive to sounds and does not like being around large crowds, so he will be less likely to clean his room even though you think it would be fun. The purpose is to focus on the child’s likes and dislikes to achieve the desired result.

Negative reinforcement is when a response is followed immediately by the removal of a stimulus and, as a result, similar responses occur more frequently in the future. In other words, negative reinforcement means when a behavior has an increased likelihood of occurring again if something is taken away after it occurs.

An example of negative reinforcement:

You are working on having the child be more independent when doing their chores. You provide a checklist of the chores that needs to be done for the day. He or she independently completes two of the chores on the list. You tell them because they independently completed two chores without any reminders, they do not have to do the rest of the chores. In the future, the individual is more likely to independently complete the chores because the rest of the chores were taken away—assuming he does not like any of the chores that were on the list.

If, however, they really like doing laundry and that was a chore on the checklist that you removed, the negative reinforcement will not have the desired effect on behavior.

You need to always keep in mind what the child likes and does not like. You give him or her things or activities that they enjoy and take away things that they do not like to increase the likelihood of the behavior occurring again in the future. If what you are presenting and taking away is not increasing the likelihood of the behavior in the future, then you are not using reinforcement.

by Adriana Sanchez, MA, BCBA

How do you use reinforcement with your child? What types of reinforcements are most effective, in your experience?

There is nothing amusing about “the meltdown”. It is reflective of a complete loss of control of the person with an autism spectrum disorder. It is often loud, risky at times, frustrating, and exhausting.

Here is a video that explains meltdowns from the perspective of someone living with autism.  Feel free to share with others, as it is available through youtube.

 Ask an Autistic: What is a meltdown?

One might say that the loss of control overtakes the child. They need their teacher or parent to recognize this and help them to regain control, as they are unable to do so on their own. A child with autism in the middle of the meltdown desperately needs help to regain composure.

Moreover, it becomes critical to learn to recognize when the meltdown is imminent.

In this way, you can both work to prevent a meltdown. The individual with an autism spectrum disorder needs to learn how to recognize the feelings of escalation and then actualize strategies to de-escalate before the crisis ensues.

LRfeelingschartThat is why a “feelings chart” or “emotion rating scale” can be such an important strategy.

Notice the left column of this particular feelings chart. It should be reviewed when calm to help identify the internal and external indicators that emotions are changing. The right hand column is just as, if not more important, in that it helps to identify calming strategies for that particular individual.

It is best to intervene early in the escalation process to increase the likelihood of a successful solution to the situation.

We are not “giving in to” or “reinforcing” negative behavior when providing one of these calming strategies, but rather throwing a lifeline to someone that is unraveling neurologically for many possible reasons.

by Lisa Rogers

Q: “I’ve heard that if my son (who is on the autism spectrum) is having a problem staying on task while in school that he should use the “keychain rules”. Would you please explain this term to me?”  – Curious in Nashville, Tenn

Rules listA: Keychain rules are short statements or phrases of desired expectations that capitalize on the tendency toward rules and structure.

They serve as reminders in a quick and easy format that prevent much discussion about them. Rather than say, “stay in your seat” over and over without much impact, the teacher can now say, “Please check keychain rule number 4”. Again, if the rules are attached to a heightened interest, their effectiveness is enhanced.

This student’s interest in Greek mythology was incorporated to his keychain rules as much as possible through the addition of pictures.

Keychain Rule #1: Use appropriate words and voice

  • Say nice things to others
  • Speak in a respectful tone [level 1, 2, or 3]

Keychain Rule #2: Follow directions from teachers

  • Teachers and Mom are trying to help me, so be sure to say “O.K. I’ll try”
  • Give my teachers and Mom a smile or a “thumbs up”

Keychain Rule #3: I will be in control of my body

  • Stay in my assigned seat
  • Keep hands and feet to myself

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Mini-maps can be highly effective in dealing with work avoidance behaviors at school and at home. Let’s now take this same strategy and apply it in community settings. Remember, a mini-map takes an event or task and breaks it down into smaller, more doable steps.shopping mini-mapsFor a family that has difficulty with seemingly simple shopping trips, a mini-map might be a good tool for the Aspergers family member. Mini-maps help to stay focused on the task at hand while preventing intense preoccupation with specific aspects.

