Water Safety Tips for Children with Autism

It’s summertime, which usually equates to a lot of time outside. And with pools open and all the lakes here in Michigan, that often means time in and around water. While swimming and playing in water are fun and great exercise, it can also be very dangerous. In 2023, the Michigan Department of Natural Resources issued a new flag warning level for the Great Lakes. Because of the increased danger lakes and pools have, water safety for children with autism, or any child, is extremely critical. 

Why water safety is so important for children with autism

Children with autism, as well as Down syndrome, often wander, which can obviously be very unsafe if they get close to water unsupervised. Additionally, drowning can occur without making any sound. Children may also be unaware of things such as water depth, water temperature, water currents, or slippery surfaces. Not every child likes to be in the water, especially children that struggle with sensory issues. However, all children should still be aware of water safety in case of accidental slips or falls into a pool or lake. 

This statistic is scary and sobering, but every parent of an autistic child needs to know – drowning is a leading cause of death for children with autism. We’ve compiled some tips and ideas to teach water safety to your child with autism to help you prepare for this season. 

Get your child in swimming lessons 

Every child should learn to swim, and for children with special needs, it’s important the skill is taught in a way that resonates with them. Make sure the teaching environment is not too distracting or overwhelming for your child. 

There are many programs that provide adaptive swimming lessons for children with special needs. You can start by contacting your local YMCA. And the National Autism Association’s Big Red Safety Toolkit for caregivers provides an excellent guide and resources for managing wandering, as well as how to find swim lessons in your area. 

Provide reinforcers

Have reinforcers and preferred items available when your child performs important or difficult tasks related to water safety. This could include tolerating getting into the water, using appropriate safety gear, getting out when a whistle is blown for “adult swim time,” or leaving the pool when instructed. 

Visual learning of water safety

Use video narratives, social stories, or visual routines to teach water safety. The Swim Angelfish channel on YouTube, for example, is a great resource which provides a variety of videos that can be utilized to teach water safety to kids with disabilities. 

Many children with autism spectrum disorder are rules-driven, so use that to your advantage. Set specific rules for how they are to behave around water. Then practice those rules in real world situations. And if you have a pool at home, or live on/near a lake, consider placing “STOP” or “DO NOT ENTER” signs on doors that open to the outside, or gates to the pool. 

Use appropriate swim gear

Even if your child knows how to swim, it’s still a great precaution to use a life jacket or flotation device around water, whether they are planning on swimming or not. It can also offer reassurance when attempting a new skill and teaching independence. The especialneeds website is a great place to purchase special needs and sensory-friendly water gear, if needed.  

Teach key information

Because of the high percentage of wandering in kids with autism – nearly 50% – make sure your child knows his or her name, address, and phone number in the event he or she is separated from you. If your child does not speak, make sure they wear a bracelet, tag, tattoo, etc. with their name and your name and phone number. 

Set up your environment vigilantly 

Even if you feel confident that your child thoroughly understands the rules of water safety, accidents can still happen. It’s important to prepare for the worst so that nothing slips through the cracks. When preparing your environment near water, consider installing fences or gates with alarms around the body of water, if applicable. Additionally, you should also think about placing alarms or chimes on doors that open to bodies of water and keep toys of interest away from the water when not in use. Taking these measures will ensure that life-threatening wandering doesn’t take place.  

Communicate with others

Talk with your neighbors, whether at home or on vacation. Ask them to contact you immediately if they see your child wandering alone outside your home or property. Even if you don’t own a pool, but your neighbors do, ask them to be particularly aware of your child wandering near their property. 

We hope these ideas help you implement water safety for your child with autism. And for more general recommendations for pools, beaches, lakes, etc., check out this swimming safety guide. We want everyone to have a less stressful and more enjoyable summer! 

If you found this information helpful, we’d love it if you’d share it with others!

Toilet Training Tips for Kids with Autism

toilet training and autism

Toilet training is a fundamental skill to teach all kids. But it can be a tricky skill for children with autism to master. Some parents may find toilet training a smooth process, while others find it a huge battle. Many parents try to start the process and feel discouraged, then decide to take a break. Wherever you are in your child’s journey to using the toilet independently, know that success is definitely possible.

Is Your Child Ready for Toilet Training?

The first step in helping your child with autism use the toilet? Determine if they’re ready. Our Director of Clinical Standards, Dr. Jennifer Thomas, Ph.D., BCBA-D, LBA, suggests a list of pre-requisites to consider before starting the toilet training process.

Can your child…

  • sit on the toilet or potty chair for a few minutes?
  • pull pants up or down?
  • hold urine for at least 30 minutes?
  • imitate skills such as sitting and wiping?
  • find the bathroom or potty chair in the house?

Your child doesn’t need to be proficient in each of these steps all at once to start toilet training. However, keep in mind that the process will be easier and more successful if your child can complete most steps first. If your child struggles with fine motor strength and control, consider occupational therapy (OT). OT can help with skills such as pulling pants up and down, wiping, etc. Additionally, there should be minimal behaviors occurring with bathroom use. If behaviors arise often, be sure to address them prior to starting the toilet training process.

Reinforcement and Encouragement

It’s important to utilize reinforcement and encouragement when working on toilet training your child with autism. You can reinforce their success in using the toilet in a variety of ways, including:

  • Food, such as candy or a small treat
  • A sticker chart
  • A highly preferred activity such as tablet time, a game or favorite toy

Along with reinforcers, use lots of verbal encouragement. Make sure it’s specific and descriptive: “I love how you asked to go to the potty.” Or “You did an amazing job sitting on the toilet for x amount of time!” etc.

