Rachel Azrin, Board Certified Behavior Analyst
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Halloween tips for children with behavior problems, autism or other developmental disabilities

10/31/2013

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Hallowee can be a wonderful and fun time or a time for anxiety or behavioral problems for children with behavior problems, autism or other developemental disabilities.  The following are some ideas on how to possibly make your halloween experience a more pleasant one!:)
1.  Prepare for haloween. Discuss the costume, where you will go, what is expected of the child and what time you will go to the event or return home.
2. Preparation might include roleplay of appropriate behavior when trick or treating or at the haunted house or party activity. Parent can model the behavior that is expected and then reinforce the child with social praise or treats for appropriate behavior. 
3.  Preparation should include a good night sleep of course the night before and making sure that all medication and vitamins are taken before the outing. 
4.  During the outing parent should try to stay near the child and advise them of the next activity and what reinforcers are expected for appropriate beahvior. For example, if the child is going to homes the parent or caregiver can coach the child that after they say "trick or treat" they will be receiving a reinforcer of a piece of candy. They should then be advised to say thank-you so that the person knows it was appreciated and will give treats in future years. Also, the parent may set up a reinforcer at home such as cake or ice-cream or other preferred activity such as the iPhone if the child does display all appropriate responses including saying "trick or treat" and "thank -you".  Parents or caregivers should provid loads of social praise that is indvidualized to the child  and smiles. For example, the parent might say " you were so polite" or " you were such a gentlleman you even said thank-you!". 
5.  After the treats are collected at the party or trick or treating they may be used in the future as reinforcers for  months later.  Parents can give the child a certain amount immediately and store the remainder in a special halloween rienforcement bag for later use as a positive reinforcer.  This also assure that the child does not eat to much suger that week.  Since many children are on special diets or large amounts of suger seem to effect there behavior in the past. 
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Scheduling your childs' day (for an autistic, ADHD or child with behavior problems) some tips in for your schedule!

10/29/2013

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A schedule is very helpful in promting appropriate behavior. It is helpful to the parent to encourage consistency and to the child to know what is expected during the day in or to receive positive reinforcement. The following are some technical tips in designing your schedule for the child.
1.  Always be specific about which behavior you except and define it breifly in the schedule
2.  Includ time frames usually an hour time frame is good so that it is not too detailed or confusing. Two hour blocks is not quite specific enough. Also, remember that the schedule is followed by humans and therefore it may have to be adjusted or approximately followed which is sufficient to achieve appropriate behavior for your child. Do not worry if you have to move something one time. In fact if one reinforcer is moved it is just as effective since intermittent schedules are actually more powerful in acheiving appropriate behavior. 
3.  It is beneficial to include specific reinforcer for a specific target that will be received so that there is no confusion for the child. The caregivere or parent will find it is even more powerful a schedule if the rewards and behaviors are reminded to the child so that he does not forget and misbehave. 
4.  The reinforcers included must be the type that your specific child enjoys otherwise they are meaningless.
5. Pairing the reinforcer with social praise and expressive facial expression will increase the power of your reinforcement. Especially if the social praise specifically includes praise about the childs' character.
6.  Remember that your child will live up to the level that you expect it is most likely. Try to expect the exact positive behaivors that you always dreamed your child would have and he will most likely become the person you wis
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Behavioral techniques to compliment hearing problems in you autistic  child.

10/24/2013

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Hearing problems and autism seem to have a strong correlation in the literature.  A large percentage of children with autism or autism spectrum disorder have a history of ear infections, tubes in the ears, colds and allergies.  The following is a list of behavioral techniques such as structuring the environment, self-care skills training, training technique that can be helpful, things to observe in your child  and referrals to specialist that might contribute to increases in learning basic skills for the child. 
1.  The environment might be structured free of allergens or bacteria in order to reduce the chances of colds or allergies.  For example, an air purifier might be utilized, lysol spray may be useful frequently, shampoo the rugs, eliminate the use of pillows that are not hypoallergenic (ex. feather pillows), frequent dusting and cleaning of furniture and changing the air filter. 
2.  Secondly, during routine self-care skills such as bathing steps should be taken to reduce the likelihood of ear problems allergies or infections. For example, keeping the ears dry after bathing seems to be essential. This can be done by blow drying on a warm or cool setting after the bath, towel drying the hair throughly, using q-tips as instructed by your doctor, combing the hair back away from the ears if it is left damp, using hair pins or headband to keep the hair away from ears. 
3.  Referrals to Otolgist, ENT and Allergist should be considered in order to rule out or address these possible problems.
4.  Parents and caregivers should try to speak clearly, loudly and have eye contact when teaching the child or communicating to assure that any medical issues with hearing are overcome if possible.
5.  Finally, parents should be aware that any infection or allergy may reoccur so the above steps should be continued and follow-up with doctors is important in order to maintain the health of the child and increase the probability that he learns new skills and understands what is being said when you speak to the child.
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How do I respond to prevent a tantrum in my child or other people

