How to Coordinate ABA Therapy with your Healthcare Team

Archive for the ‘Autism’ Category

How to Coordinate ABA Therapy with your Healthcare Team

Posted on: November 18th, 2019 by Autism Therapy Group


A conversation with Matthew Nordman, BCBA, Regional Director for The Autism Therapy Group


Q: Why is it important for parents to keep their BCBA informed about their child’s overall healthcare needs? For example, do BCBA’s need to know about things like routine doctor visits?


Matthew: Parents want the best care for their child, of course. And that means doing all they can to ensure that their child is getting the highest quality care across every area of their life. This is much easier said than done.


I mean, parents of all children have to deal with healthcare situations that are challenging. Taking their child to the dentist to get their teeth cleaned or taking them to vaccination appointments can present a behavior landmine for any parent. But, for parents of children with autism, these types of situations are even more challenging.


So, often the first thing parents look for when reaching out to their BCBA for help with other healthcare appointments, is behavioral support. And, that’s great. We can absolutely support parents in that way.


Just a couple of weeks ago, I was working with a child who needed to get some vaccinations. Based on past experience, the parents were concerned about how their child would behave at the doctor’s office. Because they talked with me beforehand, I was able to provide support in the form of implementing preventative strategies into the child’s ABA therapy sessions.


Q: When it comes to ensuring that their child gets the highest level of care, are there things other than behavior that parents can rely on their BCBA for assistance?


Matthew: Absolutely. In fact, many of the kids we work with don’t really have behavioral issues in healthcare situations. But, for most parents, having the insight and opinion of their BCBA makes their job much easier.


ABA therapy is evidence based and a huge part of the process is collecting data. BCBAs create a plan for each child based on recorded data about how they behave. Over time, the BCBA records changes in the child’s behavior and makes adjustments to their therapy plan accordingly.


So, while behavioral support is a huge part of that, BCBAs can also arm parents with the data and information they need to make informed decisions about their child’s care. This is especially important when it comes to working with the child’s school and, if they are seeing one, the child’s psychiatrist.


In IEP meetings, the parent often has to advocate for their child to get the services they need. If the BCBA is involved, they can offer guidance, observations, and hard data to demonstrate why the child needs particular accommodations or support. Sometimes this means talking with the parents and arming them with the right information so that the parent can advocate for their child on their own. And sometimes this means having the BCBA attend IEP meetings. Outside of the home, the child’s school is usually the biggest influence in the child’s life. So, coordinating ABA therapy with the care they receive at school is extremely important.


It’s also really important to have the BCBA involved in psychiatrist appointments. Although the BCBA may not always be able to physically attend the appointment with the parent (but it does still happen when necessary), we can still always equip the parent with data that will have a direct influence over psychiatric treatment.


Let’s say a psychiatrist asks a parent if their child is still hitting. A BCBA is able to provide data that’s much more specific than a simple “yes” or “no”. For example, “Two months ago the child was hitting at a rate of 4 times an hour, but this month the average is only 1 1/2 times and hour.”


Another thing that comes up a lot is a child who behaves well in the psychiatrist’s office, while acting out aggressively at home. In those kinds of situations, the BCBA can provide documentation of behavior that the psychiatrist wouldn’t have access to otherwise. In general, psychiatrists appreciate that level of involvement from a child’s BCBA.


Q: Are there any situations in which the BCBA might accompany parents to healthcare appointments outside the home?


Matthew: In general, insurance companies won’t cover the cost of having a BCBA accompany the child in community settings. This means that if a parent wants their BCBA to come with them as they take their child to an IEP meeting or to a doctor’s office visit, they have to pay out of pocket. Most parents simply can’t afford that.


At ATG, when there is a situation in which the best thing for the child is for their BCBA to go with them to a school or healthcare appointment, we do it even if the insurance won’t cover it and the family can’t afford it. We are serious about providing the level of support that our clients need and will do so regardless of insurance red tape and financial impediments.


But, in most situations, it’s not necessary for the BCBA to go with the child to outside appointments. There is a lot that a BCBA can do before the appointment to prepare the child and the parent. For example, ABA therapy might include a lot of social skills training aimed directly at helping the child know how to behave in situations that are unexpected or that come with a lot of sensory input.


The BCBA will often also work with the parents, coaching them and offering advice for how to handle their child in a particular setting or situation. We can provide more support than most parents think in helping them understand what treatment options might be in the best interest of their child.


Q: Do parents usually understand the level of support they can receive from their BCBA before their child gets started with ABA therapy?


Matthew: In almost all cases, when parents first start working with a BCBA they vastly underestimate the power of that relationship. They are often also surprised to learn how many hours of ABA is recommended and how involved their BCBA can be in supporting the child’s care outside of the home.


At ATG, these are things that we communicate during the assessment process and parents are usually very pleasantly surprised. We also do our best to schedule a school observation along with the initial assessments and gather information about any other treatment the child is receiving. We ask questions to understand how the child behaves all these situations and what the parent’s challenges are in managing their child’s care.


What most parents don’t realize at the beginning of ABA therapy is how central the relationship with the BCBA will become to all aspects of the child’s development. I mean, it doesn’t do the family a lot of good if ABA therapy only applies to the child’s behavior inside the home. All the skills learned in ABA therapy must be generalized to the outside world.


One thing that’s important for parents to understand is that ABA therapy is evidenced based. So, if the parent wants their BCBA to implement a strategy for which there is no clear evidence for how it supports ABA therapy, the therapist is not likely to implement it into their therapy sessions. For example, swim therapy is popular with many parents of children with autism but there isn’t evidence that swim therapy directly supports ABA therapy. So, even if a parent wanted their BCBA to implement swim therapy into ABA therapy, the BCBA would not be able to do so.


The most important thing for parents to know is how important it is to provide their child’s BCBA with information about every kind of care the child is receiving even if they think it doesn’t apply to ABA therapy. We can often offer advice and support that will benefit the child’s overall care to a significant degree.