Barriers to Toilet Training

Toilet training kids with autism can definitely have its setbacks. You might encounter challenging behaviors from your child, such as fear of using the toilet, refusing to use it, misusing toilet paper or other materials, or tantrums when encouraged to use the toilet.

Some children with autism might be hesitant to use the toilet due to sensory issues. If this is the case for your child, identify the sensory issue. It could be that the toilet seat is uncomfortable, they may feel cold, or feel afraid of the loud flushing sound. Perhaps utilize a toilet seat and let your child hold a stuffed animal or toy while sitting to help them feel safe and comforted.

Another barrier to toilet training is constipation. Kids with autism can be prone to constipation due to selective eating. If you notice your child struggling to void with bowel movements, consult your pediatrician.

General Tips for Toilet Training Kids with Autism

  1. Take toilet training one step at a time! While many parents are eager for their child to gain independence in the bathroom, try not to rush through the process.
  2. Have your child use pull ups or underwear as they transition from diapers.
  3. Use visuals in the bathroom such as a step-by-step laminated sheet with photos to help your child remember the toilet use process.
  4. When starting toilet training, plan a time to be at home with your child (Ideally, a week).
  5. Take data. You could create a chart, take notes in a notebook, or find a data sheet that works for you through an online search. For each toilet session, list the date, time, accident, success, location, and any independent requests.
  6. Make the experience fun and rewarding! Ensure your child is comfortable on the toilet by having them pick out a preferred toilet seat. Keep toys and books in the bathroom and even play music. The more enjoyable the experience is for your child, the more likely they will pick up skills and move towards independence.

If your child receives ABA therapy, check in with your child’s BCBA. They can give suggestions specific to your child as well as general support throughout toilet training.

Toilet training, though necessary, is a huge task to undertake as a parent. While it can be discouraging at times, remember to celebrate the successes. And with encouragement and consistent reinforcement, your child will learn in his or her own time.

Winter Activities for Kids with Autism

boy plays outside in snow.

We can all probably agree—winter is often hard to get through. Cold, icy days nix the option for frequent outdoor play. If your child needs some cabin fever relief, we’ve compiled some DIY winter activities for kids with autism. These projects are ridiculously easy to assemble and extremely cost-effective—it really doesn’t take much for kids to have fun! Many of these activities require similar materials that you can buy in bulk and have on hand. Additionally, these winter activities for kids with autism promote sensory input, social interaction, and fine and gross motor skills.  

Indoor Winter Activities

Create fake snow

This is a sensory activity that incorporates textures. It’s great for kids who seek tactile sensory experiences. All you need is some shaving cream and baking soda for some fun with fake snow. Squirt some shaken shaving cream into a bowl or plastic bin. Add baking soda until the mixture reaches a moldable consistency. Kids will love squishing their hands in the “snow,” building mini snow people, and creating little winter wonderland worlds. 

Our expert team of Occupational Therapists (OT’s) share the importance of sensory activities like this one. “The combination of soft, squishy textures with the coarseness of the baking soda provides a variety of input to the tactile system that is both alerting and regulating,” said one of our OT’s. They also suggest having your child create the snow with you, which increases processing and executive functioning skills. “For example, have your child measure and/or pour out the ingredients with you and stir them together to combine. This is a great naturalistic opportunity to incorporate fine motor skills, tool use, and bilateral integration as your child stirs while stabilizing the bowl.” 

Materials Required:

  • Plastic bowl or bin
  • Shaving cream
  • Baking soda

Frozen treasure hunt

This winter activity only requires a little bit of prep! If your child loves “heavy work,” or activities that involve applying and/or receiving pressure, be sure to have them try this. According to our OT Team, “heavy work is organizing for the proprioceptive system, helps your child integrate new information about their body’s position in space to develop body awareness, and incorporates pressure regulation skills.” 

To create, fill a plastic tub with water and place items in it such as toys, plastic snowflakes, pinecones, or other winter-themed objects. Place the bin in the freezer overnight until it’s frozen solid. The next day, remove the ice block from the bin by running warm water over the bottom. Place the block in a larger container and have kids “dig” around for the items. Digging tools can be silverware, toy hammers, or any other child-safe item. Picking at ice keeps kids engaged and motivated to find the treasures! For safer tool options, we suggest having your child use basters or eyedroppers to dispense warm water across the ice to melt it.

Our OT’s like activities like this, as they provide excellent natural opportunities to develop fine motor skills, pincher grasp and finger strengthening as well as visual motor skills. Using motivating characters, figures or toys will be more likely to hold your child’s attention. 

Materials Required:

  • Plastic tub
  • Plastic toys, snowflakes, foam cut outs, pinecones, berries, anything winter-themed
  • Silverware, toy hammers, eyedroppers, basters

Make snow ice cream

There’s no better way to utilize fresh snow than making it into a tasty treat. Collect 8 to 12 cups of clean snow. Add vanilla extract and condensed milk and stir into snow. Add more snow if needed to reach an ice cream-like consistency. Scoop into bowls or cones and add toppings! 

Materials Required:

  • 8-12 cups clean snow
  • Vanilla extract (or other flavorings, like chocolate syrup)
  • Condensed milk
  • Toppings such as candy, sprinkles, crushed cookies, etc.

Build an Indoor Fort

Gather some comfy pillows and blankets to help your child build a relaxing space of their own. You can even create a special bin/area full of your child’s favorite comforting items for this specific purpose. Incorporate reading, pajamas, a movie or even a nap into this- everything is better in a fort! 

