by Jessie Cooper | Nov 17, 2021
Last week I wrote to you about my own journey in boundary-setting as a business owner and woman. This week I’d like to dive deeper into boundaries and talk to you as both a mama and a clinician about boundaries on the home front.
As a clinician, not only do I have extensive knowledge about early childhood development but one of my areas of expertise is reducing disruptive and dangerous behaviors. I spent the first five years of my career in Applied Behavior Analysis working in early intervention and on crisis cases.
I can see my young self now, rested for the day, walking into a therapy session and teaching things like how to work through a tantrum. I worked with each family on their own values and expectations of their child, observed the needs the child was trying to get through their tantrums, and taught consistent consequences to the family as well as adaptive skills to the child. In the range of adaptive skills I often taught language (use your words), patience, tolerance to hearing ‘no,’ disappointment tolerance, and expression of feelings. Each family and child was unique but the structure of the treatment was similar and based on boundary setting.
Learning Boundary Setting as a Mom
Fast forward about 8 years to when I became a mama and my son Henry became a toddler. Henry was (and is) a strong-willed child. I remember writing in his baby journal “I didn’t know babies came out like you…” because Henry was (and is) so vocal about how he sees things and how he wants things done. As a mama, I tried to also be a BCBA and use the same tried and true treatment structure with Henry. State a boundary, follow through with the boundary, use your words, and teach new skills. Easy right? No. Hard no.
Throughout my journey into motherhood, while I love my boys above all else, I have struggled with both postpartum depression (Henry) and a toxic home environment because of domestic abuse. Toss in three boys who all have varied needs, wants, desires, and voices and the stress of setting boundaries felt impossible. You see, the thing with setting boundaries is that when you first set them children tend to resist them. Boundaries feel like a “no” to children (often they are) and the “no” feels like something for them to rebel against. As a parent, you have to be ready for the explosion as you set expectations. I’m going to be honest here; I could not weather the explosions so I became a, “yes mama”. Ugh.
Boundaries by Example
A year ago when I left domestic abuse my children & me. We were living in a psychologically frightening environment and I knew, no matter how much I wanted their dad to get help, that I couldn’t stay any longer. I set the boundary that I would not live in an abusive environment and modeled this incredibly important boundary for my children.
Yet as the last year passed my small children had so much change in their little worlds. While some of my “yes mama” tendencies went away, some remained. Want a new toy? Sure. One more piece of candy? OK. TV time? You got it. This also worked the other way and when my children behaved in ways I didn’t love (not staying in bed, dumping their food on the floor, screaming for things) I would spend time making empty threats (one more time and then…) and eventually give in. While home life was much calmer as a single mama and my children were happy with me, I knew I had to reset, buckle in, and teach boundaries.
You see, without boundaries children don’t know which behaviors are OK and which ones are not. Without boundaries, they don’t learn how to navigate unpleasant emotions and what to do with their unpleasant emotions. They also don’t learn how to behave in social situations and can become impolite, spoiled, and disruptive.
Keep in mind that little children are still children. It’s basically their job to overreact while testing boundaries early on. It’s our job as parents, however, to shape their behaviors in positive ways. Yes of course I want my children to be happy but I also want them to know how to navigate their own inner and outer worlds. Boundaries are the way to teach this.
Maintaining Boundaries
As the fall came so did a new peace in our home. I set some simple boundaries for the boys I knew I could follow through with and continued to teach them how to navigate their emotions. I spent time making sure the values I set were in alignment with my values and that I was ready for tantrums when they came. The boundaries I set were for good listening, respect, kindness, and understanding “no.”
My children have become calmer overall after the initial, “holy crap” boundary bursts. Boundaries tell them what is OK and what is not so they don’t have to guess or use tantrums to figure a given situation out. When they don’t like the answer they know we can hold space for them to be sad or mad. It’s a win-win.
Me? I have a ton of compassion for the woman I was in early motherhood and know I was doing the very best I could at the time. I also am incredibly grateful that I’m in a space to apply my clinical skills to mommyhood. One day (and boundary) at a time.
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 | Sep 27, 2021
The likelihood that a person with autism has another condition correlates strongly with the age at which they received their autism diagnosis, according to a new study. The study also noted that girls with autism are more likely than neurotypical girls to have other conditions, to a degree not seen in boys.
Study factors included whether a person with autism’s age at ASD diagnosis or birth sex changed their chance of having any of 11 common comorbid conditions (including epilepsy, anxiety, and ADHD). The study drew on data from around 16,000 people with autism and more than 650,000 neurotypical people up to 16 years old.
Among people included in the study who received late ASD diagnoses (11 to 15 years old) 26% of girls and 13% of boys were also diagnosed with a comorbid condition. The trend for intellectual disability in the study was the opposite with 40% of people with an early autism diagnosis having an intellectual disability, compared to just 10% percent of people with a late autism diagnosis.
Looking at Gender and ASD Comorbidities
For 11 co-occurring conditions considered by study researchers, the age of autism diagnosis was the single biggest predictor of whether a participant had that condition. Gender was another major factor.
Among individuals with autism, girls were 2.2X more likely to have anxiety than boys. By contrast, anxiety is about 1.4X higher in neurotypical girls than neurotypical boys. And while neurotypical boys are 2.6X more likely to have ADHD than neurotypical girls, the ratio dropped within the ASD population. Boys with Autism are just 1.6X more likely than girls with autism to have ADHD.
Looking at the ASD Spectrum Index
86 percent. That is the proportion of people with autism who show “a fair to very good level of objective psychosocial functioning,” according to a study that tracked the jobs. The happiness and close friendships of 917 adults — 425 men and 492 women — were tracked over a six-year period. These study results appeared in the journal Autism in June 2021.
The results of recent studies have started taking closer looks at both the age of ASD diagnoses and the gender of people with ASD. The early data shows promising results in the differences between boys and girls with ASD.
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
Spectrumnews.org, Community Letter
Journal of Autism & Developmental Disorders, July 2021
Acta Psychiatrica Scandinavica, July 2021
Health Services Research, July 2021