We are here to support families and their children in every way we can.


How to involve your ABA team in the IEP process

Posted on: October 4th, 2019 by Autism Therapy Group


We receive a lot of questions from parents about IEP plans. The whole process can be complicated and overwhelming, and it’s challenging to know if your child is receiving all the options they are entitled to. Furthermore, it’s sometimes difficult for parents to understand how they can create consistency for their child as they transition between the school and home environments.


To help answer these questions, we sat down with Karyn Olzak, who is one of our amazing clinicians here at The Autism Therapy Group. We asked Karyn how and why parents should get their ABA team involved in the IEP process and what parents need to know about advocating for quality, consistent care and education.


Q: What is an IEP and what is involved in creating an IEP for a child?


Karyn: IEP stands for Individualized Education Plan and it’s a requirement that must be fulfilled before a child is eligible to receive special education services. The first step is for the child to be evaluated by the school’s special education team who determine the child’s eligibility and then develop an IEP for the child.


The IEP can cover a lot of different aspects of the child’s education, but the overall goal is for all the pieces – from test results to special accommodations to progress markers – to come together and create the best possible education plan for the child. Most special education teams rely heavily on the parents’ input during this process and will set up a meeting with the parents to develop an individualized education plan with their input. Once a year, parents will attend the annual IEP meeting to review the child’s progress and develop new goals.


For many parents these meetings can feel stressful or overwhelming. It’s not only important for the parents to know what to expect from the IEP process, but to also have an idea about their rights and expectations. For parents who are already working with a BCBA, it’s very important to get them involved right away.


Q: Why is it important for the parents to get their child’s BCBA involved in the IEP process?


Karyn: The parents are the key players on the IEP team and the BCBA’s role throughout the process is to support them in advocating for their child and ensuring that the child receives the highest quality care. These meetings can feel intimidating to parents because they often involve a lot of different people. Sometimes parents don’t know the things they can and can’t ask for or what their rights are. This is especially true if they are new to special education.


The BCBA has likely been through this process many times and can really help to advise the parents about what they can and should expect, and encourage them to voice their goals and dreams for their child. The IEP process is complicated and the BCBA can be a tremendous support for both the parents and the child. Most parents appreciate having someone else there who knows their child and is able to express the challenges and progress of the child inside the home and what they expect to see for the child in the future.


It’s also important for the BCBA to be involved to ensure clarity and consistency. In most cases, consistency is one of the most important aspects of a child’s progress. It’s in the child’s best interest for everyone involved in their life to be on the same page, focused on similar goals, and working on the same behavior plan.


As progress is being examined throughout the year, the BCBA can offer insights into what they are working on at home, how the child has progressed outside of school hours, and how behavior modifications are evolving. All of these things contribute to new goals so that the IEP is not only consistent across all aspects of the child’s life, but a fluid process that is able to adjust to the changing needs of the child.


Q: How does being involved in the IEP process affect the work that the BCBA does with the child outside of school hours?


Karyn: Many of the kids we work with have a difficult time transferring skills from one setting to another without specific training. If the BCBA knows that the special education staff is working on specific skills during the school day, they can work with the child to see how those skills transfer into the home and even the community.


Teaching kids how to demonstrate the same skills in a variety of settings is not only important for creating consistency, it also allows the BCBA to support the work of the special education staff.


Q: How does being involved in the IEP process affect the goals and outcomes of the IEP?


Karyn: In most situations, BCBA’s are working very closely with parents. As a result, when BCBA’s are included in IEP meetings, they can provide support in making sure that the plan’s goals are aligned with what the parents want to see. They can also advocate for accommodations that might benefit their child by encouraging the parents to ask for what they think their child needs.


In many cases, the BCBA is there during IEP meetings to really listen, make sure that they are getting important school information, and have a clear understanding of how the special education staff is working with the child.


Q: A common theme I’m hearing throughout this conversation is the importance of consistency.


Karyn: Yes! It’s so important for children with autism to receive consistency of care. If everyone involved in educating and supporting the child’s growth has similar goals, the child will progress faster. That’s the simple truth.


The special education staff, BCBA, parents, and any other caretakers need to know that they aren’t overwhelming and confusing the child by having different goals and expectations in different situations. There must be a focus on skills being transferred and generalized from one setting to another. That’s really is key. The ideal situation is for everyone in the child’s life to be on the same page, teaching the same replacement behaviors and following a similar reactive plan.


How can we help you?


For more information about The Autism Therapy Group and what makes us different, please click here.


For questions about how we can support you and our child, please contact us. We are always happy to talk with you.

How to be an Active Participant in your Child’s Therapy Services

Posted on: September 11th, 2019 by Autism Therapy Group


Every single day, we meet with parents of children with autism who want what every other parent on the planet wants – to do all they can to set their child up for success. In many cases, the parents are stressed, overwhelmed, and struggling to do what’s right for their child while managing their many other responsibilities.


We sat down with Lisa Guerrero, M.Ed, BCBA, the Regional Director of Texas for The Autism Therapy Group to talk about how parents can be an active participant in their child’s therapy sessions and the options they have when time and resources are tight.


Q: In most cases, what is an ideal level of parent involvement in ABA therapy?


Lisa: Ideally, we want the parents or primary caretakers to be as involved as possible during ABA therapy sessions with their child. We always schedule a meeting with them prior to the first therapy session so that we can go over the treatment plan, answer questions and clarify expectations. We also spend a lot of time talking with parents about how the treatment plan will be implemented.


This is an important first step, because in order for the parents to be successful participants in the therapy sessions, they have to understand the treatment plan.


Once sessions with the child begin, we prefer for parents to be readily available to observe what the therapist is doing and how the treatment plan is being implemented. We encourage them to ask a lot of questions. As therapists, when a parent is willing to ask a lot of questions, it helps us know that they are really engaged in the process and ensures that we can clear up any misunderstandings or incongruities about the strategies being implemented.