Sensory Winter Activities

Squish bags

Sensory squish bags are a hit for children who love squishy things. And fortunately, they’re super easy and cheap to make—a perfect winter activity idea for kids with autism. Fill a sealable plastic bag with hair gel and add snowflake glitter, beads, confetti, water beads, buttons, beans, or anything else that would entertain your child. You can also seal the edges of the bag with patterned packing tape to ensure the bag won’t open. Check out this snowman sensory bag to stick with the winter theme. 

Materials needed:

  • Sealable plastic bag, any size desired
  • Glitter, beads, confetti, water beads, buttons, beans
  • Clear hair gel
  • Food coloring (just a drop or two)
  • Patterned packing tape

Sensory bin 

Sensory bins are great for fine motor skill practice. Fill a bin with cotton balls, foam snowflakes and snow people. Give your child fine motor tools such as plastic tweezers and ball scoopers and let them practice picking up items. Or they can just use their hands!

Materials needed:

  • Plastic bin
  • Cotton balls
  • Foam snowflakes, snow people, other winter themed shapes
  • Plastic tweezers, ball scoopers, anything that promotes fine motor skills (such as this tool kit)

Sensory bottle

Many kids with autism are entertained by just watching sensory-pleasing items with color, texture, and shine. Sensory bottles are yet another winter activity for kids with autism with very simple assemblage required. Find a clear water bottle with a screw-on cap. Next, put wintery glitter and snowflake confetti in the bottle. Use a drop or two of blue food coloring if desired, fill with water, screw the cap on, and shake it up. (Sealing the cap with glue is a good idea for children who might be tempted to open it.) 

Materials needed:

  • Clear water bottle
  • Glitter, snowflake confetti, etc.
  • Food coloring
  • Glue

Outdoor Winter Activities

Snow maze

After a big snow, there’s often lots of sledding or the building of snow people. But have you ever tried making a snow maze? Create a twisty path in the snow with your feet (or use a shovel) and pack the snow down. You can make one big maze or multiple small ones to keep kids entertained and active for a while. 

Tic Tac Toe in snow

Use rocks, leaves, sticks, paint, or pinecones to create a Tic Tac Toe board in the snow. Maybe organize a family tournament!

Paint snow

In the midst of a white wonderland, color is pleasing to the eye. Have kids create their own colorful outdoor artwork by creating a frame with sticks and painting within it. Be sure to use non-toxic, water-based paint to avoid clothing stains. Using jars to hold the paint works well, as you can sturdily plant them in the snow. 

Materials needed:

  • Non-toxic, water-based paint
  • Jars
  • Sticks or rocks
  • Paintbrushes

Kindness rocks

Based off The Kindness Rocks movement, this activity is a fantastic way for kids to create messages of kindness. And with all the negativity in the world, we need all the kindness we can get. On winter days with less or no snow, have kids collect smooth rocks. Clean the rocks. On the back of the rock, write or paint #TheKindnessRocks project. Then decorate and help kids write kind messages on the front. Seal with an outdoor sealant spray to prevent fading. 

Materials needed:

Social Activities

Parallel Play

Encouraging your child to give or share a toy with a playmate can be an effective play technique, if appropriate. If this is not something easily attainable for your child, even inviting a peer over and having them sit next to your child in the same room while engaging in a separate activity can benefit your child’s social skill development.   

Games

Any type of game, whether it be a simple game of Simon Says or a board game that promotes imitation, turn-taking and cooperation can be a great way to get social with your child. Remember, it doesn’t matter so much if the game is played correctly- it’s all about participation and fun!  

Be Mindful of Screen Time

While it may be challenging to reduce your child’s electronics use, it is important to monitor and be aware of how much time they are spending “plugged in”, especially during the winter when it is easy for them (and you!) to lose track of time while being indoors. Instead, encourage other activities like reading a book or putting together a puzzle.  For more ideas on managing screen time, check out this post. 

We hope these winter activities for kids with autism provide some fun during these long cold days, while also providing sensory and fine motor input. We’d love to hear about your experiences as well. Please comment below!

AAC: What It Is and Why It’s Important for Children with Autism

There are many means of communication used in our world. The most common ones used today are spoken words, gestures, eye gaze, facial expressions, print, sign language, and even GIFs. When it comes to individuals with speech and language delays, it is possible to augment and provide alternative options for them to efficiently communicate with others. Children with autism, Down syndrome, and other speech and language struggles benefit from access to additional communication tools. In this post we will explain what AAC is and why it’s important for children with autism. 

AAC stands for Augmented Alternative Communication. What does augmentative mean, you might be wondering? Augmentative simply means to make something greater by adding to it, and alternative, as we know, is to have multiple options or possibilities available in a situation. So, when thought about it in literal terms, AAC is something every person uses to communicate. 

Types of AAC

There are two different types of AAC. The first type is what most people use in addition to or instead of verbal communication, which includes some of the examples we listed above. However, many children (and adults) with an autism diagnosis utilize aided AAC, which can be “high tech” or “low tech”. Low tech AAC can be anything that involves using pictures or icons to communicate. High tech describes communication apps on an iPad or tablet, such as TouchChat or LAMP Words for Life. Any type of computer with a voice, or even large buttons that talk, would also be considered high-tech AAC.  

Myths Surrounding AAC

When it comes to AAC, many people, including parents and professionals, are misled by the myths that have historically surrounded it. The most common myth is that AAC will hinder speech development. While this may seem easily believable, we have seen many examples in our clinic and elsewhere of children who build more speech due to having another opportunity as a bridge to spoken language.  

