fbpx

A Fresh Approach: Empowering Children with Autism

Written by Alison Spanoghe, Behavior Analyst, Autism Spectrum Therapies (AST)

When I first started working in a school system with children on the autism spectrum in the early 2000s, my leaders told me to stick to my instructions — no matter what. They told me this would be best for the children in the long run. As a newbie, I followed orders.

Often, though, that approach led to anger, tears, and resistance from the children who needed my help the most. Despite science backing up the “follow-my-orders” approach, it didn’t always feel “right.”

Today, my approach has evolved to something called “assent-based practice.” It’s a model that puts an end to instruction through coercion. It prioritizes the child’s agreement to participate in therapy rather than mandating that they follow orders.

The Old Way: Extinction

If you’re familiar with applied behavior analysis (ABA), you may have come across the term “extinction.” In simple terms, extinction means not reinforcing a previously reinforced behavior. The aim is to reduce the chances of that behavior happening again.

Let’s say your TV remote stops working. After a while, you’ll stop pressing the power button and maybe look for batteries or ask for help instead. The same principle applies to ABA services. If a certain behavior — like screaming — is not encouraged, the child will eventually stop doing it. You could then teach them a better way to communicate their needs instead of screaming.

While that might be good in theory, behavior isn’t always that straightforward. Also, the extinction approach can sometimes lead to other issues, like longer tantrums, aggression, or even distrust toward caregivers. That’s where assent-based practice comes in.

The New Way: Assent-Based Practice

Assent-based practice focuses on making sure the child agrees to take part in therapy — even if that agreement is nonverbal. When a child is actively engaged, that’s one indication that they are communicating that they agree with participating in treatment.

This type of approach involves:

  • Constant check-ins
  • Respecting when the child no longer wants to participate in treatment
  • Adapting the approach based on the child’s response
  • Teaching the child to communicate

The goal of this technique is to equip children with autism with skills that are useful in any situation. It also helps them advocate for themselves and make it clear when they want to say “no.” It’s more of a compassionate way of providing care.

Why Assent-Based Practice?

There are many benefits to using assent-based practice. It can:

  • Build Trust: It helps establish a safe and trusting relationship between the child and the therapist.
  • Promote Expression: The child learns that they are seen and heard. It encourages them to express their feelings.
  • Respect Autonomy: The child’s “no” is respected, promoting their dignity and independence.
  • Enhance Learning: This approach avoids standoffs. It allows more reinforcement of language use and engagement in the session.

Assent-based practice has become a popular topic in ABA services. It emphasizes getting the child’s agreement before continuing therapy. It teaches children to express their feelings. It also respects their dignity and independence.

Therapists can use this approach with any child at any time, leading to faster learning and better rapport with the child. While our understanding of assent-based practice continues to evolve, it is a worthwhile approach to consider because it puts the child first.

Alison Spanoghe is a behavior analyst with Autism Spectrum Therapies (AST).

5 Simple and Fun Imaginary Play Ideas for Kids with Autism this Summer

By Laura Squiccimara, BCBA, MS

Assistant Clinical Director, Northeast Region, Behavioral Concepts (BCI)

Are you dreading the upcoming summer break because you worry about your child not having enough to do at home? For parents and caregivers of kids on the autism spectrum, that’s a common worry.

Long school breaks can disrupt your family’s routine, and children with autism often rely on schedules and predictability to feel secure and comfortable in their environment.

Changes at the end of the school year can be difficult to manage but have no fear. We’ve gathered simple, practical ideas for keeping your child engaged this summer. But first, let’s create a sense of consistency and structure.

Planning ahead and creating a schedule with specific activities for each day can help your family maintain a routine. By doing this, you’ll create a balance between structured and unstructured activities.

You can incorporate sensory play, arts and crafts, and fun outdoor activities into your summertime routine. Here are five ideas you can add to your list:

1. Mountain Explorers

This activity requires minimal preparation. To get started, gather some pillows, blankets, and cushions to create “mountains.” Help your child line up and stack the items in a way that resembles a mountain range.

