Tag Archives: ABA therapy

Is my ABA provider effective?

Applied Behavior Analysis (ABA) therapy for children with autism has been proven to work over a period of time. However, as a parent you may not have the necessary experience or background to determine if the level of expertise of a practitioner is meeting your child’s goals and needs.

Beyond the obvious signs of whether or not your child is making progress, there are some other factors when assessing a provider that you can use to evaluate their potential effectiveness.  Here’s a tool-kit that you can use.

Didactic Children Therapy

How many children are on your BCBA/ BCaBA’s caseload?  Of course, you might also want to check if the individual overseeing your child’s program is credentialed (Board Certified).  The best way to find out is to ask directly.  If that doesn’t work then you can approximate this by comparing the total number of children in the program with the total number of BCBAs/ BCaBAs.  There is no ‘correct’ number of children per BCBA/ BCaBA (it depends on the complexity of each program, the experience of the staff, number of assistants etc).  In our experience a good approximation is no more than 10.  You can also think about it this way – if your BCBA/ BCaBA has, for example, 15 kids, then assuming they spend about 2 hours a week with each child, that adds up to 30 hours (assuming no travel time from one location to another).  Now each child’s care also involves programming time (writing reports, collecting data training with staff etc).  Conservatively allocating around 1 hour per child for programming time totals 15 additional hours for a total of 45 hours. Add in usual administrative time for meetings, emails and other non-clinical weekly activities and very soon you’re above 50 hours/ week.  This is not an effective setting for providing quality of care and leads to compromises and shortcuts.

How many individuals are assigned to your child’s team? An effective model involves more than just the BCBA/ BCaBA overseeing a child’s program – such as such as trainers, program managers (or people assisting BCBA/ BCaBAs etc).  Additional team members should be assisting with some of the tasks mentioned above.

Is your child’s team trained?  How effective a provider’s training program is can have a direct correlation with how good your child’s program will be.  You should inquire about your provider’s training program and methodology to ensure adequate attention is devoted to this.

Is parent training offered?  For a child’s program to be successful – you should be able to ask for and receive training to implement some of the principles at home that are being used with your child everyday.

Is the child actually receiving one on one therapy? – Or are multiple children overseen by a therapist?  For ABA services to be most beneficial – your child should be one on one with a therapist.  Your child’s therapist should not be paired with multiple kids at once.  This is important not only for the quality of care – but also for how billing is done (if services are being accessed through health insurance)

Are you allowed free and open access to your child’s team and to his/ her sessions?  If not, that is a red flag… it is your child, after all and you should be able to observe your child’s sessions.  (Incidentally this is also a good way to check the above points about one on one therapy).

Are you able to interact with your child’s team on a regular basis and develop a good working relationship?  The level of communication and involvement that you have with your child’s team is a good measure of how vested the provider is in your child’s program.

What is the general vibe and environment like at the place of service?  Schedule a visit or request and observation. You can tell a lot by observing and interacting with the team.

Does your child’s staff take proper data and clinical note? You should be able to get a summary of your child’s sessions – either upon request or as a regular part of the process.  This is a good way for you to stay up to speed with your child’s progress.

Creative Children Therapy

Since time is your most valuable resource, especially when your child’s progress is concerned – it is crucial to have a toolkit to assess the effectiveness of your provider. These questions should serve as a starting point for you.

Further reading: http://www.bacb.com/Downloadfiles/ABA_Guidelines_for_ASD.pdf

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7 tips to help kids with Autism prepare for Fireworks

fireworks

The Fourth of July is a day that often involves, fireworks, barbecues and, at least around here, lots of crowds. For families that have children with autism, everything about the holiday can be a recipe for a meltdown. These seven tips were compiled for families that would like to see the show together. The key is to know your child’s limits and have an escape plan in case he or she needs a break.

