by Jessie Cooper | Nov 24, 2021
This past week I wrote to you about setting boundaries with our children. In my blog, I wrote about the importance of boundaries for the emotional development of children. I also wrote to you about my own struggles in setting boundaries as a mama. One of the main reasons I struggle with setting boundaries for my own children is the (out)bursts that come with it.
It just so happens that as a clinician one of my primary areas of specialization is problem behaviors (the bursts). It’s what I went to graduate school to study over a decade ago. Over 10 years later and I can tell you the science of reducing problematic behaviors hasn’t changed. My own journey applying clinical skills at home, of course, has not (well, not totally). Today I’d like to write to you about both.
ABA & Bursts
Let’s start at the beginning with ‘burst science.’ Applied Behavior Analysis teaches us that social behaviors, both positive and negative, can be broken into units that can be studied. In studying units of behavior, BCBAs are able to identify the function of behaviors (why behaviors occur) and missing skills in the child they are studying. When it comes to reducing problem behaviors, behavior analysts are looking for why the behavior is occurring. This involves looking at what is happening before the behavior and what happens after the behavior.
While studying the environment before bursts occur, BCBAs look for a deficit in the child’s environment. What are they missing? Studying environments after bursts allow BCBAs to see if the child’s problem behaviors filled the deficit. If they did, the child is successfully using the problem behavior to get their needs met. This means the problem behaviors are being reinforced and will continue to occur. Magic I’m telling you. Magic.
You see, by studying what a child is seeking in a specific environment you can create interventions that fill the child up with what they are seeking to immediately decrease the problem behaviors. This isn’t a long-term solution, but it creates a short-term solution to make the days easier for the child and their families. While the child is being satiated BCBAs work on teaching new skills surrounding the child’s needs. This always looks like teaching functional communication skills, how to ask for exactly what you need.
Sometimes teaching specific skills can look like teaching patience and tolerance to ‘no’ when what the child wants isn’t good for them to have all the time. For example, if a child is throwing tantrums to get access to candy it’s damaging to have non-contingent candy all of the time. But if a child is tantruming for positive attention, we can fill them up without having to teach tolerance to no. Though we might have to teach waiting because sometimes mama (or papa) is busy.
The key to this remedy is to also remove reinforcement when a child is using their problem behavior to get their needs/desires met. If, in the scenarios above, the BCBA is providing candy (one piece) every 30 minutes and within 15 minutes the child hits to get access to the candy the BCBA cannot give the child the candy. If they do they will reinforce the hitting and take the motivation away from using words. It is here, in this little sweet spot of the behavior intervention, that bursts occur. Let’s talk about that.
Why Do Bursts Occur?
Underneath the bursts for children (and adults… more on that later) is fear that their needs/desires won’t be met. The bursts occur because, in the child’s mind, that very thing they want could become unattainable, their need won’t be met, and they will have to experience negative emotions. Dealing with both the fear of a need/desire not being met alongside psychologically negative emotions is tough stuff for a child. This right here? This is the hard part for parents and the sweet spot for teaching emotional resilience and intelligence.
As a mama, I know firsthand how easy it is to give in. To not want to deal with the temper tantrum, the screaming, and the crying. We are human beings and crying children is not comfortable. When we give in as parents at a given moment it provides immediate relief to ourselves and our children. It also perpetuates the very behaviors we don’t want to see more of and does not teach our children how to deal with the big emotions.
About a year ago Henry and I were at Dametrius’s football game and Henry wanted candy from the concession stand. I had packed snacks and knew sugar was on the menu later so I didn’t want him to have extra candy. I leaned down and told my little son, “no, not now we’ll have dessert at dinner”. Of course, in public, a full-on tantrum occurred. At that moment I thought how perfectly aligned this example was. You see at that moment I could have made a concession at the concession stand by just giving in. If I gave in Henry would happily watch the game and I wouldn’t have to be teaching Henry to breathe and tell me how he feels. But giving in also meant teaching my son to numb his emotions with food and that screaming works. So I stood my ground and worked with Henry.
