Preparing for Holiday Meals

The holidays are quickly approaching, which means family, festivities, and food! While the holidays can be fun for the whole family, they can also be a stressful time for children on the autism spectrum due to the changes in typical routines and settings. Holiday meals with extended family can present issues for a child with autism, including trying new foods, sitting among loud family members, and being in an unfamiliar location. Here are some helpful tips to make the holiday experience more enjoyable for the whole family.

Prepare your child for the event.
Use photos, a social story, or show them a video, modeling what will be expected of them. Will they need to sit at a communal table surrounded by family? Will they be expected to try new foods? How about preparing your child for the family members who will be present? You can practice with role play at home with real or fake food so your child is familiar with the expectation of the meal. To make it easier this time of year, you can also bring some favorite foods along that you know will be successful.

Support them during the event.
Bring activities and toys so your child has something to do while waiting for the meal to begin. If your child is very picky with food, bring some preferred alternatives that they will eat so they don’t become agitated while waiting and to remind your child of familiar food routines.

Give them a chance to escape if they need it.
If your child becomes overstimulated by loud noises or holiday lights and decorations, find a quiet place in the home for them to decompress and take a break. Your child can rejoin the family once he or she feels comfortable doing so.

While holiday meals can be stressful, hopefully these tips will help keep everyone’s spirits bright!

 

– Sarah Low, M.A., BCBA

Autism & Trick-or-Treating

Halloween can sometimes be a little scary for parents and kids, and not just because of ghouls or goblins. Between the sights, sounds and change in schedule, Halloween can present some “tricky” experiences for kids with autism and other special needs. Practice and preparation can make a big difference in creating a fun and successful holiday experience. We use Applied Behavior Analysis (ABA) strategies every day to help our kids navigate new experiences, and these strategies are just as useful during special events and holidays such as Halloween. Here are four concepts that you can use to make trick-or-treating fun for your family:

Social Stories

Social stories should start at least a week before Halloween, for younger children this can be accomplished with a book or even a video about a child going trick-or-treating. The book or movie should match as closely as possible with the kind of experience you want to provide for your child. The parent should present the video or book alongside a scripted social story told from the child’s perspective.

Visual Supports & Schedule

Visual supports can include a sequence of pictures that reinforce the trick-or-treating activities. For example, in one photo the child in their Halloween costume, and then knocking at the door or waiting at the stoop, in the next photo. A third photo of the child receiving candy helps reinforce the repeated actions, and pay off of the outing. Having a schedule outlined and expectation clearly indicated, should reduce maladaptive behaviors and increase expected responses. These visual supports could be created during the practice sessions discussed later.

Priming

The last antecedent strategy is priming; before going trick-or-treating, parents should inform the child of the expectation and indicate that after these responses are completed they will receive candy.

Practice

To keep Halloween fun and exciting, and reduce possibly overwhelming experiences for parents and kids alike, going through several trial runs are helpful. Find some time where everyone in the family can dress up in their costumes and practice walking, waiting and receiving candy.

Halloween fun is possible with a little extra preparation!

 

– Elizabeth Jeffery-Arceneaux

How to Plan for the Upcoming School Breaks

In Tucson, Arizona many of our kids are heading into their Fall Break.  Your child’s breaks may come at different seasons and times of year. School breaks offer opportunities and challenges for all parents and children. These breaks can cause disruption in family routines and increase in down time for the child, which may result in low levels of motivation and higher levels of anxiety and stress. For parents of children with special needs, these may seem magnified. Below are some helpful tips to consider when planning for your child’s upcoming school breaks.

 

Keep Similar Routines
This may be easier said then done however, keeping your wake-up and bed-times similar and filling the day hours with activities will provide your child a predictable, structured environment, a sense of stability, and decreased stress. By reducing the amount of unstructured free time, your child will be less restless and bored. Don’t forget to include the homework routine as you have worked so hard to develop and maintain this prior to the break!  It is still important for children to practice academic skills even though school in not in session.

