Rachel Azrin, Board Certified Behavior Analyst
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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 do I encourage my children (autistic, developemental delayed or normal) to do chores? 

1/15/2014

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Parents or caregivers often ask " How do I get my children to help with chores!" The following are some tips to encourage them and motivate them to complete chores in the home. 
1.  Discuss reasons why it is important to do chores. For example, so that the house looks nice when their friends come over. A second reason might be to help the parent or caregiver so they have more time to cook for the child or go places with them. 
2.  It is helpful to make a list of possible chores and have the child choose a specific number that they would like to do. If the child enjoys the chore intrinsically he will be more likely to perform the chore. 
3.  A list of reinforcers that the child would like to earn weekly or daily for performing the chore can be useful. It is helpful to involve the child or observe him closely to make sure the reinforcers selected are actually going to motivate the child. For example, a child that does not like music will not be motivated by earning music tapes. 
4.  Making a daily schedule with the time the chores will be performed is helpful so that it becomes a rountine for the child.
5.  Make sure all the children in the household are participating in chores so that no child feels he is doing more than he should be. 
6. Finally, social praise and excitement about the chore by the caregiver can always helps strengthen the probablity that the child will continue to help out!  Try to use an excited voice, be specific about the childs positive character within the praise and specific about the chore that you are happy with. 
The above tips will increase the enjoyment of the chores and the likelihood that they will perform chores! 
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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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How to choose a household chore for my child with behavior problems, autism or developmental delays.

12/11/2013

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Parents or caregivers might consider the following in choosing a chore for there child.  
1.  Consider the physical abilities and limits of your child. If the chore involves lifting something heavy or using alot of motor movements that the child cannot do easily it will be difficult to motivate them to do the chore. For example, if you want the child to put things away on a high shelf or use a heavy vacuum this should be considered. You might want to purchase a lighter vacuum that does not have a cord in order to make the chore easier and more likely to be preformed. 
2.  The parent should consider the mental or intelligence level in choosing a chore. If you ask a child with a low IQ or to clean his entire bedroom this may be overwhelming and it may not occur. In contrast if you ask the child to put the blanket on the bed and pick up the blocks this may be easier. Giving him simpler chores may be easier for the child to accomplish and to motivate him to do on a daily basis. 
3.  The task should be one that the child might enjoy. Try to match his preferences or reinforcers with the chore. For example a child that likes sensory reinforcement may enjoy the water while washing the dishes. Another example is a chore such as serving guest lemonade may be enjoyed by a child that likes social interaction and praise! 
4.  The parent or caregiver should consider the long term goals for the child in choosing a chore. For example, if the child goals is going to be living with with his natural family (rather than  in a home or a group home) maybe try to choose tasks that are useful to the other people in the household with tasks such as cooking.  If the child is trying to learn a trade for the future making some money for himself perhaps a chore such as washing cars would be useful and he could later work in a car wash. If the child is going to try to work on the computer in the future perhaps helping the family by printing coupons for groceries' will help to develop the skills needed for a job with computer work. 
Generally, all of the above factors should be considered in choosing a task for the child. The caregiver or parent should try to find a task that the child can do, that is enjoyable for the child, that is physically and mentally possible to do and finally that fits in with his long term goals and dreams for the future. This type of chore will be more useful to teach him/her and more likely to be consistently performed by the child. 

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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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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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Exercise choices and Autism or aspergers for your child

9/23/2013

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In choosing which exercises to work on first more frequently in a child with poor motor skills and aspirer or autism one should think about the functional skill deficits of the child. If a child is having difficulty using a fork or spoon then sports or leisure activities that emphasize the hands may be beneficial since you will be strengthening these muscles and movements.  Exercises that stress the lower body are also beneficial but if the priority is to develop self-care skills that require more dexterity then he as the fine motor movements should be emphasized. Some leisure activities such as using an iPad may also improve fine motor skills. 

Finally, one should also consider forks or spoons for example that are easier for the child with motor problems to use. Considering the selection of equipment and leisure or sports activities can be important in promotion of more rapid learning of self-care and daily living skills in children with both motor and Autism or  Attention problems. 
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After graduation where to place your child with special needs, autism spectrum or other issues

9/12/2013

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Parents often struggle with thinking of what to do with their child with special needs (ex. autism spectrum) after he receives his diploma from high school. The following is a review of some of the options they might consider. The caregiver should way the short term and long term benefits of each option for their individual child and themselves.   

One option is to place them in a day program with activities. A second option is a workshop setting. Some workshops are "stand alone workshops" and some you can pay or get funding to attend even though they are part of 24 hour living facility. A third option is to try to attain employment in the community either on their own or with the assistance of supportive employment.  Supportive employment can be arranged and often the child is sent for evaluation in order to determine the best type of job for him. Another alternative is to have some job arrangement which can be performed in the home such as data entry, phone calls or other jobs in the home. 

A sixth alternative is to continue the childs education at  Community college or technical school where he can attain credentials or certificates for a job.  A seventh alternative is to enroll him in a job for special needs persons such as programs with plants or animals. Some job programs are geared toward hiring only special needs persons.   There are a large number of other alternatives. Parents will benefit by dreaming with the child about an ideal job that utilizes skills the child has as well as having reinforcing activities or items the child will enjoy.  This "brainstorm" session might include other professionals or friends and will result most likely in a more peaceful and fulfilling life for your child. 
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