Tag: Autistic

Q&A About ABA Therapy for Children with Autism

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FAQ for Caregivers

Was your child recently diagnosed with autism? Are you beginning to navigate treatment for your child? Before you get started, check out these FAQs about ABA therapy.

What is the goal of ABA therapy?

ABA therapy is designed to support autistic individuals and their families, achieve their identified goals, and improve their quality of life. ABA-based interventions are supported by decades of research and enhance social, communication, play, and adaptive skills. Services incorporate the needs and interests of the autistic individual and their caregiver(s). A behavior analyst delivers the ABA services with the help of behavior technicians, who often provide direct care to the autistic individual. Services are tailored to the individual’s unique needs, with their feedback, and evolve over time. Services for children may look quite different than services for adults, given the individuals’ needs differ over time.

What is “contemporary ABA” therapy?

At LEARN, we refer to our approach as “contemporary ABA.” It is an evolved approach to ABA therapy that promotes individualized treatment, naturalistic and play-based teaching, and is person-centered. LEARN provides a contemporary approach that acknowledges the evolution of ABA, values the individual and their family, and creates space for individuality. Practicing contemporary ABA therapy means that our behavior analysts deeply understand their responsibility to positively and meaningfully impact the lives of the individuals served.

How many hours of ABA therapy will my child receive?

Your child’s hours will be determined between you and your behavior analyst. Your behavior analyst recommends hours based on assessing your child’s needs, other therapies received, and your feedback as the parent/caregiver. Focused programs range from 10-25 hours per week, and comprehensive programs range from 30-40 hours weekly. At LEARN, we provide home-based, center-based, and community-based services, and you can reach out to your local clinical director to find out which services are available in your area. Check out this video to learn about the number of hours clinically recommended for your child.

Are your ABA therapy services individualized?

Absolutely! Each autistic person we serve is unique, and we believe that should be celebrated. Our goal is to promote individual interests and incorporate those into ABA therapy. Behavior analysts make individualized recommendations for services, including hours based on the child and customized goals that fit their needs. Behavior therapists receive training on how to understand the preferences of their clients and include those in sessions to make them fun, rewarding, and engaging.

How is neurodiversity integrated into your approach to ABA therapy?

Listening to the perspective of autistic folks has informed our approach to ABA therapy and led us to incorporate neurodiversity into our practice. Our goal is to elevate the autistic voices in our community, including the individuals we serve, our neurodivergent employees, and the greater neurodivergent community. We’re deeply committed to person-centered ABA therapy practices and promote assent-based care, meaning we validate the identities and experiences of neurodivergent folks and create space for autistic voices to be heard and upheld. Learn more about our commitment to neurodiversity here.

Will my child be required to do discrete trials and sit at a table?

Not all autistic folks benefit from discrete trials or table-top work. For example, a two-year-old child with lots of energy may benefit more from a play-based approach with the therapist sitting on the floor and embedding learning opportunities in play with their favorite toy. Behavior analysts overseeing the treatment plan take time to assess the individual’s needs and work collaboratively with the family to identify an approach to treatment that will work best for the child.

What if someone doesn’t want ABA therapy?

We understand that not everyone seeks ABA therapy, feels it’s the best fit, or perhaps, thinks it’s the right time to try. As with other medical services, the patient (along with their caregiver, if a child) has the right to decide when, if, and what treatment is right for them. Not all ABA therapy providers have the same approach, either, and LEARN supports a family’s right to choose a provider that meets their needs and is a good match for their treatment goals. We want families and our clients to be excited about services and encourage collaboration on our journey together.

Reviewed by Dr. Ashley Williams, PhD, LABA, BCBA-D, Sr. Clinical Director

To learn more about ABA, visit our website. You can also search our locations here.

3 Tips for Making Valentine’s Day Special for Your Autistic Child

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As store shelves turn to masses of pink and red, some people get excited and others groan. Valentine’s Day, with all of its joy and complexities, is around the corner. Although love and social connection are important to everyone, Valentine’s Day can be tricky to navigate for many people, including some of our autistic loved ones. Different ages bring different challenges: from the drama of classroom valentine exchanges to the heart-stopping anxiety of having a date. Wherever your child may fall on this continuum of V-Day Life Lessons, a few considerations can help them feel cherished on this day. 

