Help Your Child Build Friendships With Kids With Autism

Updated On September 22, 2022

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The following is an interview published by Chicago Parent with LEARN Behavioral Chief Clinical Officer Dr. Hanna Rue, Ph.D., BCBA-D.

By: Claire Charlton

Your child likely has the opportunity to build friendships with kids on the autism spectrum. How can you help cultivate these unique relationships?

This back-to-school season, your child is settling into a new routine alongside children of many abilities, and as they are making new friends, now is a great time to encourage them to reach out and build a friendship with a child with autism. Because autism is a spectrum disorder, your child’s classroom, cafeteria, chess club, or ballet class will likely include a child with autism, says Hanna Rue, Ph.D., BCBA-D, Chief Clinical Officer with LEARN Behavioral.

Current statistics show that 1 in 44 children has been identified with autism spectrum disorder (ASD) — for boys, the prevalence is four times higher and numbers vary from state to state, according to data from the CDC. “I’m never surprised when a parent comes to me and says their child has met a peer with typical autism characteristics in the classroom,” says Dr. Rue.

Kids with autism have strengths and challenges just like their neurotypical peers and can bring a lot of value to a friendship. “What I have found is that neurotypical kids are amazed that some kids with autism have the same special interests as they do,” Dr. Rue says. “Maybe they are passionate about zoo animals and can provide all sorts of information that neurotypical kids are impressed by.”

Each child is different and not every child mixes well with groups of peers. A child with autism is often able to look past differences or idiosyncrasies that can put off neurotypical peers, which makes them a good source of friendship for kids who struggle to fit in, Dr. Rue says.

While it may appear that kids with autism prefer to play alone, they really do enjoy companionship and sharing their interests with others. Here, Dr. Rue shares some wisdom about how to help your child build friendships with kids with autism.

How to make it happen

A child with autism may experience sensory sensitivities that neurotypical peers can empathize with. Loud noises, loud music, bright lights, even transitioning between activities can present challenges for some children.

“Sometimes a child with autism has challenges with communication and that can cause distress on either side,” Dr. Rue says. “I always tell folks if they are working with kids to develop friendships to allow for plenty of warm-up time.”

When planning a playdate, take it slow. Show your child’s new friend a quiet room in your home where they can take a break if needed, and recognize that if they take this break, it likely signals that they are overwhelmed, not disinterested. Communicate to your own child that everyone is frightened or overstimulated by something at some point and help them recognize their own fears or needs.

“I have seen some amazing pure human kindness across developmental stages,” says Dr. Rue. “When a child with autism has a meltdown, their friend can just sit and be in close proximity. They recognize independently that their friend is having a hard time. Or they assist with transitions through prompts like ‘follow me, sit at my table for lunch, hold my hand so you don’t get lost.’ Kids are pretty intuitive and can recognize that just being there and showing the way is a huge help.”

Parent encouragement can help blossoming friendships grow. Here’s what parents can do to support their children as they make and sustain friendships with kids with autism.

Talk about diversity early and often

When a parent is aware of their own child’s developmental level, they are better prepared to help them make friendships with anyone — and be inclusive on the playground and in the classroom, Dr. Rue says. This is best achieved by talking about differences on a regular basis.

“It’s important to introduce your child to diversity, especially if you live in an area where there isn’t a lot of diversity,” she says. “Read books, watch videos, and have open conversations about differences. In addition to talking about skin color, you can talk about different ways that kids communicate with each other, including the idiosyncrasies of flapping, body rocking, and squealing because this is a way of expressing joy or frustration.”

Model inclusive friendships

“We always have lots of opportunities to interact with other humans in our communities, from the playgrounds to the grocery stores,” Dr. Rue says. “This is the time to model appropriate interactions and show empathy, and then discuss it with your child.”

For younger kids, Dr. Rue is a big fan of Sesame Street’s inclusion of a character named Julia. “Julia has autism and I love for parents of neurotypical kids to watch Sesame Street with younger children and talk about Julia and how she is different. It’s a great opportunity for a shared moment of watching and talking about differences and acceptance.”

Offer a sympathetic ear to the child’s parents

Parenting a child with autism is stressful. “Research suggests that they experience more stress on a daily basis than parents of a child with a terminal illness. That’s a lot. Any small gesture, like saying hi or offering coffee or even just sitting and listening. Being an ear is very helpful,” Dr. Rue says.

Finally, have patience. Playdates can be easy but allow time for your child and their new friend to experience similar interests over a few visits. Help the other parent know that you understand and won’t give up after one meltdown or challenge.

“It’s so important to recognize that individuals with autism are all around us, doing great things,” says Dr. Rue. “We need to embrace that and learn about how to be supportive.”

For more school-related content, check out our blogs, “Five Steps to Help Your Child with Autism Make Friends” and “Back to School: Homework Tips.”

Back to School: Homework Tips

Updated On August 9, 2022

Heading back to school can bring a number of challenges for our kids, especially those with autism. Navigating new environments, teachers, therapists, and peers can each be a bit scary but full of opportunity.

