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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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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Problems solving skills and how to help my child with these skills. 

2/11/2014

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Many children have difficulty solving problems and resort to displaying inappropriate behavior to solve their problems. There are numerous ways to improve your child's' problem solving skills.   Any child with disabilities, autism, ADHD, defiant behaviors or just normal children can improve their problem solving skills. 

Throughout the day parents can incorporate problem solving practice during the daily routine.  For example, in the morning for breakfast prompt the child to try to figure out what he will eat, what he will wear and where you will go. During daily activities or outings try to encourage your child to use problem solving skills effectively. A variety of methods of problem solving might be used. He might list the options of the choices he has. For example, even a simple thing like making breakfast might be broken down into steps, list the choices of foods and choices of how to make the foods.  If there is an argument in the morning with sibling over who can sit in a certain chair you might discuss the options. For example, maybe you can take turns each day sitting in that chair, maybe you can buy another chair like that one, they might ask for your help in working out a problem, or could bargain by offering another activity to his sibling in in in in in in using the chair. 

Parents should use reinforcement for getting along. The research shows that co-operative play can be increased through the use of reinforcers. Parents can offer additional reinforcing activities if behavior is co-operative and appropriate in the morning. Social praise or special treats for getting along can be effective depending on what is reinforcing for your child. Remember to be specific when using praise. For example, "you are such gentleman the way you work together on making breakfast!" Another example might be "you are such a good brother and so kind helping each other to set the table!" Parents should try to reinforce only if play is co-operative and not if only one child is good following each activity. 

Finally, practice at specific times during the day problem solving is helpful. Often parents have time while driving, waiting at a doctor office or at bedtime to practice problem solving with their child. For example, at bedtime the parent can review a situation, list some optional solutions, reinforce appropriate solutions and try to come up with other examples of this type of situation. Remember it is better to use hypothetical situations about other people, in a movie or from your experience rather than a situation your child has currently. If you use his current specific problem you may inadvertently reinforce him for having problems frequently with others.  The more you practice solving problems that are imaginary then when he has real problems he will be ready to solve them quickly!
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Teaching your child self-care skills and adaptive equipment that might be useful. 

1/28/2014

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Caregivers and parents have in certain cases become frustrated training their child a simple skills such as toothbrushing or tying shoes.  Below are some tips for creative use of other equipment or equipment in general to make your training much more rapid and fun for your child!

1.  Toothbrushing- to make tooth brushing easier parents may try and electric toothbrush. Some of them are quite inexpensive. One can purchase a battery operated toothbrush for under 10 dollars at a drugstore or department store.  Also, parents can purchase a preferred brush for your child. For example if he likes superman  one might purchase the superman electric tooth brush. 
2.  Shoe lace tying- to make teaching shoe tying parent or caregiver might try using other types of shoes such as velcro shoes or slip on tennis shoes.
3.  Eating skills- there are a large variety of adaptive equipment available for eating. For example, a built up spoon for someone who has an unsteady or weak grasp.
4.  Walking- teaching someone to walk one can start with a more restrictive device such as a walker then fade to a three legged cane and then to a cane. Always, make sure to consult with and follow any physical therapy or medical recommendations when working with adaptive equipment. 
5.  Drinking- there are special cups such as cups with a straw, cups similar to a child's "sippy cup" and large or smaller sized cups.  Start out with one and then slowly fade to a more normal cup. 
6. Hair brushing- is your child upset when you comb her hair? Try using a wide tooth comb or brush and then gradually fading to smaller teeth. In some cases a wide tooth comb might be continued indefinitely to prevent pulling the hair as you comb. 
Always remember to use reinforcement, shaping in combination with the adaptive equipment and you will have more rapid results from your training with your client and child! 

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How to make sure your Reinforcers continue to be strong over time. 

1/22/2014

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Reinforcers can change or loose their strength over time. The following are some tips to keep your training strong over time.
1.  Caregivers or program writers should continue to assess the reinforcers for the client periodically to assure they do not change. 
2.  When the performance drops off for a few days make sure to observe and assess whether or not the reinforcers have changed.
3.  Giving the child or client a choice of reinforcers is one way of avoiding the pitfall of a reinforcer loosing its strength on a specific day.  For example, if a child is not hungry during the training he may not want the lemon cookies he usually likes to work for. Giving him a choice of an activity or other reinforcers identified is good practice daily. 
4.  As always try to give the reinforcers consistently so that the contingency or rule is clear to the child
5.  Reminding the child what the reward and what is expected of him should be done periodically so that over time he does not forget. 
6.  Presenting the reinforcers visually can help to maintain the strength of the reinforcer over time. 
In general, maintaining the strength of the reinforcer over time may determine the success you have with training over time. 
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How do I encourage my child to be nice to me, nice to others and have general social skills when working in a group!