Another popular myth regarding AAC is that it’s not necessary so long as the child or person can communicate their basic wants and needs. At Healing Haven, we support not just the very basics of communication, but each individual’s growth and independence. This means making friends, expressing ideas, showing interest in hobbies and activities, showing love, and much more. Everyone deserves the opportunity to do these things.  

Effective Use of AAC

While AAC, whether high tech or low tech, is a bountiful means of communication, there are reasons it may not be effective, which can be discouraging to families.  

AAC is most successful when parents, caregivers, and school staff have been educated to personalize the device and present models appropriately. Presenting models “appropriately” may look different for different children based on their language level, processing time and interests. When these factors are not taken into account, ineffectiveness and inefficiency can result.  

It is important that families who are adjusting to a new form of AAC have the resources and support they need to effectively integrate the form of communication into their child’s life. At Healing Haven, this is a large part of the parent training we offer to each individual and their family. 

Teaching AAC with Spoken Word Communication

One must remember that AAC is just another avenue to communication for those with language and speech processing challenges. The autistic community themselves say they need more than one avenue to communicate. Many times, speech and language professionals teach an individual AAC and spoken word communication simultaneously. Through the therapy we provide at our clinic, the two will always go hand in hand. It is important to us that every child has more than one option in their modes of communication. 

It is important to understand your child’s style of language processing to personalize the vocabulary and provide appropriate models. Please reference the “User Tips for AAC” section below to learn more and see the link to our blog detailing Analytical Language Processing and Gestalt Language Processing. The Speech and Language Pathologists at our clinic are highly skilled in helping parents and children personalize AAC based on the child’s style of language processing. 

Setting Your Child Up for Success with their AAC Device

There are many steps you can take to ensure your child with autism has a pleasant and successful AAC experience. While some of these may be easily overlooked, they are vital in encouraging and teaching your child to communicate. Some of these steps are:  

  • Ensure the AAC device is always readily available. This includes having necessary AAC accessories such as cases with handles and straps.  
  • Learn how to edit and add new content to your child’s AAC device.  
  • Allow your child to explore the device as much as they please. Even if it seems like the child is just playing or “stimming” with the device, this interaction is still helping to familiarize the child with the AAC and its functions.  
  • Model consistently and often on the AAC device.  
  • Ensure everyone involved with helping your child communicate (family members, school staff, caregivers, etc.) knows how to effectively and comfortably model language on the device. This includes knowing and educating yourself on your child’s style of language processing. 
  • Do as much as you can to encourage your child’s use of the device. This could look like modeling on the device to talk about your child’s favorite cartoon character, food, or activity, or creating communication opportunities that are appealing to your child and their interest.  
  • Always ask your child’s SLP for help when needed. These individuals are AAC experts and should be able to help with whatever you may need to be as fluent as possible with AAC communication! At our clinic, the SLPs and BCBAS collaborate and work seamlessly to support the child’s communication. You have a team of resources. 
  • Lastly, ensure the form of AAC is consistent across all professionals and/or providers (the child’s entire team should be using the same type and same brand of high or low tech AAC). 

User Tips for AAC

When it comes to children with speech-language deficits, communication is most effective when it is used naturally. With that, we encourage you to follow your child’s lead with their communication attempts and always react with praise at any attempt they make to communicate. It is best to simply model alternative ways to communicate, as opposed to requiring a response from your child before giving them what they want.  

Many children with autism are Gestalt Language Processors (GLPs). For GLPs, there are four stages of language development. What stage your child is at determines the setup of their AAC device. If your child is at a stage 3 or higher, or once they get to that point, they are working on the freeing of single words and the combining of 2-3 words. This is where it’s important to know the difference between core vocabulary and fringe words.  

Many AAC devices have a core board, which is a page on the device, typically the main page when opening the app, that includes both “core” words and phrases and “fringe” words. The exact configuration of these words depends on the device and app being used. You can then use these words and phrases to help your child build their vocabulary and customize it to fit their wants and needs. Alternatively, if your child uses lower-tech AAC, such as Picture Exchange Communication System (PECS), you and your child’s speech team can customize the words based off of the child’s interests and needs.

AAC Resources

If your child has an assigned Speech Language Pathologist, they will be your best AAC resource. Additionally, the internet is abundant with resources that can help you navigate and utilize your child’s AAC device. Here are some of the top websites we recommend to parents of AAC users:  

And of course, learn more about AAC by connecting with our speech team at Healing Haven, operated by Gigi’s Kids Speech and Language Therapy, which the information in this post comes from.  

We hope this post has helped enrich your knowledge of AAC and answered some questions you may have had surrounding it. If your child has benefited from the use of AAC, please feel free to share in the comments. Let’s continue to make communication all-inclusive! 

Sesame Street’s Autism Resources

Helping our world “See Amazing in All Children”

Can you believe that Sesame Street has been producing quality educational programs for children for almost 55 years? And it’s been six years since Sesame launched their first puppet on the autism spectrum. Julia appeared on her first episode of Sesame Street on April 10, 2017. She originally was created in digital form when Sesame Street launched their autism resources in 2015.  

The iconic television show has a long history of inclusive representation of individuals with disabilities. They often featured children with Down syndrome and cerebral palsy, as well as kids in wheelchairs, blind, or other disabilities. They were doing this when individuals with disabilities were rarely, if ever, seen in entertainment. Doing this sent a message of inclusion to children- that being “different” is okay. But the creation of Julia is the first time a puppet has had a specific disability.