Prepare

Consider the potential challenges that your child might encounter that could be helped by some advance skill-building. Think carefully about what your child will encounter that day and what easily-acquired skills might help them enjoy the day more. A younger child whose class is exchanging valentines might benefit from practice; find out how the teacher will approach this (will the kids deposit them into a box or hand them out individually?) and rehearse in advance. A teen attending a dance might benefit from a social story about what to expect, previewing conversation starters, and maybe watching some realistic shows depicting teen dances to help set expectations. If anxiety is a factor (as it can be with anyone of any age!), make sure there is an easy way for them to contact you for an early pick-up. For safety, teens and young adults who are dating should have information about consent and sexual harassment at a level they can understand. Learning about good hygiene practices, manners, and general dating “dos and don’ts” can help to set them up for success.    

Accommodate

There will also be challenges on Valentine’s Day that can’t be solved by skill-building. Consider your child’s experience and be creative about the types of accommodations that might help them enjoy the day the most. If your child is on a special diet, find out if there will be school treats so you can arrange for something yummy for your little one. Some children will not enjoy the “typical” Valentine’s Day activities. Remember, it’s once a year, don’t stress over making them go to a class party they won’t enjoy. There may be accommodations that can help make regular activities okay (headphones), or you can simply ditch the regular valentines’ stuff and think of some fun alternatives instead. Perhaps instead of going to the dance, they can rather invite a friend over to bake brownies or watch a movie with their sibling.    

Love

Valentine’s Day is an opportunity to show others how much you care. As a parent or caregiver, showing affection for our children is one of the most fulfilling experiences. Think about your child’s preferences and give them a token of your love, whether that be treats, attention, a new Lego set, or a special rock. Giving them choices in preparing for the day (e.g., picking out valentines, choosing a special dessert, etc.), thinking about how to include their preferred interests in your plans, and making plans to accommodate sensory needs can communicate your love and respect.    

Some profoundly affected autistic folks will not be affected by the fact the world has turned pink and red; they may not understand or care. But this doesn’t prevent them from receiving your love and affection in the ways they do the rest of the year, so take the opportunity to connect with them on their level. Many autistic folks tend to anthropomorphize; if there are things (e.g., trains, books, electronic devices, etc.) that are the object of your child’s affection, think about how to celebrate these objects that give your child joy. 

For those autistic children who understand the social nuances of Valentine’s Day, it can create pressure around feelings of popularity and acceptance. If your child is experiencing these common hardships, do your best to shift the emphasis away from romantic love and toward other satisfying relationships in your child’s life. For some, that may be a friend, or for others, it may be family. Reassurance that they are accepted at home and loved unconditionally is paramount. 

Have Happy Valentine’s Day!

Last but not least: show yourself some love as well. Parenting isn’t easy and requires many qualities, including patience, empathy, and, most importantly, love. The love we give our children isn’t always returned in the moment, making it hard sometimes to reflect on all the wonderful things you do for your child. Remember, you’re raising a human, which is stressful yet important and incredible work. As you nurture your relationship with your child, you build their capacity to love and show love to others. This Valentine’s Day, take some credit for all you do for your child in the name of love and find a way to treat yourself, whether that means setting aside time to read or exercise, getting an extra hour of sleep, or calling a friend. You deserve just as much love on this special day.    

For research-backed strategies on managing stress, check out “How Parents and Caregivers of Kids with Autism Cope with Stress.” To dive deeper into the topic of love and autism, learn more at “Myth: People with Autism Don’t Feel Love.”

Myth: Autistic People Lack Empathy

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Katherine Johnson. M.S., BCBA
Senior Director of Partnerships, LEARN Behavioral

Note: This article is about a form of ableism that affects one part of the autistic community: autistic people who are proficient verbal communicators. Those who communicate with AAC devices, typing, sign, or who don’t yet have the communication skills to engage with the wider world face other forms of ableism and discrimination not described in this article. 

The Double Empathy Problem

Remember the game “telephone”? One person whispers a message to another, that person whispers to the next, and on down the line until the last person announces the message so everyone can laugh at how many times the original sentence has been distorted. 