1/20/2014

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Children with disabilities, autism and a variety of behavior problems often do not display social skills such as sharing, greeting others, offering to help others, praising others and making small talk. The following are some tips on how to encourage these skills during your child's daily schedule.

1.The first step is to identify the skill you want teach.  Social skills can be taught, which is often not acknowledged by caregivers. 
2. Once the social skills are identified then prioritize which ones you will focus on first. Always work informally on all types of skills so that the training is even faster. Intensive focus on the highest priority skill does ensure that you will make faster progress with the more important skills for the child.
3. There is research that  Sharing and getting along can be reinforced and developed in a child. Some children are friendly and share on their own. The children that do not do this on their own can be taught to do so. Also, if caring and sharing are not encourage a child that is predisposed to be friendly might become less friendly.
4.  During the daily schedule be sure to include time for socializing. If your child's schedule includes only solitary activities such as his ipad or books and chores he may not have any opportunity to socialize and become friendly with others. For example, you can have time to talk at dinner, time for interactive games, talk in the car or at night before they go to sleep.  
5.  Include reinforcers for socializing such as a preferred item or activity if your children play a board game nicely. 
6.  If inappropriate behaviors do occur during the interactive activity be sure to stop the activity. Also,  do not give any preferred activity or item to anyone involved in the interactive activity. 
7.  Modeling and prompting appropriate conversations during interactive games can also be helpful for children. Often the children may not have the skill or forget to perform the skills. Social skills, sharing and friendliness are  important skills since getting along with others affects every area of the child's future including job, how they treat their family members,  friendships and general happiness of your child.
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When does a parent decide to get help with a child they suspect problems such as autistic behaviors or other behavior problems. 

12/26/2013

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Parents are usually in turmoil about when to start to look for help with their child. There are several points to consider in the list below.
1.  Parents often think a child will "grow out of a problem".  This is determined on a case by case basis. If the behavior is severe, frequent or noticed by others in the community or family it should most likely be addressed. Yes, it is true some problems you do grow out of but it is best to seek out a professional in the area of the problem as a precaution to confirm whether or not treatment or assessment is needed.
2. Parents can try exhausting ethical methods they have learned to use in our culture and then turn to the professional once the methods do not have much effect. 
3.  One thing to consider is that if you wait to long the behaviors may become worse and may not be as easy to eliminate.  For example, if a child is head banging to communicate it may accelerate and be more resistant to treatment.
4.  Some behaviors such as aggression or self-injury can lead to medical problems if left untreated for a long time.  For example, damage to the brain or skull can result from head banging. 
5.  If early intervention is not done quickly the child may be held back or not allowed to enter the next grade when starting school. For example, many schools require basic skills to move to the next grade such as toiling themselves. 
6.  Once behavior patterns are formed between the parent and child it is more difficult to break them if you wait a long time. For example, a mother that hugs the child after a tantrum may have trouble changing this habit.
7.  Many of the developmental skills such as eating, dressing, toileting and communicating are accomplished before entering the school. If you wait to help your child with these skills you are loosing time in their development and the result is they are developmentally delayed compared to other children.
8. Some parents might consider paying out of pocket for the evaluation if they have the money to do so. The advantage of paying our of pocket is that the child does not get labeled early in life which may stigmatize him later. 
9.  Finally, parents should consider the long term cost of not seeking professional help.  A child with developmental disabilities can cost large amounts of money per year for the rest of their lives.
10.  Finally, parents should realize that the time and effort they take now will reduce the effort they will need later. For example, if a child is not toilet trained or eats by himself the parent may be changing diets and feeding the child when he is an adult. 
Generally, parents should consider the above items and make the best decision for their individual child that will lead to him/her having a full and meaningful independent lifestyle as possible in the future. 
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How to use electronics as a reinforcer without causing increase in tantrums or other behavior problems with autistic, aggressive and other childhood behavior problems or developental delays?

