Rachel Azrin, Board Certified Behavior Analyst
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Leisure activities ideas that may be useful in designing a program for your child with developmental disabilities or diagnosis such as autism.

2/27/2014

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Caregivers, behavior therapist and Parents often need a leisure activity as part of the program design. The following is a list of activities that are easy and convienent to utilize in your program.  This list can be used to help brainstorm some activities for your specific child based on his reinforcers and interests. 
1.  Gardening can be a fun hobby for a child that enjoys plants.
2.  Taking care of a pet can be a great leisure activity for a child that likes animals.
3.  Washing or caring for the car can be a fun hobby  and leisure activity for a person that enjoys cars.
4.  Electronic games can be a good choice for a child that enjoys computers.
5.  Cooking can be a great leisure activity for a person that like doing things in the kitchen and food in general.
6.  Bowling, Tennis or basketball can be excellent for  a child that enjoys athletic activities.
7.  Going out to dinner or for ice-cream can be a reinforcer as well as a leisure activity for someone that like going out and food. 
8.  Picnics or hiking in the parks are great for people that enjoy the outdoors. 
9.  Religous activities may be great for someone that likes singing and social activities with others.
These are just a few to start you on your road to brainstorming with your child activities that are appropriate for your childs' leisure time. This will help to reduce behavior problems by engaging him in more appropriate activities that are also reinforcing to him! 
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Adjudication of  incompetence and guardianship in children with developmental problems or diagnosis such as autism.  

2/26/2014

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When your child reaches the age of 16- 18 parents start to hear from others that it is important to proceed to attain adjudication if this was not done yet.  Parents can attain the paperwork to do this or information from a social worker or online generally.  When the child is a minor the parent is automatically the guardian but once they become an adult this must be established in the courts.  There are many things to consider when you are thinking about whether to purse guardianship and competency for your child. The following are some of the important things to consider in making this decision.
1.  The first issue is that if your child remains competent as an adult he may be subject to any punishment that adults receive for his behavior in the community. Usually the consequences legally for adults are more severe then for a child that has not  been adjudicated incompetent and has a parent as a guardian. 
2.  The issue of guardianship has become very visible in the newspaper recently in the past 10 years and there are alot of support systems in place at this time to help parents accomplish this legal procedure.  For example, there are some pro bono, legal aide  or lower rates that may be available if you consult with a lawyer specializing in this area or with a social worker.  In the past people often can attain assistance from lawyers as "pro- bono" or from other sources based on their salary.
3.  There are different types of adjudication and guardianship. For example, there is one type of guardianship which is only over medical decisions and this may be attained at a lesser cost.  Parents may want to start out with guardianship over medical concerns and later attain full guardianship over other areas for their adult child. 
4. If any medical issues come up the parent as a medical guardianship can make these decisions.  For example, if your child is told by the doctor he needs a feeding tube the parent will have the right to decide when this might be done or whether the risks outway the benefits to your child and discuss this with the doctor. Without the guardianship procedures may be done without input from the guardian of the medical issues.
5.  Guardianship and adjudication may affect certain benefits your child can receive and parents should consult with the support co-ordinator or social worker for information regarding the financial implications.
6.  Funding and budgets in the future may include the legal status in decisions about eligibility for benefits.
7.  Parents should consult with doctors, social workers, lawyers and legal aide professionals and research in books or google to make a definite decision about guardianship and adjudication. 
In general, guardianship and adjudication should be pursued to protect your child's health, welfare, financial benefits and avoid legal problems for the future of your child. 


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Self-harm  such as "cutting" may be a version of self-injury. 