Prepare for the Show 

Letting your child know in advance what might happen in advance will give your child some sense of control and help reduce his level of anxiety. Talk about exactly what you will be doing: getting in the car, taking a picnic, eating, watching fireworks, walking back to the car, waiting in traffic and any other details you can think of. The more your child knows what to expect, the better he will be able to handle the situation.

Preview the Show

Sparklers may not have much sound, but they look like mini fireworks. You can also watch videos of fireworks displays online. Fireworks Blast-Off  is an app ($.99) that lets the user control the colors and size of fireworks on the screen. Programs like this are great at simulating actual sound but not at the intense level you would find at a real fireworks display but they can serve as a good introduction.

Watch from far away

Your best option may be a nearby parking lot, or the side of the road with the windows rolled up may provide a comfortable and safe distance for your kiddo to experience the show.

Have a solid Plan B

When you make the decision to try a live fireworks display, be prepared to leave if your child becomes overwhelmed. Despite the fact that you have spent time preparing your child and have a pair of headphones available, things may not work out as planned. Keep this in mind when parking the car so you can have an easy route out

Take comfort items

Be sure to pack items that help to calm your child, such as a weighted vest, blankets, snacks, iPad or fidget toy.

Create a Social Story

A social story may work to prepare your kiddo for any event that might be stressful throughout the evening. A great social story is up for free download here.

Headphones

If you haven’t already, invest in a good pair of noise canceling headphones or construction grade earplugs. You may be able to prepare your child for the crowds and change of surroundings, but they may be over stimulated by the noise! You can even play soothing or patriotic music through them.

Indy with Kids has laid out Fireworks in the Indianapolis Area here.

Fort Wayne area Firework displays are listed here.

Greater Boston area Fireworks are listed here.

Have fun!

Gross motor activities to keep your kids active this summer

Gross motor activities for kids are incredibly important in the development of their gross motor skills. As school wraps up, you may find yourself with kiddos who have tremendous amounts of energy to burn this summer! These seven gross motor activities for autistic children  include activities that improve social skills while improving gross motor development. These skills are good for kids with autism but can easily be adapted to be fun for their siblings or peers!

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1. Jump on a Trampoline

Around here, the trampoline is a highly preferred activity for many of our kids with autism. Bouncing offers excellent sensory input that can be helpful in alleviating sensory overload. If you don’t have access to a trampoline at home, places like Flipzone in Plainfield and Skyzone in Fishers can be a fun day trip. If well supervised, jumping on a bed can also provide satisfaction!

2. Play Ball

Sometimes, simple activities that other kids can master easily might be very challenging for kids with autism. Catching the ball may not be realistic as a beginning step but you can work your way up that over time. Begin by rolling a ball back-and-forth with the kiddo. This simple task develops important eye tracking skills and it can encourage motor planning as the child follows the movement of the ball. Other activities include:

  • Kicking the ball
  • Learning to dribble
  • Bouncing on a ball
  • Tossing a ball into a net or target

3. Balancing

Balancing can also be very challenging for kids on the autism spectrum and many gross motor tasks require a sense of balance. Test to see if the kiddo can stand motionless with her eyes closed without losing balance to gauge how much work is necessary to develop balancing skills. You can start by using painter tape on the floor or a practice balance beam for them to follow. Balancing see-saws or playing hopscotch can also be fun for kids practicing this skill.

4. Bicycles and Tricycles

Riding bikes can help develop kiddos with balance as well as developing leg muscles. Bikes and trikes can be adapted to kiddos to make riding them easier. Indy Area Ambucs can answer questions or help find bikes appropriate for kiddos. Who doesn’t love biking on a summer afternoon? Don’t forget to outfit kids with protective helmets and other equipment 🙂

5. Pretend Play

Participating in pretend play is a considerable challenge for kiddos with autism. In some of these activities, kids can benefit from moving around while developing their imaginations. Ideas for pretend play that uses motor skills include:

  • Fly like an airplane
  • Hop like a bunny
  • Play restaurant at snack time
  • Do a crab walk
  • Do a frog jump
  • Slither like a snake
  • Gallop or trot like a horse

