Using ABA to encourage healthy diets in children with Autism Spectrum Disorder.
Let’s get started
Why is food so important?
Coming together over food is part of everyday life. Overcoming these restrictions can improve the quality of life for the affected individual and their family and friends.
Common Eating Issues in ASD
Consequences of Feeding Problems
Does my child have a feeding problem?
How did this happen?
2. Obtain preferred foods
3. Obtain attention
As parents we have most likely rewarded our children’s feeding patterns over time and now are unsure of how to correct them.
What are my options for intervention?
Can I go it alone?
If you can answer yes to the following questions, go for it!
Mealtime Schedule & Set-up
Choosing Target Foods
Dirty Dozen Plus & Clean Fifteen
Choosing Target Foods
Example Meal Rotation
Getting your child to eat these foods
Helpful Behavioral Techniques
1. Pick up the new food
2. Touch new food to their lips
3. Chew & Swallow New Food
Prompting & Prompt Fading
1. Hand over hand help the child scoop and move spoon to mouth.
2. Hold the child’s elbow
3. Touch the child’s arm
4. Point to the bowl
Texture and Size Fading
If necessary modify food texture from pureed to finely chopped to bite-size.
Start by coloring the frosting on the doughnut above different colors (you will need to make multiple copies for the different doughnuts. After they are colored and cut out, laminate them for durability. Now that you have your materials ready you can play the game!
The song goes as follows:
Down around the corner at the bakery shop
there were lots of doughnuts with frosting on top
along came ____(fill in with child's name)____ all alone
***at this point let the child choose the color doughnut and have them repeat the color after you or if your learner is not able to repeat you can say the color for them. ***
He/She choose a ____(color)______ doughnut and ran back home
***keep repeating with each child present or until you run out of doughnuts.***
The following information is not meant to diagnose or take the place of treatment given by a qualified health professional or a BCBA. For any information on our services please contact us via our website.
As parents, or caregivers of children with autism we know that change can be hard for our children. Some children have a resistance to change in many areas including clothing. Although there may be a resistance, some children have their own unique issues with clothing. The change of seasons can bring this out or it can start an intricate dance on how to facilitate clothing with your child.
Here are 3 different instances of what the challenges are and how they are addressed with these three families.
Andie~A mom with 5 children and her youngest one is Ben. Ben is a fun energetic 16 year old with autism. Andie is the Parent Liaison at Behavioral Perspective Inc.
Some of us like the change of seasons. Most of us dread the trying on the clothes to see what fits and what does not fit. Mr. Ben does not care for it either. Since Ben is now 16, I realized (with the gentle push from a friend) that he needs to be an active part of assessing what fits, making a list of what he needs, shopping and picking out the items and staying within a budget. This task was daunting to me the first time we talked about it. In the past I would notice Ben's clothes not fitting and just tell him to take it off and put it in the Goodwill bag. I would then occasionally pick up clothes that I think he would like while I was shopping at any given random store. My friend pointed out that while this was the easiest method for me, it was not doing anything to foster Ben's independence. Not to mention the fact that no 16 yr old wants his Mommy to pick out his clothes. My friend was right. I am not going to be around some day. Everything I do with Ben should be focused on my end goal for him - Independence. So this season that's what I did. He was involved in every step of the process of the transition. Every step was not easy (one cell phone was destroyed during the process) but we did it! Score one for the Mom!
Tune in to our FB Live on Wednesday to hear how this went!
Kymi~Mom of Isaiah who is a warm loving 17yr old young man with autism. Kymi is a Lead Registered Behavior Technician and a helps run our Parent Network Support Group at Behavioral Perspective Inc.
Planning & Negotiating
Weeks before Fall begins, I start making my son wear clothing more appropriate for the brutal winters here in Chicago. Why do I have to think about this long before winter? Because my son, who has autism, has a hard time going from summer clothing to winter clothing.
Here in Illinois, winter months can be brutal. Wearing layers of clothing can be challenging for my son. My son has a hard time putting on socks when the weather changes. Before summer ends, I begin the process of having my son wear socks around the house. I start with a few minutes at a time and build up from there.