You see under the bursts, as we are teaching boundaries. As children burst, their hearts need to know they can ride through negative emotions and still be safe on the other side. That nothing bad comes from feelings and that needs can be met in new ways. To me, as a clinician, I know that working through the bursts creates long-lasting, positive, change. As a mama, teaching my children to ride what is underneath the bursts is more valuable than any concession I could make at any given moment.
Xoxo,
Jessie
by IABA Team | Oct 26, 2021
On the surface, social anxiety disorder and autism spectrum disorder (ASD) may look the same. Both people with autism and those with social anxiety can experience social situations differently than others.
While social anxiety and ASD can occur together, they are very different conditions. In some cases doctors even get the two mixed up, leading to misdiagnosis.
Let’s take a look at both the similarities and differences between ASD and social anxiety.
Similarities of ASD & Social Anxiety
A major similarity between social anxiety disorder and ASD is that both conditions look different in every person. With that said, there are plenty of similarities, including symptoms and treatment services offered. It’s also important to understand that social anxiety is not a form of autism and vice versa.
Similar Symptoms
One reason social anxiety and autism are sometimes confused is that some symptoms appear the same.
According to some educational psychologists, overlapping symptoms of autism and social anxiety disorder can include:
- Limited social communication
- Nervousness
- Difficulty adapting to changing plans
- Lack of eye contact
ASD & Social Anxiety Diagnosis
A psychologist can diagnose autism and/or social anxiety disorder using the Diagnostic and Statistical Manual of Mental Health Disorders 5th Edition (DSM-5). The DSM-5 is a handbook published by the American Psychiatric Association that helps healthcare professionals make diagnoses.
A healthcare professional will ask about symptoms and may observe a person in social situations before making a diagnosis. Sometimes a pediatrician or physician will recommend seeing a healthcare professional who can properly diagnose ASD, social anxiety, or other specific mental conditions. Ask your doctor for more information.
The DSM-5 diagnostic criteria for autism include:
- Persistent differences in social communication, including but not limited to lack of back-and-forth conversations and differences in eye contact
- Repetitive patterns of behaviors, such as lining up toys
- Symptoms were present in early development, even if they went unnoticed
- Symptoms interfere with daily functioning, such as schoolwork
The DSM-5 diagnostic criteria for social anxiety disorder include:
- Fear of judgment in social situations
- Consistent anxiety in social situations that does not fit the context
- Avoidance of social interaction
- Fear of social interaction that impedes day-to-day life
- Having fear for at least 6 months (and the fear cannot be attributed to another mental health condition, such as panic or substance use disorder, or a disease like Parkinson’s)
Note that social anxiety can develop in children or adults.
ASD & Social Anxiety: Brain Functions
The amygdala, which affects the brain’s response to fear, may play a role in both ASD and social anxiety disorder. Research is still ongoing. Ultimately, however, brain functioning is very different in social anxiety and ASD. The neurological causes of autism aren’t yet fully understood.
Treatment for ASD & Social Anxiety
There’s no cure for social anxiety or autism. In addition, not everyone wants to “manage” or “fix” characteristics associated with autism. People can live fulfilling lives with customized support and treatment tailored to their goals.
Treatment and support options for ASD include:
- Applied behavioral analysis (ABA) therapy
- Occupational therapy
- Social skills training
- Cognitive behavioral therapy
- Occupational therapy*
*Occupational therapy is often a first-line service for autism. It may also be used to help people cope with social anxiety in some cases.
High-Functioning Autism Vs. Social Anxiety Disorder
The current diagnostic process for ASD involves three potential levels of support needed:
level 1: requiring some support
level 2: requiring substantial support
level 3: requiring very substantial support
Autism is neurologically based, which makes it different from social anxiety disorder, regardless of communication abilities or any overlap in symptoms.
Differences Between ASD & Social Anxiety
The main difference between ASD and social anxiety is that autism is a neurodevelopmental condition, while social anxiety is a mental health condition. Experts say it’s essential to get the diagnosis correct.
