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Why Adherence to Your Behavior Analyst’s Clinical Recommendation is Critical to Success

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Parents and caregivers will do just about anything to provide for their children’s needs and requirements.  Unfortunately, for those whose children require additional supports and services, this can feel nearly impossible. For parents and caregivers of children on the autism spectrum, who are already struggling to meet the demands of their schedules and responsibilities, the added time and energy required to support intensive weekly ABA therapy hours can be difficult and overwhelming. The result is quite often a compromise on therapy hours which can seriously impact the child’s progress.

What commonly occurs in autism services is parents will seek ABA therapy for their child, knowing that it is considered the gold standard for autism intervention with decades of research and evidence to support its efficacy. As part of this process, the ABA provider will observe and assess the child, as well as interview the family to determine their recommendation for weekly hours of ABA services based on the child’s needs, age, and other determining factors. What we commonly see, however, is families not making their children available for the recommended hours. While not being able to reach the clinically recommended hours is affected by multiple factors such as family schedules, staffing issues, sickness, weather and other extenuating factors, lack of access to the child often accounts for anywhere from 5-40% of weekly clinically recommended hours not occurring.

Families who do this are typically trying to compromise between their child’s needs and the demands of their other responsibilities—and managing and navigating the needs of a child with special needs alongside all the competing needs and requirements of daily life is challenging. However, if one looks at this objectively, it is akin to getting a prescription from a doctor and telling the pharmacist to only give you part of it. Most families assume that with fewer hours per week, their child will still progress and learn new skills but at a slower pace. Unfortunately, this is not necessarily the case.

It is true that ABA therapy is unique in its intensity, but this is a core component of why ABA is so effective. ABA is effective at helping a child catch up to and develop alongside their chronological age when the recommendation for frequency and intensity of services is adhered to. There are decades of research to support the efficacy of ABA at teaching the skills necessary for communication, social interactions and self-management. In a recent research study which included 1,468 children with autism ranging in age from 18 months to 12 years old, treatment intensity and duration were both significant predictors of mastering learning objectives and goals across eight domains of functioning (academic, adaptive, cognitive, executive function, language, motor, play and social). Similar findings have been reported from other researchers over the decades. Overall, studies have strongly indicated that treatment intensity has significant positive effects on individual progress and the acquisition of skills.

Intensity or “dosage” of treatment will vary by client and should always be individualized to the child’s needs and goals. Generally, for children under the age of 5, more intensive hours are recommended to capitalize on the intensive brain growth during the first 5 years of age and to stimulate a child’s brain before children enter Kindergarten. Once a child is engaged in learning at school at least 3 hours per day, treatment recommendations generally include 15-20 hours per week. Again, recommendations for intensity and duration of intervention should always be based on a detailed assessment of your child’s needs, level of functioning compared to other children of their current age, and your child’s individual goals.

It’s very important that parents and caregivers of young children with autism spectrum disorder understand that ABA is the gold standard of treatment but is only most effective when the program recommendations are adhered to entirely. The structure and design of an ABA program is essential to its outcomes. While it is understandable that parents are trying to do their best to meet the demands of their family’s schedule, it is vital to consider the research when making decisions regarding how to prioritize interventions. Finding that extra time every week to ensure that your child is receiving their recommended amount of ABA can make a huge difference in their life and yours.

Neurodiversity: What It Means, Why It Matters

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BY RONIT MOLKO, PH.D., BCBA-D
STRATEGIC ADVISOR, LEARN BEHAVIORAL

If there is one enduring hallmark of the American experience, it’s the immense diversity found within our expansive borders. Most of the time, we perceive diversity via differences in skin color, language, clothing, places of worship, or even the foods people eat when gathered around the table with their families. There is, however, one major aspect of diversity that is often overlooked—one that comes as no surprise, considering it cannot be detected solely through visual means. I am, of course, referring to neurodiversity.

Coined in the late 1990s by sociologist Judy Singer—who is on the autism spectrum—neurodiversity is a viewpoint that characterizes brain differences among individuals as normal, rather than as a disability. This viewpoint reduces stigmas around learning and thinking differences, while calling attention to the ability of neurodivergent communities to benefit from multiple perspectives and make greater contributions to society. Central to the movement is a rejection of the idea that these unique individuals need to be cured or fixed. Instead, it’s held that people possessing different types of brains need to be embraced and provided support systems that allow them to participate and contribute as members of the community to the best of their ability.

Grounded in Science

Unsurprisingly, the foundations of this not so new movement are grounded firmly in science and empirical study. By leveraging MRI results from hundreds of individuals, researchers have been able to compare the brains of people diagnosed with learning differences to their counterparts. So far, studies have shown that the brains of neurodivergent individuals are, in fact, unique. For example, the part of the brain that maintains language processing works differently for people diagnosed with dyslexia. Additionally, the prefrontal cortex, which manages executive functioning and attention, develops much slower in children diagnosed with ADHD. In other words, these individuals are not necessarily operating with a learning deficit but rather possess brains that are literally wired differently.

A Neurodiverse Population

Whether a group of kids recently diagnosed with autism or adults still grappling with ADHD or dyslexia, the American neurodiverse population is quite substantial. According to a 2021 report from the Center for Disease Control and Prevention, one in every 44 children in the United States is diagnosed with some sort of autism spectrum disorder, and an estimated 5.4 million adults—or roughly 2.2 percent of the entire population—fall somewhere along the spectrum. Many people on the spectrum have contributed (or still do) to their communities every day, such as Albert Einstein, Anthony Hopkins, Henry Cavendish, Greta Thunberg, Jerry Seinfeld, and Elon Musk. They have been among the world’s highest achievers, impacting the arts, sciences, technological innovation, and activism.