10/23/2013

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People often start to get agitated and then it escalates into a tantrum. Parents and caregivers often have to   deescalate the situation or calm it down after it occurs. The following is a list of possible steps to take beginning with deescalation and then to calming a situation. Each person is different so an observation and analysis of the tantrum behavior will help and is essential to identify which methods to use.
1.  If the caregiver or parent observes any facial expressions, movements or behavior that show agitation it is best to intervene at this point. The intervention can include relaxation techniques, redirection or a cue word to calm the person down.
2.  Once the behavior starts to begin or even when the precursor facial expressions begin the parent/caregiver can redirect the person to another activity or distract them by discussing another topic.
3.  Another method of deescalation is to provide some relaxation methods for the person. Perhaps the person is tired and the caregiver can ask if they want to lay down or take a drink of water to relax. 
4.  Finally, if the behavior has started to occur then usually removing the person from the environment, moving the audience away or ignoring the person and engaging in another activity will deescalate the behavior. 
5. Finally any major reinforcers such as affection or activities preferred should not occur if the behavior has escalated at all into verbal or physical aggression. 
6. Also, in some cases training or physical management might be necessary if tissue dammage is imminent. 7. 7. However, on of the  best way to avoid aggression or tantrusm from occuring is to fill the time during the day with activities and reinforcers for those activities.Finally one should seek advice of a trained Behavior Analyst for aggression or tantrums. 

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Rienforcement types and how to choose the most effective reinforcers for your child:)

10/22/2013

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Rienforcers are difficult to choose that are effective. Some ideas to make them more effective are listed below. 
1. The definition of a reinforcer is something that increases the probablity of the behavior. Therefore this should be considered and determine in order to select an effective reinforcer. The larger the increase in the probabliyt that occurs the more powerful the reinforcer may be. 
2.  The reinforcer selected can be determined by several methods. One is formal assessment tools, observation of the childs behavior or simply interviewing the child or caregiver to find out what he likes most in the world!
3. Giving the child choices of several powerful reinforcers is a great idea since the reinforcers may not be as effective on different days. For example, if the child likes chocolate he may not like chocolate every day and may be full! Therefore, if he has choices then another reinforcer might be used on some days. 
4. Finally, another tip is to select reinforcers that are easily attainable since if they are not the parent or caregiver may not be able to deliver them consistantly. More tips will provided in the future good luck with this start on making your reinforcers as effective as possible each :)
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Exercise is important for children with disabilities, autism and other behavior problems. How do I get my child to exercise? 

10/21/2013

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Exercise is important for children (and adults) with behavior problems, disabilities or autism spectrum diagnosis. Daily exercise can help to relax the child, redirect inappropriate behavior, replace inappropriate behavior with appropriate behavior, exercise can be a reinforcer, exercise can eliminate excess energy that might have been used for inappropriate behaviors. The following is a list of some methods of encouraging and arranging for the behaviors that are called exercise. 
1.  Parents or guardians can arrange a schedule for the day (including the week-end) to make sure that exercise is included each day.
2.  The daily schedule should have the exercise(if it is preferred) after the non-preferred activity (ex. such as homework). If exercise is a non-preferred activity then it should be scheduled before the preferred activity ( such as a computer game). 
3. Exercise can be an organized activity such as soccer or basketball outside or it can be built into the routine. 
For example, when parents go shopping they can park far away from the store so that the child has to walk. 
4.  Exercises should be designed to address any specific weakness the child needs to overcome. For example, if the child has poor fine motor co-ordination with the fingers games with the hands such as shooting basketball, playing with play dough, hand games with clapping, playing the piano or other games that require exercise and movement of the fingers would be great! 
5.  Another example is if the child has poor muscle tone in the stomach exercise such as aerobics with sit-ups. 
6. If the arms are week movements with the arms such as  pull-ups at the park, helping to carry groceries or carrying boxes of toys from the bedroom to the living room.
7. Finally a reward or reinforcer at the end of the day if the schedule is followed is important. The most effective is to have a choice from a token store of a variety of reinforcers or activities that they enjoy as a reinforcer!   
8. Finally social praise is very important throughout the day especially if that is a  major motivator for your child!:)


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Diet and children some basic behavioral techniques that might help

