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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.

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.

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.

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.

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.

Spotlight on Diversity in ABA: An Interview with Joshua Polanco

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A board certified behavior analyst (BCBA), managing technician, at LEARN’s Autism Spectrum Therapies (AST) in California’s Inland Empire region, Joshua Polanco provides supervision and behavioral intervention plans for clients in need of ABA services. He earned a master’s degree in psychology and ventured into ABA because he wanted to use that degree in a more direct and meaningful way. He’s also legally blind.

Here, he shares stories from his journey and experience working with children and young adults with autism—and his take on the importance of diversity, equity, and inclusion (DEI) in the field of applied behavior analysis (ABA).

Q: WHY DID YOU GET INTO ABA?

A: I was working as a behavioral technician and providing one-to-one services with multiple clients. I was about to quit after the first two weeks of working in the ABA setting because I did not have any experience with children with disabilities and felt like I was not helping my clients. Ironically, the clients and their families are what made me stay. To me, nothing can beat the sensation of knowing you have made a difference in someone’s life, and I have had so many fun experiences that helped me realize the importance of ABA, and how prevalent it is in our everyday lives. All of these experiences are what drove me to continue pursuing ABA to the position where I am now.

Q: WHAT DOES DIVERSITY, EQUITY, AND INCLUSION (DEI) MEAN TO YOU?

A: Everything. I feel these concepts as a whole are very overlooked at times. It’s not only important to have diversity, equity, and inclusion in the workplace but to also recognize the benefits provided when DEI is incorporated into a work environment. In my case, I may be legally blind, but that does not make me useless in a work environment that relies heavily on vision. I am able to continue to make an impact on peoples’ lives through my work and can actually provide a different perspective and understanding when helping clients or co-workers because of my loss of vision. 

Q: IN YOUR OPINION, WHAT IS THE MOST CHALLENGING ASPECT OF WORKING IN A DIVERSE ENVIRONMENT?

A: Trying to comprehend various interactions that take place. Balancing the state of empathy and understanding, while simultaneously needing to support and accomplish work objectives that need to be achieved.

Q: WHAT IS YOUR APPROACH TO UNDERSTANDING THE PERSPECTIVES OF COLLEAGUES OR CLIENTS FROM DIFFERENT BACKGROUNDS?

A: The short, easy answer is that I take a step back and just listen. Self-awareness and self-control over your own biases and habits go a long way. It’s important to me to recognize the limitations you have in the moment. For example, you may not always be able to truly understand the perspective of others. This is OK—we are only human. I feel like there are ways to still attempt to understand to some degree. Failure to truly understand someone should not give us permission to disregard their perspective.

I’ve relied, to some degree, on multiple psychology books, articles, and notes from when I obtained my master’s degree in psychology, with an emphasis in clinical counseling and marriage and family therapy. When communicating with colleagues and clients, I always try to review and remember the concepts I learned on the dynamics of communication, including those on cognitive distortions and positive feedback loops. Understanding these can play a huge role on how I understand and communicate during a conversation.

Q: WHY IS DEI IMPORTANT IN ABA?

A: Without DEI, we would be refusing to grow ABA as a whole. ABA is a science that expands to more than any one individual population. Part of everything we do is to help, expand, and make a difference in the world. What better way to accomplish this than to recognize the different things people have to contribute.


Q: TELL ME ABOUT A TIME WHEN YOU ADVOCATED FOR DIVERSITY AND INCLUSION IN THE WORKPLACE OR IN YOUR PERSONAL LIFE.

A: One poignant instance in which I had to advocate for myself is the moment I was officially diagnosed blind, and I had to reach out to the HR department to figure out some resolutions and next steps forward. Luckily, I was part of a supportive team and was able to continue doing the core work I was educated to do and hired for, with some slight accommodations and adjustments.


Q: WHAT’S SOMETHING MOST COLLEAGUES DON’T KNOW ABOUT YOU?

A: I do not know how many people know that I am legally blind. My condition is called Retinitis Pigmentosa (RP). There is no treatment. With this condition, my vision will gradually worsen. There is no telling how much vision I will lose tomorrow…or over the next 30 years. I don’t only have to think about how this affects the work I do with clients but how I adjust my everyday life to prepare for this. Through my work with rehabilitation specialists, I am learning to use technology, to read braille, and even to cook without looking.

Q: ANYTHING ELSE YOU’D LIKE TO ADD?