My son also has a hard time going from shorts to long pants. This change in clothing can cause a tantrum or hours of negotiating to get him to comply. For my son this issue of clothing is not all sensory based. Some of his issues were around “routine”, what he is use to and what he really prefers.
Once I had a better understanding of the function of the behavior, I was able to decide what is and is not negotiable. As a mom, I pick my battles, and if I can get the socks on the feet when there is snow on the ground I am happy. I will negotiate if the socks have to be long or short.
Isaiah does not like to wear hats, so I often buy coats that have a hood. I can get the hood on him easier than the hat. I pick my battles and remember that we can both feel good about the choices being made.
One of the best pieces of advice I have received is to know what I am being persistent about, and to be flexible. I have also learned to remove the summer items out of sight. For my son, “out of sight out, of mind”.
I am not an expert, but I do have some tools that have worked for us in the past or currently working now:
Denise~Mom of 2 children. Her youngest son, Rocky, is a fun loving, quirky 8 year old who has been diagnosed with autism. Denise is the Director of Operations at Behavioral Perspective Inc.
The unexpected, necessary lesson
I would consider myself lucky in this arena. Tags, scratchy fabric, & season changes don’t seem to bother Rocky. Rocky is 8 and is close to mastering the art of getting himself dressed properly. He LOVES to pick out his own clothes although needs help to match items with the weather. We are still fine tuning the occasional backwards shorts or shirt along with some tricky buttons or zippers.
We have run into issues with rigidity surrounding clothes. Recently we were away for the weekend and forgot to pack a pajama top. Rocky ALWAYS sleeps in pajamas. I told him he could sleep in his regular t-shirt or even no shirt like his brother. He wasn’t having it. He had a meltdown and was just completely thrown off by not having an actual “pajama” shirt to sleep in. In the end he eventually went to sleep, however, when we returned home at 3 in the afternoon, he immediately went to his room and put on a full set of pajamas, reenacted his bedtime routine and “went to bed.” He literally got in bed for a few minutes and then “woke up” again to start his day. I guess this is what he needed to move on with his day.
I find my best reaction in these moments is to tell him once or twice what his choices are and then ignore the tantrum. I don’t cater to the rigidity. I don’t go to target and buy pajamas at 9pm. I prefer not plan ahead for every little thing that is going to throw him off. Life doesn’t always go as planned and I hope he can eventually learn to just “meltdown” quietly in his own head like most of us do. He is already making great progress and finding his own quirky ways to cope with life’s annoyances.
As parents of children with autism, challenges can occur in many areas of daily living.
We are not experts, or noted researchers in this area. We are moms who are all on different paths in our autism journey. We are offering 3 different perspectives of the challenges of clothing and how we approached them in our own lives.
Thanks for checking out our blog this week! Join us this Wednesday on FB Live as we continue this conversation!!
It's not what you do for your children,
but what you have taught them to do for themselves,
that will make them successful human beings.
- Ann Landers
Let’s see how the topic of chores is viewed from three autism moms at different stages of life. None of us are experts on this topic. Just mom’s trying to help out other parents that are on this autism journey.
Meet Denise - Denise has 2 children. Her youngest son, Rocky, is a fun loving, quirky 8 year old who has been diagnosed with autism. Denise is the Director of Operations at Behavioral Perspective Inc.
To a non parent chores might seem like a dream. Extra hands to help with cleaning, laundry and yard work! Yes!
Unfortunately the reality is that teaching chores to children is no easy feat. Add special needs on top of that and yikes, the teaching of chores is another chore for parents! Wait, what?!
Sadly yes, teaching does create some extra work up front. However, with the right strategies it can be very successful, and in the long run, really helpful to parents.
With the help of our BCBA & ABA technician, my son Rocky, 8, can now pick up his bedroom, make his bed and clean the playroom on his own. I am so blown away by his independence that I can’t wait to teach him more chores.
We created this simple chore chart. He earns 25 cents per chore, per day and we keep track of his earnings on a spreadsheet. Once he saves $10 he will be able to buy a new hotwheels box set!