Keep Busy
Find educational, recreational and social activities to engage in daily. This will limit the amount of time your child is at home watching TV, texting, or playing video games. Ideally, an outside activity such as playing ball, going for a walk or participating in a team sport would be on the schedule daily. Even if your child doesn’t play a sport, any exercise activity has obvious health benefits, and increased physical activity helps reduce repetitive behaviors and improve sleep. Some resources to find community activities are your local Parks and Recreation Department, newspaper, and libraries. Some examples of home activities are board games, arts and crafts, academic tasks, meal preparation, outside games and reading.

Have a Daily Visual Schedule
The whole idea of a school break may be confusing for younger children since they are still developing the concept of time. School breaks also challenge the typical Monday-through-Friday predictable morning, school and after school routines. Utilizing a visual schedule will help your child understand the “what, when, where and why” of their day. It is also important to involve them by letting them choose what activities they would like to do. You can also have them cross off completed activities as well as the days so they can see how many days are left until school starts.

Read to your child
Children are exposed to literacy concepts many times throughout their school day. Continuing to expose them to books while they are home will only increase their language development, listening, and comprehension skills. Reading to your child also stimulates their imagination and facilitates a positive interaction where they receive one-on-one attention from the parent. Research recommends that parents set a side a scheduled time each day to read to their child (Raisingreaders.net).

Limit electronics
Allowing a child unlimited access to TV and computer can lead to childhood obesity, lethargy, difficulty in school, and insomnia. The American Academy of Pediatrics recommends children be limited to 1 to 2 two hours of educational programming daily. Here are some ways to limit your child’s access to electronics: First, keep them out of reach and out of your child’s bedroom. Have your child earn their time with electronics upon completion of other activities. Specifically allocate times within the day that are appropriate for your child to have access to electronics.

Work on Social Skills
This is the biggest opportunity provided by school breaks. Integrating social opportunities within your child’s day can take many forms such as homework assignments, board games, community activities, sports, and play dates. Some parents forget that activities like swim lessons, apple picking, and vacation trips can all be valuable new settings to prompt the use of social skills.

 

Hey Tucson families! Here are some additional resources to help make your season great for the whole family:

 

– Lindsay Abbott, MA, BCBA, LBA

Halloween Costumes for Kids with Autism

As fall approaches, we get excited by the prospect of cool weather, warmly colored trees and the festivities that come with Halloween. However, selecting a comfortable Halloween costume for your child on the autism spectrum can sometimes be more of a trick than a treat. When selecting a costume there are three helpful things to keep in mind: types of fabric, the interest of your child, and how your child will react to wearing a costume, as well as seeing others in costume.

What do you do when your child has a favorite superhero, but the costume is anything but sensory friendly? Try decorating a regular t-shirt with fabric glue or a hot glue gun. You can also decorate comfy pants to match. Another option is to create your costume using clothing made from jersey fabric. The jersey material will be thinner than the t-shirt material so be mindful when applying glue.

When deciding what kind of costume to make, it’s a good idea to start with whatever your child enjoys the most. Is it Baby Shark? Outer space? ABC’s? Creating a costume tailored to your child’s specific interest will be both fun and highly-motivating for them.

Finally, preparing your child to wear their costume and see others in their costumes can be a difficult task. Familiarizing them with the Halloween festivities beforehand is a good way to ensure things will go smoothly. If you have any costumes around your home, show them to your child. You can also show your child pictures and videos of people in costumes or read them a social story about Halloween.

It may be Halloween, but choosing a costume doesn’t have to be scary!

 

– Kristen McElroy

Beyond Picky Eating – Addressing Your Child’s Feeding Issues

Feeding is part of our daily life. Most people eat at least three times per day and mealtime is typically a pleasant experience; however, for children with feeding problems, this daily routine can become an aversive situation for children and their caregivers. 

Studies suggest the majority of children with autism have some type of a feeding problem (Volkert & Vaz, 2010). Feeding problems can include complete food refusal, disruptive mealtime behaviors, inappropriate pace of eating, lack of self-feeding skills, and “picky eating,” as caregivers often refer to it.