Though a formal diagnosis is best made by a licensed professional, understanding the differences between social anxiety and autism can empower parents to seek an evaluation. Because autism and social anxiety are distinct conditions, they have nuanced symptoms and diagnostic criteria.
ASD & Social Anxiety Symptoms
People with autism and those with social anxiety alike may seem to avoid eye contact. Importantly, however, autistic people aren’t necessarily “avoiding” eye contact out of nervousness or fear. They’re simply not making eye contact in the first place, which is a distinct difference.
Researchers have suggested that individuals with autism look toward a person more slowly, while people with social anxiety look away faster. ASD is a spectrum, meaning people may communicate in different ways. Some may not speak at all, while others may engage in one-sided conversations or miss social cues.
On the other hand, people with social anxiety intentionally avoid conversations because of fear.
Social anxiety can be the result of trauma. A brain dealing with social anxiety may be compensating for something that happened or trying to prevent something from happening reoccurring. Social anxiety is different from autism because autism isn’t triggered by an event, experience, or trauma.
ASD & Social Anxiety Brain Functions
The amygdala may be implicated in both autism and social anxiety disorder, but current research supports the idea that autism is neurodevelopmental. There are comprehensive conclusions available concerning what causes ASD, but research is ongoing.
Social anxiety, on the other hand, is mental-emotional.
Please note that all of this information is for reference only. If you are concerned about your child, please contact your pediatrician or a mental healthcare specialist.
ABA Therapy from IABA Consultants
If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.
Originally Posted as How to Tell the Difference Between Social Anxiety and Autism at Healthline.com
by IABA Team | Oct 19, 2021
One of the challenges of modern life is the lure of having it all. We believe that if we can just manage our time, our child with autism can have the best experiences at school, at ABA therapy, with friends, and at home with family. When we’re spread too thin, though, we don’t benefit fully from anything. But when we learn to prioritize according to our values, we may not feel regret about making difficult choices and doing less.
Letting our values guide our choices is an unfamiliar concept for most of us — and it requires a little self-exploration to determine our priorities. But the rewards can be huge.
How COVID-19 Affected Priorities
Despite COVID’s continued impact, families are beginning to have more options for kids with autism. In-person school might be slotted in next to ABA therapy, and the combination can radically alter evening routines as everyone in the family also needs to take time to prepare to do it all again the following day. Here, families may struggle to decide which treatments to pursue for their child.
A family may see major benefits with ABA therapy but also recognize that COVID-related disruptions were very hard. Many parents think their child will benefit from going back to school, yet they don’t want to lose ABA therapy and they also want to have family time.
In a situation like this would a family benefit from having some of everything? Or would fewer activities that allow for richer experiences be better? In a lot of cases, efforts are not necessarily concentrated enough to have positive outcomes in any of the choices.
A tough decision is easier when a family can figure out what they really value. Evaluating what parts of in-school therapy, clinical therapy, and at-home therapy can help families decide what is most important for their child.
Developing Priorities for Children with ASD
As with everything else in life, values are not necessarily constant. This means we can adjust behaviors and choices to align with shifting values.
Determining our values can help steer us toward more fulfilling outcomes, even on a day-to-day basis. If your child is working toward learning to tie their shoes independently, for instance, repetition will help them achieve this more quickly. The downside to a lot of repetition is that you aren’t able to get other values-related tasks done. Putting the things you value most at the front of your list can help tackle important issues first.
The beauty of a values-based approach to lifestyle choices is that each parent’s values are personal and specific to them. There’s no comparison or measurement of personal values, so no guilt should be involved.
For example; if a parent can better approach each day when there’s no lingering laundry to fold, they’re not prioritizing laundry over children. But they are placing value on having an uncluttered mind so they can be more present in the moments that really matter.
ABA Therapy from IABA Consultants
If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.
Originally Posted as Values Can Help Clarify Choices With a Child With Autism, Chicago Parent, September 17, 2021
by Jessie Cooper | Oct 14, 2021
Over the course of the past year, I’ve been writing to you about standing in your own worth, your truth. I’ve taken you down many paths in the forest of life and shared both challenging and joyful paths that I have walked down. Through writing to you about personal experiences I have healed and still seek to heal further. Life is full of encounters and experiences that can deliver this; for us to hold each moment of being human in our hearts to live a life of freedom.