Meet Andie- Andie has 5 children and her youngest one is Ben. Ben is a fun energetic 16 year old with autism . Andie is the Parent Liaison at Behavioral Perspective Inc.
Chores. Most of us were given and taught how to do chores when we were kids. As parents, we have passed this important learning tradition on to our own children. When we were doing them none of us were probably ever convinced that they were an important part of the process of growing up and learning to be an independent adult, but lo and behold that’s exactly what they did!!
My four neuro typical children (who are now all grown up) used to gripe, and try to get away with doing chores in the shortest way possible but in the end they learned how to do chores. For a child with autism it is often far more difficult to not only learn how to do a chore properly but also to do it without tantruming or causing a major scene.
Our job as a parent is more important for the child with autism because the skills he/she is learning plus the social cues he/she has to learn in order to do these tasks will be extremely important for the child when they enter the workforce as an adult.
Learning to complete a chore is complex. The child not only has to learn to do the task, he/she also has to learn how to interact with the people who assign him/her a task. In addition the child has to learn how to react when given a task that is not necessarily a favorite thing to do. The child has to learn that tasks are important for not only a work environment but also essential for living independently as an adult.
You have to realize that if your child does not practice doing chores on a daily basis, he may never survive in the real world independently. The inappropriate behaviors that he exhibits during chore time will just turn into the norm. He will not ever be able to look around and figure out social cues to figure out how to complete a chore/task appropriately without this daily practice.
This is why I have set up a program for my child with autism to practice daily chores in our home. We try to find chores/tasks that he would need to do if he lived independently as an adult. It takes effort on our part as parents every day but it is essential that he master these life skills in order for him to grow up to be an independent adult.
I am not going to lie, it is NOT an easy task on a day to day basis to continue to organize, manage and supervise these daily tasks. However each chore he learns to do independently at this stage of his life will provide one more level of independence as an adult. We parents aren't going to be around forever, so not making him do chores is not an option as far as I am concerned. It is my job to teach him chores are a life skill and essential for an independent life.
Meet Kymi - Kymi is the mom of Isaiah. He is a loving warm 18 yr old young adult on the autistic spectrum. Kymi is a Lead Registered Behavior Technician and a helps run our Parent Support Group at Behavioral Perspective Inc.
“You cannot go outside until your chores are done” may be a phrase many adults heard from their parents when they were younger. As a parent of a child with autism, having your child do chores or the importance of chores in your child’s life may not be on your radar.
Going outside may not be a reinforcing thing for your child, so the threat would be in vain. As a parent of a child with autism, you may question the importance of chores in your child’s life.
Chores can be a useful tool in the development of children with autism. Just as it does with children who do not have autism, chores can be a great tool in promoting independence.
Chores are a necessary part of life and can provide your child with a sense of purpose and can help them with skill building, confidence, feelings of accomplishment, and being part of a group. The household group, where everyone contributes to the wellness of the house.
You may ask yourself, if it is ever too early to have your child do a chore. You may not want to ask a 4 year old to wash laundry, but that same 4 year old could be responsible for putting a trash bag in the garbage can or putting their eating utensils in the kitchen sink.
In my house the motto is, “there is not a chore that is too small.” Chores can be what you make them. From putting all napkins from dinner time into the trash, to stacking a cup on top of a plate, there are probably several ways to implement chores into your child’s daily life.
Knowing some of your child’s capabilities help in deciding what chores they can do and be successful at. Modifications or breaking down the steps of a chore could also have benefits in teaching how to complete a chore.
Chores can teach your child some skills that they will need as they age into adulthood. Chores can be useful in helping to develop and build on skills such as: sorting, scanning, fine & gross motor, organizing & money skills.
Parenting is hard enough with neurotypical children. It becomes even harder when you throw in a dash of autism. I want to reiterate that we are not experts, just mom’s trying to survive everyday. If you wish to attempt to teach chores, skills or activities of daily living, we suggest you contact a professional to meet the needs of your child. Hey… we know of some awesome BCBA’s if you are interested. :) Please tune on Wednesday when we talk about our home chore programs on our FACEBOOK LIVE!
