Doctor, what’s wrong and tell me what to do…

Perfect Baby…
Our special needs son W was born 18 years ago looking perfect, with a full head of shiny black-brown hair and gold and cream colored skin. He was our first, and only. Nothing on our Little Prince seemed unusual or damaged. He was so long that he didn’t start with chubby cheeks. In the Italian baby jumpsuit a friend had given him, he looked like a slender European Formula 1 race car driver, minus helmet. He was my Little Einstein Continue reading

Raising Children with Positive Social Experiences, for learning, behavior, and family

My firm belief is that when you have something good to offer your child – not food, not a toy, but an experience – the child will respond. The smaller and less varied a child’s world is, the less influence adults will have over behavior. The more you take away from a child and the more you remove a child from the world, the less opportunity the child has.

** The ABCs of Behavior is on hiatus and will return.
Today’s tip on creating positive experiences is: museums.

Continue reading

ABCs of Behavioral Problems: Keeping Cool in a Crisis: being prepared for behaviors

Crisis Intervention Training
Behavioral crises involving people with autism are a common concern of professionals and parents. Parents don’t talk about them as much because of stigmas, but professionals rarely hold back. Sometimes the parent is blamed for spoiling the child. If so, I hope the professional has several children of his or her own, never needed to ask a question of a seasoned parent, and never made a parenting mistake with any one of their children. (People in glass houses shouldn’t throw stones!) Parenting is hard. Let’s avoid judgement and get down to work.

Why?
Crisis intervention training is not enough, but it is a necessary first step for parents and professionals: teachers, therapists, aides, and law enforcement. This post is appropriate for communication disorders. (I cannot claim to speak for mental illness.) Let me be clear. Generally, “aggressive” moves by people with communication disorders are a form of communication. Aggressive-Kids

Prevention is best. Many parents of people with autism suffer from the fear and memories of painful incidents of the past. The child’s behavior makes him a pariah, or changes how others treat him and his life choices.

First, however, you have to get everyone out of the current incident safely. The behaviors have to be addressed without judgement. Otherwise, behaviors can escalate and someone may be seriously hurt. Concepts and techniques of Crisis Intervention Training are similar regardless of the age and size of the person. I can tell you, fearing the person you love or need to work with doesn’t help the person at all. You have to be safe, confident, and fearless.

Crisis Intervention Training Should Include
This forum is not appropriate for providing crisis intervention training, but as a diligent and caring professional or family member, you should know what to ask for. The training involves learning and practicing a series of physical maneuvers that protect the responsible adult without harming the person with a disorder. If the people involved are verbal, de-escalation techniques will be covered.

Training should handle such situations as grabbing of clothing and grabbing of hair. This video from http://www.therops.com (a provider of instruction with which I have no relationship and whose training I have not reviewed) covers grabbing a shirt. 

It’s For You, & anyone living or working with people with developmental disabilities
Be prepared. Do not expect to need crisis intervention training. Do not give the training to someone who may abuse it, or abuse others. The person who could have triggered the incident may not know that he or she did, but the person who triggered it should generally step aside so another person can follow through with crisis intervention.

As a parent or professional evaluating the quality of a school, after-school, day, or residential program, check that staff and security personnel have this training. Sadly, crisis intervention training may be rare in the U.S. outside of some school settings. It is, however, perfect as topic for staff training sessions. Staff certification should be renewed every few years in any setting where physically inappropriate behavior may occur.

Here’s an example for sessions held for school transportation staff of Eden Prairie Schools:

The “A” in ABCs, an introduction to behavioral triggers
Antecedents are the “A” in “ABCs” of managing behavior.  Analyzing antecedents of a behavior is important, after the throes of an incident. Understanding these “antecedents” of behavioral problems will be the subject of further posts.