A: I was diagnosed legally blind less than a year ago. In that time, I’ve taken and passed the BCBA exam, which was the first test I’ve ever had to study for and take without my vision, while finding ways to balance my work, as I learn a new lifestyle. I hope the message from all of this is one of inspiration—that no matter how bad things may seem, it’s important not to let the events around you, define you. Take control of the things you can, adapt, and persevere through the adversity. Because this is what we ask of our clients each day.

For more from our Spotlight on Diversity in ABA series, read “An Interview with Angela Parker.”

Myth: Kids with Autism Don’t Have Emotions

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BY KATHERINE JOHNSON, M.S., BCBA
SENIOR DIRECTOR OF PARTNERSHIPS

My cousin, a teenager with a broken heart, lay on my couch, crying. Her little brother, a mostly-non-verbal autistic four-year-old, wiped the tears off of her face and then tickled her to get her to laugh. 

A boy I worked with many years ago wanted desperately to get his baby brother to stop crying. He ran to get some scissors and told his mom, “Tag, Tag!” He, himself, was often irritated by tags in clothing, and, seeing his brother inconsolable, believed that maybe the tag in his onesie was the cause of his distress.    

A young autistic girl in a social skills group I ran years ago woke up earlier than her parents one day. She got out every glass, bottle, cup, and bowl in the house and arranged them in intricate patterns around the kitchen floor. When her mother got up, she looked up with pride and said, “Mommy, I made breakfast for you!” 

Autistic people have emotions. They love, they hurt, they empathize, and they care. So, where in the world did the myth about being “unemotional” come from? 

The answer may be in the concept of alexithymia. 

Alexithymia refers to the inability to recognize and express emotions. It’s not considered a clinical diagnosis or disorder but rather a condition or a personality trait, and has been studied since the 1970s. It occurs in about 10 to 13 percent of the general population but is more common among people on the spectrum, occurring in close to 50 percent of autistic folks—a high prevalence that may lead to people confusing the trait with autism itself. 

If you or your child experiences alexithymia, then you know firsthand that those with this trait still have deep feeling—they just have difficulty naming their emotions and explaining their feelings. Some may not be able to distinguish between their emotions and the bodily sensations connected to them, and may have less imagination or ability to fantasize than those without alexithymia. As one non-autistic man with alexithymia explained it: “Obviously, I’ve got a vocabulary. I’ve got words for emotions. But whether they’re the right words for the right emotion is a different point altogether.…”

Although experts have been unable to pinpoint a cause, research suggests a genetic component, and that environmental factors such as trauma, health conditions, and socioeconomic factors may play a part.  A brain injury to the anterior insula can also cause alexithymia. 

As parents and caregivers, we are always eager for more information on what we can do to help our children. Since autistic people are more likely to have alexithymia, it is important that family members, service providers, and the community at large understand the condition and the unfortunate risks that come with it. For instance, research suggests that people with alexithymia experience depression and anxiety significantly more often than those without the condition—problems that should be taken seriously and treated.  

Anxiety and depression may be due to people not understanding their own feelings, and to the effects alexithymia can have on their personal relationships. For example, some people with the condition report that they know when other people are experiencing negative emotions, which can feel distressing. Not understanding what those emotions are or how to react to them can make the situation even worse. For these reasons, it’s important for others to recognize that what may just seem like a simple skill deficit can affect an individual’s quality of life and well-being far more than they are able to communicate. And of course, if the person also has autism, communication may be even more difficult.       

When one team of researchers conducted a meta-analysis of studies on alexithymia and autism, they concluded that although the two things can co-occur, alexithymia is NOT a core feature of autism— although there isn’t yet a consensus. Regardless, since alexithymia appears to increase the risks for mental health challenges like anxiety and depression, and for unhealthy behaviors like greater alcohol consumption and lower levels of physical activity, healthcare providers consider it a trait that is important to identify. This way, alexithymic individuals—autistic and non-autistic alike—can be proactively supported in all of these areas.

The last few years have seen more and more autistic people raising their voices, sharing their experiences, and inviting others to hear their stories. As we listen, it’s important that we all work to dispel myths around autism, so that we can see people for who they truly are. Alexithymic autistic people have emotions, like everyone else. They just need support from loved ones in expressing and processing their feelings, and they need professionals to understand their unique needs so they can provide the best assistance. Likewise, non-alexithymic autistics deserve to be seen as themselves—and not bogged down in harmful myths about their lack of an emotional inner life. Once again, science arrives at a truth that harmonizes with what philosophers have long told us: regardless of what we look like—or behave like—on the outside, we are all humans, craving to connect emotionally with other humans.   