One very common request we get is about supporting autistic kids with their homework. How do you get your child to do his or her homework? There are many strategies to help keep your child on task; all of them tried and true. Here are some to consider:

Make It Easier by Sticking to a Schedule

Set a schedule and stick to it. Like any other priority, if homework always occurs at the same time, and the routine becomes ingrained, your child will eventually accept the routine. This is true for teeth brushing, baths, and all of the chores children prefer to avoid. Initially, it is hard to hold the line on the schedule, but it sure pays off later.

Reinforce the Message That Homework Is Important

Set the stage and set the tone. Show your child that homework time is important and respected. Give them a special place to sit. Ask siblings to be quiet or leave the area during homework time. Check in frequently to see how they are doing and intersperse praise throughout homework tasks. Show them that you care and are invested in their homework efforts, and help them feel successful and competent.

Motivate with Kindness

Be firm but encouraging. Everyone tends to push back when they are nagged. Try to avoid nagging when you are frustrated by your child’s efforts. By observing your own behavior, you can better support theirs. You can set expectations for what the homework routine looks like, but make sure to be encouraging and motivating, too. Remind your child what you believe their strengths are and why you are proud of what they are learning.

Positive Reinforcement is Powerful

Use rewards. It is OK to reward your child for completing their homework. They are doing something difficult every day. Consider giving a reward for being successful at participating in homework time (not getting everything correct). Eventually, as homework time becomes easier, you can shift rewards to more academic goals. It does not have to be an ice cream sundae. Find out what they might like to do with you after they are done. This can be an opportunity to consider setting aside quality time that you will enjoy.

Every Opportunity for Choice Increases Compliance

Giving choices has been proven to increase motivation. What choices can they have during homework time? It is important for you to keep the time and the expectations the same. But, can they choose where to sit? Can they choose what materials to write with or write on? Can they choose what task to begin with? Also, consider letting them choose their reward as well. Give them at least three options. Empowering them in this way can be very powerful. The more control they have over the task the more motivated they will be.

Interested in more back-to-school tips? Check out our blogs, “Five Steps to Help Your Child with Autism Make Friends,” “This School Year, Build a Trusting Relationship with Your Child’s Teacher,” and “Tips for Reducing Back to School Anxiety.”

Tips for Reducing Back to School Anxiety

Updated On August 1, 2022

Getting ready for the new school year can be a hectic and exciting time. Transitioning from the extra playtime and novelty of summer back to the routine of the school year can be challenging. For children with autism (and their parents), all this change can feel overwhelming.

Here are some suggestions for how to help ease your child’s back-to-school anxieties:

Get a Sneak Peak
Scope out the school and classroom in advance. If your child is going into a new classroom, ask to visit it at least once before the first day of school. If transition has been a struggle in the past, consider taking as much time as your child needs to explore the classroom. Make it as much fun as possible, playing in each of the new areas.

Check Out Seat Assignments
For older children, ask the teacher if a seat assignment has been made. Do some enjoyable activities in that seat. If familiar classmates will be in the room, show where they will be sitting, too.

Rehearse New Activities
Find out from the teacher what new activities are planned. Then, prepare your child by performing, practicing, and talking about them. This rehearsal will reduce anxiety when the new activities come up in the first week of school.

Anticipate Sensory Overload
The noise and chaos of a typical classroom can sometimes be a bit much to handle. Establish a plan for what to do in this situation – perhaps there is a quiet room where your child can “take a break” for a short time.

Volunteer in the Classroom
Many teachers welcome assistance from parents. If your child’s teacher welcomes volunteers (and your schedule permits), your presence may be a source of comfort to your child during those challenging first weeks.

Going to school can pose many challenges for children with autism, as well as offer countless opportunities for building crucial social, language, and academic skills. Be positive and encouraging, and your child will be off to a great year!

Looking for more school-related tips for your child with autism? Check out our blogs, “Five Steps to Help Your Child with Autism Make Friends” and “This School Year, Build a Trusting Relationship with Your Child’s Teacher.”

What in the World Is a Behavior Tech?

Updated On July 26, 2022

Ever heard of the job behavior technician? If you like working with kids and families—and making a difference in their lives, while earning a paycheck—this might be the job for you.

A job as a behavior tech is a fairly new entry-level position that involves working with children and adults with autism spectrum disorder (ASD), a developmental disability that can cause language, social, and behavioral challenges. Behavior techs (BTs) receive training to use a science-based therapy called applied behavior analysis (ABA) to help people with autism build skills in communication, socialization, self-help, and play.

If you’re still uncertain or want to learn more, read on for answers to common questions about the job.

Where do behavior technicians work?

As a behavior tech, you would work one-on-one with a client in a variety of settings, such as a child’s home, community, or school, or learning center.

Who do behavior technicians work with?