What I haven’t written to you about in detail is my career and the work that started my journey. This past week I was recertified by Board Certification as a Behavior Analyst for a fourth time marking a decade as a BCBA. This summer I will celebrate a decade as a BCBA entrepreneur as the owner of Instructional ABA Consultants. It was emotions and injustice that brought me to my career and success. This week I’d like to share my professional journey.
Starting a Career Helping with ASD
My work in the field of autism began fifteen years ago when I was obtaining my bachelor’s degree at the Ohio State University (OSU) in human development focusing on early childhood. I was curious about how environments shaped the developmental outcomes of children. During my time at OSU, I worked in their preschool program and was a home-based therapist for two children with autism using applied behavior analysis (ABA).
This was back in the early 2000s and in both cases, the children were accessing services but their ASD symptoms were not being treated. The ABA program I was working under was state-funded and both children I worked with had high levels of physical aggression. Neither child had a treatment plan that actually alleviated the aggression. I was passionate about the kids and knew from my undergraduate work that environments mattered. In the fall of 2009, I began my master’s degree in Applied Behavior Analysis at The Chicago School of Professional Psychology.
My choice to begin a master’s degree stemmed from a desire to understand why aggression, as well as other aberrant behaviors, occurred in children. I also wanted to understand how applied behavior analysis treated autism symptoms in early childhood. During my master’s degree, I worked as an early childhood line therapist and joined the Illinois Crisis Prevention Network (ICPN) as my internship. I had to work during my degrees to pay my bills and at the time was focused on nothing outside of my career. I was thirsty to learn so I could create change for children.
Working at the ICPN
As I began working on the ICPN I was introduced to adults with mental illness and developmental disabilities. I quickly fell in love with the population and saw how lack of access to quality treatment affected their lives. In spending the first five years of my career focused on children I had never really thought about where they would go when they grew up. I had never thought about the adults with disabilities who had never gained access to care as children themselves. Most of the adults I served at the time had been raised in state-run institutions. Through my work with the adults, my eyes were opened to not only what happens immediately with small children with autism who do not have access to care, but also what can happen in adulthood.
During my time at the ICPN, I worked to gain my associate certification first and followed it up with BCBA board certification. I was given the opportunity of a caseload of clients (from children to geriatrics) who needed immediate crisis support; first under supervision, then as my own caseload. During this time I was wildly in love with my job but fiercely angry at the lack of care my clients received.
As a young woman, I cannot tell you the number of parents’ hands I held as we talked about their child’s (young or adult) experience that led to a crisis. The stories they told me both broke my heart and filled me with a fire to change their experience. Time after time the constant theme that led to a crisis was lack of intervention due to either a lack of funding or an unethical & uncaring therapy team. I worked with each client and family to stabilize their loved ones from crisis to community-functioning. Without access to outside care of the crisis team, success was usually not sustainable.
Changing the Game
In 2012 I decided to change that. I had met my own personal mission to understand aberrant behaviors and the impact of the environment on childhood development. Now, I know through science that the environment is the key predictor of outcome. I also knew that applied behavior analysis provided a scientific approach to at-risk symptoms of autism as well as behaviors.
With my own hands, through applied behavior analysis, I was able to change the outcome of lives for the better. I wanted to open a private practice that used these skills to close the gap in services based on funding sources. I also wanted to challenge my field ethically to create a place where all of our clients received quality care. A decade ago this was not the case. Even today ABA has mountains to climb regarding regulating quality care for all families.
It’s been a decade since I sat for my boards and I still have a fire burning in me fueled by what our science can do to help serve clients who otherwise would not have access to therapy. I went from just me to five locations, across three states, with a team of professionals who have the same passion. Each day I wake up knowing that we (not just me) are creating lasting change. Learning to run a company is for a different blog but as a BCBA I know I have a decade to be proud of.
To the next decade of service. Wherever we may go.
