Rachel Azrin, Board Certified Behavior Analyst
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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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Feedback is a useful tool to use when working with children or adults with autism or developmental delays.

1/21/2014

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Feedback is a useful therapeutic technique to use when working with people with autism or developmental delays as well as normal children or adults.  Feedback has effectively  improved behavior according to research articles in a wide variety of targeted behavior problems. This technique can be applied with the following types of problems and in many other creative ways. 
  A child or adult with weigh control issues might use a diary for food intake, weight, water intake too. This can be useful to review with them to assure they are eating the right things, drinking enough water and reducing their weight. The feedback provides useful information to the person and changes in habits can be made with the therapist based on the information recorded. A journal or calendar is useful for this. 
  Recording sleep times each night can provide useful information for treating sleep problems. The therapist can provide a data sheet, diary or calendar to record the sleep patterns. The information gathered in written form can be discussed and changes can be made based on this important feedback regarding sleep patterns. For example, if week-ends are particularly low in number of hours slept then the therapist might suggest going to sleep earlier, listening to a sound machine or music to relax before bedtime. 
   Recording general mood with a happiness scale or in a journal can provide useful information for behavior change.  For example, if the person is upset frequently then adding some more reinforcing activities may change the behavior. 
Generally, any data collection can be used as feedback to the individual or parent in designing and changing procedures in the program and informal procedures. 
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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 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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Selection of skills to teach your child that has autism or asperger diagnosis

9/10/2013

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Parents and therapist often are not sure which behaviors to prioritize in training new skills or choosing replacement behaviors.The following identifies some important factors to consider in the selection.  One factor to consider is to try to select a skill that will lead to the long term goals of the client.  This often requires alot of imagination, observation and research to come up with some alternative goals with the client and his caregivers that will lead satisfying to a more satisfying lifestyle for the client.  Once these goals are established all other training should be in agreement with these long term objectives. A second factor to  consider is  the inappropriate behaviors and the caregiver or trainer should attempt to design acquisition skills that will most likely reduce those behaviors. This may be done by teaching skills that are difficult to do at the same time as the inappropriate behavior or skills that result in the same types of reinforcement.  Parents and trainers should always keep in mind that teaching skills that are not connected to the overall treatment plan goals to achieve will not lead the client as rapidly to acheiving the satisfying lifestyle the client and family want to achieve.
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Scheduling activities and children with behavior problems and autism

9/10/2013

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Caregivers often do not realize the importance of a schedule for their child with problems such as autism, behavior problems or even attention deficit and non-compliance problems. The following includes some of the advantages and how to implement scheduling effectively  

The advantage of a schedule are the following. The parent is able to let the child know what is to be done next in a positive manner. Also, children know that the previous activity will end at a specified time so they do not get upset. Thirdly the child can look forward to certain prefered or reinforcing activities during the day. Finally, the child is more productive with his time learning since there is not as much time that does not include an activity for learning. 

To effectively implement the scheduling of a childs day it must be first individualized to the particular client. Secondly, it should include some preferred activities or reinforcers or time for choosing a reinforcer during the schedule. Thirdly, it is helpful to make the child aware of the schedule or review the schedule in the beginning of the day and throughout the reminders of the next activities scheduled. This serves as a stimulus for good behavior.  If paired with the reinforcer to be expected this will improve the childs' behavior even more during the activities. 

Posting the schedule is usually in practice not that helpful, The child frequently ignores the posted written schedule and in many cases has vision, reading skill problems or simply does not bother to look.  Although some therapist and researcg reports it is helpful to post it is suspected by this author and others that posting is more of a help to the parent or caregiver in most cases. However, It is very helpful for the caregiver to have a copy for themselves either posted or in a binder or other location. 

The schedule of course should be updated regularly and include the childs choices and preferences in the schedule. Consistancy, throughout the day is also very important. If changes have to be made in the schedule it is helpful to discuss the changes prior to the day or hour in which the change will occur with the child. The prior discussion of a change, may avoid any strong reactions such as tantrums that could result from changing the routine. Parents and caregivers will find that the schedule is a very useful tool in improving the childs' Behavior. 



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How do parents teach there child to talk with behavioral therapy(an easy basic step by step example)

9/3/2013

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Parents often find themselves frustrated after months of going to therapy sessions and no success. One of the quickest way to increase your childs vocabulary is through behavioral techniques.  The key to success is consistency, powerful reinforcers and generalization of your training in different situations. 
One example of teaching your child to say juice is the following. In this case we have identified the targeted word or phrase and this must be done before you start teaching. Also the item identified is preferably a strong reinforcer and an item the child frequently wants.  Usually you want to choose a word the child might use frequently and that is fairly easy for him to pronounce or that he has some approximations to the word already in his repertoire. Secondly, the caregiver waits for the child to have a situation in which he wants the items such as the juice. Third, the caregiver delays giving the item until the child says some approximation or the actual word. Fourth, the caregiver gives the child the item immediately or as soon as possible after the word or approximation is completed by the child. Fifth the parent continues to delay giving the item in every situation in which the child wants the item during the day. Sixth, the parents delays giving the water until the child states the complete word clearly. Seventh, the caregiver adds other words to the criteria for reinforcement of the juice. For example, the caregiver might wait for the child to say "juice Please".  Finally, the caregiver continues this process and adds more words to the original words and additional words for other reinforcers! In a sort time usually even in the most difficult cases the child will be talking!
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Parents should always rule out medical issues such as hearing, vision or other problems in their child with autism or aspergers.

9/2/2013

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Parents should always make an effort to rule out any signs of medical issues in order to increase the effectiveness of the behavioral treatment. If the child has a medical issue it may reduce, slow down or prevent the child from a complete habilitation from behavioral intervention or mainstreaming.  Some medical issues to keep in mind include the following. The following list includes some items that research has suggested a relationship to developmental delays and autistic type behaviors.  One example is hearing or hearing problems. Numerous research articles and papers at conferences have talked about the strong relationship between hearing problems in clients with autism, aspergers, aggression and developmental delays. They often present data with a direct correlation between these problems or control studies. These children usually have a history of ear infections, tubes in their ears or pain in their ears.  When a behavior therapist or parent does an assessment this is a very useful thing to ask about when reviewing the history of the child and the "organism" variables in the SORC analysis. If the parent or child has a history of ear problems they should be referred to a specialist for ear problems not just the general practitioner. The reason for this is that often a general hearing test may not pick up some more specialized problems with the ears. A specialist such as an otologist or ENT is preferred to be sure there is no problem that could jeopardize learning for the child. Other examples might be medical problems that lead to sleep problems, genetic disorders that causes a variety of problems, small seizures that are not detected, vision problems, allergies, stomach problems and constipation. These topics will be discussed more in depth in future blogs. Medical issues should be ameliorated so that the child can progress to his upmost ability developmentally through behavioral interventions. 
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Sleep problems for my child where and what do you do !

8/23/2013

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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
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