See Amazing

The Sesame Workshop’s autism awareness initiative is called “Sesame Street and Autism: See Amazing in All Children.” What an encouraging message for families impacted by a disability! Everyone has something to offer, even if they struggle to talk or learn in the same way other kids do.

One of Sesame Street’s autism resources are Daily Routine Cards. These are digital social stories to show kids about various activities or daily skills. Visuals like this can help prepare children for things that may cause them anxiety (like getting a haircut), or other daily living and social skills. We work on many of these things in our ABA Therapy, as well. 

In addition to visuals, other autism resources from Sesame Street include helpful information for adults. They have a guide called Taking Care of the Caretaker with tips on reducing stress and taking care of yourself so you can take better care of your child. This falls directly in line with our philosophy of stress management for parents and caregivers.

“The Amazing Song” celebrates how every child has something amazing to offer. And it’s wonderful to see how inclusive it is by showing how some kids talk with a digital device, others struggle with eye contact, and others may flap their hands. But it’s all displayed in a way that’s made to show it’s okay and normal.

Creating Inclusive Places

Another aspect of these resources is the Provider Guide. It’s filled with ideas and suggestions for providing autism-friendly atmospheres and events that organizers can create within their communities. With this kind of focus it’s no surprise that Sesame Place, the Sesame Street themed amusement and water park, was the first theme park in the world designated as a Certified Autism Center by the IBCCES.

Even though the program states the goal is to provide resources “designed to serve autistic children and their families”, simply by including Julia as a friend of Elmo and Abby communicates a powerful message to all neurotypical kids watching. Children can learn at a young age that the classmate they have who is like Julia can be a friend.

In addition to the website, you can search the hashtag #SeeAmazing on social media to find content related to this initiative and even include it in your own social media posts.

We are huge fans of Sesame Street Workshop. They educate children on the fundamentals like letters, numbers, colors and shapes. But they also do an incredible job of teaching even more critical skills like friendship, acceptance, diversity, inclusion, and care for one another.

If you found this information helpful, we’d love it if you’d share it with your network!

Strategies for Managing Challenging Behaviors for Children with Autism

“Challenging behaviors” are defined as “behaviors that can be disruptive and/or difficult to manage.” Challenging behaviors may manifest in several different forms including avoidance, aggression, self-harm, destruction, eating inedible items (otherwise known as Pica), elopement, tantrums, screaming, and more. These behaviors can happen in any setting, whether it’s in a public place or in the home. But depending on the cause (or “function”) of the behavior, there are ways to lessen the likelihood of behaviors happening. Likewise, there are ways to respond when they do occur. We have gathered strategies for managing challenging behaviors for children with autism from our Director of Clinical Standards, Dr. Jennifer Thomas, Ph.D., BCBA-D, LBA. 

Why Challenging Behaviors Happen 

While behaviors often have a driving reason for their occurrence, they can sometimes be dangerous. If your child is engaging in behaviors that put them or someone else at risk, we strongly recommend you seek professional help.  When it comes to managing challenging behaviors in children with autism, it is important to remember that behavior is communication.

There is always a reason for a child’s behavior. For example, the behavior may be the result of the child wanting to get something or to get away from something. This, in simple terms, could be a person, place, activity, or type of internal/external stimulation. Dr. Thomas says that challenging behaviors “often have more than one cause,” making it difficult to pinpoint why they occurred. A Board Certified Behavior Analyst (BCBA) has the expertise to help parents. Through careful observation and data collection, BCBAs can determine why a behavior is occurring. Based on this, they can craft an individualized plan to help teach parents how to respond in a way that will minimize behaviors and maximize success. 

How to Prevent the Likelihood of Challenging Behaviors Occurring 

While specific expertise is needed to craft a plan to decrease severe challenging behaviors, there are some tips that can help parents plan ahead to decrease the likelihood of these behaviors occurring in the first place. It is important to remember that having good communication between yourself and your child is a great starting point! While this is no easy task, there are ways you can prepare your environment(s), and your child, so that these behaviors are less likely to occur. 

“Set your child up for success,” says Dr. Thomas, by recognizing the components that are likely to cause behaviors. This can be done by being observant. Look for patterns such as similarities in context or environment that a behavior happens, similarities in reactions to certain events, and changes in setting and mood before, during, and after a behavior occurs. Physically make note of these patterns, if possible, to reference and help yourself to make mental connections. Doing so can help you identify and plan ahead to possibly prevent a behavior. This is also great information to provide to your BCBA. 

The following are some tools to help prevent challenging behaviors: 
  • Having a consistent communication method (AAC device, PECS, signs, gestures, vocal language). 
  • Carrying sensory toys or snacks with you.  
  • Having headphones or sunglasses available in public places to reduce sensory irritations. 
  • Prepare your child’s expectations before doing something difficult or novel. 
  • Bring fun activities or snacks to make undesired activities or outings a bit more fun. 
  • Make trips short, if possible. 
  • Avoid areas that you know may trigger your child, if possible. 
  • Use timers and countdowns. 
  • More ideas are available through the Autism Research Institute. 

How to Respond When Challenging Behaviors Occur 

How you respond to your child’s challenging behaviors depends on the behavior that is occurring and what the trigger is. The cause of behaviors, Dr. Thomas emphasizes, oftentimes lies at the root of a communication struggle, impulsive behaviors, or issues with emotional regulation. Dr. Thomas says it is helpful to think about what the child is trying to communicate and to be observational. This is the first step in figuring out how to respond when a behavior occurs. As every child’s situation is unique, professional expertise is necessary when formulating a specific way to respond. It is also helpful to teach your child calming strategies, in addition to focusing on some of the other areas of struggle.