In much the same way as the neurotypical population, the neurodivergent population is broad, diverse, and multidimensional. It’s crucial, then, for the public not only to embrace their different brethren but also to actively promote opportunities for them both in society and in the workplace at all abilities and levels.

Fortunately for society writ-large, corporate America is starting to take notice. A recent article published in the Harvard Business Review named neurodiversity as a bona fide “competitive advantage,” noting the unique and, often, incomparable output provided by atypical members of their workforce. Numerous companies, including Hewlett-Packard, Enterprise, Microsoft, SAP, and Ford, have recently begun to reform their HR practices in an effort to expand neurodiversity in their ranks by identifying, hiring, and empowering these unique individuals. The results, so far, have been outstanding, with managers noting legitimate “productivity gains, quality improvements, boosts in innovative capabilities, and broad increases in employee engagement.”

Diversity of all kinds, including neurodiversity, strengthens our daily institutions. Just as we are seeing a focus on diversity, equity, and inclusion (DEI) in employment and other areas of life and commerce, we must also remember that recognizing and celebrating differences, promoting justice and fairness, and ensuring true support and inclusion applies not only to people with observable differences but also to our neurodiverse populations. Not all cognitive differences are visible, and it’s crucial to keep in mind that there’s more than meets the eye when it comes to true diversity.

In another blog post, Dr. Molko explains the history and evolution of applied behavior analysis (ABA) therapy. Read the story.

6 Calming Activities for the Hectic Holiday Season

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Navigating the world of autism can be especially hectic during the holidays. While you juggle your to-do list, you may also be wondering how in the world to make this the most wonderful time of the year for your special-needs child. Sometimes, that magic is hard to create. Sometimes, it’s downright impossible.

But that’s all right. Take it from moms who have been through it. There are practical ways to handle the parts of the holidays that could lead to sensory overload for your child. Enjoying the holidays with a child on the autism spectrum starts with having a plan. You need real-world solutions. Here are some practical calming activities that may work for you.


1. Pack a bag of tools and toys.

 The first activity is up to you. In the scouting spirit of “be prepared,” come up with your emergency kit you can take with you. Think of it as your bag of tricks. It’s not just a big purse full of random items. It requires thinking about what you really need to have on hand to soothe or occupy your child’s attention. Some people call it a calm-down kit.

 In her blog, Word to Your Mother, Heather Burnett says the first time her son, who has autism, had a meltdown in public, she also melted down.

 “Nobody told me what to have on hand that may help,” she wrote, “and nobody offered us a helping hand the first time we experienced a public meltdown. I felt hopeless and angry — and entirely out of control.”

 She found nothing in her purse to distract her son, but the experience made her change what she carried with her. She discovered certain toys or food were good to have on hand in case of a meltdown. Kits might include noise-canceling headphones, crunchy snacks, fidget toys, or bubbles.

 “I’m not going to lie to you and say all of these items will work,” Burnett writes, “but they are worth trying.”

2. Give your child a blanket, a book, and a quiet space.

 In Chattanooga, Tenn., Bria Jones knows when her toddler daughter, who is on the autism spectrum, needs a calming distraction, a comforting object or quiet time might help. Jones’s bag for her daughter, Anavi, includes a maroon throw blanket that Anavi loves.

 Anavi can’t verbalize what she wants, so Jones tries to anticipate her needs. Sometimes, Anavi is just hungry, thirsty, needs a diaper change or a nap. Sometimes, it takes a little more to calm her. Jones knows Anavi likes it when she rubs her feet. Sometimes, she just needs quiet, maybe a board book, and a few minutes left alone. Often, that’s enough to soothe her.

 Jones doesn’t claim to have the answers about avoiding meltdowns. She is learning as she goes. Her daughter is in a therapy program, and Jones seeks support from other moms of kids on the spectrum.

 “I don’t know it all,” she says. “I just knew my daughter was different.” And she’s learning a new way of parenting to meet her needs.

 

3. Take a bath, a walk, or make Play-Doh animals.

 Alix Strickland, an applied behavior specialist and founder of the Le Chemin ABA Learning House in Paris, France, says in addition to a calm-down kit, calming activities can help kids feel better as well. Depending on the age, she recommends drinking a glass of water, going for a walk, taking a nap, or taking a bath.

 Each of those things can distract your child, change the situation, and remind them of a familiar routine that they may crave. Preschoolers might like animal Play-Doh mats, Strickland says in her blog. She creates zoo-themed mats that have pictures of animals. She says parents can teach their kids how to roll noses or other shapes and put them on the mat. The sensory activity is something many of her students love.

4. Give your pre-teen an exit strategy.

 For older kids, a good calming activity may be coming up with a “secret code” that lets you know your child wants to leave a social situation.

 “Your kid may be eager to participate in social situations (like a birthday party) but feel anxious about what to do if it gets too overwhelming,” blogger Clara Muriel writes in Very Special Tales, a blog about parenting kids with special needs. “You can agree, for example, on a short-time attendance, a ‘secret code’ to let you know your kid wants to leave or agree on a phone call to be picked up.”

 Kids aren’t always sure how new situations will work and what rules apply when they don’t have a clear routine in place, Muriel writes. So, teaching them how to plan for a social situation by giving them an exit strategy may give them some control over the situation, she says, and make an outing a success.

 

5. Try yoga, martial arts, archery or horseback riding.

 Shelley Brewer, the blogger behind STEAM Powered Family, found plenty of calming activity ideas when her kids were young, but as her boys got older, she had to come up with her own. While she still finds things such as stress balls and essential oils useful as calming tools, she’s looked to other things to meet sensory needs for older children, tweens, teenagers, and adults.