Using a variation of this exercise, a study looked at how a message fared if the string of people in the telephone line were all autistic, all neurotypical, or a mix of both. It turns out that the rate at which the message degraded among the verbal autistic people was no greater than that of the neurotypical people.  It was only when the message was sent through a mix of autistic and neurotypical people that the meaning deteriorated significantly faster. 

What does this tell us? 

If effective social communication was objectively deficient (not just different) in verbal autistic people, we would expect that the all-autistic string of people would produce the worst decline in messages in the study; that wasn’t the finding. Instead, the autistic people received and passed along messages amongst themselves just as well as the neurotypical people. The faulty communication resulted not from the autistic participants but from the mismatch between autistic and neurotypical communication.  

This small study illustrates a theory by Dr. Damian Milton that he calls the “double empathy problem.” Challenging the assumption that neurotypical people have social skills that autistic people simply lack, he posits that the disconnects between autistic and non-autistic people are not the result of a one-sided skill deficit; they are instead a mismatch of neurotypes.

Reframing

This is a dramatic reframing of the common belief about these communication breakdowns, which placed the fault squarely on the social skill profile of the autistic folks. The “empathy” part of the theory’s name refers to the widely-held idea that autistic people lack empathy, when the theory would suggest that autistic empathy is simply expressed differently. Slowly but surely, researchers are beginning to look at that other side of the coin: how the social skill profiles of neurotypical people might also undermine relationships.   

For years, research has demonstrated that autistic people have difficulty interpreting facial expressions; a 2016 study finally looked at the reverse. They asked neurotypical people to interpret facial expressions of autistic folks – and they were unable to do it. The results of a series of studies in 2017 suggest that one reason people of different neurotypes have difficulty connecting is because neurotypical people form negative first impressions of autistic people (based upon appearance, not conversational skills), and subsequently avoid them. This indicates that some of the social isolation that autistic people face is due to ableism and discrimination.  

Missing Out

The difficulties autistic and non-autistic people have connecting negatively impact both sides. Since autistic people are in the minority, disconnection from the neurotypical portion of their community can increase their feelings of loneliness and isolation. For its part, the neurotypical world is missing out on the unique, often innovative, autistic perspective. 

Autistic people who have had huge cultural impacts on our society (environmental activist Greta Thunberg, actor Dan Akroyd, and Pokemon creator Santoshi Tajiri, to name a few) have had success in spite of a society that is largely unsupportive of and, at times, openly hostile to, the social profile of autistic folks. Imagine what brilliance we miss out on when autistic people are looked over, avoided, not hired, etc.  

Even those who are not destined to become one of the famous few mentioned above have a perspective that can deeply impact those around them. Autistic people see the world from different angles, which can be an advantage in everyday problem-solving. They generally have a strong sense of justice, an unwillingness to be cowed by hierarchy, and a drive for honesty, sincerity, and specificity, all beneficial qualities in social relationships and the workplace.

Expanding Neurotypical Empathy

The solution to the separation between people of different neurotypes has largely been to teach autistic people how to understand the rest of the world better. But by considering the double-empathy problem, we can see that this is only part of the issue. The other part is that non-autistic people also have skill deficits: interpreting and interacting with autistic people. 

Just as history is written by the winners, social norms are written by the majority. If we want to work toward a future where people of all neurotypes better understand one another, we must listen to the experiences of the minority. It’s important to recognize that neurotypical “social norms” exist because they’re most common, not because they are inherently superior. These dominant “social norms” directly result from how neurotypical people think, behave, and process the world. 

“Empathy” is about understanding another person’s experience. Ironically, to succeed in our society, autistic people must display empathy nearly constantly: decoding others’ unwritten rules and learning to approach the world in a way that works for others. To bridge the divide, nurture the gifts of the autistic people in our society, and for everyone to benefit from the valuable perspectives of the neurodivergent, those with neurotypical brains must follow this example. By challenging themselves to work toward understanding and adapting to the way autistic people see and experience the world, neurotypical folks can open themselves up to new friends with an intense devotion to honesty. Employers will find innovative autistic employees with rare specializations and a knack for accuracy. And society will benefit from recognizing and celebrating the valuable and previously underappreciated gifts of the autistic mind. 