All situations that end in aggression have a kernel – medical or personal – in a concern that was not communicated effectively. These are examples from my personal experience with my son and other children with autism:

  • A middle ear infection causes pain, and the staff doesn’t understand how to help.
  • The child is expecting to see someone (a familiar therapist, a friend, a pet) at a certain time, and the person or pet isn’t there.
  • Lunch is “supposed to be” at exactly noon, and the child cannot tell you when he’s hungry, so 12:05 pm is “late.”
  • One kind of cookie is kept on the edge of the top shelf, and the child can’t see or reach it.
  • A migraine is coming on, and the child is in a public place.
  • When changing planes, the child knows a bowel movement is coming, cannot explain, refuses to leave a terminal restroom, nearly misses the connecting flight, and soils himself in-flight.

As someone who cares for and about people with developmental disabilities, I know we want to fix people. Now. That’s not realistic, but we can help, incrementally, and the people we care about can get better. Communication problems can cause a lifetime of misunderstandings, mistakes, and hurt feelings. As we fix the communication problem, we remove potential sources or future behaviors.

Coming up here: Why’d he do that! Consider “antecedents”

Copyright 2015, Laura Ann Weinberg

What is Autism – Love is the Drug (autism treatment, autism families and SLP/SLT, autism professionals)

What is Autism, anyway:
Autism can be slippery. We don’t know what it is. We give it a name. We diagnose it. Diagnoses shift (…DSM-IV, now DSM-V…) Autism doesn’t come with a set of medical charts showing where it comes from or how it does its business. We give drugs for it. But drugs are really given for something else, not for Autism. This drug may mask some symptoms for awhile in some people. That drug may cure an intestinal disease that hitchhiked in with the Autism. Neither drug changed or reduced the autism. Most symptoms of Autism don’t match up to any drug that’s ever been produced.

Love is the Drug:
The only drug that helps everyone with Autism at least most of the time more than doing nothing is …. training. We can call it therapy, or education, or play intervention. In each and every thing we do for someone with Autism, we’re pushing the individual with the disorder in a way that’s hard for them to do on their own. We who work with people with disabilities believe everything we do and do not do is changing a neural pathway, stimulating myelin production, improving coordination of the indirect pathways in the brain, and helping.

Tracking Progress = Watching Paint Dry:
Usually the progress is slow. If progress is fast, if there’s major improvement, you can bet that the person’s own neural network is healing. Even if the treatment made a difference, Autism is such a mystery that it’s arrogance to claim the treatment did it all. Give the child some credit, too, since it’s the child’s neural network that was reacting quickly to your stimulus. It was the child’s acceptance of whatever strange-looking thing you did with him.

Without Kids, Humans would be the next mass extinction:
There’s a child involved. (Whether growing or full-grown, they’re still our children!) They are unique individuals. (Grammarians, relax, it’s still a word in English!) You can’t assume that the interventionist – parent or professional – is a genius. You can’t blame the interventionist – parent or professional – for what you see as failure. Who sets the standard? What are we comparing progress against?
the boy next door who’ll get decent grades in a 2-year college?
our image we have of a “successful” disabled person?
the last kid we treated with the same diagnosis or symptom?

Parents: we all have them:
We all want our kids and students to be successful, in all circumstances, and with all kinds of people. Even poor matches between teacher and student are experiences that can help the child work through difficulty.

Let’s be kind to each other. When someone’s not kind, draw a line, but you’ll never know what the other person is going through. Behind closed doors, you don’t know if you’d ever want to switch places. I know enough speech and language therapists to say most are thinner skinned than the Wharton MBAs I went to school with once. I know lots of parents of kids with Autism, and we admit we’re often tired, worried, and skeptical.

R-E-S-P-E-C-T:
Every one of us has limits. Some limits are regulatory. Some are fiscal or non-reimbursable. Parents’ limits are time and money and other children and maintaining a marriage. These limits are all real. Children don’t make steady progress on all fronts all the time. Regressions are normal. (Typical children lose 2.6 months of learning every summer! http://bit.ly/1ldPHjg) Focus on the child, and remember what the professional’s scope of practice is. Remember, don’t shoot the messenger.