Liltle Preschooler Kid Playing With Wood Blocks And Teacher Educ

While a large number of jobs involve working with children with autism, behavior techs can work with people of any age. Most people who receive services from behavior techs have a diagnosis of autism spectrum disorder (ASD), which affects one in 54 children worldwide, according to the Centers for Disease Control and Prevention. As a “spectrum disorder,” ASD causes individuals to experience the signs and symptoms in various ways and to varying degrees. Most often, though, ASD can affect a child’s ability to communicate, form friendships, interact with other people, and manage emotions and behaviors in tough situations.

What does a behavior technician do?

A large part of your job would be to follow the guidelines laid out in each client’s treatment plan, which provides specific treatment goals and information in a paper-based or digital format. Written by the behavior tech’s supervisor, who is often a board certified behavior analyst (BCBA), goals target important skills for that person to practice and develop. These can include communication skills, play and social skills, and self-help skills like tying a shoe or zipping up a jacket.

Along with each skill, the treatment plan provides specific instructions on how to teach each lesson, outlining what to do when a client responds correctly, and what to do if they need more help. Throughout the entire session, you would provide praise and encouragement, doing what you can to make the session fun and engaging. In addition, you would collect data to later use to evaluate the effectiveness of treatment and guide future treatment decisions.

What does a social skills group look like?

Some behavior techs work in small groups of children, practicing social skills or facilitating play-dates. In these situations, you would “assist” children in playing, which could involve going over skills before they play with their peers, observing them as they play, prompting when necessary, and praising any effective social skills you notice children using.

What is it like to work with adults?

Adult programs typically take place in homes or “day-habs,” which are facilities in the community that provide services to groups of individuals during weekday hours. Sessions often focus on independence in self-help skills and vocational activities. In these settings, you might help your client practice activities like grocery shopping or keeping the house clean, or improve vocational skills such as cooking or making copies. Sometimes behavior techs take on the role of job coach for adults in their workplace, supporting their success at a job or volunteer position. In this situation, the tactics are similar to working with children, but the treatment goals shift to the working adult’s unique needs.

How can I tell if my work is making a difference?

As behavior techs practice each lesson with their client, they take data on each response the client makes, making a quick note about whether the client gets it right or wrong, or needs extra help. The data, graphed regularly and over time, form a beautiful, visual graph of the client’s learning and growth, allowing you to see progress, or the lack thereof, at a glance.

If a career as a behavior tech sounds like the right fit for you, browse our openings, and apply for a job today.

View Behavior Tech Jobs

Neurodiversity – Origins and Impact

Updated On July 20, 2022

By Katherine Johnson. M.S., BCBA
Senior Director of Partnerships, LEARN Behavioral

Judy Singer is an autistic Australian social scientist. In the 1990’s, seeing echoes of her mother’s struggles in herself and her own daughter, it occurred to Singer that this common thread pointed to the possibility that their differences were actually neurological traits. They were having a first-hand experience of that part of biodiversity that is the natural range of variations in brain functioning: she coined it neurodiversity.

The neurodiversity paradigm considers all brains to be normal; brain differences are simply the neurological counterpart to genetic variations in height, eye color, or hair color. Scientists consider such variation in biological traits to be essential to the health of individual populations and entire ecosystems. When viewing autism through the lens of neurodiversity, it comes to light that some of the individual differences that have been assumed to need remediation in the past, may actually be important in helping society as a whole make progress through new and different ways of thinking.

The concept of neurodiversity has been enthusiastically embraced by that portion of the autistic community who are able to speak, as it promises to alleviate some of the bias and discrimination they have experienced. Their common message? Specific words and types of support can have unintended negative effects, causing them to feel inferior, powerless, misunderstood.

Arising from these negative experiences is a more widespread understanding of how words and actions affect the private events (thoughts and feelings) of people on the spectrum. ABA practitioners are charged by the BACB Ethical Code to “treat others with compassion, dignity, and respect,” and the voices of the neurodivergent convey essential information about ways to do this.

LEARN’s Response

LEARN’s neurodiversity initiative is a direct result of listening to the insights of autistic folks who are able to express their experiences of living in a society that was built for neurotypical people.

Development of a Person-Centered ABA workgroup – Learn Leadership charged a workgroup of clinical leaders with the task of supporting clinicians in reaching our vision for a neurodiversity-informed, Person-Centered ABA approach. The workgroup includes clinicians, supervisors, and clinical development individuals.
Forming of a Neurodivergent Advisory Committee – The first action of the Person-Centered ABA workgroup was to formalize a process for getting input from the neurodivergent community. The committee is made up of neurodivergent clinicians and non-clinicians who work at LEARN; they meet regularly to review and give feedback on articles, trainings, and other materials, and are compensated for their role on the committee.
Co-creation of the Values Statement – The Person-Centered Workgroup and the Neurodivergent Advisory Committee co-created a values statement, entitled “LEARN Values Neurodiversity.” The statement was written in order to express our position to our clinicians and also guide subsequent actions by the Person-Centered ABA Workgroup. It was presented at an internal training and is available on our website.