For more on mental health and autism, listen to our recent podcast, “Nobody’s Normal: How Culture Created the Stigma of Mental Illness.” Here, Roy Richard Grinker, a professor of anthropology and international affairs at George Washington University, explores stigmas around various diagnoses, including autism.

 

 

Gaigg SB, Cornell AS, Bird G. The psychophysiological mechanisms of alexithymia in autism spectrum disorder. Autism. 2018 Feb;22(2):227-231. doi: 10.1177/1362361316667062. Epub 2016 Nov 2. PMID: 27811193.

Martino, G., Caputo, A., Vicario, C. M., Catalano, A., Schwarz, P., Quattropani, M. C. (2020).  The Relationship Between Alexithymia and Type 2 Diabetes: A Systematic Review.  Frontiers in Psychology, 11, 20-26.  DOI: 10.3389/fpsyg.2020.02026.   

Kinnaird, E., Steward, C., & Tchanturia, K. (2019).  Investigating alexithymia in autism: A systematic review and meta-analysis.  European Psychiatry, 55, 80-89.  doi: 10.1016/j.eurpsy.2018.09.004. 

Top 5 Autism Studies from the Last Year

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BY KATHERINE JOHNSON, M.S., BCBA
SENIOR DIRECTOR OF PARTNERSHIPS

Looking back at 2021, there were significant developments, both in research and thought leadership, in the field of autism and applied behavior analysis (ABA).  Here are some studies and papers you don’t want to have missed!

 

Girls’ Genetics and Autism

2021 gave us another important building block in the ongoing investigation in to how and why autism manifests differently in girls than in boys.  A study by Jack et. al. found that there was a much greater difference in brain activity in autistic and non-autistic girls, than was previously found between autistic and non-autistic boys when viewing biological motion.  In the second half of the investigation, they looked at the girls’ DNA.  What they found (greater differences in brain activity and more gene mutations among the girls) bolsters the “Female Protective Effect” theory, which holds that girls require more genetic predisposition to autism in order to show autistic traits.  Inquiries into how autism manifests differently depending on sex is integral to being able to more accurately identify and support girls on the spectrum.  

Allison Jack, Catherine A W Sullivan, Elizabeth Aylward, Susan Y Bookheimer, Mirella Dapretto, Nadine Gaab, John D Van Horn, Jeffrey Eilbott, Zachary Jacokes, Carinna M Torgerson, Raphael A Bernier, Daniel H Geschwind, James C McPartland, Charles A Nelson, Sara J Webb, Kevin A Pelphrey, Abha R Gupta, the GENDAAR Consortium, A neurogenetic analysis of female autism, Brain, Volume 144, Issue 6, June 2021, Pages 1911–1926, https://doi.org/10.1093/brain/awab064

 

How Can Behavior Analysis Help Prison Reform?

Many behavior analysts have heeded the call to focus on their own cultural competence and anti-racism work; this paper outlines ways they can put those skills to good use.  Crowe and Drew review the history and current state of a social injustice faced by many people with disabilities: segregation via incarceration.  The authors posit that behavior analysts can help to interrupt the “school-to-prison pipeline” and outline their theory.  Although the authors call for a grand restructuring of the prison system (including abolition of the current system), they also offer thoughts on how behavior analysis could improve current institutions.

Crowe, B., & Drew, C. (2021). Orange in the new asylum: Incarceration of individuals with disabilities. Behavior Analysis in Practice, 14(2), 387-395. https://doi.org/10.1007/s40617-020-00533-9

 

Bridge Over Troubled Water…

If you have been following the conversation about ABA and neurodiversity, you’ll want to read this paper.  A group of Autistic and Non-Autistic authors challenge the belief that ABA is inherently harmful for Autistic people and proposes the perspective that behavioral interventions can be “compatible with the neurodiversity paradigm.”  After a history of autism and behavioral interventions, the authors delve into a thorough discussion of how Naturalistic Developmental Behavior Interventions may bridge the gap between opposing viewpoints about the use of behavioral interventions with people on the spectrum.  

Schuck RK, Tagavi DM, Baiden KMP, Dwyer P, Williams ZJ, Osuna A, Ferguson EF, Jimenez Muñoz M, Poyser SK, Johnson JF, Vernon TW. Neurodiversity and Autism Intervention: Reconciling Perspectives Through a Naturalistic Developmental Behavioral Intervention Framework. J Autism Dev Disord. 2021 Oct 13. doi: 10.1007/s10803-021-05316-x. Epub ahead of print. PMID: 34643863.