Xoxo,
Jessie
by IABA Team | Oct 12, 2021
Many parents of a child with ASD wonder what the best therapy method for their child is. In-home therapy (in tandem with other recommended programs) is a critical part of the development of any child with ASD.
In-home ABA therapy can be conducted by a licensed therapist or the parents on a daily basis. Let’s take a look at how in-home ABA therapy works and how it can benefit your child’s development.
In-Home ABA Therapy: How it Works
A huge benefit of in-home therapy is the comfort for both parents and children. If you sign up for professional in-home therapy, an ABA therapist will come to your home to work with your child. This minimizes driving time by seamlessly fitting therapy without travel into your everyday routine. In-home ABA therapy is very useful for families who have issues with transportation.
Buying therapy materials for professional in-home ABA therapy is not necessary. The therapist will use in-home materials & toys the child already has access to. ABA therapy tools for reinforcement can be almost anything: toys, snacks, social praise, etc.
ABA therapists assess what each child likes during every session. Reinforcement tools are an essential part of ABA therapy. These tools are used to help reinforce good behavior and teach a variety of different skills like communication, play, and peer interactions.
Certain behaviors may often occur in the home, making it important to change them in a familiar setting. Resisting instruction for daily tasks or problem behaviors with siblings during playtime are things that may not happen in a clinical setting.
BCBAs make assessments to pinpoint why problem behaviors happen and develop intervention strategies to treat problems as they occur. This gives many opportunities to target problematic behaviors and help change them.
During in-home sessions, an ABA therapist observes everyday interactions between the child and family members in real-time. This allows the therapist to provide quick feedback to parents on different approaches to creating parent-conducted treatment outside sessions.
In-home therapy can be used for toddlers, teens, and adults with Autism. Younger children from ages 2-5 who spend most of their time at home may benefit the most from in-home ABA therapy. A BCBA creates a treatment plan that best suits a child’s needs at home, allowing therapy to start in a familiar environment.
ABA Therapy & Family Support
Another advantage of in-home therapy is that parents and siblings can get involved in a child’s development. All family members are recommended to be active participants during in-home ABA therapy. This includes visiting relatives, grandparents, caregivers, and other regular visitors.
ABA therapists can provide support to families who want to learn more about their child’s therapy program, treatment, and development. Family engagement has been actively demonstrated to increase progress when everyone implements ABA therapy strategies outside professional sessions.
ABA therapists can guide families on how to use ABA therapy to increase appropriate behaviors while reducing problematic ones. At-home ABA therapy also helps develop sibling relationships by working on age-appropriate skills. Social activities with siblings like playing, sharing, and interacting can be strengthened by ABA therapy. Peer interactions are also encouraged among friends and close relatives.
ABA Therapy & Independent Living at Home
Independent living skills are best taught and reinforced at home. Personal hygiene skill reinforcement at home provides a natural environment for children to develop skills. Important tasks like brushing teeth, washing hands, washing face, are best reinforced where they regularly occur.
Independent living tasks are typically broken down into smaller steps with reinforcement being provided after each step is accomplished. Repeating the individual steps of a process followed by completing the process as a whole every day will help a child learn to be self-sufficient.
For early learners, in-home ABA therapy can also include daily routines. Things like toilet training, dressing, learning to tie shoes, can be taught and reinforced on a daily basis. Parents can select times that work best. Talking to your child’s BCBA can help you develop an effective schedule that will benefit your child.
Older children and teens will have different needs than younger kids. Tasks for older kids may include organizing or cleaning their room, preparing meals, and learning how to communicate (both verbally and through phones or other electronic devices).
Peer interaction for teens, things like board games, video games, or social outings with friends, can be very beneficial as well–just make sure to talk to all involved parties about any specific needs beforehand. Knowing what situations or places your teen is comfortable with can help set up a successful social outing.
Designing a template for how to develop social outings for your teen with their BCBA beforehand may help you avoid any undesirable situations. An ABA therapist can also help develop skills for situations where a teen must interact with others.
ABA Therapy from IABA Consultants
If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.
Sources
Achieve Beyond Pediatric Therapy