Communication – Shifting the mindset of a large organization doesn’t happen overnight. In order to connect regularly with our clinicians on person-centered topics, a portion of our monthly video message to clinicians includes information about subjects related to neurodiversity, such as ableism, assent, and including client input in treatment planning. It’s important that staff are not only hearing this information but also discussing it, so each month, clinical teams engage in discussions with their colleagues on these topics.
Assent Leadership Workgroup – With the addition of “assent” to the BACB ethical code and the subject’s importance to treating our clients with compassion, dignity, and respect, LEARN is offering “guided exploration” groups in assent that meet regularly for four months. The intention is to create local leaders in Assent-Based Programming throughout our network.
Treatment Plan Evaluations – Our Treatment Plan Evaluation team works hard to review clinicians’ clinical work through the permanent product of their treatment plans. These reviewers have been given resources to help them identify Person-Centered practices to promote in their feedback.
New Hire Training – In the 2022 revision of our New Hire Training for behavior technicians, we are explicitly teaching them about neurodiversity and assent, as well as ensuring that language throughout is respectful, and that programming examples fit Learn’s conception of Person-Centered ABA.
Autistic Voices – Throughout this process, we are having an increasing number of autistic guests on our podcast and making it a regular practice to interview autistic folks for guest blog posts. These are ways that we can listen to autistic voices ourselves and also use our resources to center those voices in the ongoing cultural conversation.

As ABA practitioners, we have always cared about our clients – helping and supporting others is our entire reason for being. In the initial years of our still-young field, that care was expressed by taking a singular approach: teaching skills to help them function in our society. As autistic self-advocates find more channels by which to make their voices heard, the themes that are emerging tell us that there is more to supporting this community than just teaching skills. For instance, using words that validate our clients’ identities and sense of self is important. We can create a positive emotional experience for the people we support during the learning process – by listening to them and giving them agency. And most importantly: where success measures are concerned, our clients’ quality of life should be central.

LEARN is listening.

To learn more about neurodiversity, check out our other blogs “Voices for All: Ash Franks” and “Neurodiversity: What It Means, Why It Matters.”

Women Leaders at LEARN Talk About Working in STEM—and Why Behavior Analysts Sometimes Get Left Out

Updated On July 18, 2022

Most of us in the autism field know that women make up the bulk of board certified behavior analysts (BCBAs). In fact, women represent 85.43 percent of BCBAs, according to the Behavior Analyst Certification Board. What often gets overlooked, however, is that the nearly 78,000 female BCBAs across the country are also part of STEM, the acronym for an area of work—science, technology, engineering, and math—notoriously lacking in female leadership. Why are behavior analysts left out?

This week, in honor of Women’s History Month, we asked three female leaders at LEARN what it’s like to work in a STEM field—and how they use science, math, and data analysis in their positions. The women include Chief Clinical Officer Hanna Rue and Senior Vice President Sabrina Daneshvar, in addition to consultant and Women in Behavior Analysis (WIBA) Conference Director Devon Sundberg. Here’s the conversation.

Q: STEM is a hot topic right now, but the field of behavior analysis tends to get left out of the conversation. Why do you think that’s the case?

A (Hanna Rue): If you ask behavior analysts if their friends and family understand their job, the answer is usually “no.” As a field, behavior analysis has not done a great job at marketing the positive impact the field can have on socially significant behaviors. When we work with kids, our work looks like play—and that’s great, but what people don’t often see are the copious data collection, critical analysis, and data-based decisions that happen behind the scenes in treatment.

A (Devon Sundberg): As humans, we have an overwhelming desire to pigeonhole all aspects of our lives and tend to view helping individuals as a form of therapy. Mistakenly, society does not often consider therapy a form of science. Applied behavior analysis, especially as practiced at LEARN, represents the union of science and the love for helping others. For instance, we can’t track meaningful change objectively without data, and science is a huge part of what we do.

A (Sabrina Daneshvar): Some people consider behavior analysis a soft science and underestimate the importance of the science we exercise. The term “soft science” is a misnomer. In actuality, we’re doing the same things scientists do by using observation and data to make treatment decisions.

Q: You actually use a lot of science and math, both in your leadership positions at LEARN and in your previous clinical work as behavior analysts. Can you talk some about the STEM skills you use—and why they’re a big part of behavior analysis?

Hanna Rue(Circle) — Hanna Rue – Chief Clinical Officer

A (Sabrina Daneshvar): We have scientific rigor and methodologies in place that aren’t always visible. For instance, we make a hypothesis, test the hypothesis, and use evidence-based, scientific evaluation to make decisions and refine our approaches daily. Our work requires us to account for what we observe, while also accounting for sources of variability. There’s nothing simple about behavior analysis.

A (Hanna Rue): I constantly use math to evaluate how we’re doing as a company from a clinical perspective. For instance, we conduct surveys at LEARN to evaluate our services and use the data to inform our training and clinical practices. A number of projects require data analysis and an understanding of parametric and nonparametric statistics.

Q: How has ABA therapy evolved with the use of data gathering and analysis? What about aggregated data—how does that contributed to better treatment and services?

