The latest trend is to buy and iPad, Ipod or other computer gadget and expect learning to magically occur. In most cases more is needed. I a few cases the child may learn on their own but in most cases parents should consider the following in order to have success. One point is that often a child with autism is not visually motivated to use the equipment. In this case the parent can motivate the child with extrinsic reinforcers for use of the equipment. For example, if the child plays one educational game or looks around on the web for 30  minutes then the child receives a preferred food snack such as chips or an activity.  Another point is that the computer must have reinforcers within the aps that reward the child automatically. For example there are programs such as "head sprout" that include reinforcers within the educational game at the end of a correct response by the child. Parents should be careful to set-up reinforcers within the device programs and extrinsic reinforcers in order to achieve optimal chances of success when purchasing an electronic gadget so that the money is put to good use and learning occurs in the child!!

Caregivers and Parents often complain that there child does not sleep. Some options and ideas about what issues to bring up to doctors and behavior analyst are listed below.  The first thing a caregiver should do is to make some sort of data sheet or log with the behavior analyst recording how much sleep the child is actually getting and at what time of the day. 

A second suggestion is to rule out any medical problems. Children often suffer from sleep apnea, allergies, colds, urinary tract infections, or incontinance,  ear infections or other medical conditions or side effects of medications that lead to a reduced number of hours of sleep. Situational problems such as living arrangements that are loud or noisy, roommates, recent break-up of parents, loss of a relative, stress at school or with other problems.  The above issues should be addressed before designing  complete and effective sleep program procedure. 
Note:These are just a few of many items to consider

Parents are often in great turmoil about when to agree to move their child to the next grade or wait in his current grade.  The concerns parents often have are in regard to whether the child is ready and what the effects will be if the child is moved up or stays in the current grade.  The concerns often occur as earlier as preschool, nursery school, kindergarten or first grade. The following is a list of some possible things to consider in making this decision.

First, the parent should consider the level of problems the child is having and whether they will be easily overcome or remedied in the next year.  Supports can be put in place to assist the child at home or within the school system. 

Secondly, Social concerns are often something parents worry about. The stigma form the parents peers or from the childs peers is often a roadblock in the parents mind to keep them what they think might be better developmentally for the child.  In many cases parents should remember that the social disapproval from other peers will probably be forgotten very quickly and may not be worth years of the child having problems academically and socially.  If  the child has another year to develop he may be far in advance of his classmates and academics and socialization will be a joy for him and very easy. 

Thirdly, if the child is placed in a special classroom and need additional help this is often helpful if the cild has severe problems. However, many cases in which a  child that has only few issues that could be resolved with intensive ABA and delaying the move to the next grade. The child may have a very small chance of being promoted out of a special education class. The actual statistics (or the approximate number per year)  of your school for how many children are put back in the normal classroom can be attained from the school. 

In most cases with very strong supports from behavior therapist (ex. CBA or BCBA) children with mild autism  can often be mainstreamed in the normal classroom. In general, the level of supports, level of functioning of the child should be considered. 

The present discussion provides some general points for you to weigh in making this difficult decision of whether to move your child up to the next classroom and not a formula for every child. If the numbers are very low for mainstreaming in your school then the stigma of being in a special classroom may not be worth it. It may be better to have your child be the tallest smartest kid in his class by delaying his enrollment in the next grade. People will forget about the problems once they see how wonderful your child is progressing  and moving toward attaining his degree in the regular classroom! 

There are many options for selection of a person or persons' to run your childs' program. Some of them are reviewed in the following. One options is to hire a BCBA,CBA or BCaba to run the program or supervise others running the programs in the home or via electronic such as Skype. Another option is to hire some aide or person with a certificate to do this type of training such as a behavioral assistant.   The advantage of this is that they have some training to do the program and some safety training that may protect your child. Another options parents choose is to have a nanny or other person with no training provide the service. One advantage is that this is easy to find. One disadvantage is that they may not be able to learn the skills needed to run the program and may not have the safety concerns that a trained or certified person has.  Another choice is to send the child to a school that provides the training. The advantage is the convenience of dropping them off at one location. The disadvantage is that they do not always have the certified staff or available hours to help your individual child and certainly would not address directly the problems at home. Finally, one  option is for the parent to run the program or another family member. This may be in addition to others running the program. The advantage is that the parent spends alot of time with the child typically and the parent is with the child  on vacations and at night. The disadvantage is that a parent may need others to help with running the program when working.  Whatever service provider is used the Parent needs to know how to run the program so that when they are spending time with the child they are consistent and the child will be able to achieve more skills more quickly! 

Parents with a new diagnosis of their child of Asperger or Autism often forget to consider the effect on their other children since the demands of the treatment of the child with a diagnosis are so intense.  Below are some topics to think about and decide if they apply or could be helpful to the lives of the siblings. 

One factor is the time demands of the treatment of the child with a diagnosis prevents the parent from having much time left for the child without the diagnosis to do activities. Many parents deal with this problem by including the child with a disability in all or many of the activities with the sibling without a disability. For example, if an activity schedule is designed for the child with a disability both children participate in the general activity identified such as reading but just read different books or play different learning to read games. 