6. Dance

 Parents and therapists can use dancing with music to encourage imitation and it can be a great way to teach daily living skills. Dance ideas include:

  • Clean It Up
  • Freeze Dance
  • Head, Shoulders, Knees and Toes
  • Wiggle the Sillies Out
  • Hokey Pokey

7. Obstacle Course

In addition to improving gross motor skills, obstacle courses can be a great way to encourage kiddos to follow directions!  The course does not have to be complex to be effective. In fact, parents and therapists can begin with a course consisting of one step and gradually introduce other steps to the activity. Simple ideas for an obstacle course include:

  • Crab walk
  • Frog jump
  • Ball toss
  • Jump rope
  • Limbo bar
  • Walk a line or paint tape design
  • Climb over objects
  • Beanbag toss
  • Crawling through a tunnel or a cardboard box
  • Roll along mats or underneath obstacles obstacle_ladderrun1_l

Tips for grocery shopping with your child with Autism

grocery

Hey parents!  I know grocery shopping with a child on the spectrum can be challenging at times.  Here are a few helpful tips that may help you get your get in and out of the grocery store successfully!

  1. Keep little hands busy from grabbing items outside of the cart by giving your child something to hold onto while in the cart.  It can be a little bag of snacks or a fun toy to play with.

 

  1. Make shopping a game.  Share the list of items with your child.  You can even make a visual list if it will be more helpful for your child to see the pictures of the items you need to find.

 

  1. Set rules and stick to them.  If you don’t follow through with the rules you set, your child will learn your rules don’t need to be followed.

 

  1. Reward good behavior and don’t reward the bad!  If your child is being cooperative, praise your child and deliver other desirable items and activities while you shop.  If your child makes it through the entire shopping trip successfully, reward your child afterwards such as go to the park or get some ice cream.

 

Start with short trips and work up to keep your child successful if shopping trips have a history of being very difficult.  You may need to start with going to the store to purchase only 1 item so that you can get in and out quickly to begin teaching your child how to behave while in the store so that you can get a chance to reward your child for being successful.  Once your child begins to understand how to behave in the store and learns that being cooperative leads to other desirable and fun things, you can gradually begin to increase the number of items on your list and the length of your shopping trip.

How to get your child to follow directions in 5 easy steps

Mother and daughter playing with ball in the park

Many parents of children with and without disabilities often struggle with getting get their child to listen to them or follow directions. Here are 5 simple steps we’ve compiled  to follow to help teach your child to listen and follow directions.

  1. Get close to your child before you start talking or giving a direction. It is suggested that you are less than 5 feet from your child before giving any directions. If your child can’t hear you or understand you, they can’t follow your directions!
  2. Gain eye contact with your child. This will get their attention and provide a good opening to give a direction. You may need to prompt eye contact by calling their name. For example, “Johnny, look at me” or use physical guidance to move their face toward yours. ALWAYS praise them for looking at you.
  3. Once you are close and have eye contact give a clear and concise direction.  When giving a direction make it a command or statement, do not make it a question. Instead of saying, “Can you get your backpack”, say, “Get your backpack”. At first it might be necessary to use only simple one-step directions in order to avoid confusion.
  4. Praise and reward your child for every direction that is followed and for all attempts to follow directions. If your child attempts to follow the directions but can’t quite get it done, praise them for trying and help them complete it. Praise and rewards should follow immediately. Avoid negative statements like “That’s not what I asked you to do” and “You aren’t listening to me” and ignore mistakes, remember at least they are trying.
  5. ALWAYS follow through. Make sure your child completes what you ask them to do even if physical guidance (i.e., hand over hand) is needed. In order to avoid empty threats or promises, only issue the directions if you are 100% committed to making sure that your child follows through. Don’t allow your child to avoid or escape directions placed upon them, as you want your child to learn that when you give them a direction the expectation is that it will be followed or you will help.