An Example of How to Use Mini-Maps When Shopping

A family would struggle when going to a store where there was a video section. The son would immediately take off for this area of the store as soon as they got there. He would stay there for long periods of time in spite of many verbal reminders on the way in the car.

This behavior would turn a short trip to the store into a long and almost painful event for everyone. Over time, this family might avoid these trips all together.

A mini-map for this situation might include a list of different departments in the store that they plan to visit. By adding either time limits or number of items to purchase at each part of the mini-map, their child might be able to flow through the strategy more successfully.

The following is an example of what this mini-map might consist of:Continue Reading

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.

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A flip card is a quick and easy visual strategy that highlights one behavior, and clarifies through graphics and words when certain behaviors are acceptable, and when they are not.

Place a visual that indicates that it is O.K. to engage in the target behavior on one side of the paper. Place a different visual that indicates it is not O.K. to engage in the specific behavior at this time.

Think of it as a version of an “Open” and “Closed” sign in a store window. The sign, or flip card, gets turned around to indicate when it is O.K. to enter and when it is not. Much the same, the flip card will tell the student when it is O.K. to do a particular behavior and when it is no longer appropriate. Of course, not every behavior lends itself to this strategy. It is only for behaviors that are acceptable some of the time.

Stop and Go sign in illustration

I had the pleasure of working with a young man at a Middle School campus as he attended a general education art class. The art teacher began each class with about 10 minutes of whole class lecture where she would explain the project and expectations for the day. It was this first part of the class that posed most problematic for Samuel. Samuel found great pleasure in singing and talking to himself . . . constantly.Continue Reading

Self-management techniques have been found to be more effective in managing student behavior than teacher-mediated interventions (Stage & Quiroz, 1997; Fitzpatrick & Knowlton, 2009). When self-management strategies are linked to functionally equivalent behavioral interventions, students increased the amount of time on-task, demonstrated more appropriate social behaviors, and completed more assignments.

Student Self-Management Interventions DESCRIPTION

  • Self-monitoring: Students both observe and record targeted behaviors.
  • Self-evaluation: A student compares his or her performance to established criteria.
  • Self-instruction: Student-directed behavior is guided through the use of self-statements.
  • Goal-setting: Students select a goal and create personal guidelines for commitment, and progress toward that goal.

When possible, incorporate the student’s interest as in the following example.

selfevalContinue Reading

Feelings Chart in Class

If a student can express their inner feelings, then adults could help them prevent further escalation. This can be done by engaging the student in conversation about the problem, or beginning a calming activity. Often however, the student has difficulty expressing those feelings until it is too late. A feelings chart may be an effective visual support to help students express how they are feeling with or without using any words.

Feelings Chart in Class

In order for the feelings chart to be an effective strategy, students must understand the meaning of different feelings represented at each level. What does it mean to feel great versus having a problem?  Connecting meaning for each feeling may require direct instruction. Lessons to build this understanding can be done in a variety of ways, including the use of props or pictures of self or others.

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For some students, a simple checklist is all they need to get them started and keep them moving through academic activities. The following is an example of such a checklist:

1The checklist corresponds to the numbered folders. The student knows to complete the work in the four folders. After checking each number off, the student then has a few minutes to engage in a highly reinforcing activity.Continue Reading

A T-Chart can be made by placing a line down the middle of a page and labeling the left and right side of the page according to acceptable and unacceptable behavior. The T-Chart is then used to clarify acceptable or desired behaviors versus unacceptable or undesired behaviors by listing those under each of the categories.

Empty Library With Arranged Tables And Chairs

I was visiting with a teacher about one of his high school students that was wreaking havoc with her profanity. They had many conversations with her and had a tried several other strategies, but the profanity continued to spew. I offered this as a possible strategy and the teacher immediately told me that she knows she is not supposed to say those words, but she just doesn’t care about that. He was trying to tell me that writing good words on one side of the T-chart and bad words on the other side was just too simple.

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