That said, we don’t expect the parents to be present for the entirety of every session, which generally lasts several hours. But it IS extremely helpful for parents to be available to come and go throughout the sessions. This allows the therapist to call them in when they want the parent to observe or model an intervention.


Q: Why is it important that parents and caretakers be involved in their child’s therapy?


Lisa: ABA therapy is a 24/7 strategy. But, even in intensive therapy situations, the therapist is only there for a few hours each day. It’s up to the parents and caretakers to maintain the consistency of the treatment plan even when the therapist isn’t there.


Consistency is extremely important to the success of ABA therapy. If the parents and caretakers don’t understand the treatment plan, the child will not be as successful. ABA therapy is not the kind of thing that the child is engaged in for a few hours before returning to “normal” life. The treatment plan must become the foundation of all the interactions the child has with everyone in their life.


Q: What do you do in situations where the parent simply can’t be there during every session?


Lisa: Often, parents can’t be available for the entirety of every situation because they are at work or managing activities with their other children. In those cases, we try to schedule appointments with the parents outside of the sessions with their child, at a time that’s convenient for them.


These meetings are an opportunity to talk to parents about what we have been doing with their child during ABA therapy sessions, including the things we’ve been training the child’s other caregivers to do. We ask the parents questions such as, “Have you seen them {the caregiver} modeling this behavior with your child? Have they shown you how to implement this particular strategy?”


Whenever we train a nanny or family member on aspects of the child’s treatment plan, we always leave notes for the parents instructing them to watch the caretaker to see what they are doing with the child. This helps ensures a higher level of consistency in the child’s treatment.


As I said earlier, it’s critical that everyone who is involved in caring for the child is on the same page. Consistency is key when it comes to the success of ABA therapy.


Q: If the family has other children, is it important for them to be involved in the therapy plan as well?


Lisa: Everyone who is involved in the life of a child in ABA therapy will benefit from being trained in the strategies the therapist is implementing with the child. It’s a family effort. It’s in everyone’s best interest to be an active participant in the therapy plan.


When everyone is involved, the child will experience faster progress and more overall success. However, the level of involvement from other children depends largely on their ages. This is one of the things we assess and talk with parents about right from the start.


Q: How do you and the other therapists at The Autism Therapy Group involve parents in their child’s treatment plan right from the start?


Lisa: In most cases we conduct a thorough intake with families before we even do the first assessment with the child. This is a good opportunity to set expectations about parent and caretaker participation. At that time, if there are going to be any barriers to participation, we work out a plan for how to deal with those barriers in light of what’s best for the child and the family.


Most parents who are seeking out ABA therapy not only understand that their involvement is necessary – they want and expect to be involved. They already understand the level of dedication to really see progress and are willing to do what they need to do for the success of their child.


That said, there’s no such thing as a one-size-fits all approach. Every situation is different, and so we try very hard to be very flexible to what the child and the family needs and work within the time and resources that the family has. Whenever possible, we arrange treatment sessions to ensure that there is consistency across all situations and with all the different people that are involved in the child’s life.


For example, if a grandparent is the primary caretaker of the child several days a week, we do our best to schedule some sessions during the times when the grandparent is there. Again, consistency is key to success.


Q: What is the most important thing you want parents to understand about their involvement in their child’s ABA therapy?


Lisa: ABA therapy produces significant long-term benefits if parents and caretakers can manage to devote a lot of time up front. All the time spent now will serve to reduce stress and time-consuming behaviors, like temper tantrums, later on. That’s one of the most important things for parents to understand. If they put the effort in up front, they will reap the benefits later.


It’s also very important that parents understand the different variables that may come into play and how important it is to be open and honest with their child’s therapist. Many parents are working full time jobs, parenting other children, and managing busy lives with multiple responsibilities. Maintaining a consistent treatment plan is easier said than done! It’s very easy to become discouraged and overwhelmed.


Because of this, it’s extremely important that lines of communication are open between the child’s therapist, parents and other caretakers so that we can adjust the plan if something isn’t working.


We want the plan to be a positive experience for everyone involved!

10 Effective Strategies for Parents of Children with Autism

Posted on: April 3rd, 2019 by Autism Therapy Group


As a parent, receiving a diagnosis of autism for your child can be overwhelming and invoke feelings of fear, grief, and even loss.  However, these difficult emotions can also be important motivators for parents to find the resources they and their child need to cope, grow, and thrive.


What is Autism?


Autism literally means “aloneness,” or living in one’s own world.  In severe cases, children may have no ability to interact with others, treating people the same way as they treat objects. Even in milder cases, children may have difficulty understanding and relating to others, and will find it especially challenging to understanding other people’s perspectives and emotions.


Without treatment, children on the spectrum may not develop effective social skills and struggle with communication and appropriate behavior. It’s very unusual for individuals to function well in society without any intervention.


While finding appropriate treatment is essential, dealing with the day-to-day care of a child with autism is challenging for the best of us. If you’re the parent or caretaker of a child with autism, our hope is that the following strategies will help you manage the realities of life in an effective, positive way.


  1. 1. Ask for help.

Don’t be ashamed to ask for help. As a caretaker of a child with autism, one of the best things you can do is to be open and honest about what you need. Often, there are more people out there than you think who are ready and willing to help.


Reach out to other parents who are on a similar journey and professionals who can help and support you. Most importantly, find a supportive community for you, your child, and your family.


  1. 2. Find a support group.

Part of asking for help is connecting to other parents and caretakers in the ASD community. You may be surprised at the welcome that you’ll receive. Receiving the diagnosis of Autism or Asperger’s for your child can be overwhelming. Having the support of those that have faced the same challenges is not only desirable – it’s essential.


  1. 3. Give others the benefit of the doubt.

When you’re the parent of a child with autism, it’s probably inevitable that you’ll receive a negative comment from time to time and feel that people are judging you and your child’s behavior. Most of the time, it’s just that they don’t understand the truth about ASD. Take the opportunity to educate them about what autism is. Explain the effort required by a child with autism to cope with normal day-to-day interactions that the rest of us take for granted.