A (Hanna Rue): I started working in the field before it was common to have apps assist in data collection. Back then, I collected paper and pencil data and graphed it on good old-fashioned graph paper. Now, we can collect data via an app that can be downloaded to a tablet or smart phone. It is incredible to think that I can see updated behavioral data from clients at any point in time. Quick access to behavioral data helps to improve the quality of behavioral programming and efficiency in clinical practice.

A (Sabrina Daneshvar): I can relate to Hanna—and add that as a field, we’re starting to look not only at a single client’s response to a particular behavior intervention but also to multiple clients across the country. This can only strengthen the work we do and the interventions we administer. Insurance companies are starting to request data, too, as evidence that our services work. Thankfully, we’re in a good position at LEARN to provide it.

Q: Did you pursue math, science, and other STEM-related fields growing up? When did you take interest in these areas?

Sabrina Daneshvar(Circle) — Sabrina Daneshvar – Senior Vice President

A (Devon Sundberg): I had little interest in math or science growing up, though I was interested in helping people. My first job was at a group home for children with autism, but no one trained me, and my efforts weren’t all that successful. In my next job, I learned how to provide applied behavior analysis—and realized how much it could have helped kids in my former job, at the group home. I was disappointed that not all children had access to this amazing therapy and excited to finally feel effective in my work. From this, I learned how useful math and science can be when applied to real-life problems. From then on, I was hooked.

A (Sabrina Daneshvar): Like Devon, I didn’t pursue math and science as a kid. In college, I majored in psychology and fell into the field of autism when I worked as a special education teacher at an autism treatment center affiliated with my school. It was one of the hardest jobs I’ve ever had. I didn’t feel equipped to handle my students and decided to go back to school to earn a doctorate in developmental psychology—to learn how to make things better. As I got more involved, not just in the treatment but also the research, that’s when the science interest in me piqued. I saw the need for science and statistics and haven’t looked back.

Q: A longstanding belief (or perhaps a myth) in our society—and in many societies—is that boys are better at math than girls. But what does the research say?

A (Hanna Rue): Empirical evidence does not support male superiority in math or science. In fact, history suggests that the environment was the primary factor resulting in so many more males than females in math and science, with gender stereotypes leading teachers and mentors to encourage boys and young men to participate in math- and science-related activities. Given that behavior analysts understand how much adult attention and praise can shape behavior, it isn’t surprising that more men ended up in careers in science or math. That is all changing now, and I am thrilled.

A (Sabrina Daneshvar): Yes, research shows that boys and girls learn math at similar rates, but it’s the social expectation that boys are naturally better at math that can make boys perform better. Carol Dweck, who wrote the book The Growth Mindset, has done some interesting research in this area. Dweck found that girls who viewed math ability as “a gift” performed more poorly in math than those who viewed it as something they could improve through practice and experience. According to Dweck’s theory, when girls believe they can achieve in math by applying themselves, they can, in fact, achieve in math (and science, too).

Q: What advice would you have for girls or women who shy away from or just dislike or struggle with math and science?

Devon Sundberg(Circle) — Devon Sundberg – Consultant & Women in Behavior Analysis (WIBA) Conference Director

A (Sabrina Daneshvar): Math and science skills are a continuum. There’s a lot of variation in skill levels among various skill sets. For instance, someone might be great at data analysis and struggle with communicating findings or understanding the impact. I’m not the best of math, but I have a solid grasp of statistics and how to do a scientific study. My advice is not to be intimidated—and trust that you will have strengths in one area and limitations in another. And that’s OK.

A (Devon Sundberg): Math and science can make us more effective in the areas we care most about. I wasn’t excited about math or science until I realized these disciplines allowed me to do my job more effectively. At that point, math and science started to come naturally because they served a meaningful purpose in my life.

A (Hanna Rue): For young girls, I think it is important to find activities they really enjoy and discover how they connect to STEM. One of my favorite websites to recommend to parents is A Mighty Girl—it’s full of inspiring stories, books, and resources that focus on female contributions to science and technology.

Q: What advice would you have—for women and men, or girls and boys—about working in ABA? What, in your opinion, are some of the advantages of a career in the ABA field?

A (Hanna Rue): Anyone who finds human behavior interesting should consider a career in ABA. The technology of ABA can be used to address an endless number of socially significant behaviors. In fact, behavior analysts now work in fields that involve social justice, health and fitness, reducing waste, and safety.

The field of ABA is relatively young, and opportunities for research and discovery—and to advance our science—are endless.

A (Devon Sundberg): Join the field of behavior analysis, even briefly. In addition to making me more effective in all facets of my life, behavior analysis makes me a better human. Understanding why we behave in the ways we do leads to enhanced communication, grace, and acceptance of others. For these reasons, I hope everyone learns about behavior analysis throughout their life.