12/23/2013

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Computers and electronic devices have become very powerful reinforcers for many children in the past few years.   Parents and Caregivers can use the following methods to more effectively and without behavior problems such as tantrums.
1.  First thing the caregiver should do is select the reinforcers specificlally through asking the child or an inventory which identifies the most powerful electronic reinforcers. 
2.  Next the caregiver or parent should explain specifically to the child what he has to do to attain the reinforcer. For example, the parent might say if you do your chores, have no tantrums or screaming, get ready for school on time then you can use the iphone that day.
3.  Next once a behavior occurs he/ she will not gain access to the reinforcer the next day or longer as specified by the parent or guardian. This should be a definite rule regarding how many days or hours of good behavior are required to attain the electronic and how many days he/she must have good behavior in order to attain the reinforcer for a specified amount of time. 
4.  If the child resists giving up the computer or phone there are environmental ways of preventing the use of them without a struggle. One way is to put the phone away once they go to sleep if there was a tantrum that day.  Secondly, the keyboard or mouse can be put away in a locked reinforcer cabinet if there is a tantrum and the reinforcer is the computer. Another technique is to remove the battery from a device, turn off the fuse box.
5. Parents might consider adding a password that can be turned on and off on a electronic device or computer. 
6. Parents should consider turn off a television with the remote or if there is a parental lock or timer this can be useful in making sure the reinforcer is delivered consistently.  
7.  Parents should try to give the child at least one or two warning statements so that the child is prepared and realizes that he has not behaved appropriately. 
8.  Finally it is important to make sure that the parent states the rule as a house rule and not as something mean imposed on the child. Also, the parent should state something empathetic such as " I wish you could have earned the phone or computer today that is too bad I am so sorry about that. Maybe you will earn it tommarow." 
9.  In order to prevent a tantrum parents should include the time from the loss of the item to the time it will be earned as a criteria for earning the reinforcer again. For example, if you are good and do all your chores and no tantrums or screaming you will probably be able to earn computer time tommarow.
In general, the parent should be viewed as a  sort of Santa Clause or bearer of gifts for the child not an negative person that enforces the contingency. This attitude of the parent will lead to a more postive relationship with the parent, less arguments and behavior problems in the future!:)





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Teaching new skills and how to fade out physical assistance with autism and children with developmental disabilities. 

12/19/2013

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Parents and caregivers often want to teach an autistic or developmentally delayed children. After identifying a targeted behavior and assessing what level of assistance is needed. The person teaching should start at the level the child is currently functioning  at. If the child needs complete or full guidance to perform the task that is the level of assistance to start at.  Next after reinforcing the child at this level then move to less assistance or partial guidance. This can be done by moving gradually up the arm for example or using less physical contact to perform the task such as just one finger or sporadic touching of the arm. After reinforcing the child with partial guidance one touch and fading away from the child. Perhaps just giving one or two instructions and one touch and then reinforcing when he performs the task. Finally the trainer moves away physically from the child and just gives the one or two specific instructions and then reinforcers the child. This guidance training procedure can be used with almost any skill you want to teach your child.


Summary= Full guidance-Partial guidance- Verbal prompts
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Running away problem with children how to prevent. 

12/12/2013

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Parents or caregivers often have problems with children running away. This occurs with normal children, children with disabilities, children with behavior problems, children with autism and teenagers often have this problem.  The consequences of running away can be devastating present inconvenience  of time and money to the parent or caregiver. Prevention of this behavior is simple and will cut back on all these consequences for the caregiver.  The following are some ideas to prevent the problem.
Generally the following are ways of making the environment in the home much more reinforcing to the child so that the incentive to leave is reduced. 
1.  Parents or caregivers might make a list of reinforcers for each of the children and try to include them in the home environment. For example, if the child likes games include in the home fun computer games, board games, basketball hoops or other equipment to provide them with this reinforcer in the home when their behavior is good or during leisure time.
2. Similarly, if a child likes certain foods or social attention these should be provided for good behavior in the home and the absence of the behavior of running away.
3. Weekly conversations about how to improve your child's' life at home is also useful
3.  If the behavior of running away occurs then the reinforcers above should not be available for a specified short period of time. Also, parents or caregivers should try not to give to much attention when the running away occurs since this may be reinforcing to the person. For example, yelling, talking to much about it or touching or holding the child in your lap may be reinforcing. This will decrease the likelihood the running away will  occur again. 
Generally, caregivers and parents should realize that the child will run away when things in the home are not as reinforcing as they are in the places the child is running away towards. The increase in the number of reinforcers in the home and the more pleasant the home is the less likely they are to leave.

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