 She says just a few minutes of yoga a day can make a difference, while something like martial arts can build strength, routine, and calmness. She has also tried activities that build body awareness, such as archery, or activities that have lots of sensory inputs, like horseback riding.

 “In the end it’s about finding what is right for each individual,” she writes, “and sometimes, that involves lots of trial and error. Also, what doesn’t work at one age, may be a great fit at a different age.”

6. Download a meditation app.

 No matter your child’s age, meditation apps developed for different age groups may be a solution for times that call for a little calm. Some teach kids specific relaxation techniques, like the cartoon-based Chill Outz, an app for kids as young as 3 and up. The characters in this app tell stories and teach kids how to relax by humming, focusing on breathing, relaxing tense muscles, or getting ready for bed.

 Other apps, like MindShift, can bring anxiety relief for pre-teens or even adults. It’s meant to develop helpful ways of thinking about things such as sleep, riding out intense emotions, dealing with social anxiety, worry, panic, or conflict.

 Another, Headspace, offers guided mediation and mindfulness for a range of ages. It focuses on improving focus, exercising mindful awareness, and reducing stress. You can find each of these apps in the App Store, where you can read more about them and follow the steps to download and use them.

 

Experiment to find what works for you and your child.

 There’s no magic wand for making your holidays especially magical. Whether you try sensory toys, yoga, or meditation apps, experimentation may offer a solution for your situation. Not every strategy will work for every child.

 Calming activities that worked for the moms in this blog have something in common – they’re all practical ways to help kids relax and unwind. Whether you’re in the toddler stages of the autism journey or raising young adults, what works for you one day may be different than the next. Trying activities like these may give you a better sense of what will calm your child — and yourself.

Learn more about making the holidays successful for kids on the autism spectrum.

6 Ways to Celebrate the Winter Solstice

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Winter solstice, the day “the sun stands still,” marks the longest night and shortest day of the year. It’s the day with the least amount of sunlight, and it’s the day when the North Pole is tilted farthest from the sun. For those of us in the Northern Hemisphere, winter solstice falls on Dec. 21, the official start of winter.

Just the idea of so much darkness may make you want to stay inside and hibernate. But around the world, it’s a day crowds go outside to celebrate the “turning of the sun.” Many see the winter solstice as a day of rebirth or a celebration of light, as British author Susan Cooper captures in her poem “The Shortest Day”: 

And so the Shortest Day came and the year died
And everywhere down the centuries of the snow-white world
Came people singing, dancing,
To drive the dark away.
They lighted candles in the winter trees;
They hung their homes with evergreen;
They burned beseeching fires all night long
To keep the year alive.

EMBRACING TRADITIONS


For centuries, cultures around the globe have turned winter solstice into a time of celebration. Some use this time as a countdown to Christmas. Some bring their own light to the night, with fires, candles, and music. Others look to the day as the end of darkness and the start of the new year, when days will begin to have longer periods of sunlight.

If you’re looking to start a holiday tradition with your kids, the winter solstice has many teachable moments. Whether you want your kids to learn about the tilt of the sun, the theme of death and rebirth, or about how Stonehenge is aligned to the sunset on the winter solstice, this day offers a lot to explore.

Families and kids of all temperaments, interests, and abilities can share in the spirit. While the holidays can bring stressors for families with children on the autism spectrum, you can get the whole family involved in traditions that bring joy. Here are some ways you can make winter solstice traditions your own:

 

1. MEASURE THE DAYLIGHT

 Winter solstice can be a reminder of our connection to the natural world. This is a good time to get in touch with nature’s cycles. The solstice doesn’t have to be a bleak reminder of darkness. Entire festivals revolve around celebrating it as the day the sun begins to return to us.

 Take your kids outside and look at the sky. You don’t have to wait until the solstice to start recording sunset times. You can graph these and calculate the total sunlight for each day. When the graph is complete, you can ask your kids if they can see whether the days are getting longer or shorter. The winter solstice has about half the daylight as the summer solstice. Where does your city stack up in terms of hours of sunlight?

 

2. MAKE A WREATH

 Some holiday traditions, such as hanging mistletoe and wreaths, have roots in pagan solstice rituals. Even if you aren’t religious, you can make a connection to nature.

Go outside and collect holly, ivy, evergreen boughs, and pinecones. These are meant to symbolize everlasting life, protection, and prosperity. You can use them to decorate a table or mantle or make a wreath. Your treasures could even become gifts for loved ones.

 

3. PREPARE A FEAST

One tradition that overlaps many cultures is to celebrate the solstice with a winter feast. Since the winter solstice falls at the end of the harvest season, families have long celebrated with an abundance of in-season food. Get the kids involved in the kitchen by letting them help prepare the family meal.

The recipes you prepare could become family traditions by themselves. Maybe it’s grandma’s mashed potatoes or aunt Rachel’s perfect pumpkin pie. Getting ready for the feast could become as much of a tradition as the meal itself.

 

4. DINE BY CANDLELIGHT

You can create your own festival of light. Bring some light into the darkest night of the year by lighting candles. You can make it a ritual by adding another step.

The extra step could be coming up with something to say as you light your candle. Get everyone involved by making resolutions and saying them out loud as you light a candle. Your intention could be something as simple as a wish you want to come true in the new year. Then try dining by candlelight.

 

5. BURN A YULE LOG

 Lighting a “Yule log” fire is a Nordic tradition that goes back before medieval times. During the longest nights of the year, they would decorate and hoist a large log (sometimes a whole tree) into the room and feed a fire through the 12 days of Christmas. Those who helped were said to bring good luck into the new year. Your “Yuletide” tradition doesn’t have to involve dragging in an entire tree. Your tradition could be having a bonfire in the backyard or placing a log in your fireplace as you tell the Yule log story of days of yore.