  1. 4. Engage in floor activities.

Many children with autism have difficulty making eye contact and engaging with other people. This is the perfect opportunity to get down where they are and enter THEIR world.


  1. 5. Introduce different textures through play.

Children on the autism spectrum are often challenged with tactile sensitivities, finding specific textures irritating or even frightening. It can be useful to explore various textures with your child through play. Playing games with textured balls or blocks, introducing different washcloths at bath time, making crafts or playdough from scratch, and even baking can be fun, safe ways for your child to experience different textures.


  1. 6. Learn to speak in 2-3 words phrases.

For children with limited vocabulary, or those who are completely non-verbal, limiting communication to 2-3 word phrases can be more effective than long sentences. For example, Stand up. Sit down. Get the toy. Lights off. Brush teeth.


  1. 7. Create as much structure as possible within your home.

All individuals with autism have a high need for structure. As much as possible, create reliable systems for your child so that they know what to expect. For example, many parents find it useful to use a timer to communicate when one activity is over and another is beginning. Structure decreases anxiety and helps children with autism feel more in control of their world, which can, in turn, decrease destructive behavior.


  1. 8. Set reasonable expectations.

Help your child find success more often through setting reasonable expectations for them. Be realistic with goals and create specific strategies for their achievement. (Your ABA Therapist can help!) Every step towards a goal should be broken down into clear, manageable steps so that your child can experience their progress in a concrete way.


  1. 9. Establish play dates.

It’s common for parents of children with autism to express frustration that their child has a difficult time making friends or doesn’t seem to like anyone. They might even appear afraid of other children because they don’t know how to manage social interactions. Work with your ABA Therapist to create a plan for regular, controlled social interaction so that your child can begin to learn how to engage with other people in socially acceptable ways. This process can be difficult and slow. Ask for help, be as patient as you can, and keep going. This social training will form the foundation for their future success.


  1. 10. Never Lose Hope.

The most important piece of advice we have for parents of children on the spectrum is this: Children with autism have the potential to grow, improve, and thrive. 


Autism IS treatable and if you hear otherwise, the source of that information is out of touch with current therapy options. It IS important to find effective therapy options for children with autism as soon as possible. The earlier children receive appropriate treatment, the better their prognosis.


The good news is that there are effective treatment options.


Even though every child is different, children with autism are typically challenged with deficits in the areas of sensory processing, visual perception, motor skills, social skills and communication.


Applied Behavioral Analysis (ABA) is the most effective therapy for dealing with these challenges and creating growth patterns that help the child function in a more positive way in the world. ABA therapy generally involves a therapist working one-on-one with your child for as many as 20 to 40 hours each week. Children are taught skills in a simple step-by-step manner that includes plenty of repetition and routine. After a while, therapy generally includes more global situations and community environments.


If you suspect that your child has autism, but have not yet received a diagnosis, we urge you to make an appointment to see your child’s physician. If you like, you can review some of the most prevalent signs of autism in this article. However, if your child does have autism, getting a diagnosis is important because it can open the doors to many services, and help you as a parent access quality information about treatments options.


As always, we are here to help! Contact us for questions about the most positive, effective treatment options available for children on every point of the spectrum.

Does My Child Have Autism?

Posted on: February 27th, 2019 by Autism Therapy Group

No parent wants to believe that their child has a problem. It’s natural to hope for happy, healthy, well-adjusted children who will grow up without any major difficulties. But, when it comes to children on the autism spectrum, identifying the signs early in the child’s development can make a big difference.


Regardless of your child’s age at this moment, if you suspect they are somewhere on the spectrum, there is hope. Today more than ever, there are a variety of effective treatment options that can help your child grow, develop, and thrive.


Understanding Autism


Autism Spectrum Disorder (ASD) is a spectrum of complex neurobiological disorders with common symptoms that are most often characterized by difficulty communicating and relating socially to others, and an obsessive need to engage in repetitive behaviors or language. Symptoms of ASD show up in infancy and very early childhood and might include avoiding eye contact, delayed speech or not speaking at all, not responding to his or her name, and restricted interests.


It’s important to understand that there are a wide variety of symptoms for children who fall somewhere on the spectrum. Symptoms that are easy to spot in one child might be virtually invisible in another.


However, every child who lands somewhere on the spectrum struggles with challenges in these three areas:


1. Verbal and non-verbal communication.


2. Relating to and understanding other people and the world around them.


3. Adapting to change or dealing with unpredictability.


Warning Signs


If you’re the parent or primary caregiver for a young child that is exhibiting behavior you feel might be indicative of autism, we encourage you to trust your instincts. As the person who spends the most time with the child, you’re in the best position to identify early warning signs. Schedule a visit with your child’s pediatrician, who will most likely recommend thorough evaluation and testing. However, sometimes even the best doctors can miss or underestimate signs and symptoms.


Remember that you know your child better than anyone else and are privy to behaviors that might not show up during a doctor visit. The key is to educate yourself as much as possible so that you have a good idea for what’s normal and what’s not. If you feel that your child is not receiving the care they need, seek a second opinion or a referral to a child development specialist.


“Don’t worry….”


Many people’s natural response to a parent concerned about the development of their child is to say, “Don’t worry”.  Or, “I’m sure everything is fine.”  After all, no one wants to believe that there is something wrong with a child. But, early intervention with children who’ve been diagnosed with autism can make a tremendous difference. If you have any concerns about whether your child is on the spectrum, don’t wait to seek evaluation.


It’s true that every child develops at a different pace. There’s no need to panic if your child is 12-months old and not walking even though your neighbor’s child walked at 10-months. “Normal” development carries a wide birth. But, if your child has not met several milestones for his or her age, or if you’re noticing other signs for concern, don’t wait. Call your pediatrician right away.


Early signs of autism in babies and toddlers.


Autism is difficult to diagnose before 24 months, but symptoms can show up as early as 12 months and early treatment can capitalize on the significant plasticity of a child’s young brain.