Prompting is a way of assisting the client to accurately complete a task. One of the best prompting hierarchy's to use with clients is most to least prompting. You want to use the most effective prompt for the learner to complete the task and prevent any errors from developing within the response chain. As the client is learning the responses, you will fade your prompts until your client can complete the response independently. Most to least prompting hierarchy may look like the following: Full physical prompting, partial physical prompting, gestural prompt, independent. This depends on the skill that the client is learning.
There are many different prompts that are utilized depending upon the learner. A few common types of prompt levels are:
Full physical prompts: this is when the instructor fully prompts the complete action for the client
Partial physical prompt: this is when the instructor only needs to prompt part of the action for the client
Gestural prompts: this is when the instructor can gesture or point towards what the client needs to do
Model prompts: this is when the instructor demonstrates the skill/action for the client
Full verbal prompts: this is when the instructor states the full word/sentence that the client needs to emit or gives an instruction
Partial verbal prompts: this is when the instructor is able to fade to part of the word that the client needs to emit (e.g. "Ch" instead of "Chips")
Cookies, now! Can I have a drink please? Play? I want to see that toy. These are all examples of mands! In the presence of a motivation to gain access to a desired item or action, the speaker identifies this in the form of a word, sign, picture, AAC output, etc.
Manding: The first form of language that is targeted with the ineffective communicator, as it indicates the learner’s wants and needs. This is the only verbal operant (behavior that is mediated through the response of the listener) that states exactly what is wanted, and the reinforcement is in the delivery of the item. In the presence of the learner’s motivation to attain the item (and inability to retrieve item independently) and a listener present, the learner with ‘mand’ or request for the item. This request will be demonstrated using the learner’s primary mode of communication (i.e. sign language, words/phrases/sentences, AAC device, PECS, etc.).
A learner that stands in the middle of the kitchen by him/herself stating ‘cookie, cookie, cookie’ is not considered a mand, as there is not a listener present to deliver the cookie. However as soon as the learner’s sister enters the kitchen and the learner states ‘cookie’, the cookie will be delivered from the sister, thus reinforcing his mand.
Although this is less than ideal, it also demonstrates a mand. The learner that requests ‘milk’ in the presence of mom, however mom states ‘not now’ is also a mand but is not reinforcing the learner’s mand/request. Refrain from engaging in these interactions when language is developing, as this may punish the learner from manding again in the future, because his requests are not fulfilled.
A mand may request an item or action; examples include ‘game’, ‘play’, ‘swing’, ‘upside down’, ‘walk’, ‘cookie’, etc.
The purpose of mands is to communicate your precise wants and needs with the listener who must mediate to provide the access. This is one of the initial steps of setting up social interactions and the basis for more complex language.
First, grab all the materials for the activity. Once you have all the materials, grab a pipe cleaner of your choice. Measure your wrist with the pipe cleaner. If you need to cut it, use the scissors to cut the pipe cleaner, so it fits around your wrist. Once you have done that, grab some buttons and beads. Find beads and buttons that you enjoy and add them to your pipe cleaner. After you add your buttons and beads, put it around your wrist and twist the pipe cleaner ends together. Enjoy a fun and simple bracelet to wear wherever you go.
ABA (Applied Behavior Analysis) is ready to assist your family to become more structured and less stressful. The science of ABA provides tools that will make your days a little bit easier. I have heard from many families (those with a child on the spectrum and those not) that ‘oh boy these summer days are quite long’. Here are my recommendations for success today and throughout the year.
2. Review the daily schedule in the morning: This means that you have to think through your day, but this
can also be done with your child present. A predictable day will lead to less questioning.