Damian E.M. Milton (2012) On the ontological status of autism: the ‘double empathy problem’, Disability & Society, 27:6, 883-887, DOI: 10.1080/09687599.2012.710008

Sheppard, E., Pillai, D., Wong, G.TL. et al. How Easy is it to Read the Minds of People with Autism Spectrum Disorder?. J Autism Dev Disord 46, 1247–1254 (2016). https://doi.org/10.1007/s10803-015-2662-8

Sasson, N., Faso, D., Nugent, J. et al. Neurotypical Peers are Less Willing to Interact with Those with Autism based on Thin Slice Judgments. Sci Rep 7, 40700 (2017). https://doi.org/10.1038/srep40700

Back to School: Homework Tips

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Heading back to school can bring a number of challenges for our kids, especially those with autism. Navigating new environments, teachers, therapists, and peers can each be a bit scary but full of opportunity.

One very common request we get is about supporting autistic kids with their homework. How do you get your child to do his or her homework? There are many strategies to help keep your child on task; all of them tried and true. Here are some to consider:

Make It Easier by Sticking to a Schedule

Set a schedule and stick to it. Like any other priority, if homework always occurs at the same time, and the routine becomes ingrained, your child will eventually accept the routine. This is true for teeth brushing, baths, and all of the chores children prefer to avoid. Initially, it is hard to hold the line on the schedule, but it sure pays off later.

Reinforce the Message That Homework Is Important

Set the stage and set the tone. Show your child that homework time is important and respected. Give them a special place to sit. Ask siblings to be quiet or leave the area during homework time. Check in frequently to see how they are doing and intersperse praise throughout homework tasks. Show them that you care and are invested in their homework efforts, and help them feel successful and competent.

Motivate with Kindness

Be firm but encouraging. Everyone tends to push back when they are nagged. Try to avoid nagging when you are frustrated by your child’s efforts. By observing your own behavior, you can better support theirs. You can set expectations for what the homework routine looks like, but make sure to be encouraging and motivating, too. Remind your child what you believe their strengths are and why you are proud of what they are learning.

Positive Reinforcement is Powerful

Use rewards. It is OK to reward your child for completing their homework. They are doing something difficult every day. Consider giving a reward for being successful at participating in homework time (not getting everything correct). Eventually, as homework time becomes easier, you can shift rewards to more academic goals. It does not have to be an ice cream sundae. Find out what they might like to do with you after they are done. This can be an opportunity to consider setting aside quality time that you will enjoy.

Every Opportunity for Choice Increases Compliance

Giving choices has been proven to increase motivation. What choices can they have during homework time? It is important for you to keep the time and the expectations the same. But, can they choose where to sit? Can they choose what materials to write with or write on? Can they choose what task to begin with? Also, consider letting them choose their reward as well. Give them at least three options. Empowering them in this way can be very powerful. The more control they have over the task the more motivated they will be.

Interested in more back-to-school tips? Check out our blogs, “Five Steps to Help Your Child with Autism Make Friends,” “This School Year, Build a Trusting Relationship with Your Child’s Teacher,” and “Tips for Reducing Back to School Anxiety.”

 

Voices for All: Sam Krus – An Interview Discussing Gender Diversity

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First off, let’s talk about gender identity.  How do you identify?

I identify as floating between more of a masculine view and a gender-neutral view. If I was going to put a label on that, the closest I’ve heard is demi.

Now of course, gender identity is different than gender expression. Can you tell me a little bit about your gender expression?

I’d say my gender expression comes more with whatever accessories I have with me or how I decorate my house. Clothing-wise, I dress for practicality and male clothing is more designed for practicality rather than decorative purpose so I generally dress more “male.” But I have some feminine-tinged decorations around the house. My big aesthetic is horror, folklore, and mystery (not violence).  [Sam turns the camera to show me a well-organized closet and shelving system filled to the brim with a bright assortment of costumes.]  I have a lot of things based around ghosts and creatures. I’m interested in strange anatomy, not the act of doing harm. How bodies move, the forms of a body, the wings, the features. 

I also carry a lot of toys in my car for work, like child-appropriate things that I feel like anybody could play with; I like to have these items with me. It makes me feel like I’m passionate about my job and also, I can zone out and [play with] them. That’s how I establish my aesthetic more than what I wear. 

One thing [about my gender expression] that’s my actual body is my long hair. It’s partially a feminine thing but also a gender-neutral thing. On me, it doesn’t look feminine, so it’s blending both. My gender expression is how I surround myself with objects, and I pick objects that are not specifically gender coded…but if they are gender coded, they’re more coded toward feminine. Like the fashion dolls, but those have a component of horror and mythology, which I don’t view as being a gender-coded subject.  