Once your mountain range is complete, grab your gear and go exploring. This is a great way to encourage your child to use their imagination and pretend they’re hiking, camping, or climbing to the top of a mountain peak.

Practice taking turns, following someone else’s lead, and discussing your expedition with your child. You can even create lasting memories by snapping some pictures and placing them in an album that you can add to all summer long.

2. Dress Up

Dressing up is a classic activity that never goes out of style. It’s an excellent way to use old clothes* you might otherwise donate. To get started, gather your well-loved shirts, pants, hats, shoes, and accessories, and lay them out on a table or bed. Now you’re ready to use them in a game of dress-up.

Have your child pick an outfit and then play out different scenarios or even have a fashion show. You also could have a contest to see who can come up with the silliest, most mismatched outfit. This is a great way to work on daily living skills. Your child can practice putting on and taking off clothes, choosing appropriate clothing, and even learning how to fasten buttons and zippers.

*Keep in mind that some children with autism have sensory issues with clothing. You know your child best and what types of clothing materials they prefer. This could also be a way to introduce new materials that your child might like.

3. Pots and Pans Band

Start your very own home band this summer. To do this, all you need are some common household items like pots, pans, and spoons.

Explore different utensils such as wooden spoons, plastic spoons, and rubber spatulas to see how the sounds and tones change with different materials.

Encourage your child to create new beats and follow along with rhythms that you create.

You can challenge your child to a game to see who can repeat the longest beat, play the most recognizable song, or try to play as loud* or softly as possible.

This activity not only encourages creativity and imagination but also enhances important cognitive skills such as pattern recognition, memory, and fine motor skills. So, gather some pots and pans and let the music-making begin.

*Again, every child with autism exhibits different sensory sensitivities to sound. Your child might not enjoy this activity due to sensitivities, and that’s okay. Or, if your child seems interested but is sensitive to sound, they can try wearing headphones.

4. Hometown Restaurant

Hometown Restaurant is a fun and exciting activity that lets your child use their imagination while learning important life skills.

To start, gather some kitchen utensils, plates, bowls, cups, and pots and pans to create an in-home restaurant. You can use play food or gather simple no-bake ingredients so your child can create snacks and meals for the family.

Help them take orders, gather ingredients, “cook” their meals, and serve them to family members. They can even practice cleaning up when finished (wink wink).

Hometown Restaurant enhances creativity and improves important life skills, including problem-solving, communication, and social skills. Put on your aprons, and get ready for an unforgettable dining experience.

5. Box City

Here’s a way to put your delivery boxes to good use. Gather boxes of all shapes and sizes and help your child cut, glue, tape, stack, and arrange them however they like.

If you have big boxes, you can even create a fort. Otherwise, create a town or city for your child’s dolls, action figures, or favorite stuffed animals.

Try taking turns as the architect and builder to practice following directions and taking play suggestions. This activity presents endless opportunities for your child to ask for help, problem solve, and work together.

Boredom Is Your Imagination Calling to You

Refuse to be boring. Teach your child to use their imagination with activities that will keep them engaged. These activities promote creativity, imagination, communication, and problem-solving skills.

With these activities up your sleeve, your child will have a summer filled with adventure, learning, and fun. Get ready to watch your child grow in ways you never thought possible.

Laura Squiccimara, BCBA, MS, is the assistant clinical director of the Northeast region of Behavioral Concepts (BCI). BCI is part of LEARN Behavioral, a national organization dedicated to nurturing the unique potential of children with autism.

Building Social Skills During Summer

School is out! Let summer break be a great opportunity to continue your child’s learning and growth.