Addressing Health Equity in ABA Treatment Part I: A Black Mother’s Experience

Updated On June 24, 2022

LEARN is committed to fostering a culture that embraces what makes us each unique—be it race, ethnicity, gender/gender identity, sexual orientation, religion, national origin, disabilities/abilities, or socioeconomic background. LEARN aims to acknowledge the lived experiences and diversity of perspectives of our staff and welcomes our teammates to share their story to help foster conversations about diversity, equity and inclusion in our communities.

By: Asia Johnson, BCaBA, Autism Spectrum Therapies

Asia Johnson (she, her, hers) is an Assistant Behavior Analyst in AST’s greater New Orleans, Louisiana region and the co-chair of LEARN Behavioral’s DEI Employee Resource Group.

Walking on her tiptoes was interesting but cute. Rocking back and forwards raised my eyebrows. But the repetitive “I’m going to stop, I’m going to stop,” felt like weights pulling on my heart.

I had never heard the word autistic before. Little did I know that in a matter of months, the diagnosis of autism spectrum disorder (ASD) would be commonplace. I would sit in my living room with tears in my eyes and my phone in hand watching my daughter attempt to self-regulate. I felt helpless. For days this cycle would continue, leaving me uncertain if I was a good mother. I revisited each trimester of my pregnancy, actively attempting to re-evaluate anything I may have done wrong.

A mom of two with limited resources but a Medicaid card ready to go, I assumed it would be a walk in the park to get my daughter evaluated. I naively thought they would immediately tell me what was causing the concerns and provide tools to assist her. I imagined myself falling backwards into a hammock free from the weight of the world only to fall through the very net I assumed would hold me up. I was told there would be a nine-month wait before I’d receive a call about the evaluation. I was devasted. Even more, devasted to learn that if I had private insurance, I could have achieved a diagnosis in a few weeks.

As a Black woman who experienced medical malpractice during my pregnancies, I was on edge. I wasn’t sure I could trust clinicians to have my best interest at heart, let alone my child’s. With the pending evaluation, I wanted help but preferred help from someone who looked more like me. I kept wondering how a white female could relate to my child or me. Culturally we are different, from the way we comb our hair to how we greet another person.

When diagnosis day finally arrived, I was elated to put a name to all the restless nights. My daughter was diagnosed with autism spectrum disorder. I left that day with reassurance that I was indeed on the right track. But as I toured different facilities, I did not see anyone that looked like us. This feeling left me disappointed. No one in my family had walked this path, so I had no help with guidance or insight, but I was determined to obtain some help. As a parent, we are tasked with some minor and some major decisions to make on our children’s behalf; making the natural choice to seek applied behavior analysis (ABA) services was a significant decision in my eyes.

While I was grateful and relieved to finally have a diagnosis, I soon had a new concern. I quickly learned that the field of ABA lacked diversity within leadership roles. The most recent demographic data report by the Behavior Analyst Certification Board (BACB), reports 70.05% of certificants are white, with the remaining identifying as Latinx (10.56%), Asian (6.85%), Black (3.93%), Pacific Islander (0.38%), and American Indiana (0.28%).

My daughter’s primary struggle was with receptive communication. She could speak but would often talk at people. Her conversations would lead to questions she overheard on television: “Did you know your heart is located in your diaphragm?” However, my child was rarely truly interested in the actual response; if she was, she didn’t wait long to receive the answer before jumping in with another medically driven question. It seemed as if her focus was on the oohs and ahhs or the “wow, how smart” conversations that would follow.

ABA was described to me as a treatment option using empirical studies to promote behavior changes among people living with autism spectrum disorder (ASD). ABA included various treatment settings, and my daughter was provided two options. Option one was to have a behavior technician come into our home. The clinician explained how they would use ABA practices to decrease her comorbid diagnosis of sibling rivalry. Option two was an after-school social skills group to target her ability to reciprocate verbal responses when communicating with others. However, both did not resonate with my lifestyle nor my views as a Black parent, especially with the syntactic structures and linguistics I noted in our brief conversation. I often wondered if my family’s values would be accepted or would I have to have a practitioner come into my home and encourage their societal norms, and that was not something I was willing to accept. As a single mom, I also pondered how I would be able to bring my daughter to a social skills group while working a full-time entry-level job.

I wasn’t wrong to worry. Research shows that Black Indigenous Persons of Color (BIPOC) families and those of low socioeconomic status may encounter issues with inappropriate treatment delivery because of different cultural perspectives. I knew BIPOC families receiving treatment from white practitioners could often face implicit biases because of the country’s systematic racism, which frightened me. Unfortunately, the data says white clinicians are likely to make assumptions regarding treatment based on stereotypes and their own lived experiences, leading to inaccurate recommendations. So, I did not move forward with ABA services. I did not feel any facility I visited had clinicians who knew how to properly teach my brown-skinned child how to speak the English language, consistent with my families’ syntactic structures.

This pivotal moment in my life shifted my perspectives and my professional journey. I decided that I could (and would) become the Black clinician I once sought. My journey has been harrowing, and often times I still feel like I remain the elephant in the room. But today, there is a peek of light at the end of the tunnel.