 

6. CELEBRATE THE LIGHTS

 If you’re ambitious and outdoorsy, you can take the opportunity to walk around and see the holiday lights decorating your area. Or you can pile in the car and go on a drive to see the best light displays in the city.

 Embracing ways to celebrate light can bring joy to the season. A short car ride to a holiday display could be the right amount of time to feel festive, without feeling overwhelmed.

No matter how you celebrate the solstice, use it as a way to replace winter doldrums with a sense of renewal. The winter solstice may signify the day the sun rises lowest in the sky, but it’s also the day before we start growing closer to days of more light.

 

Looking for other fun holiday traditions and activities to try with your child? Learn about holiday gifts you can make with your child.

Make the Holidays Successful for Kids on the Autism Spectrum

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It’s beginning to look a lot like that time of year when your list of things stressing you out is as long as your shopping list.

Keeping the magic alive during the holidays for families living on the spectrum may mean taking extra time to look at the season through your child’s eyes. Maybe your notions of holidays past belong in the past because those traditions no longer work.

For families dealing with autism, the key to a successful holiday season may lie in your ability to adapt to what works now, even if it’s unlike the holidays of your youth.

1. Talk to your family about what to expect.

Not everyone knows what it’s like to face the holidays when you have kids on the spectrum. When Holly Bird’s grandson was a toddler, her extended family just kept saying her grandson was in his “terrible twos” when he would act out. Her grandson wasn’t diagnosed with autism until he was four. But it was clear from his early days that he would not experience the holidays like the rest of the family, she says.

“It took us a while to get the rest of the family to understand,” says Bird, a retired health counselor in Arizona who writes a blog about her family’s adventures. Her family advised her to utilize disciplinary tactics like “time out” to get her grandson to listen, Bird shares.

It took some communication to get everyone on the same page about how to make holidays successful for the entire family.

“The biggest thing we try to do for the holidays is to make sure the family knows that when we’re together as a family, it isn’t all about the child with autism” and the whole family responding to the child’s behavior, she says. “It’s all of us being calm and …  him just being able to do what he regularly does” in his normal routine.

Bird communicates with family members who are coming in from out of town with a phone call, email, or text message to let them know how they can adjust for her grandson’s special needs.

Katie Koole-McCurdy, a Michigan mom who has two boys on the autism spectrum, started writing about life on the spectrum while preparing for a family reunion several years ago. She experienced the same feeling about needing to communicate what was happening.

Her oldest was three at the time and had sensory issues and needs beyond what her family had experienced.

“I was like: I’m going to go to this family reunion. I’m going to get all these questions, or they’re going to judge that my kid is acting very differently than what is typical,” Koole-McCurdy says. “I have no shame in this. I’d rather just explain to everyone what’s going on.”

Seven years later, she still runs The Maseman, “the musings of two normal parents to two normal boys. Because normal is relative.”

 

2. Change your own expectations.

Successfully handling holidays can start with changing your own expectations of what the holidays should be, Koole-McCurdy says.

“Sometimes, you have to say no to things, and it’s hard,” she says. Sometimes, when she knows they’re invited to a house with 30 people where her boys are going to be expected not to touch anything, it might not go well. So, she might opt out.

“I can’t expect my kids to do things that they’re not able to do,” she says.

Bird knows the struggle.

“It is hard,” Bird says, “because people’s expectations of the holidays have been pounded into our heads for so many years.” Families coping with autism can’t do things the way things have always been done, she says. And that’s OK.

3. Choose the traditions you want to keep.

Expectations also include knowing what’s important to you as a parent, Koole-McCurdy says. She wanted her children to be able to enjoy some of the same family traditions she enjoyed as a child. She had to take time to process and figure out which traditions would work for her kids.

Before kids, she thought she couldn’t wait to try the Elf on the Shelf® tradition of setting a magical elf around the house. After having two boys with autism, she realized that was something they wouldn’t understand.

 But she discovered her 10-year-old loves helping to put up the Christmas tree.

“So, we make that time a really special time,” she says. “It’s not something for me that I really cared about as a kid. It wasn’t a big tradition. But my one son really likes that.”

4. Don’t force-feed holiday foods.

Sometimes, Bird’s family orders pizza for the kids’ table to remove some of the stress that comes with family dinners. Her grandson is partial to simple foods, so they don’t make a big deal about it.

“If he eats chicken nuggets for dinner, he’s going to have chicken nuggets for dinner on Thanksgiving night,” she says. “We’re not going to force him to eat something because Aunt Sally brought it and it’s everybody’s favorite dessert and he has to try it. He’s not going to try it. It’s no different than a regular day. He just knows there’s more people around, there’s more noise, and there’s more aggravation.”

5. Have a settle-down spot.

Bird noticed that in her grandson’s school, kids with autism gravitated toward beanbag chairs that were set up in spaces made to help kids calm themselves.

“We’ve started doing that at home,” Bird says, “where there’s an area where if my grandson or one of the other kids feels that they’re angry, they can go sit there and think about it. There’s no tablets, no nothing. They can just sit there and then come talk to me about it. As parents and grandparents, if we could listen more with our eyes and pay attention to what the children are trying to say to us, it would be easier for all of us.”

 

6. Keep something tangible on-hand for your child.

For Koole-McCurdy, a go-to item such as a push-pop sensory fidget toy for her younger son is a good distraction. For her older son, who’s less verbal, she brings an iPad.

Before she was a mom, she might have thought letting a child use an iPad at a party would be rude. She’s let that mindset go.