Another factor is that the child with disabilities receives more reward for his motivational program then the child without disabilities. This can be easily solved by providing a reward system for both children with different individualized rewards.

In addition the child without the diagnosis can assist to teach the child with a diagnosis play certain games such as for example nerf basketball or computer games.  The child with Asperger diagnosis might play the computer games with his brother or watch him play. This leads to bonding between the two children. It also leads to a higher self-esteem for both children and increases the value of the friendship between the two siblings. 

Parent should be careful not to talk negatively about the child with the diagnosis in front of the other child. so that the sibling continues to perceive the child in a positive manner. 

Parents should praise the child that is normal for providing any teaching or praise of his brother and maybe say things like " you are a great brother" or " you are great at teaching games". Reinforcing the sibling for helpful behavior will make the child feel that he is a help to the child that needs help! Rather than feeling that it is a chore to help with tasks for his sibling with a diagnosis.

Further issues will be discussed in future blogs to make life happier for everyone in the family!

Parents and caregivers are often confused by the myriad of types of providers available. Here are some of the types of service providers, that might be used in a short list, in order to make the decision more clear. 
1.  There are government funded service providers though medicaid and medicare. They have various programs within these categories. 
2. There are service providers that are funded by insurance companies. Parents can attain the insurance privately or sometimes from an employer.
3.  There are service providers that accept private compensation for coming to an office.
4. There are service providers that come to your home for private compensation (ex. cash, credit card).
5. There are service providers that provide services via electronic methods such as on the computer for private compensation  (at a lower cost usually with cash, credit card) or some insurance companies. 
6.  There are some providers that provide supervision of others with less qualifications and train them to provide services in the home. 
7. There are 
This is  a rough outline of some of the options and may guide parents or caregivers in there search for services to help there child get the services he needs to achieve as high a skill level as possible.

Parents and Caregivers are often very upset when they learn of a diagnose of Asperger or Autism about the future of Vocational employment for their child.  There are some hopeful points to think about that may encourage the parent in this regard.  There are a large number of clients with Autism that improve and are then labeled as Asperger or even mainstreamed into society. There are several types of jobs available that might be a future for your child. If his/her IQ is low and he/she has few skills there are a plethora of workshops, farms (ex. with horses), nurseries, packaging projects, paper routes, washing cars, fast food chains, stores, helping others with daily task available to them in the community which do pay a wages.   If the child is very high in intelligence in certain skills such as computer skills and ability to concentrate on a task he/she may have even more doors open to him. In fact some very successful, wealthy people have the diagnosis of Aspergers. Some heads of companies or people in the computer field have this diagnosis or a history of the diagnosis. In fact some new companies in the field of technology have opened recently that only hire people with autism or asperger since they have this ability to concentrate and some higher level technology skills that the general population does not always have. They pay very well reportedly.  Also, a child with Aspergers or autism if he receives behavioral intervention and his/her skills are focused appropriately may achieve jobs as heads of corporations or in the field of technology and become very successful. These people may not even speak of the diagnosis again once their goals of employment are achieved and they may be mainstreamed into a very successful job or lifesyle. The future can be wonderful providing the family or caregiver work very hard and provide consistent behavioral treatments to achieve a happy life for their child. 

Bathing is a very complex task for a person that has not done this task before. Therefore it definitely should be broken down into small steps.  After one step is mastered then move to the next step. Usually, the first step is to step into the shower. The last step is usually the hair which is a little more complex.  Many caregivers do not realize the amount of time it saves for them by making the child or person independent in bathing. This is a task that is usually done daily.  The effort for a month or two of training will pay off in the long run with years of not having to bathe them.  Also, the child or adult will feel much better about themselves and the control they have over the activities in their own lives. In general, people that can perform most of their own care feel much  happier:)Consistent

There are several concerns to consider in addressing your childs toothbrushing problems. If your child has no skills at all in this area a task analysis is needed and training program designed by a behavior therapist is essential. If  it is totally a problem of motivation the child can be encouraged to do so through a reinforcement inventroy or reinforcer sampling. If he has few reinforcers and/or moter problems enviromental and scheduling issues can be considered. The parent might try using an electric toothbrush which eliminates some of the time it takes to brush his teeth and avoids some of his motor limitations. Another option is to comine the electric toothbrush with the motivational program. Each individual case should be analyed to determine the function and possible changes in reinforcers or enviormental changes. 

Parents and Caregivers often say that they use the techniques they have for years since it is easier for them to respond in that way rather than to use another recommended procedure from a behavior therapist.  
One reason they do not choose to change is that they do not realized that in the long run it will be easier for them to eliminate the undesired behavior.  For example the parent may give the child a reinforcer at the grocery store to stop a tantrum.  They do not consider that the result is that the parent will be doing this for the rest of their lives. In contrast if they wait patiently, even though it may be difficult, and deliver the reinforcer only after good behavior at the store then future shopping trips will be much more pleasant and they will have years of "easier" more pleasant shopping trips. Consistent reinforcement of appropriate rather than inappropriate behavior will result in a much easier lifestyle.

Note:  Many other issues related to consistency will be discussed in future blogs.