2/24/2014

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Parents today often come face to face with a really serious problem that is referred to as "cutting". This new label may really be a new version of what is commonly referred to as self-injury.  The following are  some issues to think about when you find your child has been practicing this problem.
1.  Immediately consult and retain professional assistance for this problem since it is causing tissue damage and you will need professional assistance to address this problem.
2.  Try to observe what situations this occurs and what some of the "triggers" are for the behavior. 
3. The cause of the behavior and consequences  vary with each individual child and should be investigating with the assistance of a trained professional. 
4.  Try not to overact before designing a plan for treatment since the behavior may be maintained by attention or a reaction from the parents. 
5.  Try to take immediate safety precautions such as close monitoring of your child to try to prevent the behavior from occurring while designing a procedure to address the problem. This can be done by leaving doors open at night, security monitoring video cameras or just trying to be with your child as much as possible or have someone else with them to prevent the problem.
This is a problem not to be taken lightly and should be addressed immediately and with professional guidance. 

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See attached link to a radio show related to behavior therapy with Rachel Azrin

2/22/2014

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http://archive.weinetwork.com/shows/BrainMatters/Brain%20Matters020514-RachelAzerin-Rabbi%20Keisler-wei.mp3

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Sharing and teamwork can be learned by your children! 

2/21/2014

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Many parents or caretakers do not realize that sharing and teamwork can actually be reinforced and learned based on numerous research studies.  Teaching your children to work as a team and to share will reduce the behavior problem frequency in the future that the parent will have to address in the home and at school! The following are some ideas on how to encourage these skills. 
1.  One idea is to reward your children for working or playing with no tantrum or behavior problems. For example, if they are playing a game give social praise or a snack only on days they work together or play nicely! 
2. Practice giving the something and telling them they can have that item  (such as a cookie) only if they share it with their siblings.
3.  Encourage children to take turns playing with a toy when they both want to play with it.  You might even suggest they discuss it and come to some agreement about the use of the toy.
4.  Purchase stories  that include the theme of sharing or teamwork and discuss the story after reading it together.
5.  Point out to your children when other people display team or sharing skills. For example, if someone picks up something that someone drops compliment the action by saying " wow what a gentleman he helped that woman!" 
6.  In the evening roleplay and discuss how people work together or play together at school or in the community. 
7.  Play alot of games with your children and focus on good sportsmanship, complimenting each other on playing skills, taking turns, talking nicely to each other and manners. Praise these skills when the occur during the game!
Developing these social skills of teamwork and sharing will probalby lead to many happy experiences when your child is with another person or a group and a happier life! 



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Parents with children with special needs and how to treat the other siblings in the household. 

2/20/2014

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Parents or even caregivers with other children in the home sometimes forget about the other children in the home. It is important to keep in mind that the other children should be considered along with all factors in the home of a child with special needs. The following are some ideas that will optimized the effectiveness of your treatment package through the inclusion of the other children in the home. 
1.  Any reward program should be available to all the children in the home. If you child with special needs is receiving a token or reward system then include all children in this program. By including everyone the children all feel they are treated equally and will not feel resentment or anger towards the child with special needs when they receive reinforcers such as a cookie or an outing.  If the other children are resentful or angry that might result in more aggression and aggitation or non-compliance from the child with special needs. 
2.  When consequences such as loosing an outing occurs then you have a choice of either having both children loose the outing or making sure the child with good behavior gets some alternative reward.  The most important factor is that the child with special needs realizes he earns the outing only after good behavior.  In the case where the other child is good it is usually better to have both children loose the priveledges since that way the child without special needs may help his brother to avoid having tantrums in the future.  However, it can also be helpful to have the special needs child see the other child get the reinforcer for good behavior. Either method is useful. Parents should try to see which method results in more improvements in the children's behavior. The only crucial factor is that the consequence of not earning it for the special needs child is implemented consistantly.
3.  If the child with special needs requires alot of doctor appointments it may be helpful to take the other child with you and see the doctor for a general check-up or any minor issues they have. This will help to include him and avoid the situation in which the "normal" child is not getting as much attention and time from the parents. This can also be accomplished by offering another fun activity for the "normal" child while his sibling is at the doctor office. 
4.  If the child with special needs has special equipment such as ipad or toys it is good to provide the "normal" child with some other equivalent toy or equipment while working with the special needs child. What often happens is parents focus on teaching the special needs child something on the computer and the "normal' child begins to tantrum and resent the special needs child. This can be avoided by having similar alternative equipment or taking turns with the equipment you do purchase for the special needs child. 
5. If the "normal" sibling is able to understand the parent can ask him to help teach his brother something. This is useful since they can facilitate even more learning and even run some of the reward programs you have set-up for the special needs child.  A general description would be useful of what you are trying to teach his brother.  Try to avoid any negative statements about how smart he is and focus on just learning new things.  Always praise the "normal" child for helping by saying things like " you are so helpful you taught your brother to sing the alphabet!"

