Friday, April 11, 2014

Causes: Autism Awareness Month.

Next up in my Causes series is a post by my friend, Kallie.  She is an Autism Specialist Social Worker and has many years experience working with individuals with Autism Spectrum Disorder (ASD) in a variety of roles.  Although she is a mom, her perspective is that of a professional.  Thanks to research and awareness efforts, we are hearing a lot more about ASD, but there are still many misconceptions.  I enjoyed reading and learning more and I hope you all do, too! (If you would like to get in touch with Kallie, please let me know by leaving a comment or clicking the Contact tab at the top of the page and I will be happy to connect you two.)
Autism is a neurodevelopmental disorder.  There are many misconceptions about cause and onset of ASD...some feel it is due to vaccinations, others to food enzymes, and others due to environmental factors.  There are also a lot of unanswered questions about Autism.  Studies continue to be done to find a common entity for individuals with ASD to see if a 'cure' or preventative action can be taken.  People continue to become concerned about ASD as the numbers seem to rise.  In my opinion, I feel the numbers rise due to the awareness we (professionals and parents) have of ASD.  Kiddos are being diagnosed significantly earlier than in previous years as well as kiddos that are 'higher functioning ASD' or Aspergers.  Some kiddos years ago never received a diagnosis and were just considered 'quirky'.  Now, I think because we have the DSM-IV and the DSM-V with particular criteria including other criteria that previously wouldn't have been considered, we're getting kiddos the diagnoses they need that make sense.
So, great, your child is diagnosed with ASD... now what?  That's where I come into the picture.  In the past I worked with kiddos on the spectrum doing ABA (Applied Behavioral Analysis) in a center and doing in-home based services.  Now, I am an Autism Specialist Social Worker.  Different roles completely... but helpful non-the-less!  In my opinion, there is nothing better than starting services as soon as possible... the younger the better!  Because kids on the spectrum lack social awareness (part of the diagnosis) it is common to see increased challenging or problem behaviors when something does not go their way.  Sure, I'm guessing a lot of you are thinking, 'well, doesn't every kid throw a fit when they don't get what the want??' Yes!  They do!  The difference here is that typically developing kiddos learn that it is socially unacceptable to throw a fit in public, or without end, as they get older.  (and yes, I realize this is still a struggle for some kids!)  Kids on the spectrum don't learn that.  We (parents, professionals, teachers, paras, therapists) have to teach them how to respond to situations.  We have to provide them with the information they need to know how to process the situation and respond appropriately, or move on to the next activity.  Does that make sense?  I'll give more examples...
Kids/individuals with ASD can only process what they've been given.  Think of the brain (any brain) like a file cabinet or Google.  Brains of individuals with ASD need to be filled with information.  If we were to search their Google, we're only going to get what we've put in it.  You'll find that generalizing one situation (place, time, season) is more challenging.  When there has been one experience in one place... it is hard to carry it to another situation without having experienced it.  When I worked with kids for this process, we'd teach as much as we could of a variety of skills across different settings (community, in-home, center, school, etc.).  If you think of typically developing kids, think of how they respond to things in different settings?  Doing homework at a desk at school is different than doing homework on the bedroom floor at home... Right?  Some kids that have lower functioning abilities and are maybe non-verbal often do really well with a visual schedule.  The more specific and step by step the schedule, the better.  Schedules that use pictures that are of that child and real life situations, make the most sense.  Using visuals and a schedule for everything one possibly can is the best route to go for these kids! 
The last thing that I want to talk about is reinforcement and behavior.  So, as I mentioned, it is not uncommon for children with ASD to have more temper tantrums that typically developing kids.  So how do we teach them and how do we make them stop?  Million dollar question, right?  Here's the answer... reinforcement.  A reinforcer is something that is strong enough to elicit a change in behavior.  This is much different than a motivator (helpful, but not strong enough).  Think of it this way... we go to work because we get paid and can pay bills, buy things, have fun... right?  Money is reinforcement for us to do our jobs, and do them well.  Most of us get paid at least monthly if not more frequently.  So, how are we 'paying' kids to learn?  How are we 'paying' kids to follow a schedule?  I know it sounds like bribery... but would we do our jobs if we weren't getting paid?  My guess is most people would not.  I know that I would not sit at work all day if I was doing it for free... Don't get me wrong, I love my job, but I also have to pay for things!  If we're going to teach kids how to behave, we want to do it with positive intervention.  That means, we are not going to say 'no, stop, don't' unless it is immediate safety related.  We are going to say 'quiet hands' or 'let's walk'.  We are going to provide other alternatives to self injurious behaviors (i.e. a kid who bites his hand when stressed might need a chewy).  We are also going to find reinforcers that will change behavior.  We are going to praise, give tokens, give points, to reward appropriate behavior (the things we want to see) and ignore or simply redirect the behaviors we want to get rid of.  Also, providing 4:1 attention to kiddos for appropriate behaviors is quite an essential. This means that for every negative interaction or redirection (stop, no, don't, do this, etc.) it is crucial to provide 4 positive attention actions/touches/hugs/looks/praise etc.
A lot of kids will learn that 'if I do this, I get this' which works in our benefit and against us.  For example, if a child has a meltdown in the store because Mom said 'no' to a piece of candy, and she gives in to give the candy because she's waiting in line and people are looking at her and it is easier in the moment to just do it... she's unintentionally reinforcing the behavior (yes, we are all guilty of this from time to time... just an example that is easy for most to relate!)  So let's break it down and look at this... child cries, mom says no, child cries more, mom gives in, child stops crying, child gets candy.  A child on the spectrum would likely pair this as being rewarded for having a behavior because that is what they are communicating at that time.  So, accidently what's happening is we are reinforcing the crying to increase or continue when there is a want... even if it just happens once every now and then.  It is kind of like playing the slot machines... we don't often win, but when we do we get a big pay off and it is worth enough to continue to try until it happens again.  This shows us that the candy (or the money from the slot machine) is a strong enough reinforcer that it gets us to continue to behave that way... I sure hope that makes sense!
I could continue to go on and explain more behavior perspectives of working with kiddos (and adults) on the spectrum... and would gladly do so if you have questions :-)  I hope this is helpful to anyone who wants ASD information.  I often get questions about behaviors and how to change them, that is why I decided to write so much about that.  Let me know if there's anything else I can do for you!
Click here to see a list of the other posts in this series.

No comments:

Post a Comment

Related Posts Plugin for WordPress, Blogger...