How does being gender-expansive affect your life?

It affects my life mostly in my interests and how open I am. I feel like I have to pick and choose what parts of myself I’m going to share; whether that’s going to be welcomed or not. It only affects me fairly mildly, I know for other gender diverse people it affects them more. For me [the question is], “this is something I like, is this something I keep to myself or something I share with somebody else?” 

I have interests that are not considered masculine. For instance, in the other room, I have a shelf full of dolls. That’s something that I used to feel was inappropriate. 

These barriers are fading with these new generations, but there are autistic adults that have things that are not viewed as age-appropriate interests. There are these set boundaries of what is appropriate for you to be interested in that you transgress. Your interests and the boundaries that you transgress go hand-in-hand with being gender diverse and being autistic. 

How did you first recognize that you were demi, or gender-diverse?

A big thing that made me realize that I was gender-diverse was that I watch a lot of cartoons, a lot of shows with younger people. I like shows where there’s an all-girl cast; I identify with them a lot more than shows where there’s an all-male cast. [How an all-girl cast relates to each other is] how I want to talk to people. Because that’s more of an intimate, caring viewpoint. I wonder if that’s going to come off as weird or especially because I’m a man, is that going to come off as sexual and therefore threatening. I wonder how to approach people, because I want to approach people in a very caring way; but do I need to stamp that down? Sometimes, I’m meaner than I feel like I should be in terms of jovial insults to balance it out. I think, “I’m being too considerate, too genuine, I have to call you an idiot now. Oh, wait, was that too harsh to call you an idiot?” 

Can you tell me more about your fashion dolls? 

As a kid I liked dolls. Getting a toy from McDonalds, if the choice was the car or the Barbie, I wanted the Barbie. I liked that they had arms and legs that I could manipulate, I was more of an action figure person. Besides McDonald’s, I was never interested in them on my own, but as an adult in 2014, I came across Monster High dolls. The idea is that they’re based on monsters from folklore as teenagers and they each have something with their body they have to deal with. The Frankenstein girl, her body occasionally falls apart. The doll from the black lagoon has a skin condition where she constantly has to moisturize or she dries out. They all have an inconvenience that they have to deal with, they’re just accepted for who they are. For me that’s a very autistic narrative, very living-with-a disability narrative. 

Tell me about being a gender-diverse BCBA:

And then when it comes to gender diversity, that comes into effect more with interests…. If my kid likes vacuums, I will bring my vacuum…. If my kid likes fairy tales, mythology, or magic, I will go to the library and get 11 books on fairies, and we’ll just go through them together and pick out our favorite creatures. There have been a couple of times where parents have wanted their kids to stop being interested in what they’re interested in and be interested in something more “gender appropriate.” I had to think about how I would approach this to defend my client without revealing too much about myself. I’m a man working with children and there’s a stigma about men working with children, with queer people working with children, with homosexuals working with children. I feel if I’m revealing too much about myself or not enough, there could be a misinterpretation, they might view me as a danger to their child when I’m just trying to defend them. Fortunately, I haven’t had to deal with it too much.

Tell me about being an autistic BCBA:

Primarily, being autistic is what comes into play when I’m working with the kids, and more often, with the parents when I don’t necessarily come into conflict, but I come in to decisions that need to be made, and how I approach things. When that comes in as a general rule, I never let any parents know that I’m autistic because I don’t want to set myself up as an example of what their kid is going to be or create the illusion that I’m an expert in autism. 

So…you are autistic and work to support people who are autistic…but you don’t consider yourself an expert in autism?

The thing is that when I was younger, I tried to be an expert in autism, and I realized how much pressure I was putting on myself, undue pressure, because autism is such a wide thing. I tried to make myself a representative and I realized that it was kind of out of guilt for being autistic, where I was like, “I’m sorry I’m this way, let me be as easy to understand, let me be a lesson.”  Only in my adult life did I kind of realize that, so I’m trying to un-do that pattern of behavior.

Because it took a toll on your mental health?   