“Picky eating” may consist of a variety of selective feeding behaviors such as only eating foods of certain textures (e.g., crunchy, pureed), brands (e.g., from a particular restaurant), types (e.g., meat, starches), or colors.  When a child does not eat enough or does not eat a wide enough variety of foods, there may be significant medical implications (e.g., weight loss, malnutrition, poor growth) or social implications (e.g., not eating with peers, at family gatherings, or at restaurants). Children with feeding problems can create additional burdens on caregivers if caregivers need to prepare a separate meal for one family member, bring special food on community outings, or decline attending social events in fear of how their child may behave when presented with novel foods.

Extensive research has been conducted in the field of applied behavior analysis on feeding interventions for children with and without autism. Like any behavioral intervention, feeding interventions are specifically tailored to a child and his/her family to produce the best possible outcomes. An intervention that works for one child may not work for another. Additionally, there are several reasons why a child may not be eating and these reasons will vary from child to child. It is important to assess why a child is not eating (i.e., a medical or behavioral reason) before beginning an intervention. Feeding problems can involve many complex factors, and interventions to help children with feeding problems are by no means a one-size-fits-all situation.  This is when the help of specialists is crucial. Often, feeding interventions consist of a team of specialists which may include doctors, occupational therapists, speech therapists, nutritionists, and Board Certified Behavior Analysts. Caregivers, being a specialist in their child, are also a vital part of the feeding intervention team.

Caregivers may be resistant to feeding interventions and may have negative perceptions of what feeding interventions entail. Some may think feeding interventions consist of extremely aversive procedures, such as forcing a child to eat; however, there are several less intrusive interventions that have demonstrated successful results for a number of children.

Some interventions simply alter what is done before a meal begins to increase the likelihood that a child will eat (e.g., telling the child, “first dinner, then dessert,” creating a dinnertime routine, mixing a non-preferred food with a preferred food). Some children respond well to these less intrusive strategies, but some children require more intensive feeding interventions (Seubert, Fryling, Wallace, Jiminez, & Meier, 2014). Depending on the severity of the feeding problem, a feeding intervention can be a challenging and lengthy process; however, after a feeding intervention has been successfully implemented, the once unpleasant mealtime can become an enjoyable experience for both the child and his/her family.

In my own experience working with clients, I have had the opportunity to see many of the rewarding effects of feeding interventions. Here are a few examples of successes that can be achieved through intervention:

A child who only ate pureed foods received intensive intervention and began to eat the same meal as his family, smiling and laughing in the process. Another family could not eat at a restaurant because their child would scream, cry, and refuse to eat restaurant food; after slightly modifying their restaurant routine, the family could enjoy a relaxing meal together at a restaurant with their child eating food the restaurant served.

One particular selective eater refused to eat anything except chicken, which limited his ability to attend social events; more foods were slowly introduced to this child’s diet and eventually, he was able to eat many foods that were previously refused, including enjoying pizza and cake at a friend’s birthday party.  Growth and weight are a common concern of parents. I have seen a child who regularly refused to eat and was completely below the growth chart; after training her parents on a feeding intervention, she steadily gained weight and is now back on the growth chart and continuing to grow. It is important to keep in mind that all interventions are individualized, but these are just a few examples of the positive changes the right team and the right intervention can have for children and their families.

It is remarkable to see this difficult, daily routine become an enjoyable experience for those involved. Effective intervention for feeding problems can truly change the quality of life for our families.

If you have concerns about your child’s eating or food selection, speak to your child’s pediatrician.

 

Christine Seubert, M.S., BCBA

 

Seubert, C., Fryling, M. J., Wallace, M. D., Jiminez, A. R., and Meier, A. E. (2014). Antecedent interventions for pediatric feeding problems. Journal of Applied Behavior Analysis, 47,449-453.

Volkert, V. M. & Vaz, P. C. M. (2010). Recent studies on feeding problems in children with autism. Journal of Applied Behavior Analysis, 43,155-159.