While summer can bring parents a welcome relief from making lunches and school drop-off and pick-up, it also offers time for kids to build valuable skills. Social skills programs are offered in several cities by different service providers and can offer a structured, play-based environment for children to build essential social, communication, cognitive, and sensory skills. Kids have fun and make friends as they learn while maintaining a helpful routine for themselves and their parents.

Many skill-boosting summer programs take place in group settings that are similar to the school environment, while still providing one-to-one support. These specialized programs promote collaboration and inclusion of peers and some welcome siblings, too.

Make Friends

Social skills programs provide activities that encourage and reward the building of social relationships rather than individual play. Children are grouped with other kids of the same age group and skill level, enabling them to share in age-appropriate games, activities, and communication. Groups are led by highly-trained staff, known as behavior technicians (BTs), who are overseen by behavior analysts. BTs encourage kids to get out of their comfort zone and try new things.

Stay Mentally and Physically Active

School breaks can impact children academically. The “summer slide” as it is called, refers to a loss of learning that students experience during the summer months. Social skills programs can help children stay mentally and physically active. While promoting positive behaviors and peer interaction, physical activity is suggested to improve self-esteem and general levels of happiness.

Improve Motor Skills

Engaging in physical play and teamwork exercises can also support overall motor skills, which support many everyday activities. This can help children feel more confident and capable.

Behavior Management

By consistently promoting positive behaviors and language, a child can learn what they can do rather than what they cannot do. Social skills programs offer valuable learning opportunities for kids to communicate their needs and engage in behaviors that help them in daily activities and in different environments.

Click here for other summer-themed blogs to support your family this season.


What is Nonverbal Autism? Dispelling the Myths Around Non Speaking Autism

RONIT MOLKO, PH.D., BCBA-D
STRATEGIC ADVISOR, LEARN BEHAVIORAL

Just because someone is nonspeaking, does not mean they’re non-thinking. Around 25 to 30 percent of children with autism spectrum disorder are minimally verbal or do not speak at all. These individuals are referred to as nonverbal or nonspeaking, but even the term nonverbal is a bit of a misnomer. While nonspeaking individuals with autism may not speak words to communicate, many still understand words and even use written words to communicate.

Nonspeaking individuals with autism utilize a variety of augmentative and alternative communication (AAC) methods. These range from no-tech and low-tech options such as gestures, writing, drawing, spelling words, and pointing to photos or written words, to high-tech options like iPads or speech-generating devices.

There are several reasons that an individual with autism may have difficulty talking or holding conversation that are not related to intellectual disability. The disorder may have prevented the normal development of verbal communication skills. They may also have conditions such as apraxia of speech, which affects specific brain pathways, making it difficult for a person to actually formulate and speak the words they’re intending to say. Some may also have echolalia, which causes a person to repeat words over and over again.

While these conditions prevent many individuals from speaking, it does not mean they cannot learn, understand, or even communicate. There is a pervasive misunderstanding about this among the general population due to a lack of education. It is often wrongly assumed that anyone who has difficulty speaking is intellectually disabled.

This misconception can be particularly harmful when held by medical professionals. In the 1980s, as many as 69 percent of people with an autism diagnosis had a dual diagnosis of mental retardation, which would now be labeled intellectual disability. By 2014, that number had declined to just 30 percent, as researchers improved the diagnostic criteria for autism and a fuller picture of the disorder emerged.

Researchers are still working to try and improve diagnostics and better distinguish nonspeaking autism from intellectual disabilities. As Audrey Thurm, a child clinical psychologist at the National Institute of Mental Health in Bethesda, Maryland says: “We have to figure out who has only autism, who has only intellectual disability and, importantly, who has both intellectual disability and autism. That’s millions of people who could be better served by having an accurate distinction that would put them in the right group and get them the right services.”

It’s important to challenge the perception that those who do not speak cannot think. Not only do we risk failing to give them the proper supports and services, but we also undermine their individuality, ingenuity, creativity, and humanity by failing to see them as they truly are. Just because they are not talking does not mean they do not have much to tell us.