The earliest evidence of autism is, frustratingly, the absence of “normal” behaviors, not the presence of “abnormal” behaviors. Making it more difficult, the earliest symptoms can be interpreted as a baby just being really good  because they are quiet and undemanding.


Early signs.


Your baby or toddler doesn’t:


1. Respond to cuddling, reach out to be picked up, or make eye contact when being fed


2. Smile when being smiled at, or mimic facial expressions


3. Respond to the sound of a familiar voice


4. Respond when you call their name


5. Seem interested in play or games


6. Follow gestures or look at an object when you point to it


7. Attempt to use gestures to communicate or make noise to get people’s attention


Occasionally, a child with ASD will seem to develop communication skills normally and then regress. Regression generally happens between 12 and 24 months. For example, a child who waved goodbye when someone left the room might stop communicating entirely, with gestures or otherwise.


Signs and Symptoms in older children.


As children grow, signs of autism become much more diverse, but typically revolve around a lack of social and communication skills, and particularly inflexible behavior.


1. Seems unusually sensitive to sound, smells, textures, and bright, colorful or moving objects


2. Are unresponsive when people leave or enter the room they are in, seems oblivious when others try to get their attention, and generally appear disinterested in what’s going on around them


3. Avoids eye contact


4. Doesn’t seem to understand the context of language – humor, irony, and sarcasm – and takes what is said literally


5. Exhibits facial expressions that don’t align with their words or tone of voice.


6. Doesn’t seem to understand that other people’s facial expressions, tone of voice, and gestures are communicating something


7. Has difficulty picking up on nonverbal cues


8. Repeats the same words or phrases over and over, getting stuck on the words not the meaning


9. Responds to a question by repeating the question


10. Uses language incorrectly (grammatical errors, wrong words) or refers to him or herself in the third person


11. Has difficulty communicating needs or desires


12. Does not to like to be touched, held or hugged


13. Insists on following rigid daily routines


14. Does not adjust to changes in their normal schedule or inconsistencies in their environment


15. Seems to form deep attachments to toys or objects but not with people


16. Obsessively places objects in a row, sorts them, or arranges them in a certain order


17. Repeats the same behavior over and over, such as rocking, twirling, or flapping their hands.


What to do if you’re concerned that your child might have autism


If many of these symptoms sound familiar, or if your child is developmentally delayed, schedule an appointment with your pediatrician.The diagnostic process is sometimes long and can be difficult. But, if your child is diagnosed with autism, it’s important to engage in treatment as soon as possible.


If you’d like to talk with one of our therapists or technicians, contact us today. We welcome your questions, comments, and suggestions.



Behavioral Modification Strategies for Children with Autism

Posted on: February 1st, 2019 by Autism Therapy Group

8 Strategies for Dealing with Challenging Behavior in Children on the Autism Spectrum


A little girl painting a picture.


Dealing with the behavioral challenges in children with autism can be quite frustrating for parents, teachers, and other care professionals. Acting out can happen suddenly, last for hours, and be hard to control. In public settings, the behavior can trigger fear or embarrassment, further compounding the problem. At home, constant temper tantrums can create feelings of hopelessness and exhaustion for parents and other care takers.


The child is frustrated because they don’t know how to get what they want. Care takers are frustrated because they don’t know how to help or change the situation. Something has to give.


The following is a list of strategies that can help prevent difficult behavior AND promote positive behavior for children on the autism spectrum. Remember that every child is different. It’s important to be patient and know that it might be necessary to try different strategies to determine what works best with your child or student.


Remember that there is no such thing as a magic one-size-fits-all solution for every challenge.All any of us can do is try our best to implement effective strategies that teach children positive ways to get their needs met. As always, if you feel like the situation with your child is unmanageable, seek help.


1. Be clear with the child about what’s happening next.


For example, “After you finish this game, it is time to put on your pajamas.” Or, “In 10 minutes, we are going to get into the car and drive to school.”


For many children with autism it’s helpful to set a timer. Being able to visually track time can help the child understand the difficult concept of time. For some children, it might even be necessary to include reminders as the time is winding down – “There are 2 minutes left until we leave. There is 1 minute until we leave.”


For children who struggle to understand verbal communication, pictures that visually represent a series of upcoming events can be extremely useful. For example, if you want the child to sit down at the dinner table after they complete a puzzle, you might show them a “first/then” board with pictures of a puzzle and then the dinner table.


Technology can be a tremendous help with these kinds of strategies. There are several great apps for tablets and smart phones that contain a library of photos to create “first /then” boards right on the screen.


  1. 2. Children with autism thrive on predictability.


It’s extremely important for children with autism to know what to expect from the people and situations in their world. If caretakers don’t implement expectations with consistency and follow through, it creates uncertainty that often leads to anxiety and acting out.


Do your best to make their world predictable. For example, tell the child that you will give them a snack if they finish their homework and then do not fail to keep your end of the bargain. It can also be helpful to create predictability through daily routines. For example, homework, then dinner, then one television show, then get ready for bed.


As we’ve already discussed timers and “first/then” boards are useful to communicate the predictability of events. In many cases, as the child comes to know what’s expected and trust that caretakers will follow through, the rigidity of routines can relax a bit over time.


Keep in mind that difficult behaviors are more likely to come out when things aren’t predictable, and no one can make life predictable all the time. Just do your best and get back in the swing of a predictable routine as soon as possible.


  1. 3. Allow children to earn privileges in exchange for compliance with clear expectations.


Children with autism often respond well to the concept of earning privileges if they follow the rules. For example, let’s say your child has a history of throwing a fit when you won’t allow them to visit the toy section at Target. Before going to the store, explain exactly what to expect from the outing: “We are going to Target. We are going to shop for groceries, pay for our groceries, and then we are going home. We are not going to the toy section. If you follow the rules, you can play video games for 30 minutes.”