3. Lots of positive interactions: provide your child with hugs, high fives, ‘good job’, smiles, etc. along with
specific praise of what they are doing (then you are more likely to see these actions in the future! (It is called reinforcement)). Then when you have to redirect for poor behavioral choices, state with what you want to see (example: ‘Let’s walk’, not ‘Stop running’)
4. Lastly, have fun! Enjoy every day with your child!!! Go to fun places and make wonderful memories.
These fun places, could be something new in the backyard (This does not have to large, grandiose or
ABA can help you to establish some of these routines in your home, provide you with new suggestions, or provide more intensive therapy to your child with ASD to assist them in fully participating in the above-stated (or modified) plan, based on their need. ABA is an individualized therapy that can focus on behavior reduction, just as much as communication, leisure skills, daily living skills, play skills, etc. ABA’s services are boundless, and ready to offer you assistance. If you have any questions, feel free to visit our website or reach out to our clinic.
Wouldn’t you prefer to learn things in a natural way? Learning things when you are motivated and interested? How could learning be more fun and applicable? The NET is where Natural Environment Teaching occurs, and commonly looks like play.
The focus is on communication, social interactions, play skills, and other skills that the child would engage in during their typical days. In our clinic, many clients receive instruction in a Verbal Behavior approach. Verbal Behavior focuses on teaching the different verbal operants, such as mands, tacts, intraverbals, echoics, etc. as a replacement (or alternative) for problem behavior. The session is organized to be a combination of table time, where skills are learned in isolation, and NET time when skills are learned through opportunity (contrived and natural). The session is a ratio of NET and ITT (Intensive Table Teaching), based on the needs of the learner. Many of our early learners, spend 75-80% of their session (about 45 minutes) in the NET and 20-25% of their time at the table (about 15 minutes). This allows enough time to become engaged in a variety of play tasks and social opportunities.
Now let’s walk through what a sample NET session may look like, but first you must know about the learner. The learner is a 3 year old male with an older brother, vocal verbal communicator (which means he can communicate with speech) in single words, and loves trains/cars. The learner enters the basement, where sessions are typically held, and approaches the train table. He quickly gets out the big box of trains and begins digging for his favorite train, which changes on a daily basis. The Registered Behavior Technician (RBT) begins to move a train back and forth on the train tracks, while making ‘choo choo’ noises, ‘look at this blue train’, ‘it’s moving so fast’, ‘train, train, train’, etc. The learner finds today’s beloved blue ‘Thomas the Tank Engine’ and is ready to play on the train track. The therapist moves the train box closer to him/herself, thus encouraging the child to request next time they want a train. The train track is only partially completed. Therapist hands the child 2-3 pieces of train tracks, while stating ‘here’s the track, track, track’, ‘let’s make the track longer’, etc. The therapist will continue to play with his/her train, and the learner reaches for the track pile, The therapist will verbally prompt ‘track’, then provide the track. Over several more opportunities, and referencing the data collected per trial, they will fade out the verbal prompts and provide more opportunities for independence. You will note that the therapist provides plentiful speech around the play, as well as targeted language around a similar level to the learner. Since this learner is primarily communicating in single words, much of the modeling should be at this single word level (i.e. ‘train’ and ‘track’), however also modeling and providing experience for the higher level phrases and sentences, applicable to that activity. One of the other important components is to not spend all 45 minutes in the same activity. There are several ways to make the transition, but here are just a few:
- After some time of engagement with preferred activity, prepare the child 5 minutes before, stating ‘5 more minutes, then (name next activity)’. Similarly prepare the child at 3 minutes, 1 minute, 30 seconds, 15 seconds, and 5, 4, 3, 2, 1 All Done’ (or something of a similar structure). It may also be helpful to have a visual schedule for the learner to see what is coming next.
- Therapist can incorporate novel activities into the preferred activity. The previous learner loves trains. The therapist may incorporate music, bubbles, placing the train down a car track, racing trains on the ground, etc. The therapist may be working to condition new reinforcers (i.e. providing experiences with novel activities while incorporating their currently highly preferred activities.), in an effort to increase the variety of their interests (and possibly to be used as reinforcers in the future). Also the therapist may be working on variety of play actions with the same preferred activity (i.e. train races, trains on the car ramp, etc.).
- The learner may also transition to another activity while bringing the preferred toy with, to initially make the transition easier. Over time, we can work on transitioning without that preferred item.
These are just a few ways to structure your NET time!