Remember learning should be fun. The more excited you are about it, the more excited your child will be to do it. You can also make a game of learning to follow directions. Hide a quarter (or something the child likes) somewhere in a room. Tell the child that he may have the item if he will listen to your directions and follow them exactly. Remember give the directions only once and if they find the item they get to keep it.

 

– guest blogger, Chrissy Barosky, MA BCBA

Manager of Clinical Development, Bierman ABA Autism Centers 

Planning Ahead: Tips for Increasing Your Child’s Success when Dining out in a Restaurant

We know that sometimes as parents it can be very difficult to take a child with autism to a restaurant with you. You might be worried that people may judge you if your child misbehaves. Below are some tips on how to plan ahead before going out to help keep your child successful and your trip enjoyable!

dining

1.) Find places that are designated as autism friendly; that may not have as many people and are not as brightly lit or as loud.

2.) Keep your child with you at all times, this will make them feel safe knowing that you’re by them.

3.) Set the expectations ahead of time as to where you’re going and what they can or cannot do while you’re there.

4.) Let your child have a say in what you do, you can even show them pictures so they can help decide where you’re going.

5.) Use the bathroom before leaving the house so your child is comfortable.

6.) Bring an item for your child to play with that they enjoy while you wait for your food – this could be an iPad, sensory items, toys or even a snack.

7.) Look at the menu beforehand, make sure there is a food option for your child that they will eat.

8.) Make a reservation or call ahead so you don’t have to wait to be seated upon arrival.

9.) Ask for a seat in a quieter, less crowded section of the restaurant, this can be less over-stimulating for your child.

10.) Don’t be afraid to ask the server for help – if your child needs a lid for their cup, or a snack to come out quickly.

11.) Request the check as soon as your food arrives.  This way, you will not have to wait long after your child is done eating.

12.) When your child behaves desirably reinforce good behavior with a snack or preferred item to play with.  Make good behavior worthwhile so they will want to behave well in the future.

13.) Have your child keep a preferred item with them so they will be less likely to be upset if they cannot have something they want.

Post by Holli Novinger, BCaBA, Manager of our Indianapolis Area Locations

Can the ACA help my family?

HealthINFO

The period for open enrollment is drawing to a close.  The last day for open enrollment is March 31, 2014.  After this period, an individual (or family) wanting medical benefits must wait for a qualifying event (marriage, childbirth, loss of employment, etc.) or wait until the next open enrollment period to sign up for benefits.
Individuals or families wanting benefits to begin on March 1, 2014, must complete registration by February 15, 2014, to guarantee coverage.

Healthcare.gov is the federal website (often referred to as an exchange or marketplace).  Indiana elected to use this website so a family who qualifies for the premium subsidy must go through this website in order to qualify for the reduced rates.

The government has restrictions for who qualifies for the subsidy.  Below is a grid which shows the household size and maximum household income allowed.

Household Size    Maximum Household Income

1                              $45,960

2                              $62,040

3                              $78,120

4                              $94,200

5                              $110,280

6                              $126,360

7                              $142,440

8                              $158,520

If you meet these qualifications and are interested in purchasing a policy through the exchange, please know that there are other qualifications, too.  For more information, please call Eric at (317) 815-5501, ext. 2

Restrictions on Policies Available to Purchase

The policies available through the exchange are typically not available if the patient is already covered by Medicare, Medicaid, or Tricare.

For more information on this topic, please explore our previous Newsletters about the ACA Health Care Exchanges. 

Autism Specific ACA information
Information about how the ACA specifically will affect families with children on the Autism Spectrum.

General Information regarding ACA laws
Information compiled by our Insurance guru to help you to navigate the ACA myths and laws, especially how those may impact ABA coverage.

If an individual or family needs additional coverage beyond what is provided by Medicaid, Medicare, or Tricare please call Eric at (317) 815-5501, ext. 2, to discuss other options.