 

The Function of…. Happiness?

And the Functional Analysis (FA) gets another twist!  Thomas et. al. assessed whether or not paying attention to indices of happiness would assist in finding effective interventions to decrease challenging behavior.  They found that when interventions were derived from what they learned about the children’s happiness, they were as effective as interventions based solely on the function of the challenging behavior, and they were associated with more behavior associated with happiness.  In the search for effective treatments that are maximally acceptable to consumers, this is a useful addition to the FA!   

Thomas BR, Charlop MH, Lim N, Gumaer C. Measuring Happiness Behavior in Functional Analyses of Challenging Behavior for Children with Autism Spectrum Disorder. Behav Modif. 2021 May;45(3):502-530. doi: 10.1177/0145445519878673. Epub 2019 Sep 30. PMID: 31565953. 

 

Assent in Research

With the addition of “assent” to the BACB Code of Ethics, behavior analysts have begun the search for research, resources, and materials on the topic.  After a discussion of the federal statute and how it may or may not apply to autistic subjects, the authors discuss assent in the context of the behavior analytic values of self-determination and choice.  They then examine how frequently assent has been obtained in the behavior analytic research (spoiler alert: not frequently), note the methods that have been used, and propose a procedure for obtaining assent from nonverbal potential research participants.  This may be the only JABA article on assent in 2021, but it’s a fair bet that it will inspire many more in 2022. 

Morris C, Detrick JJ, Peterson SM. Participant assent in behavior analytic research: Considerations for participants with autism and developmental disabilities. J Appl Behav Anal. 2021 Sep;54(4):1300-1316. doi: 10.1002/jaba.859. Epub 2021 Jun 18. PMID: 34144631.

Reframing Your Child’s Intense Interests as a Strength

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

The first child I ever worked with wanted nothing more than to play with Thomas the Tank Engine—all day. Over the years, teaching many different children on the spectrum, I experienced a dazzling array of special interests: animals, birthdates, the Titanic, horror movies, fireworks, constellations, dinosaurs, parades, American Idol, the “guts” of any electronic device. The variation was delightful. 

One of the diagnostic criteria for autism is “restricted, repetitive patterns of behavior, interests, or activities,” according to the Diagnostic and Statistical Manual of Mental Disorder, the DSM-5. There’s no doubt that these preferred topics can be absorbing. When an autistic person is engaged in one of their favorite activities, it can be difficult to get them to want to talk about anything else. But while the powerful interests of people on the spectrum have often been called “restricted,” some research shows that people on the spectrum actually report having interest in more topics than people without an autism diagnosis.[1] 

Historically, our society has used negative language like “inflexible” and “obsessive” to describe the interests of people on the spectrum, and therapists have often focused on decreasing them, or using them exclusively to reinforce behavior. Autistic advocates and more recent research have started to change the minds of those who would reduce behavior simply because it is “repetitive” or “intense.”  In fact, it is becoming all the clearer that special interests can be an important and fulfilling part of autistic living and learning. 

What do verbal autistic people tell us about their special interests?

By and large, autistic people speak of their special interests as something that brings joy to their lives.  Special interests can be calming, helping people cope with strong emotions and reducing stress.[2]  Thøger Kari Hass writes that his special interests differ from hobbies in that he can put hobbies on hold when life becomes overwhelming, while the opposite is true for his special interests. “When I’m going through stress or life changes,” he writes, “I literally need my special interests to stay functional.”[3]  While some complain that their fascination with certain topics can begin to eat up spare time, most autistic people feel “enriched, not controlled” by their interests.[4] 

Are there other benefits to these interests? 

The fact that special interests bring joy and calm is certainly a persuasive reason to rethink old notions of how to approach them, but there are other reasons, too. In 2012, an article published in the Journal of Positive Behavior Interventions showed a significant increase in meaningful social interaction for three teenagers on the spectrum when social groups were created around their specific interests.[5] Since then, many others have followed suit, reporting that focusing on their special interests can help an autistic child shine, leading them to show more affect, use more complex language, and initiate conversation and organize their thoughts better, studies show. This makes sense, considering that a group of researchers at MIT are finding that listening to stories about their special interests actually activates key language regions in the autistic brain.[6]

Other studies have used special interests to improve cooperative play and to ease difficult transitions by integrating them into teaching, rather than by using them as reinforcers. One strategy is the use of “Power Cards,” which are cards that promote social skills by incorporating the autistic child’s special interests into the instruction.[7] [8]

Even more compelling is research that reveals that “special interests are tied to improved subjective well-being in adults with autism” and that adults engaging in their highly-specific activities had “increased satisfaction with social contacts and leisure time.” [9] And of course, an interest enjoyed as a child can become an expertise in adulthood—and can occasionally launch a career, such as with Temple Grandin, Clay Marzo, or Jennifer Cook O’Toole. 