“I have to understand where my son is at,” she says. “He doesn’t have back-and-forth communication skills. For him to go to a setting with a lot of people, he’s not going to converse. It would be so unrealistic for me to have an expectation that you have to sit here and act a certain way when you don’t have the skills to be able to do that.”

 

7. Be mindful of noises.

 Sometimes even the sound of unwrapping gifts can be annoying for a child with autism.

Bird recommends games such as seeing who can unwrap presents the quietest. She also tries to help her grandson understand that loud noises usually do not last a long time. And she knows when it’s time to get the headphones out and let her grandson block the noises.

“If it’s in the middle of dinner, give them their headphones,” she says. “Make it a great day for everybody. Don’t worry about what your family is thinking. Worry about when everybody leaves, and you walk out that door from the holiday, that you guys have had a great day.”

 

8. Don’t forget to count your blessings.

So much about making holidays successful is meeting kids where they’re at and starting things small, Koole-McCurdy says.

She doesn’t force her kids to do things they don’t like. She gives them breaks. She gets behind the things they love, like decorations. And she finds things in the community, such as a lights and decorations display they can see from inside their car. She sets an appointment to see the Sensory Santa at the mall and adapts holiday traditions to her family’s needs.

“What’s best for our family is that we’re all in a happy place,” she says.

 Flexibility and patience are good gifts to have for yourself, Bird says. They help reveal what the holidays are all about.

“Don’t worry about spending money,” Bird says. “Don’t worry about anything. Just remember that you’re fortunate. We’re blessed to have the holiday and to have these kids in our lives. Because, you know, they’re pretty special. They really are.”

 

To find traditions that may work for your family, consider something tangible. Browse ideas in “Holiday Crafts to Make with Your Child” and “Making Holiday Baking a Success.”

Why Gratitude Matters, and How to Foster It in Kids with ASD

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There’s a science behind thankfulness. What researchers are learning about gratitude is that it can be transformative for families, neighborhoods, schools, and workplaces. And it can be good for kids.

At the University of California at Berkeley, scientists at The Greater Good Science Center study social and emotional well-being. In 2014, they launched Expanding the Science and Practice of Gratitude, a multiyear project studying gratitude.

“Studies have consistently found that people who practice gratitude report fewer symptoms of illness, including depression, and more optimism and happiness,” notes the book The Gratitude Project: How the Science of Thankfulness Can Rewire Our Brains for Resilience, Optimism, and the Greater Good, by Jeremy Adam Smith (New Harbinger Publications, 2020).

Families of kids on the autism spectrum have taken note. Some say there’s a misconception that people think kids and adults with autism lack empathy and struggle with anything in the social-emotional realm. They counter that there are things families coping with autism can do to cultivate gratitude in their kids and make them feel included. And they say Thanksgiving is a good time to put those strategies into action.

THE FOUR ASPECTS OF GRATITUDE

Some of those strategies are about modeling behaviors for your kids that they can understand. Researchers at the University of North Carolina at Greensboro say parents can teach their children about expressing thanks in a meaningful way by focusing on:

·      NOTICING things in your life that make you grateful

·      THINKING about why you have those things

·      FEELING grateful for your gifts

·      DOING somethingto express your appreciation

In the study, parents reported on how often they saw these four types of gratitude in their children. They started with helping kids simply notice gifts, and then helping them make sense of their thoughts and feelings about specific gifts. Parents reported that actions to show appreciation really made an impact on kids.

“What children DO to show gratitude won out over what they NOTICE-THINK-FEEL,” the researchers found. “These findings suggest that there are opportunities for fostering gratitude in children that many parents have yet to tap.”

The study’s researchers concluded that asking questions about what you NOTICE-THINK-FEEL and DO when you receive a gift can help kids learn not to take things for granted. Parents can teach this concept by recognizing kindnesses and showing kids how other people feel when you express thanks in a real way.

FOSTERING GRATITUDE

Georgia mom Shanita Swanson connects with the idea that actions are more important than words when it comes to fostering gratitude.

Something another woman told her when her son was young still sticks with Swanson, an emergency medical technician and autism awareness advocate in Conyers, Ga., who raised a son on the spectrum.

“She said: ‘Never treat your son like he’s any different than anybody else,” Swanson recalls, “because if you do, you won’t do anything but hinder him.”

Though her son passed away two years ago when he was 19, Swanson spent years helping him grow to love celebrating Thanksgiving. She took him with her to feed the homeless. She let him help in the kitchen. And she kept her cool through occasional meltdowns.

“They might not be able to do everything,” Swanson says, “But you find something that they’re good at and let them participate in all the family events where they feel included. I think that helps with their empathy and shows them what they’re thankful for. We can teach them how to appreciate certain things. Let them know that they’re included, instead of thinking they can’t help do something.”

MORE THAN WORDS

Raising grateful kids means more than teaching them polite responses like “please” and “thank you.” Even if kids on the spectrum have trouble understanding some emotions, they may be able to understand how showing appreciation makes other people feel, the Child Mind Institute says.

Demonstrating that idea could mean finding other ways to say thanks, whether it’s drawing a picture for Grandma or bringing cookies to the fire station. Days like Thanksgiving can be a good time to help kids put things into perspective, develop compassion, and turn interests into action.

Learn more about making holidays a success with our blogs on holiday baking and helping kids through meltdowns.

How to Help Your Child Through a Meltdown

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by Bradley Ross, M.A., BCBA, LBA
Assistant Clinical Director, LEARN/AST, Louisiana

There is no “one-plan-fits-all” approach for handling meltdowns. When children with autism hit sensory overload, their reactions can be intense, and knowing how to respond thoughtfully in the heat of the moment can be challenging.  

Unfortunately, there is no magic wand to make meltdowns go away. But there are tactics and strategies to help tame a meltdown when your child feels overwhelmed. The key is to stay calm and work your way through it.