10/14/2013

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Obesity is very common in the past few years in children. Parents can use some of the following behavioral techniques to assist their children to maintain or loose weight when it is recommended by their doctor. 
1.  Environmental structuring of the home is a basic behavioral technique that can be used. One example is to have only healthy snacks in the refrigerator and kitchen so that when the child is hungry he will eat something healthy.
2.  A second environmental technique is to reduce access to the refrigerator. Some newer refrigerators have locks that can be activated or deactivated.  This is particularly useful with extreme obesity or Kids with problems such as "Prader Willi" syndrome. 
3.  A third technique is scheduling which leads to less snacking between meals.  Children can be informed that eating is to occur only at meals and during two snacks during the day.
4. Another behavioral technique is to reduce the size of the plate at meals so that it looks like more food. 
5.  Encouraging children to chew each bite at least 10 times so that they digest the food.
6.  Eating only when hungry and not for social reasons can help children to loose weight. 
7. Parents can take time to explaining long term and short term consequences of weight gain and over eating or eating unhealthy.
8. Children can be encouraged to participate in shopping and purchasing healthy items rather then items that are high calorie. 
9.  Parents can purchase books to read that talk about healthy eating and eating food from each food group. 
10.  Parents might try regularly scheduled weight and height measurements to increase awareness of health and eating habits and the effect on weight. 
11. Another concern is making sure to schedule specific limited amount of time for sedentary activities like computer or television. Exercise time should also be included in the schedule each day. 

It is never to early to start encouraging healthy eating habits, reinforcing these habits and discussing consequences for you children to encourage healthy eating habits in your children as they become adults! 

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Autism treatment and the importance of making a schedule for the day

10/10/2013

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Parents and caregivers often forget or do not realized the importance of a daily schedule. This schedule should include two specific types of events at the least. These are describled and listed below. A detailed schedule which includes both activities and rienforcers will usually lead to elimantion of inappropriate behavior and maintenance of good behaviors.

The first thing that should be included in a schedule is the actual activities and the time frames in which they occur.  Some examples include activities such as school, workshop that occur on a daily basis during week-days. Also, include activities such as outings or vacations that may occur only once a  month or once a week. 
Another type of activity are  self-care activities that occur daily such as going to the bathroom, brushing teeth, eating breakfast, dressing. Also, daily living activities such as chores of wiping the table, taking the trash, making the bed, moping, cooking  or cleaning the dishes.  Bedtime and time to wake up are important factors to include in the schedule since children need more sleep and behavior problems are often correlated with a lack of sufficient sleep for people. The more detail is preferred so that if another caregiver is there even just for a few hours the routine is still followed. Also, children with autism and developmental delays as well as any child prefer to have a routine which reduces frustration and confusion related to what activities will be done that day.  

Secondly, caregivers or family should include in the daily schedule reinforcers. For example, time to use the computer, television, radio, toys can be built into the schedule as available if the behavior is good.  A token exchange or time to choose a reinforcer can also be included in the schedule. The schedule should be updated and reviewed regularly for any changes needed in order to assure that it produces the maximum beneficial effect on the childs' behavior! 
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Autism and computers or Ipads used therapeutically

10/8/2013

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The latest trend is to purchase an iPad or computer and assume that this will teach your child everything!
There are three important things to note about the use of an electronic device.

First, the computer itself does not teach your child. If the software has reinforcers built into the games or activities that you purchased then this might work. However, if your child does not like the particular reinforcer in the program then the child will not learn. For example, if your child likes music and the reinforcer in the game is music delivered for a correct response then the child will not learn.  Before purchasing a game it is important to look at the game and see if the reinforcers are included.

Secondly, it should be noted that many games are specifically designed to include reinforcers and many are not.  Some are based on psychological research including games such as those developed by "Headsprout" ( recently purchased  by another company) and many others. Parents should read and look at the information about the games to see if they are based on research or psychological principles such as reinforcement. 

Third, parents should also consider the skills taught by the electronic device. Are these skills you want your child to learn. There are games to learn most anything such as spelling, reading, self-care skills, morals, social skills and much more.  I contrast it should be noted that children might model some behavior in games and there is such discussion and research that indicates that some aggression can be learned from modeling of television or games. This should be considered in your purchase of a game. Games your children might like might have some benefits and some deficits in their affect on your child's' behavior. All of these factors should be weighed and considered before purchasing a device and programs for your child. 

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Aggression in children and adults and some ideas for clients to relax before they are to aggitated 

10/7/2013

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Aggression is often a targeted behavior problem for therapist. It is a great idea to try to stop the aggression in the beginning as soon as precursor events occur. For example, some ways to relax are listed below.
1.  Listening to music
2. going in the bedroom or to a quiet area to relax a few minutes
3. Counting to ten.
4.  Designing some positive statements to say to themselves when they start to become aggitated such as " that is no problem!" 
5.  Using some kind of object to hold such as a sensory ball to distract from the aggitation.
6.  Getting a drink of cool water or tea to relax.
7. Saying calm reasuring things to the other person in the room or complimenting them.
8. reading a magazine
9. Engage in some deep breathing exercises
10. Engage in some relaxing deep muscle exercises to calm down. 
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