When to intervene? 

Limiting special interests simply because they involve a different focus or greater intensity than those of their peers is no longer the prevailing practice. Even when an interest produces challenges, such as interrupting or monologuing, interventions can target those problem behaviors connected to the special interest without discouraging the interest itself.[10] [11]    

When interests are interfering with a person’s ability to access school, work, or desired social groups, intervention may be appropriate. But again, accessing other environments or expanding interests can be targeted, while simultaneously maintaining time and space for the person’s special interests.   

For me personally, one of the most rewarding experiences of my decades of work with children on the spectrum is the privilege of seeing the adults they become. When they were small, our goals were focused on achieving certain levels of language or daily functioning. But when I encounter a former client now, my measure of success is largely wrapped up in their sense of happiness and fulfillment—two things that are often connected to the “restricted” interests they showed as children. One of my former clients owns her own Etsy shop, crocheting and beading items for her dozens of buyers, and echoing her childhood love of beads and crafting. Another works for the transit system, building train schedules—and living exactly the “dream job” his parents joked about when he was three and could lovingly recite every stop of every numbered bus in his town. A third loves to post critiques of restaurants online, taking me back to his second-grade lectures on Italian cheeses. 

Redirecting or attempting to de-intensify an autistic person’s favorite topics used to be assumed to help them connect better with neurotypical peers. Now that evidence to the contrary is emerging, it is difficult to argue that this practice is in their best interest. It seems fitting that the extraordinary enthusiasm autistic people have for specific subjects can be leveraged to further enrich their lives. As I’ve witnessed firsthand many times, these passions can help them learn, de-stress, connect with others, and perhaps most importantly, experience pure joy. 

For more tips for parents and caregivers, read “How Books Can Help Kids with Autism Build Language.”

[1] Jordan CJ, Caldwell-Harris CL. Understanding differences in neurotypical and autism spectrum special interests through Internet forums. Intellect Dev Disabil. 2012 Oct;50(5):391-402. doi: 10.1352/1934-9556-50.5.391. PMID: 23025641.

[2] https://www.sciencedaily.com/releases/2017/02/170201092629.htm

[3] Why Special Interests Are Important for People on the Autism Spectrum | The Mighty

[4] https://www.spectrumnews.org/features/deep-dive/the-benefits-of-special-interests-in-autism/

[5] Koegel R, Fredeen R, Kim S, Danial J, Rubinstein D, Koegel L. Using Perseverative Interests to Improve Interactions Between Adolescents with Autism and their Typical Peers in School Settings. J Posit Behav Interv. 2012 Jul 1;14(3):133-141. doi: 10.1177/1098300712437043. PMID: 24163577; PMCID: PMC3806136.

[6] https://mcgovern.mit.edu/2020/03/02/embracing-neurodiversity-to-better-understand-autism/

[7] Campbell, A., & Tincani, M. (2011). The power card strategy: Strength-based intervention to increase direction following of children with autism spectrum disorder. Journal of Positive Behavior Interventions, 13(4), 240–249. https://doi.org/10.1177/1098300711400608

[8] Gagnon, E. (2001). Power cards: Using special interests to motivate children and youth with Asperger syndrome and autism. Shawnee Mission, KS: Autism Asperger Publishing

[9] Grove, R., Hoekstra, R.A., Wierda, M. and Begeer, S. (2018), Special interests and subjective wellbeing in autistic adults. Autism Research, 11: 766-775. https://doi.org/10.1002/aur.1931

[10] Fisher, WW, Rodriguez, NM, Owen, TM (2013) Functional assessment and treatment of perseverative speech about restricted topics in an adolescent with Asperger syndrome. Journal of Applied Behavior Analysis 46: 307–311.

[11] Smerbeck A. The Survey of Favorite Interests and Activities: Assessing and understanding restricted interests in children with autism spectrum disorder. Autism. 2019;23(1):247-259. doi:10.1177/1362361317742140

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.