by A is for Apple, Inc. | Jul 13, 2016

Maximizing Your Autism Treatment Team

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In today’s issue of “Thrive,” we’ll continue the discussion on dealing with an Autism Spectrum Diagnosis.

Last month we talked about ways to deal with the stigmas surrounding ASD. This month we’ll wrap up by talking about your family’s Autism Treatment Team.

Working with A is for Apple means having a team of therapists and supervisors on your side.  By analyzing your child’s test results and your goals, we assemble a Treatment Team best-suited to help your child thrive.

The team’s goals are not only to provide therapy, but assist you in finding the most effective techniques for your child’s growth.

Every team member has an important role to play (including you!), so let’s explain what each person does.

  1. Behavior Technicians. Front Line.  Behavior Technicians work directly with your child, running programs, managing moment-by-moment interactions.  It’s their job to monitor and work on the child’s behaviors and developing skills.
  2. Senior Technicians.  Support System.  The Senior Technician helps the Behavior Technicians by answering technique questions, suggesting additional methods, and providing support.  They’re also responsible to ensuring the treatment proceeds according to plan.
  3. Program Supervisor.  Leader of the Pack.  A Program Supervisor keeps the “big picture” in mind while developing the treatment programming and monitoring data.  Supervisors make sure everyone knows and follows procedure.
  4. Clinical Director. Behind the Scenes.  A Clinical Director builds the “blueprint” for your child’s long-term goals.  They manage treatment plans and Supervisors.  They also teach parents how to “think like a therapist.”
  5. Parents/Caregivers. Central Provider.  The Parent(s) recognizes and shares information about the child.  You know what life is like “outside of therapy” times.  As such, your feedback provides invaluable background and insight into how well the treatment progresses.

Maximizing Each Team Member’s Effectiveness

The data we gather is regularly assessed by the Program Supervisor.  If a certain procedure isn’t working well for the child, we change our approach.

You can help increase the team’s effectiveness too.  How?  Here are a few ideas.

Training:  Each Treatment Team member receives training (including you!).  We train on treatment methods, how to read data, even modifying our own mannerisms while interacting with your child.

Observing:  Watch what’s happening during your child’s session.  Take notes on how the team members interact and structure their time with your child.  Pay special attention to particular phrases or ways of speaking to the child that appear most effective.

Asking Questions:  Don’t be afraid to ask questions about how things are done, and about what you’re seeing. Program Supervisors and Clinical Directors will happily explain treatment details.  Technicians can share how they shape the environment, and your child’s motivation, to optimize learning.

Participating:  Based on what you’ve seen, find out how and when you can jump in and try something out!  For example, play the game he/she is learning by using the same strategies you saw the technician use.  Give your child some simple instructions, and follow through in the same way you observed.

Your Role on the Team

As a parent, your role is imperative and unique to all other positions.  The sheer amount of information you provide regarding your child is critical knowledge for all other team members. This acts as the building blocks for your child’s treatment.

Additionally, you’re presented with countless learning opportunities every day.  Think about how often your child wants something from you.  These are great opportunities to practice communication.  Or how about learning to recognize things they can do for themselves?  This helps their autonomy, and builds self-esteem.

Taking Full Advantage of the Therapy

Treatment doesn’t stop when the technician leaves.  So how do you give your child the best possible chance to learn?

Repeat the lesson.  The most effective teaching repeats itself—not only across people, but across environments too.  If you and the Treatment Team members continue reinforcing the lessons, your child will learn faster and better.

Get local support.  Ask neighbors, friends, even local businesses for help in practicing your child’s skills.  Something as simple as a neighbor asking your child what they did today can do wonders.

Stay aware of your child’s progress.  Day-to-day interaction will show you where your child improves the most, and the least.  Sharing this with your Program Supervisor will help them to refine future sessions. 

You Have a Responsibility to Work with Your Child – And a Huge Value

Remember that you’re not just the parent.  You are a teacher, a therapist, an advocate for your child…and a team member.  It’s your responsibility to seek training & help from your fellow team members, so you and your child continue to thrive.

If you have questions about the Treatment Team, please talk with your A is for Apple supervisor.  

See you next month!


Local Events

Free Class on Teaching Functional Language to Children, and the SARC Summer Festival

july2016sanadreasTwo local events to enjoy this month!

First, the San Andreas Regional Center is having its Summer Festival on July 30.  Everyone in the SARC Community is encouraged to attend.  They’ll have games, entertainment, food trucks, service provider booths, and prizes to win!

  • When:  July 30, 11:00am to 3:00pm
  • Where:  Harvey West Park in Santa Cruz 326 Evergreen Street, Santa Cruz CA 95060 (Google Map)

Register to attend here: Summer Festival Hosted by San Andreas Regional Center, July 30

Tickets are free!

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After that, join us for an important autism class on August 18!

july2016teachinglanguageTeaching Language to Children with Autism – the Verbal Behavior Approach

This class will focus on functional language, and how it helps children with autism grow.  Deborah Van Tuyl, a Board Certified Behavior Analyst (BCBA) with more than fifteen years of experience, will speak.

It’s free to attend, but sign up early!  The seats will fill up fast, so register for a seat here:

Teaching Language to Children with Autism Class – Eventbrite.com

  • When:  August 18, 10:30am-12:00pm
  • Where:  Sobrato Center for Nonprofits, Shoreway Conference Room 350 Twin Dolphin Drive, Redwood City CA 94065 (Google Map)

RSVP: openingdoorspta@yahoo.com


Autism Tips: Potty Training III – Potty Training Guidelines

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This is Part 3 of our Potty Training series.  (Post 1 is here; Post 2 is here.)