Remember that children who struggle with understanding verbal communication often respond better to pictures and visual cues. In these cases, set expectations with pictures and physical examples. For example, rather than telling the child to hold on to the shopping cart, demonstrate what it looks like to walk while holding onto the shopping cart. Show, rather than tell.


  1. 4. Offer the child a few set choices.


Every child likes to feel that they have some control over their world and one way to do this is to offer choices. For children with autism, it’s usually a good idea to limit the choices to a few pre-determined options. Too many choices, or choices that are too open-ended, can be scary and overwhelming. For example, “Would you like to play this video game or work on a puzzle?” Or, “Would you like a peanut butter sandwich or a tuna fish sandwich?”


Once again, for children who struggle to understand language, present choices with pictures, encouraging them to point at the option they choose.


  1. 5. Create a daily schedule and allow the child to bring a transitional object from one activity to the next.


As we stated earlier, children with autism thrive on predictability, so daily routines are extremely beneficial. Break down routines into specific times of day. For example, create a before school routine, a during school routine, an after-school routine, and a bed time routine.


Visual schedules might include pictures of activities in order, such as the child eating a snack, doing their homework, setting the table, sitting down to dinner, etc.


In some cases, it’s useful to allow the child to bring a favorite object from one situation to the next. For example, if the child is at home playing with a stuffed toy when it’s time to go to speech therapy, allow them to bring the stuffed toy along. This can assist with helping him transition from one environment to the next.


6. As much as possible, when giving a child a task or assignment, set clear expectations for start and end times.


For example, instead of saying, “I want you to put all the toys in your room away”, tell them, “From 1:00 to 1:15, I want you to pick up the toys in your room and put them away.” For most children, it’s useful to set a timer so that the child has a concrete representation of the specific block of time.


For certain tasks, it’s more useful to communicate the visual cues that will allow the child to know when the task is complete. For example, “When you complete these 10 math problems, you are done with your homework and can go watch your television show.” In cases where the task has a clear visual ending, a timer is not always necessary.


In situations where the child is getting overwhelmed or frustrated with the length of time the task requires, it can be useful to allow a clearly defined break that lets the child do something enjoyable before returning to the task.


  1. 7. Many children with autism excel at hands-on or visual activities.


A great way to encourage calm behavior like sitting still and waiting patiently is to keep the child focused on a hands-on activity they enjoy. For example, if you are waiting in a doctor’s office with your child, bring a handful of blocks and instruct them to sort them by color or size. If you need your child to allow you 15 minutes to prepare dinner, instruct them to sort silverware or laundry, rather than telling them to “play quietly”.


  1. 8. Remain calm.


We know that caring for a child with autism can be difficult and frustrating. However, getting upset is a sure-fire way to make difficult behavior even worse. When your child is acting out, do your best to remain calm. It can be useful to create a system of support for those times when staying calm is particularly difficult. For example, you might call a friend, family member, or therapist for support.


Understand that yelling and threatening a child with autism will not improve their behavior, and may actually make the behavior worse by creating anxiety or fear in the child. Children with autism are not choosing to frustrate you. That is not their goal. They are trying to get their needs met and simply don’t know how.


Keep in mind that some children on the autism spectrum have trouble generalizing expectations across situations, and if you are using a strategy for the first time, you might not see a change right away. In some cases, the child will push against the strategy at first simply because it’s new and unfamiliar. It can be tough, but do your best to remain patient and implement these strategies with consistency.

The Impact of ABA Therapy for Children with Autism

Posted on: January 3rd, 2019 by rebecca blackwell


What is ABA Therapy and how can it help children on the spectrum?

The Impact of ABA Therapy for Children with Autism


Autism Spectrum Disorder (ASD) is a spectrum of complex neurobiological disorders with common symptoms that are most often characterized by difficulty communicating and relating socially to others, and an obsessive need to engage in repetitive behaviors or language. Symptoms of ASD show up in infancy and very early childhood and might include avoiding eye contact, delayed speech or not speaking at all, not responding to his or her name, and restricted interests.


It’s important to understand that there are a wide variety of symptoms for children who fall somewhere on the spectrum. Symptoms that are easy to spot in one child might be virtually invisible in another.


However, every child who lands somewhere on the spectrum struggles with challenges in these three areas: 


• Verbal and non-verbal communication.
• Relating to and understanding other people and the world around them
• Adapting to change or dealing with unpredictability.


The goal of any treatment option is to maximize the child’s ability to function by reducing ASD symptoms in a way that also supports positive development and learning. However, the range of home-based, school, and clinical treatment options can be completely overwhelming. Parents of children with autism want what all parents want – to provide their child with the support and resources they need to lead a happy, meaningful life.


We believe that Applied Behavior Analysis (ABA) is one of the most effective ways to support families by helping children with autism acquire new, positive behavior and communication skills while decreasing behavior that is destructive and detrimental to their development. 


What is ABA Therapy?


In a nutshell, Applied Behavior Analysis (ABA) is a systematic approach to treating the symptoms of autism while increasing communication and decreasing maladaptive behaviors. The approach starts with the understanding that not being able to communicate is incredibly frustrating for children with autism, and this frustration can cause them to act out in destructive ways.


ABA therapy has been proven to improve a child’s ability to communicate and teach behavior that helps them form vital social relationships. The approach is also an effective way to teach play and self-care skills that support long-term healthy development. Children who receive consistent treatment, especially from a young age, generally show significant improvements in school performance and their ability to act appropriately in a wide variety of social situations.


The Impact of ABA Therapy for Children with Autism


Hundreds of studies have demonstrated that ABA therapy can improve communication, social relationships, play skills, and self-care for children with autism. The techniques have been shown to help children perform better in school and may even prepare some children for future employment. Early intervention is most effective, but even when applied to adults, research confirms that ABA is a powerful method for reducing undesirable behaviors and increasing positive social interaction.