Assessing the Situation, Identifying the Triggers

One thing that can help is to understand the reason for the meltdown, while recognizing that reasons can vary greatly from child to child. For instance, your child may not want to do certain tasks. They may be nervous about school. They may get embarrassed about underperforming, when compared to peers. Or they may struggle with separation from mom or dad.

Some kids have meltdowns because of environmental factors like room temperature, new students, or how the desks are set up in the classroom. Even small changes in the environment can lead to lead to intense feelings—rearranging furniture, for instance. Take note of the time and place of the meltdown and factors that might be overwhelming. Once you identify the trigger, you can see if there is a way to avoid it.

If your child can have conversations, try to discuss and get to the root of the problem. This can also help you identify patterns of behaviors to address. If your child is unable to have a conversation or communicate verbally, pay attention to other communication cues to try to better understand the problem.

Knowing the cause of the behavior isn’t mandatory, but it is helpful in knowing how to address it. In some cases, you can eliminate the trigger. Other times, you just have to wait it out and  give your child space to rest and recover.

Home-Based Strategies

One way to make your expectations clear is to create a token/reward system at home. For example, you can create a chart on which you and your child come up with and list desired behaviors. Use pictures instead of words if it helps your child understand your expectations. Talk out loud about your goals and the rewards your child can expect for meeting those goals. Remember: the rewards don’t always have to be tangible items like a pack of gummies or a cup of hot chocolate. Rewards can also be experiential, such as playing a special game before bed, reading a favorite book, or baking a tasty treat together.

As you work with your child to create your list or chart of behavior goals, consider these possibilities:

  • Turn-taking: Here, you can explain that you and your child are going to sit down and play with toys. After a minute, ask your child for a turn with their toy. If your child gives you a turn, they can earn a token/reward.  

  • Sportsmanship: Play a game with your child. Ask them if they want you to let them win the first game. During the second game, let them know you’re going to try to win. Tell them that if you win, and they tell you “good game,” while keeping a happy face, they will earn a token/reward.

  • Doing work: Let your child know that in two minutes, you’re going to ask them to pick up their crayons. If they pick them up quickly, they can earn a token/reward.

Start with easy goals. Over time, you can provide less warning and make these more natural,  everyday interactions.

Understanding What Happens at School

Targeting meltdowns at school can be more difficult since you aren’t there. If your school has a reporting system to give you a sense of your child’s behavior each day, that can help you measure progress.

For example, some schools use a color scale: green equals good behavior; yellow is slightly disruptive; and red is a meltdown. If your school does not have a behavior reporting system and you think your child could use one, talk to your child’s teacher.

You could include behavior reports from the school in your token/reward system at home—or even set up a separate system based on these reports. For example, a green mark at school could equal an hour of TV time or three tokens, while a yellow mark could equal 30 minutes of TV or two tokens, and a red mark could equal 15 minutes of TV or one token.

You’re probably wondering, “Why reward a red score?” The reason is to reward your child for the positive behavior—bringing home the report—and to avoid taking away everything. For instance, if they think they will lose every privilege, this can increase the chance of a meltdown at school. Remember that you’re creating a reward system, not a punishment system. Focus on reinforcing positive behaviors, without being too harsh when there is a meltdown.

Also realize that reports you receive from school—or from your child or from your own observations, for that matter—are not a complete representation of the situation. Typically, a number of factors contribute to the situation, and behaviors that happen at school (or anywhere else, such as at the doctor or on the playground) can change according to the environment. Be careful not to make assumptions about solutions that may not work in every environment.

Stick to Your Rules, Celebrate Small Victories

Once you set the rules, stick to them. Avoid bartering. This system holds your child accountable and can begin with goals that are easy to reach. Accept that kids will make mistakes and that all kids engage in meltdowns from time to time. Remember to stay calm and keep your cool—these are key to addressing your child’s behavior successfully.


Start with small goals and set realistic expectations—the first one being: your child’s meltdowns will not stop at once. This is a process that will happen slowly over time. Track your progress, and celebrate the little victories when your child reaches behavior goals.

Looking for more strategies on raising kids with autism? Learn how a “calm down kit” can help your child through the hectic holiday season.

Autism and Siblings: Tips to Help Your Neurodivergent and Neurotypical Kids Get Along

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

All sibling relationships have their ups and downs. Siblings are our first friends, our childhood tormentors, and our longest-lasting connection. With a shared childhood, siblings can often understand each other better than anyone—including how to push each other’s buttons!

These hallmark features of sibling relationships remain true when siblings have different neurological profiles—for instance, when one is autistic and the other not. But there can be additional complexities that make fostering a healthy sibling relationship a bit more work. Here are some tips for nurturing a loving, supportive relationship between your children, when one is autistic, and the other is not.

Use attention-prevention.

Ease the inevitable sibling jealousies by carving out one-on-one time for each child. Neurotypical children may feel unseen as troupes of family members and specialists focus on their autistic sibling.  Special “dates” in which they’re the center of attention can help. But you’ll want to carve out intentional time with your autistic child, too—time not spent shuttling to therapies, teaching, or managing behavior but simply engaging and enjoying. If possible, set aside time once a week, but don’t abandon the idea if that’s too ambitious. Just make it monthly or even quarterly.

Be open about their differences.

Staying away from the subject of differences can inadvertently send the message that it is taboo or shameful. Instead, take a step toward a deeper mutual understanding by sharing age-appropriate information with your children about how they think differently. Perspective-taking can be difficult for all children, particularly those who are very young and those with autism. Siblings can offer a rich mine of learning opportunities to build skills in asking for and listening to another’s point of view. Talk about emotions openly and often to teach your kids the range of reactions individuals can have to the same event.  Also build a history of open communication, in which your children can come to you with their questions and worries.