Generally, including the other siblings needs and assistance can promote faster progress for you child. The siblings are part of the family system and the enviorment that the special needs child lives in and can contribute to teaching and progress of your child with special needs.  If they are not considered or addressed it can actually slow the learning progress. All family members should be a part of the treatment plan!





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How do I relax when my kids are upsetting me!

2/19/2014

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Parents and Caregivers often become frustrated with clients or their own children. This occurs even more often when working with children with behavior problems or diagnosis such as autism.  The following are some tips for handling stressful days!
1.  Parents and Caregivers should plan time to take breaks from teaching and relax. Parents can do this by hiring a babysitter, having time for walks, taking deep breaths, relax each muscle systematically in your body,  count to ten or baths to relax. Time for yourself is important to keep your balance when dealing with difficult behavior problems.
2. Incorporate time for teaching your children into your routine so that you can accomplish errands and not become overwhelmed with activities in your day.
3.  When you realize you are feeling tired or stressed a quick trip to the bathroom, drink some cold water or other drink or to relax in a soft chair may help you to cope with a stressfull situation.  After you are calm then return to the situation and things will be easier to resolve. 
4.  If you child does something upsetting in a public place you may have to work on this problem at a later time. Perhaps roleplaying difficult situations after dinner or brainstorming theses situations will help you to avoid these upsetting situations in their future.
5.  Parents or caregivers can change a stressful situation into an appropriate one by simply changing the subject.  For example, the parent might say wow  look at the rain outside it is really pouring or I can't find my cellphone can you help me find it. 
6.  Parents can have cue words for their children that they say when they are getting upset so the child is aware and can avoid a big argument. Parents might say for example "use your words and ask me what you want". This is a good cue or reminder for the child and this can result in a more appropriate or less upsetting interaction with the parent. 
Parents and caregivers must realize that their own behavior can escalate a problem. By making efforts to relax, change the subject or talk about similar situations (role play) later you can reduce the number of situations that upset you and your child in the future. 
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Homework and how to get my kids to do it quickly and correctly!

2/17/2014

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Homework is the basis for you childs' learning and determines what grades he will get. Parents  and caregivers spend hours trying to convince, nag or even yell to get their kids to do this homework. This is not acceptable for most people since they can get health problems or their kids can have health problems related to this stress. Also, it disrupts the family household routine and the other family members become agitated too. The following are some tips to make homework a more enjoyable experience and reduce the amount of reminders and agitation needed to encourage your child to complete this task.
1. The first step is to set a goal you are working towards for homework. It is best to include both the quality and quantity of homework you want your child to achieve and alternative learning tasks for the days he does not have homework. This way you will achieve both good quality homework, a consistant routine of learning for a specified amount of time or amount of productivity each day.  For example, a good example of  a goal might be to complete the assigned homework each day and to check  over a few of the items with you at the end to make sure it is high in quality.  If there is no homework the child might be required to complete on page of a workbook or oe level on a computer program for learning reading such as the Mimio or headsprout program levels. 
2.  The next step is to identify why we are doing the homework clearly for the child. Parents can even go on you tube and find different colleges of professions that require a degree in high school or more to achieve. Discus life goals wth your child and different options. Make sure to point out to your child that by getting a job he will have the ability to earn money and by preferred items such as toys, cars, house or anything they want in life!
3.  Parents must have available some immediate rewards to give their child after homework is completed. Each child is different. Some children like edible items such as gummy bears or cookies. Some children like games such as computer games, television,  ipod games or interactive board games. These should be delivered immediately as possible on days that the homework is completed. 