Perhaps most important, many parents of children receiving Applied Behavior Analysis report a significant reduction in daily stress. Parent involvement is incredibly important to the healthy development of all children – but, being the parent of a child with autism is not easy. ABA therapy can offer parents significant relief from the stress of caring for a child on the spectrum by offering the skills to help them communicate more effectively with their child.


It’s hard to underestimate the impact this can have on the overall health of a family. So, let’s dig deeper into why ABA therapy is so effective.


Behavior Analysis: Let’s start from the start.


Behavior analysis is simply a way to understand a child’s behavior by observing them in a variety of situations. No child operates in a vacuum. So, behavior analysis seeks to understand how environmental influencers affect behavior. The approach is founded on the premise that we can learn a lot about what’s happening inside a child by investigating what the child does – their actions, words, and skills. And, in seeking to understand why a child behaves the way they do, we must also examine the physical and social influencers that might change or be changed by that behavior.


Behavior analysis is also an excellent way to help explain how learning takes place for children with autism. Learning is a complicated and intricate process with countless variables. Through understanding the many intricacies of how learning takes place, we can develop principles and techniques for increasing positive behavior and reducing harmful and destructive behavior.


Applied Behavior Analysis is simply the application of what’s learned from Behavior Analysis.


ABA is a systematic approach to treating the symptoms of autism while increasing communication.


It’s all well and good to understand why a child is behaving in a certain way, but Applied Behavior Analysis takes that information and uses it in practical ways to help children acquire important life skills. Starting with specific knowledge about how the child is having trouble getting their needs met, ABA therapy implements practical skills that teach them how to make healthy self-care choices, work well with others, and pursue personal interests. As the child learns more effective ways to communicate with the outside world, destructive behaviors are no longer necessary and naturally decrease.


“One of the most effective ways to understand ABA therapy is to compare behavior to a pendulum. Communication skills are on one side of the pendulum and maladaptive behavior born out of total frustration are on the other side. By helping a child communicate in a way that puts them in control of getting their needs met, the pendulum swings away from the difficult behavior. It’s not easy, and takes time, but ABA therapy is one of the most effective methods we have to support the health and happiness of children with autism and their families.”
– Crystal Ciszek, Director of Operations and Business Development, The Autism Therapy Group


What Does ABA Therapy Involve?


ABA is one of the most effective treatments for autism in part because of how easy its principles can be applied in both structured environments, such as a classroom, and in day-to-day life, such as trips to the grocery store, play dates with neighborhood friends, or getting along with siblings.


ABA programs are highly structured, providing children with the consistency and repetition they need to test and modify their behavior. Therapists create a plan for the development of specific skills that is specific to each child’s needs. Skills are broken down into specific steps so that progress can be clearly tracked and the treatment plan can be adjusted if necessary.


The Impact of ABA Therapy for Children with Autism

One of the most effective parts of ABA treatment is the opportunity for repetition. Repetition is necessary for learning, so children are given ample opportunities to practice skills in a variety of situations. When the child achieves the desired results from an action, they are immediately given positive reinforcement which serves as further motivation to repeat the behavior.


Our approach at ATG is focused primarily on in-home therapy and other environments in which the family is consistently present, such as houses of worship, community events, extended family involvement, and athletic or cultural performance events.


Most ABA programs include support for the child at school and facilitated play with other children. As such, the therapy is tremendously effective in nurturing the development of basic life and social skills. Children learn to look at people who are speaking to them, notice things in their environment, understand social cues, and listen to people who are speaking to them. ABA therapy is also effective at helping children develop complex cognitive skills such as reading, holding a conversation, and even understanding other people’s perspectives.


ABA treatment is not a one-size-fits-all textbook like approach to the treatment of autism. There is no instruction sheet to follow or checklist to mark. On the contrary, one of the things that makes it so effective is that the intervention is customized to each child’s abilities, interests, situation, and needs. An ABA program for one child will look different than a program for another.


Progress builds on progress.


It’s important to understand that ABA therapy is an integrative, long-term approach, and the rate of progress varies from child to child. However, in most cases, small noticeable improvements will be apparent soon after therapy begins. As children recognize the personal benefits of behavioral changes, their progress becomes a natural stepping stone for further improvement.


ABA programs, including the programs offered through The Autism Therapy Group, create room for children to learn new skills and then put them into practice in both structured and unstructured situations.


Perhaps the most vital element in the effectiveness of ABA treatment is the treatment team. At ATG, we take a team approach to treatment, which may include a Client Case Manager, a Board Certified Behavior Analyst (BCBA) who manages and assesses your child’s progress, and additional specialized therapists brought in to meet specific needs. This team approach ensures that families are supported throughout the entire treatment process.


If you have a child with autism and are wondering if ABA therapy might be a useful component to their development, please contact us. We welcome all your questions, comments, and suggestions.
For more information and resources related to autism, please visit the ATG Resource Page.


Autism-Friendly Eating Out Tips

Posted on: December 7th, 2016 by Autism Therapy Group

Eating out should always be an escape, an enjoyable, relaxing experience, but when you’re going out to eat with your kids, things don’t always go as planned. If your family has a member on the autism spectrum, these challenges may keep you at home, feeling too overwhelmed to take on the whole endeavor.


But it doesn’t have to be that way, and every family deserves to enjoy a nice outing where you share laughs over delicious food (that you don’t have to cook or clean – bonus!).  Here are some tips you can try to embrace going out to eat with the whole family.


  1. Prepare before your outing:

  3. food-plate

Those with autism thrive on schedules and predictability, so springing a restaurant trip out of the blue may be a trigger for your child. Instead, plan and prepare ahead of time by talking about the plans, going over questions and answers such as:


  • Where are you going and why?
  • When are you going there? What day, what time, how much longer?
  • Who is going with you?
  • Has your child been to this restaurant before?
  • Will there be a waiting period? If so, where will you wait and how long will that be? What activities can you do while you’re waiting? Are reservations available?
  • Review the menu online with your child – what foods sound good to them?
  • Is there a special event you’re celebrating?