Right. And because it’s stressful. And because it’s not true. No doctor, people assume that an expert knows absolutely everything. And nobody knows everything about autism. We barely understand it.  There’s like 400 genes that affect it, and we don’t know how they affect it, they just do. And we know some techniques that we can use to help people learn what they normally would not be able to learn, we know some of the symptoms, but the definition is always changing. Autism is that something you can’t really be an expert in, you can just be knowledgeable. 

Sam Krus is a BCBA in Waukegan, IL who practices in Kenosha and Madison, WI. Sam enjoys fashion dolls, podcasts, making costumes, role-playing games, board games, and reading when they have the time and energy. 

Voices for All: Ash Franks Talks about Supporting Autistic People While Being Autistic and Her Role on LEARN’s New Neurodiversity Advisory Committee

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In September 2020, LEARN convened a group of neurodivergent staff to form our Neurodivergent Advisory Committee. The committee reviews and gives feedback on matters relating to neurodiversity and other person-centered ABA topics and was instrumental in the content, messaging, and visual design of LEARN’s Neurodiversity Values Statement. We asked Ash Franks, a member of the Neurodivergent Advisory Committee, to share her thoughts with us.   

 

HI, ASH! FIRST, I’D LIKE TO ASK YOU WHAT IT MEANS TO YOU TO BE AN AUTISTIC PERSON SUPPORTING OTHER AUTISTIC PEOPLE? 

Supporting other autistic people while being autistic means listening to what they have to say, however they communicate it, whether it be through an AAC device, sign language, PECS, or verbal language. It also means giving them breaks if they need it, and allowing them to use tools to cope (e.g. stuffed animals, headphones, weighted blankets, etc.). Looking back on my experiences as an autistic child has been very helpful in trying to help children who are at AST.

HOW DOES BEING AUTISTIC INSPIRE YOUR WORK IN ABA? 

Being autistic allows me to see different perspectives and ideas compared to neurotypical people, as they tend to think differently than I do.

TELL US A LITTLE BIT ABOUT THE NEURODIVERGENT ADVISORY COMMITTEE AND HOW IT WORKS. 

Basically, we are trying to re-vamp ABA materials through a more neurodivergent-friendly lens, so we can make our treatment as effective as possible. Having autistic people and other neurodivergent people look at ABA therapy through their eyes allows them to explain what works and what doesn’t work. This way, we can work to have treatment be as effective, safe, and as fun as possible for everyone involved. Having BCBAs see the autistic perspective is important because we have direct experience with what worked for us growing up versus what didn’t and might be able to help streamline the treatment to be as effective as possible.

CAN YOU GIVE ME AN EXAMPLE OF SOME FEEDBACK YOU HAVE GIVEN IN YOUR ROLE ON THE COMMITTEE? 

I tend to give feedback on the more artistic and creative side of things, as I am very geared towards having an eye for creative things in the world.

FROM YOUR PERSPECTIVE, WHY IS IT SO IMPORTANT TO INCLUDE AUTISTIC PERSPECTIVES IN OUR FIELD? 

Including autistic people in ABA is super important because we need to account for neurodivergent perspectives to make treatment as effective as possible. Since I am autistic, I can give a firsthand account of what has personally worked for me throughout my life, and what hasn’t. I myself was never in ABA therapy growing up, but I did other types of therapies that I also have found helpful from time to time.

WHAT ARE SOME OTHER PLACES IN OUR SOCIETY THAT YOU THINK IT WOULD BE HELPFUL TO LISTEN TO THE AUTISTIC PERSPECTIVE?

I think listening to autistic perspectives in the workplace would be very helpful. I think having a quiet room for staff that has sensory toys specific for staff would be very helpful, also maybe including a comfy place to sit with a weighted blanket would be good too. Another place it would be helpful to listen to autistic people is when it comes to shopping at malls, since malls can be overwhelming for most autistic people. I know some stores have “quiet” shopping hours where they reduce the lighting and turn off the music, and I really wish more places would do this.

ASH, THANK YOU FOR YOUR THOUGHTS AND FOR THE EXCELLENT WORK YOU’RE DOING ON THE NEURODIVERGENT ADVISORY COMMITTEE!

Ash Franks is a Behavior Technician for Learn Behavioral. Ash works in AST’s Hillsboro, Oregon location. Outside of work, she enjoys photography, cooking, video games, and spending time with family and friends.