Some coping strategies may include:  
  • Squeezing hands 
  • Stomping feet 
  • Counting 
  • Taking deep breaths 

Some children are easily redirected if you can draw their attention elsewhere during a behavioral episode. This may be effective in the moment but is not a long-term solution. The most important thing to remember when trying to manage a challenging behavioral scenario with your child is to “get safely through that moment and know there is another learning opportunity to come,” says Dr. Thomas. Also, remember to have compassion for your child and yourself as you’re going through this tough and often stressful situation.   

Where to Get Help with Managing Challenging Behaviors 

ABA Therapy is a very effective resource for addressing challenging behaviors. In ABA Therapy, we focus on teaching ways to communicate and behave. “Children should always have a functional way to get their needs met,” Dr. Thomas says. This is where Functional Communication Training, or FCT, comes in. Functional communication can be as small as the child pointing to something they want, as a means of asking for it, or handing over a picture icon of an item. 

“We begin by teaching a communication task that children find easy, this varies based on skill level. The idea is to give children another, more appropriate skill to use to communicate in lieu of using a challenging behavior.” If your child is already in ABA Therapy, their Board Certified Behavior Analyst, or BCBA, is a great resource.  For children enrolled in a school program, an Individualized Educational Program, or IEP, can be a great resource to reference. If your child has not had a developmental evaluation, and is exhibiting challenging behaviors, it may be time to seek out a pediatric or developmental psychologist. From there, a psychologist would be able to perform assessments that could determine if there is anything underlying the child’s behaviors. Healing Haven’s Testing & Assessments services can help with this process, as well as contacting your child’s pediatrician.  

In addition to these resources, there are several organizations that can help, such as: Autism Alliance of Michigan, Autism Support of Michigan, Michigan Alliance for Families, National Autism Association. 

Challenging Behaviors: Finding Community 

The behaviors you encounter from your children can sometimes be difficult to manage, but keep in mind that you are not alone. In addition to the professional resources we have shared, there are other parents who understand. Finding community is important in helping share ideas and reducing your own stress.   

If you’re thinking you need more help in how to manage your child’s challenging behaviors, please contact us for information about our ABA Therapy for kids with autism. And our testing and assessments services can empower you with information on how to best support your child.  

We hope that throughout this article you were able to find useful information that can be utilized going forward. Don’t hesitate to share this piece with others, as well as comment, if you found it helpful! 

The Importance of Early Intervention for Autism

child working on fine motor activity in early intervention
child working on fine motor activity in early intervention

In recent years we’ve experienced a noticeable increase in parents of younger children – 2-3 years old – contacting us for services. This means they are getting evaluations and receiving an autism diagnosis at younger ages than the national average. Data from the CDC indicates that the average age to receive an autism diagnosis is over 4 years old. Receiving an autism diagnosis before the age of 3 provides great opportunity for early intervention for autism to begin.

Early Intervention for Autism

But once parents receive that diagnosis, choosing the right treatment for their child can be as complex as the diagnosis. There are no miracle cures for the varied challenges that can come with an autism diagnosis. However, behavioral therapy, or Applied Behavioral Analysis therapy, is evidenced-based and the most frequently recommended treatment for helping a child diagnosed with autism.    

“Research very clearly states that early intervention for children with autism and other developmental disabilities is vital,” explains Jamie McGillivary, MS, LLP, BCBA, Director of Healing Haven. “When children start therapies like ABA early on, they receive strategic learning opportunities that support them in the areas they need.” 

Whether it’s communication, social and play skills, or activities for daily living (brushing teeth, eating with utensils, potty training), children who struggle with these skills can make great strides when provided early intervention support. Additionally, the likelihood of negative behaviors decreases because they learn appropriate behaviors from the beginning. 

ABA Therapy

early intervention for autism

A child’s individual early intervention plan will address their unique areas of need. For instance, if it’s developing language and communication skills, the ABA therapist will work on helping the child learn to label items and appropriately request things they want or need. And the mode of communication will vary. It may be pointing to a picture, or handing a picture of what they want (Picture Exchange Communication System). And some may use a communication device (tablet), or verbal expressions.  

In addition, if the child has negative behaviors their ABA therapy plan will address them. Some common negative behaviors include: damaging toys or property, non-functional crying and screaming, resisting transitions by falling to the ground or running away, aggression or self-injurious behaviors.

The behavior plan developed by the child’s BCBA will include strategies to address the types of behaviors listed above. They will work to pinpoint the reason for these behaviors and teach them skills or replacement behaviors to reduce them. 

“For example, some children flop to the ground when transitioning to a new activity. Their ABA Therapist may address functional ways to communicate that the child may need a break,” Jamie explains. “Or they may introduce proactive strategies to warn the child that a transition is about to occur. Giving warnings and visual information about what is to come helps decrease the anxiety surrounding transitions.”  

Generalizing New Skills

As a child makes progress on and eventually achieves their goals, we can work on scaling back one-on-one support. The ultimate goal is for the child to generalize the skills they’ve learned into their natural environments. We provide additional programs to support the child and family in this goal. 

“We place a significant emphasis on parent training and involvement,” says Jamie. “When parents participate, we increase the likelihood that what children learn in the clinic will carry over to their natural environments.”  

As a result of early intervention services, young children with autism receive a strong foundation to learn, develop and grow. It’s good to remember that autism is a spectrum and each child is unique. Some children need more support, while some need less. Some will need ongoing ABA therapy, while others will move on to their school environment with varying levels of support.  