Now that you’ve prepared your home and your child is ready…it’s time to begin the training!

For this article, we’re citing a training method developed in 1971 by Azrin and Foxx.  The program is evidence-based, like our ABA techniques, and geared toward toilet training individuals with ASD or similar developmental disabilities.  It remains the standard today.

We’ll focus on two activities: reinforcement and scheduling toilet times.  You’ll have two goals to aim for with these:

  1. Your child eliminates when sitting on the toilet.
  2. Your child remains dry when they are not sitting on the toilet.  Simple.

How will you encourage your child to use the toilet and not a diaper?  With these 4 actions:

  1. Giving them increased fluids
  2. Scheduling times to sit on the toilet
  3. Positive and negative reinforcement for the desired “target” behaviors

Redirection when accidents happen

Action 1: Increased Fluids

Increase the amount of fluids your child drinks about 1 hour before starting training.  Choose a drink they will finish, or water.  Don’t force them to drink too much, though.  The goal is to maximize the chances they will need to use the bathroom soon.

Action 2: Scheduling Sitting Times

Set a time interval for checking your child for dryness.  During this time, give him/her the chance to sit on the toilet.  Repeat the process every 10 to 30 minutes.  Increase the time between each dryness check as your child improves, and encourage them as they progress.  For example:

  1. Starting Out: Check your child for dryness every 5 minutes over a 15-minute interval.  Ask the child, “Let’s see, are you dry?”
  2. On each check, if the child didn’t wet himself/herself, give them some positive reinforcement (e.g., a hug, tickle, or high-five).
  3. If your child remains dry for 15 minutes one day, go longer between dryness checks (e.g., bring them to the bathroom every 20 minutes the next day).
  4. Keep increasing the time until your child can remain dry for one hour.

If you like, use the Toilet Training Data Sheet below to track your child’s successes.  It can tell you when to adjust the time intervals.

trainingdatasheet

Reinforcement for Success

After the time interval passes, instruct the child that it’s time to use the bathroom. Something as simple as “Let’s go potty!” often works.  Hold their hand and take them to the toilet.

Place your child on the toilet, with pants down, and have them stay seated for 2-4 minutes.  Just long enough for them to calm down, and go.

  1. If the child successfully eliminates while sitting, give them reinforcement right away.  A toy, a small snack, or going to an activity they enjoy all work.
  2. If the child urinated, he/she can get up from the toilet without waiting the whole time.

If the child didn’t urinate in the toilet, training continues.  Before you leave the bathroom, tell the child, “Let’s stay dry,” and start the time interval again. 

Redirection for Accidents

If an accident occurs, give your child a neutral redirection (i.e., “We go pee-pee on the toilet”).  Then take them to the bathroom.  If the child is playing with a toy when the accident happens, take the toy away and say, “You are not dry.”

Have your child sit on the toilet for one minute, before cleaning them up.   If they finish eliminating in the toilet, praise them!  This counts as a training success.  Afterwards, return to your normal time interval.

Summary: Patience + Consistence = Success!

It’s important to keep a positive attitude about potty training.  Believing your child can do it (and they can!) will help them succeed.

Most parents find that potty training builds on itself over time.  Once your child consistently uses the toilet, you’ll have an easier time teaching related behaviors like wiping, washing hands, etc.

A child has learned bladder control if he/she:

  1. Has no accidents,
  2. Eliminates immediately upon sitting on the toilet, and
  3. Tries to eliminate while sitting on the toilet (usually shows as straining in the body or face).

Remember, potty training is a long-term process.  It may take a while before you see any improvement, so you’ll need consistency and dedication to stick with it.  We hope this information will help you succeed!

Check in with your program supervisor and/or Clinical Director for further guidance and recommendations.

Please join us on our Facebook Page with your potty training questions or stories: https://www.facebook.com/AisforAppleInc/


Ask the A is for Apple Community

Summer Travel Tips from A is for Apple Parents & Caregivers

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“Dear A is for Apple, We have a pool, but my child wasn’t old enough to go in it until now. What should we do?”

With summer here, most of us are thinking of ways to cool off. But, before everyone jumps in the pool, we want to make an important point.

The second leading cause of death among individuals with autism, after wandering, is drowning.

It’s critical to learn water safety before your child dives in. To help, here’s some advice on teaching water safety.

  1. Start early. Introduce your child to water early in life, so they grow familiar with it. Use a visual, like a picture card, reinforce water rules (like, “Don’t go in the water without Mom or Dad!”).
  2. Take swim lessons. If your child knows how to swim, it makes them much safer in water! The YMCA has several locations which offer Special Needs swimming instruction. The list indicates YMCAs in Berkeley, Redwood City, San Mateo, and San Jose.
  3. Watch out for wandering. Some individuals with autism are drawn to water. If yours is, take precautions against their falling into a pool or creek.
    1. Put up a safety gate if you have a pool.
    2. If you live in a complex with a communal pool, notify the property manager so others can keep an eye out.
    3. Never leave your child unsupervised when you’re in an area with water.

Water safety is about more than learning to swim. Take the time to educate your child on how dangerous water can be. Knowing how to stay safe will make summer more relaxed & fun for everyone!