When parents embark on a journey designed to make socially significant changes in their child’s life, resistance is likely to happen when approached by a white clinician – especially in southern regions. The south has been known for racial divides and limited resources for Black communities. Southern states have long represented large Black populations and are often referred to as the Black Belt. Nonetheless, Black patients continue to fight a battle for health equity and justice. ABA services are no different; the Journal of Autism & Developmental Disorders found that African-American children with autism were diagnosed an average of 1.4 years later than white children and spent eight more months in mental health treatment before being diagnosed.

BIPOC patients deserve support in their fight for equal services. BIPOC patients deserve consideration when formingeffective treatment plans. After a long road to a proper diagnosis, families should not face additional challenges in teaching their children the tools necessary for productive and responsible citizenship consistent with their cultures.

My goal as a clinician has always been to inform the world of societal differences that may impact treatment modalities. One example is the lack of acknowledgment often witnessed when practitioners teach verbal and behavioral skills. Often, Black individuals are forced to code-switch. When practitioners not familiar with the cultural nuances in language, work in some homes, they may dictate using what they are familiar with. Code-switching is exhausting, yet many Black individuals are forced to use the “standard language” society deems acceptable in a field focused on effective treatment. As a Black woman, I’m aware of this struggle (and have had to do it in my own life and work). I’m even more aware and conscious that it may be more challenging for those who are autistic to change their behavior readily, let alone the spoken language they are accustomed to hearing.

My experience as a Black Medicaid recipient who crossed various obstacles with my daughter’s diagnosis and treatment process encouraged me to seek out a company devoted to expanding diversity when I finally received my certifications. I am now a Black clinician striving for continued growth with ABA services in the south. I am hopeful for change as I continue to acknowledge cultural differences within my treatment plans.

LEARN pledges to create a community centered around trust, respect, tolerance, and empathy. Read more about LEARN’s DEI journey in our 2021-22 DEI Annual Report and find out how we are investing in our clinicians cultural competence and increasing the diversity of our clinical team. Together, we’re better.

Building Social Skills During Summer

Updated On June 16, 2022

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

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

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

Make Friends

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

Stay Mentally and Physically Active

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

Improve Motor Skills

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

Behavior Management

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

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

7 Tips for Creating Summer Fun For Autistic Kids

Updated On June 2, 2022

Summer is a few short weeks away! The joy of completing the school year also brings the challenges associated with unscheduled days, unpredictable new environments, and the unexpected elements of the season.

Here are seven helpful tips for planning your family’s summer that we hope will help create more fun and reduce stress:

1. Maintain Some Structure

Try to maintain your child’s typical eating and sleeping schedule as much as possible. It’s not easy to stick to a schedule during summer, especially as this is a time when you want to let go a bit and relax. If you can maintain the basic structure of your child’s routine with eating, sleeping, and some routine in the day, you are less likely to have an overwhelmed or anxious child.

2. Be Clear on Your Goals

You may want to create opportunities for your child to build social skills. Summer is a great time to enroll your child in social skills programs where they can participate in small-group activities and learn how to navigate relationships while receiving one-to-one support.

3. Prepare in Advance

Whenever possible, it can be helpful to familiarize your child ahead of time with the destination by using photographs, videos, etc. If your child has never flown or stayed in a hotel before, practicing these on a small scale can be helpful. Some airlines offer practice travel for families with autism. You may also want to visit a hotel room before an overnight stay.

4. Travel Safety

It‘s important to acquaint your family with your vacation details, such as where you‘ll be staying during your trip. If you are staying with family or renting an apartment or home, be sure to check that each door has a lock and that the perimeter of the house is secure. It’s also a good idea to familiarize yourself with other parts of the property, such as areas that have access to water and other roads. Knowing these will help keep your child’s safety top of mind should they explore the area.

5. It Takes a Village

While vacationing or sunbathing with friends or family, welcome them to become part of your team. By sharing your concerns and requests for support, your community can be mindful and diligent with any possible safety or wandering risks. Helping others understand how they can best support you and your family, can make your experience more relaxed and enjoyable.

6. Get Support from Your Team

Remember to use what works for your child while planning your family’s activities. If you‘re working with an ABA provider, ask for assistance with goals that support a specific outing or trip.

7. Don’t Forget to Have Fun!

Summer is the perfect time to maximize learning opportunities, access resources that may have been limited due to school schedules, and work on intensive programs that require a larger time commitment.

While that is all true, it’s still important to find time to have fun, enjoy the activities summer has to offer, and watch your child thrive!

Here are some additional resources to help make the summer season a success for the whole family:

Autism Speaks: Traveling with Autism
National Autism Society: Big Red Safety Toolkit – to prevent wandering
Pathfinders for Autism: Parent Tips: Summer Camp

Sensory Processing Issues and Summer: Sand, Sweat, Fireworks … Oh, My!