Listen, listen, listen.

Let’s be honest—even adults can have difficulty connecting with other people whose brains work in different ways than theirs do. Children need a hefty amount of patience and understanding to learn how to love, care for, and enjoy someone who has a different experience of the world. As negative emotions like jealousy and resentment come up, don’t try to talk them out of them. Listen closely, and validate their feelings before you try to solve anything. Your autistic child may communicate their hurts and disappointments in their own unique way, so “listening” may look different across children. Whatever the case, as you learn to recognize the ways your autistic child communicates, pass on this information to their siblings, to build more understanding among your kids.

Share positive experiences.

One key to establishing a strong relationship is to share positive experiences. This can be tricky if you have kids with vastly different interests, sensory preferences, or abilities. Don’t get stuck in old-fashioned thinking that family togetherness only means board games or sports. Instead, find new ways for siblings to play together. One way to expand everyone’s palate for fun is to have regular family time in which each person takes turns determining the activity. In its simplest form, this shows your children how much you value your time together and respect each family member’s interests, even when you don’t share them. When your kids are ready for it, you can use this as a perspective-taking lesson about considering what others will enjoy.

Assist with conflicts.

When you’re trying to foster a healthy sibling relationship, advice from others is often to “let them work it out on their own.” However, if your kids have different neurological profiles, you may need to help your children build skills to problem-solve their conflicts first. You can prevent physical tussles and diffuse situations before they escalate by teaching them to separate from one another to calm down. To prepare, have them practice going to separate “calm-down spots” during conflict-free times. While this method will help in the short-term, to support conflict resolution long-term, seek to learn each child’s methods of communicating, and help them grow those skills so they can use them to express their needs—and better understand each other.

Seek out similarities.

Although differences among our children may be huge, look for commonalities, and mention them often. Do both of your kids like ice cream or have the same kissable cheeks? Emphasize the similarities, particularly when they involve a shared goal, such as not wanting to go to bed or clean their room. After all, siblings are rarely closer than those shared moments of ganging up on their parents! Even a tense moment in the family can be an opportunity to point out that they’re on the same team.

Parenting multiple children is a stressful endeavor, and when siblings are different, it can feel easier to just let them do things separately. But siblings will be in each other’s lives for longer than most other friends and family, so this is a relationship worth investing time in right from the beginning. A healthy sibling relationship can be a lifelong source of comfort and support—and this is something we want for all of our children.

Looking for the latest on bringing up kids with ASD? Listen to our “10 Top-Performing Podcast Episodes About Autism.”

How to Make Halloween a Treat for Kids with ASD

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Halloween tips for kids with autism spectrum disorders

There’s a lot about Halloween that can be tricky for kids on the autism spectrum.

The holiday is full of everything out of the ordinary: costumes, candy, and a certain amount of chaos. Routines get replaced with class parties, strange sights and sounds, and droves of costumed-kids roaming around trick-or-treating after dark.

The University of Alabama at Birmingham School of Medicine says recent studies indicate that five percent of children are affected by a sensory processing disorder. For kids with autism, as many as 80 to 100 percent experience sensory processing challenges, according to an article from JAMA Pediatrics. Challenges include being over-responsive or under-responsive to sensory input like bright lights, loud noises, or tight clothing.With the many opportunities for sensory overload that come with Halloween, the holiday can present a particular challenge for kids on the autism spectrum.

Experts say their biggest tip for making Halloween a success for kids with ASD is to prepare with some planning so your child is not caught off-guard. Here, we share six steps to help you plan.

1. Talk about it.

In the days or weeks leading up to Halloween, give your child some time to adapt to the concept. Read books and show pictures, movies, or cartoons that give them visual cues of what to expect. Start talking about people dressing up, decorations you see in your neighborhood, and what happens when kids go trick-or-treating. Talking about these traditions can take some of the “scary” out of Halloween. It can be confusing when you’re suddenly hearing creepy music and allowing your child to take candy from strangers. A little prep can go a long way in easing their fears.

2. Try on the costume.

If your child is going to wear a costume, have them try it on well in advance to get used to the feel of it. Let them play in it for short intervals, and avoid costumes that are uncomfortable or get in the way of their mobility, breathing, or vision.If clothing texture is an issue, consider something simple like a decorated hoodie, character pajamas, or an accessory they could wear over regular clothes, like a cape. Also do some sleuthing online by searching for “Halloween costumes for kids with autism” or “sensory friendly Halloween costume ideas.”

3. Role play the day.

Role play what it would be like to go trick-or-treating. You can even see if neighbors will let you ring their doorbell to practice the “trick-or-treat” skill a few days before Halloween. Talk about safety rules for crossing the street, and set boundaries on taking only one treat and not more than what’s offered. Bring a flashlight, and consider taking noise-cancelling headphones, in case your child needs them.A trial run might also give you a sense of whether your child is comfortable dressing up and trick-or-treating. If they’re not up for it, consider whether an activity, such as decorating pumpkins or cookies at home, would be less overwhelming. After all, trick-or-treating is only one part of Halloween. Don’t feel the least bit guilty about opting out.If you do opt to stay home, consider letting your child practice handing out candy at your own front door. Practice with a real piece of candy or healthy snack, and consider offering your child a piece as a treat.

4. Know your child’s limits.

You don’t have to walk the whole neighborhood to enjoy a Halloween outing. Try starting early, before it gets dark, and skipping houses with a lot of noise, crowds, or scary decorations. Know your child’s limits—and your own limits. Maybe you need to go to just a few houses before you head home. Keeping your outing short may help your child avoid a meltdown—and may help you feel less stressed and overwhelmed.