  1. Role play:

  3. tables

There are several YouTube videos specifically for children and children with autism role playing different situations like going out to eat. You can watch these videos with your child and practice role playing with your family at home.


Simulate the restaurant experience, including the following: walking in the doors, checking in with the host, waiting, choosing seats, meeting the server, being given a menu, looking at choices and making up your mind, ordering and speaking to the server (or asking mom or dad to help), talking with the guests, etc.


You can also read books or point out on TV shows when families are eating out, talking about their behavior and steps in the whole process.


  1. Create a visual schedule:

  3. schedule

To coincide with your planning and preparing ahead phase, you can also create a visual schedule that will remind your child in an easy way the steps in going out to eat. Create the visual supports with your child so he or she is involved in the experience from start to finish. Some steps to consider including:


  • Driving or other transportation to the restaurant
  • Who will be there with your group
  • Waiting to be seated
  • Who else will be there at the restaurant (other guests, hostess, servers)
  • Menu and ordering food
  • Communicating with family while waiting for food
  • Table manners
  • Paying and leaving the restaurant

You can make this by hand or use an online visual tool kit or organizer to create something on the computer.
With proper planning and practicing, your family can enjoy a nice trip out to a restaurant. Don’t let fear get in the way – the more you try, the more you will learn, and if an obstacle arises, don’t let it throw you off track. Use it as a learning experience for how you can modify your plan and trip for the next time around.


How do you prepare for restaurant outings with your family?

Enjoying the Holiday Season with Your Special Needs Child

Posted on: December 7th, 2016 by Autism Therapy Group

The holidays are often a stressful time for adults, filled with party engagements, shopping, spending, cooking, cleaning, and lots of preparations. As the parent of a child with special needs, sometimes the holidays can bring an extra stress, with movies, television, and commercials showing supposed “normal” families smiling and laughing through their holiday traditions.


But what if your family looks and feels different? What if your family doesn’t fit that cookie cutter mold (and whose does, actually?). You might feel sad that your family doesn’t match those picture perfect ones on TV; then you might feel guilty that you feel this way and ultimately you may feel alone, like you’re the only one feeling this way.


Shouldn’t the season be filled with love, peace, joy, and enjoying simple family moments? You don’t have to just survive this season – you deserve to embrace it! Check out these 3 tips to maximize the special time with your special needs child and your family in general.


  1. Lose the guilt:

  3. How can you say yes to a cocktail party and leave your special needs child at home? How can you have a carefree night out filled with laughter when you have far more serious, pressing issues on your plate? Just because you’re the parent of a child with special needs does not mean you don’t get to enjoy time away from home.

When you take time to take care of yourself, you’ll actually be a better spouse, friend, and of course, parent. So say ‘yes’ – having time away from home with your family and friends and allowing yourself to let loose a bit will help you emotionally, mentally, and physically, giving you the recharge you need to be the best parent you can to your children.


  1. Take on what you can:

  3. At the same time, you don’t have to say yes to every invitation and engagement; spreading yourself too thin or putting yourself in social situations that you’re uncomfortable with never end well. Don’t worry about what your family or friends will think about you saying no – ultimately you have to decide what is best for you and your family.

Think about activities, events, and locations that will make you and your child feel happy – isn’t that what it’s all about? Surround yourself with supportive people who will add to your experience and make your child feel comfortable. Don’t use your child as an excuse to shut yourself away or to isolate yourself, but find a happy balance of fun, engaging activities, even a small get together at home, and pushing yourself to try new, safe activities to get out in public.


  1. You’re not alone:

  3. You may feel like the only family who is different, but guess what? You are not alone. In fact, there are other families in your very own community who are feeling the same way, so why not reach out to those who will understand you most?

The holidays are a trying time for anyone, with financial burdens causing stress and having a general feeling of being spread too thin. You’re not alone. Connect with others online or through community groups to bridge the isolated gap, have your feelings validated, and unite with like-minded people.


There’s plenty of time to take back the holiday season, and not only ‘get through’ it, but to truly embrace it, as an individual and for your whole family.  How do you welcome the holiday season? How do you manage difficult, stressful times?

Practicing Social Skills with Your Child

Posted on: November 14th, 2016 by Autism Therapy Group


Understanding social cues and having appropriate social skills is incredibly important yet challenging for those with special needs. Just like with any skill, practice makes perfect – check our list of activities you can practice with your child to enhance his or her awareness of social cues and allow your child to run through these actions in a safe and supportive environment.

Not only will practicing these skills be a bonding experience with your child, but it will show him or her that you care while boosting confidence.
Interpreting emotions

No matter where your child goes – home, school, the cafeteria, playground, soccer field, or out at the mall – it’s imperative to be able to pick up on emotions and understand them correctly. By understanding emotional faces and body language, your child will be able to appropriately respond to various social situations.

A simple way to work on emotions if to make a face or show body language associated with a certain feeling; then have your child imitate you. You can start off with something silly and goofy to keep the mood light and fun.


Understanding idioms

Picking up on idioms can be challenging for children, and for those on the autism spectrum, idioms are downright confusing. To help your child understand the difference between a literal statement and an idiom and to understand what those idioms mean, try some activities with them.


  • Books:

  • Take a trip your library and check out books on idioms. Try this list for a great, fun way to teach idioms from The Best Children’s Book site.
  • books


Eye contact

Establishing solid eye contact creates interest in conversation and shows confidence. Try these activities to practice strong and appropriate eye contact.

  • Sticker on the forehead:

  • This idea comes from Children Succeed. Put a sticker in the middle of your forehead (you can use a sticker of eyes if you want!) and encourage your child to look at the sticker during conversation. Many people find direct eye contact intimidating, so this is a great stepping stone to train them to look in the right direction in a less threatening way.
  • eye-contact


  • Staring contest:

    When practicing social skills, why not make a game or contest out of it? Have a friendly staring contest with your child, or if he or she is competitive, it could turn into a serious competition! Let the games begin.

How do you practice social skills with your child? What activities or strategies work for you?