Updated On June 1, 2022

by Katherine Johnson, M.S., BCBA
Senior Director of Partnerships, LEARN Behavioral

Families everywhere are chucking backpacks and school shoes to the back of the closet and getting ready for some fun in the sun. While other members of the family enjoy themselves during the quintessential summer activities, sensory-sensitive kids may feel overwhelmed and uncomfortable. How can you anticipate problems and find solutions ahead of time, so your entire family can make the most of the summer?

Planning and Preparation

Last-minute plans, like any schedule changes, can be disruptive to children with sensory processing disorders and issues, so planning is key. As you map out your summer, think about the types of activities everyone will enjoy and how you can make those with potential sensory triggers comfortable for your child.

Start by looking for sensory friendly events on your local events calendar. Many communities host special events or days for sensory-sensitive kids, such as performances at theaters without spotlights, blaring music, and crowds, or trips to shopping malls without the usual mob of consumers.

Other ways to plan and prepare in advance include:

Calling facilities ahead of time to find out what days and times are less crowded
Doing a sensory analysis of stimuli your child might encounter on an outing to pinpoint potential triggers (noise, crowds, smells)
Helping your child “practice” the sensory experience in advance (e.g., applying sunscreen to a small part of the body and increasing the amount daily until your child gets used to head-to-toe coverage)
Arranging an “out” for your sensory-sensitive child (e.g., creating a Plan B for your overstimulated child, in case Plan A doesn’t work)

Clothing

Clothing and sensory issues go far beyond tag removal. Summer clothing can make or break an outing. The wrong clothes can be a source of irritation, but the right ones can offer protection from other sensations your child may not like.

If your child takes time to get used to wearing shorts and short-sleeved shirts, buy some long sleeves and pants in light, natural, breathable fabrics to ease the transition. Likewise, keep in mind these tips about swimsuits, which can cause all kinds of sensory-related problems:

Tight straps, elastic waists, tags, and ruffles can make swimsuits itchy and uncomfortable. Have your child try a variety of styles to discover the best fit.
Consider shorts-style suits for girls, which can avoid sand inside the suit from sitting.
Getting used to a wet suit can take time. Help your child grow accustomed to it by taking baths or showers in the suit ahead of your day at the pool, lake, or beach.

And don’t forget about shoes. The right shoes can help your child avoid the sensory discomfort of walking on sand, grass, and rocks. In addition, flip-flops can irritate some kids’ toes. For an alternative, look into plastic clogs, slides, or different types of water shoes.

Sun

When spending time in the sun, make sure your child drinks enough water and takes some shade breaks, while watching out for signs of overheating. Also realize that sunglasses are a must for light-sensitive kids. In fact, if your budget permits, buy multiple cheap pairs at the beginning of the summer, so your child never goes without.

When it comes to sunscreen, know that it is essential but, just like bug spray, can be greasy, sticky, creamy. What can help?

Try out different types of sunscreen and bug spray to find what’s most acceptable to your child, including sprays, wipes, and unscented versions.
Consider using a color-fading sunscreen, too, which fades in color as the lotion is absorbed—and disappears when your child is protected from and ready for the sun.
If your child finds pressure relaxing, use the application of sunscreen as an opportunity for a massage.
When bug spray is necessary, find a combination bug-spray/sunscreen so only one application is necessary. Alternatively, you can apply bug spray to their clothing before they put it on.

Water Fun – Beaches and Pools

Most children love to get in the water. Some of the sensory experiences that go along with it, like sand and chlorine, are less welcome. Protect your child’s beach towel from sand by placing it in the center of a fitted bedsheet with weights on each corner. Also apply sunscreen before getting to the beach to avoid sticky sand that won’t come off. To remove sand from skin quickly, rub a little baby powder on the area.

Chlorine in pools can be another problem for kids with sensory sensitivities. Nose plugs and goggles that cover the nose can help with the smell. If your child has chlorine-sensitive skin, consider a salt-water pool—or, if possible, stick to lake and ocean excursions. And, of course, remember to take extra precautions to help your child stay safe around water and while swimming.

Parties, Parades, and Car Trips

If parties, parades, and car trips are on your agenda this summer, you’ll want to plan ahead as much as possible to deal with the stimulation. Noise-cancelling headphones can be a life-saver not only in the car but also at parades, fireworks displays, and in many other situations. If your child gets carsick, avoid the rear seats of busses and backward-facing seats, and keep ginger candy on hand (real ginger, not ginger-flavored) to ease nausea.

With summer, of course, comes pesky bugs like mosquitoes and gnats. Carry along an anti-itch stick or cream, in addition to band-aids to cover bites. No one likes to feel itchy, and for sensory-sensitive kids, itchiness and the urge to scratch can feel even worse.

Having an overresponsive sensory system does not mean that summer activities must be missed. With a thoughtful plan that includes carefully-selected activities and the right supports, your entire family can get some rest and relaxation—and enjoy a delightful summer and school break.

For more tips on making the most of summer, read “Transitioning to Summer: 5 Tips to Make It a Success.” And if you’re looking for an autism provider with the ability to tailor treatment to the unique needs of your child, reach out to us at 1.877.576.4824, or fill out and submit our form.