You can learn more about all our early intervention services for autism here. And contact us to get your child started with therapy services.

If you found this information helpful, we’d love it if you’d share it with your network!

How to Explain Death to a Child with Autism

image of grave headstone, explaining death to a child with autism

Losing a loved one, whether it is expected or not, is hard for anyone to navigate. It’s a process that involves accepting reality, seeking support if necessary, and allowing yourself time to feel natural emotions. So it’s not surprising that explaining the death of a loved one to a child with autism may bring some additional challenges.   

Death is a difficult concept for any child to understand, let alone those who may have a hard time grasping abstract concepts. But death and loss are also unavoidable. That’s why we put together some tips to help your child with autism or special needs understand and deal with the process of losing a loved one.  

Be literal and thorough when explaining the loss 

When explaining the death of a loved to your child with autism, use literal terms. This may help the death make more sense to them.  Avoid using terms such as “passed away”, “gone to sleep”, or “gone to another place”. Using these terms risks your child taking them literally and becoming frustrated when their loved one doesn’t wake up or come back.  

Be direct when you are explaining the passing of a loved one to your child. The more direct you are, the easier it will be for them to understand. Allowing room for questions is key here and answering them honestly to the best of your ability should take priority.  

Keep routines as unchanged as possible 

Change in routines can be particularly challenging for individuals on the spectrum. The death of a loved one is a major life changing event. That’s why it is best to keep everything else within their routine as consistent as possible. People with autism find comfort with routine, and comfort is something we all strive for while grieving. Bedtime routines, playdates with friends, school and therapy may be part of daily routines. You should try your best to maintain these activities if they bring your child peace. 

Involve them  

When helping a child (with or without autism) through loss and grief, it may seem best to exclude them from certain parts of the process, like attending a funeral with an open casket. While it largely depends on your child’s level of cognitive understanding, as well as your expertise in making the best-informed decision for your child, many professional sources suggest that shielding a child with autism from the complexities that come with loss will likely confuse them more. These sources suggest being transparent and asking your child if they would like to be part of a certain aspect (like the funeral, wake, or burial). With this, allow them to ask any questions they might have.   

Another good option, as Alicia says in The Mom Kind, is “to have a celebration of life that they can attend instead of the funeral”. Doing this, Alicia says, “allows involvement without having to see all the grief”.  

Prepare them, if possible  

If you know that a family member or loved one is terminally ill, try and familiarize your child with all the places they will be during this time. This could be places like the hospital, funeral home, or cemetery. Remember to talk about the emotions they will see from others throughout the process. A great way to do this could be through pre-made “social stories”. Social stories use photographs to help explain and show the child what will happen before it happens in real-time. These photographs and descriptions of the photographs can include emotions that they will observe of others. More information on constructing a social story can be found here.  

As we know, children who are on the spectrum can have an especially difficult time dealing with the unexpected, so it is a good idea to make the loss as “expected” as possible. Of course, this may not always be possible and sometimes a loss can be sudden. In this case, you can still do your best to show and tell your child what to expect. Use any photos you have available or pictures online to do this. More ways to prepare your child for loss and help them understand it can be found in this article from Child Bereavement UK. 

Utilize books that help explain loss 

When it comes to bereavement and children with autism, a lot can be gained from books that are specifically made for this life event.  

The 2017 book, I Have a Question about Death: Clear Answers for All Kids, including Children with Autism Spectrum Disorder, is a straight-forward, color-filled read that addresses the questions that concrete thinkers might have surrounding death. It answers them in a simplistic manner. This book has an abundance of good reviews from parents who have had to explain this topic to their children. We recommend it as well!  

Another book that is a good choice for the topic of grief is the interactive workbook, Finding Your Own Way to Grieve by Karla Helbert. This book is unique in that it encourages expressive techniques and exercises to help your child identify and process the feelings that accompany loss. This book is perfect for children and teens to work through on their own. They can also use it with the help of a parent or professional. Find this book here. 

Lastly, How People With Autism Grieve, and How to Help: An Insider Handbook, is best suited for teens and young adults who need security and affirmation after losing a loved one. Though the book only bases suggestions off one person’s unique experience, it can prove helpful in relating to what your child might be feeling emotionally. Find out more about it here. 

Takeaway

We all have different ways of dealing with loss. It’s important to make it known to your child with autism that there is no “right” or “wrong” way to respond to the death of a loved one. The most vital thing, though, is to ensure that your child knows there is support around them and that they have people to talk about it with when they feel sad or confused.  

What is ABA Therapy: Your Questions Answered

child doing therapy explaining ABA Therapy
child doing therapy explaining ABA Therapy

Following an autism diagnosis, many professionals recommend ABA Therapy as the first form of support. But many parents often leave those meetings wondering what is ABA Therapy? It’s common to have lots of questions. It’s important to feel informed and clear on treatment options as you seek support for your child. Not to mention, choosing a therapy provider can be overwhelming and can take a lot of time. We’ll break down some commonly asked questions about what ABA Therapy is so you can feel prepared to help your child.  

What is ABA Therapy? 

Considered the “gold standard” in autism treatment, ABA (Applied Behavior Analysis) Therapy is a scientific approach to understanding behavior. It’s a method of therapy used to improve specific behaviors, decrease interfering behaviors and help a child gain new skills such as communication, play, social, and daily living skills. ABA Therapy is evidenced-based and the most frequently recommended option for the treatment of autism.  

Is ABA Therapy effective? 