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How to encourage your kids that have picky or unheathy eating habits.

2/13/2014

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Parents or caregivers often complain that the kids have "picky" or "unhealthy" eating habits.  This can lead to major health problems, vitamin deficiencies, weight problems and may contribute to behavior problems when they do not feel their best!  The following are some tips on how to encourage healthy eating and of a variety of food in your children. 
1. The first step is to structure the environment or in this situation that includes the refrigerator might be the first step.  Make sure you purchase the foods that encourage the types of foods you want your child to eat.
2.   Secondly, going to restaurants that have the foods you want to encourage is important.For example, if you want to encourage healthy eating you probably want to go to restaurants with a healthy variety of foods. 
3.  Parents or caregivers should provide an preferred food such as desert, gummy bears or activity that is reinforcing for the child if he eats one new food at least at each meal that is served. This will gradually increase the number of foods the child will eat.
4.  If the child does not want to eat the new food the parents should say no problem maybe tommarrow and try not to give attention or reprimand the child. The parent or caregiver must be careful not to give the desert that day or reinforcer and provide it the next day.
5.  Many parents serve different foods to each child. Serving the same menu encourage children to try new foods and does not encourage picky eating habits. If the child does not eat the foods presented he will eventually learn that this is the food available and be more open to trying at least a few of the items served. Otherwise he will eat the next meal more completely since he will be very hungry.
6,  Parents should assess the child's food preferences and try to make foods that include some variable of their preferences. for example, a child might love ketchup or tomatoes and these can be served as a condiment or sauce on a non-preferred food item thus encouraging more variety in the childs list of foods' he will eat. 

The above are a few of the things to consider in encouraging healthy eating habits. Encouraging a larger repeitoire of foods will make your childs' life much easier, avoid health problems from bad eating habits, they will eat healthy foods, probably have less behavioral issues and enjoy eating at restaurants with others in their future! 


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How to have a haircut with low stress for you and your child! 

2/12/2014

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Children with no problems and children with disabilties or diagnosis such as autism or ADHD often have problems while getting a haircut.  A haircut can be a fun activity if preventative techniques and the environment is structured to encourage appropriate behavior. The following are some tips to consider in order to have a good experience with your child and his hairdresser! 
1. The first steps begin before you go to get the haircut. Prepare you child by describing what will occur at the hair dresser.
2. Also, include what reinforcers they will earn while at the hairdresser and afterwards. For example, if the hairdresser has cookies or chocalate available you can let them know they can have access to any treats as long as they are behaving nicely, not crying and co-operating with the hairdresser by sitting still. 
3. Always plan a reinforcer for after the haircut. This should be individualized for your child. if they enjoy an outing you might take them to lunch or the mall. The parent should evaluate his child and decide on a very strong reinforcer to give the child after the hair is done. 
4.  As usual always use social praised during the haircut. For example, you might say "you are such a gentleman you are sitting so nicely for the hairdresser". 
5.  You can point out the good reasons for sitting still. For example, you can tell your child that if he sits still his hair will look better and the kids at school will like his hair.
6.  During the haircut you might give the child a toy or computer or cellphone to use while getting the haircut this will distract him and relax him during the process. 
7.  During the shampoo also praise your child, encourage the woman who shampoos his hair to massage the scalp and make it a very happy pleasant expereince with plesant conversation. 
8.  Always test the water before the shampoo on your hand, or the shampoo person can do this, to assure that the water is not to hot or not to cold.
9.  Make sure the chair is adjusted to the right hight and position so the child is comfortable or provide a booster seat if necessary. 
10. Try to include the child in the plan for how to cut the hair so that they feel in control of the situation and they feel their rights are respected. 
11. Finally, make sure your child is feeling well the day he goes to the hairdresser. Try to go when he is not overly hungry, tired or sick.
Parents or caregivers should realize that using some of these small tips may be the diference between a pleasant haircut and a big tantrum or problem at the hairdresser.



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