5. Have a candy plan.

Once you get home, turn off your porch light to signal Halloween trick-or-treating is over at your house. Have a plan for your child’s candy stash and how much they’ll be allowed to eat. If sugar before bedtime is off-limits in your house, consider letting your child trade in the candy for a toy or coins for their piggy bank, or a chance to do something else enticing like playing a game, listening to a song, or watching a show.

6. Adapt to your child’s and your own comfort level.

The most important thing is to create a plan and a Halloween environment that fits your child’s comfort level, in addition to your own comfort level. Remember: your holiday traditions can be unique to your family.

There’s no holiday better than Halloween to show that special days come dressed in different ways, and everyone has a place. If you play to your child’s strengths and know your family’s limits, you can set yourself up for a successful day that really is a treat.

Learn more on our blog about routine changes and avoiding meltdowns.

Autism and Picky Eating: Help Your Child Build Healthy Eating Habits

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By Ashley Williams, Ph.D., LABA, BCBA
Senior Clinical Director, BCI

Does your child only eat one brand of chicken nuggets or refuse anything other than a single flavor of yogurt? Do you pack the same lunch for your child, day after day after oh-so-tiring and monotonous day?

With the school year underway, now is the time to take a look at your little one’s eating habits to see what you can do to make mealtime a success. While picky eating is a common problem among all kids, the issue can especially challenge children on the autism spectrum. Here, I share a few strategies that can help. Keep in mind, though, that if your child’s picking eating interferes with their ability to take in enough calories or nutrients, you should reach out to your pediatrician right away.  

Set a Goal

As a family, pinpoint what your goal is when addressing picky eating. What’s something specific you want to address?

Do you want your child to waste less? Do you want them to try new foods? Do you want to try more meals and recipes that all family members can enjoy together? Identify and set a specific goal. That way, you can figure out what strategies and steps you need to take to achieve it.

Think About Solutions

Take time to plan and think critically about the goal. For example, if you want to cut down on your child’s snacking, take a step back to consider what it is about snacking that concerns you. Is it that they won’t eat dinner? Or they fill up on foods that lack nutrition? In either case, consider what’s available as a snack. Is there a food you typically offer at dinner that you could offer as a snack? That way, if your child does “fill up” on the snack, that’s OK.

When evaluating your concerns regarding the behavior, be sure to look at a span of time, instead of just one meal or even one day. Give yourself enough time to establish a broader sense of their caloric intake and nutritional needs.

Consider Your Environment

When we think of picky eating, we often focus on the moments in which food is in front of the child. But many factors that influence behavior actually start before this.

Preparation and activity before a meal have a huge impact on the likelihood of eating, including the quantity and variety of food your child eats. Think carefully about the environment you’ve set up for meals and snacks at home. Variables include where your child sits, how you present the food, how much food you present, and more.

Limit Distractions

Regarding the physical setup, have your child sit at a table where they can focus on eating as the primary activity. Are there distractions?

While allowing screen time during snacks and meals may help your child stay seated, screen time can also detract from their attention to eating and to their own internal cues. These cues are important for your child to notice as they explore new foods and how much food to eat.

Aim to minimize distractions. Doing so will help you notice what scenarios lead to more success at mealtime.

Give Your Child Choices

Are you planning to have your child participate in preparing the food or choosing an aspect of the meal? Allowing your child to participate in the preparation and decision-making that go into the snack or meal can help increase motivation to eat the meal.

Perhaps your child can get out ingredients for the meal or hold the bowl while you stir. Allow your child to make small decisions along the way that build buy-in, without compromising the boundaries that you’ve identified for the meal.

For example, you may have decided that the meal will include some fruit at dinner (a food type that is often involved in picky eating). Allow your child some choice in getting to this outcome by letting them know, “We’re going to have chicken drumsticks with a small bit of fruit. Do you want blueberries or watermelon as the fruit?”

This provides boundaries, while still giving your child an opportunity to choose. It’s likely that having chosen blueberries, for example, will lead to a greater likelihood of eating them.

Let Them Serve Themselves

Another way of promoting choice and control is by allowing your child to serve themselves. Your child may not be ready to prepare the meal from start to finish, but they may be able to sprinkle toppings or help squirt dipping sauce on to their plate.

By allowing your child to make small choices throughout the preparation of the meal, you’re deciding what is served (such as tacos), with room for your child’s opinion and preferences to be considered.

Identify Sensory Issues

Some aspects of preparing and presenting food can tell us more about food selectivity and picky eating, and can provide us with more information for the future. In fact, you may discover that your child outright refuses certain foods or entire food categories.

Take a closer look at which foods are left on the plate or pushed away. Try to identify certain sensory and texture properties of foods that are often refused, such as squishy or tough foods.

As adults, we often forget that certain foods, particularly produce, don’t actually taste the same each time we eat them. A tomato purchased at peak ripeness in-season may taste very different from a similar-looking tomato past its prime off-season. For children, this may lead to refusal, often without a corresponding explanation as to why the food was refused. In the future, this could lead to even more refusal.

Of course, there’s not much we can do to minimize variability in produce, but this knowledge can help us understand some of the shifts in preference. And, just as our own food preferences change over time, so do our children’s. We may never know why hot dogs moved from the favorite list to the repulsive list. But a strategic approach to food goals that involves stopping and observing over a period of time, while limiting distractions and making choice part of your child’s eating routine, can make a real difference—and over time, help make family meals more enjoyable for everyone.

Looking for more tips on raising kids with autism? Dr. Temple Grandin shares some of what worked for her as a child in her latest conversation with us on All Autism Talk. Listen to the podcast.