ABA Therapy proves to be highly effective, based on over 50 years of research. Medical professionals and institutions such as the American Psychiatric Association, the American Psychological Association, and the U.S. General Surgeon approve ABA as a valid treatment for autism.  

ABA Therapists and BCBAs (Board Certified Behavior Analysts) create and implement plans for the client to meet specific goals tailored to the client’s needs. They set the client up for success by breaking down the steps to each goal. If an approach isn’t working, the ABA Therapist and BCBA will find another one. For example, a child may be working on regulating their emotions during tantrums. The ABA Therapist and BCBA might implement tactics such as deep breathing, sensory input, and physical relaxation. But if sensory input seems to further aggravate the child, that tactic will be removed and replaced with a helpful one. 

Is ABA Therapy a fit for my family? 

Parents love their children and want what is best for them, no matter their diagnosis. You may be asking, ”How can ABA Therapy help my child?” All children have the right to learn important skills in order to be independent and to maximize their happiness later in life. For children with autism, learning some skills can be harder. ABA Therapy can build on your child’s strengths while also supporting their learning in the areas they need it most.  

In deciding if ABA Therapy is a fit for your family, it’s important to understand the provider’s approach to ABA. ABA Therapy should be customizable to your child’s needs, with an emphasis on generalization to make sure skills transfer to the natural environment.  

Additionally, it’s important to know the credentials of the BCBA and understand the center’s training program for their ABA Therapists. This is to ensure they are qualified for the work they are providing. Another factor is to make sure they have a positive and comfortable relationship that allows room for learning. There should also be frequent and open communication between you as the parents and the child’s BCBA in order to build goals that are appropriate and sensible to you. Remember, you know your child best and it’s important to find professionals that align with your specific values.  

What do ABA Therapists do? 

ABA Therapists are trained behavioral professionals that work closely with and under the supervision of BCBAs. They help implement behavioral goals set for the client. As a team with the child and BCBA, the Therapist will help teach functional skills, address problem behaviors that interfere with learning. They also help the child gain skills that will allow them to better participate in school and the community. 

What is a BCBA? 

According to the Behavior Analyst Certification Board, “A Board Certified Behavior Analyst, or BCBA, has a graduate-level certification in behavior analysis. Professionals certified at the BCBA level are independent practitioners who provide behavior-analytic services. BCBAs may supervise the work of Board Certified Assistant Behavior Analysts – (BCaBAs), Registered Behavior Technicians (RBTs), and other professionals who implement behavior analytic interventions.” 

At Healing Haven, BCBAs also provide parent training and can work with school professionals to help therapy translate efficiently across all situations and settings the client is in. To become a BCBA, an individual must undergo a 5-step process that includes: earning a relevant Master’s Degree, completing required behavior-analytic graduate coursework, completing required supervised fieldwork, apply for, take, and pass the BCBA exam, and then apply for state licensure.  

What happens during an ABA session? 

An ABA session typically begins with specific goals established for the child, which are discussed prior to starting therapy sessions. Throughout the session, the Therapist works one-on-one with the child. Their job is to ensure the child is learning and understanding the skills that are being taught. ABA Therapists utilize encouragement, praise and other motivational tactics tailored to the specific child and programs being worked on. Therapy is delivered both with and without supervision by the BCBA. 

Kate Fritz, MA, BCBA, LBA, is the Clinical Manager of our Early Intervention Clinic. She describes a typical ABA session at Healing Haven this way: 

In ABA sessions, we work hard and play hard! How an ABA session looks can greatly vary depending on the client’s age and skillset – programming is individualized to the client. In general, you can expect to see the use of play to work on communication and social skills, building up independence with daily living skills (e.g., working on putting on a winter coat), and both individual and group times to work on behavioral goals related to school-readiness. In action, this may look like a kid sitting in circle time imitating song motions, then reading a story with their therapist and pointing to animals and colors throughout the story, sitting and eating snack with peers, going to the restroom to work on washing hands independently, then heading to the playroom and pointing to toys up on a high shelf to communicate what they want to play with.  

When should my child start ABA? 

A child should start ABA Therapy if deemed appropriate, after receiving a medical diagnosis of autism spectrum disorder. Autism, for example, can be detected and tested for as early as 18 months old and by age 2 can be considered a reliable diagnosis as a means for therapy intervention.  

Early intervention is key. “Research very clearly states that early intervention for children with autism and other developmental disabilities is vital,” explains Jamie McGillivary, MS, LLP, BCBA, Founder and President of Healing Haven. “When children start therapies like ABA early on, they receive strategic learning opportunities that support them in the areas they need.”  

However, ABA Therapy is also beneficial for older children and teenagers. Even if a child is diagnosed later, ABA therapy could be worth looking into to learn and improve in areas that may be challenging for them. It is also important to remember that ABA Therapy isn’t automatically a lifelong commitment. Many children transition to lesser levels of therapy as they master skills.  

Is ABA Therapy covered by insurance? 

Because it is considered a behavioral health service, ABA Therapy is covered by most insurance policies. However, this can vary by plan and from state to state. In Michigan, it can vary by employer insurance plans, so it is important to call your insurance provider. It is important to discuss the specifics of what is and what is not covered by your plan as it pertains to ABA Therapy services in your location. More information about this can be found when you search “Autism Spectrum Disorder Health Coverage” on your state government website. For example, Michigan’s explanation of autism health coverage is found here. The Autism Alliance of Michigan is also a great resource for parents navigating insurance coverage. 

We hope this information is helpful as you navigate therapy options for your child. To learn more about Healing Haven’s ABA Therapy programs for children and teens up, contact us today.