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At Home- Parents' Role

        Raising a child is a tough job, let alone raising a child on the spectrum. As parents, we know effective parenting is a learned skill - it takes time and practice. Learning to be an ABA parent is essential for managing stress levels for your family and for your child to reach his maximum ability. Your child's ultimate success will largely depend upon consistency across environments, which requires the parent to learn how to implement some basic and some not-so-basic techniques. Who else is in a better position than the parents to generalize and apply the skills learned in the therapy sessions?

        It is absolutely critical that you support the goals your therapists are working on. Our children spend most of their free time with us. If the team is working on a goal and it is implemented during therapy, it's equally important (if not more) that it is implemented by you and others outside therapy. If you drop the ball, then the hard work done by the ABA team goes down the drain. (Read: wasted resources, time, and a set-back for your child.) It's essential that you keep the communication open with your team and have them "coach" you on how to implement these techniques if you are not clear. Below are some parenting tips I learned from my ABA team which were useful in managing certain behaviors. (Keep in mind that this is a work in progress, so please consult with your ABA professionals if you're not clear):

(1) You must follow through with your request at all times.
Rational: If you don't follow through, or if you sometimes do and sometimes don't (read: "inconsistency"), you are essentially sending a message to the child that it is alright to ignore you. Here is an example.

Mom: (in the bathroom) "Evan, come here so we can wash up and get ready to sleep."
Evan: (No response, keeps on playing with his toys.)
Mom: (Instead of yelling at him from the bathroom, walks over to him, gets down to his eye-level, and after making sure Evan's attention is on her, says again): "it's time to wash up. Come to the bathroom with me."
Evan: "No! I want to play."
Mom: "Ok, you have a choice: do you need help to get to the bathroom, or are you a big boy who can come all by yourself?"
Evan: "A big boy", and walks to the bathroom by himself.
(Alternatively, if he continues protesting)
Mom: "OK. I will help you"(and without getting emotional, takes his hand and leads him to the bathroom. If Evan is resisting, mom will pick him up and transports him to the bathroom, ignoring the protest.)

Tip: If you ask a child to do a task (e.g., "close the door") and he does not, make sure that he follows through with your request even if you have to help him. If it's necessary, have your hands guide his hands to accomplish the task. Likewise, if you tell him you will do something, you must hold up your end of the bargain. (Example: If you say "if you clean up your toys, you get to watch T.V.," and he does not clean up, then you cannot let him watch TV.) The act of follow-through must be done at all times as consistency is the key. Otherwise, you are sending a mixed message and the child will have compliance issues. This is the follow-through technique.

(2) With some behaviors, you must learn to ignore them.
With some behaviors, you must learn to ignore them (Extinction).

Rational: The function (purpose) of certain behaviors is to gain attention (surprise!), and therefore, the idea is to not reinforce the particular behavior with attention as that will cause the behavior to increase rather decrease. If a behavior has been reinforced in the past with attention, and the behavior continues or increases, you must remove the reinforcement (read: attention) in order to decrease the behavior. Remember, your attention could include negative attention such as yelling, screaming, or even attempts at discipline. Thus, when you decide that certain behaviors are attention seeking, and decide to put the behavior on extinction, you must give it zero attention, meaning you must completely ignore the behavior as if it isn't happening. It is important to understand the function of a behavior before deciding upon a behavior plan, and it is also important to never ignore a behavior that is potentially dangerous to the child or the others. Extinction does not work on behaviors that are self-reinforcing (self-stimulatory behavior).

Sophie: Starts hitting the table and looks at mom for a response.
Mom: Pretends nothing is happening and gives no response (including body language).
Sophie: Keeps on hitting table.
Mom: continues with no response until Sophie stops hitting.

Tip: When you are putting a behavior on extinction, make sure NEVER to respond. In the above example, if mom reacts to Sophie after several minutes of hitting, Sophie will remember that next time, she will just have to try harder to get the attention. It's analogous to a car with ignition problems; if the car sporadically starts when you turn the key, then you will try it longer the next time because it "worked" before. However, when the car appears "dead" no matter how many attempts are made to turn on the engine, then you will eventually give up and move on. We used this technique to manage my child's whining problem. My ABA team instructed my family to not give ANY attention whenever he started whining and to reinforce him when he spoke correctly. He first responded with higher frequency of whining, but after a few weeks, it went down considerably and is now at a minimum level. Please consult with your ABA team before putting certain behaviors on extinction.

(3) Giving choices
Rational: Having a choice empowers the child. The issue here is that Aidan is sitting on the toilet too long. It's been about 12 minutes since Aidan went to use to the toilet and you have reasonable belief that he is done with his business and is in fact just chilling out.

Dad: "Aidan, it's time to come out."
Aidan: "No, I am not done yet."
Dad: "Do you want 1 more minute or 2 more minutes?"
Aidan: "No, 100 minutes."
Dad: "That is not a choice. You can have 1 more minute or 2 more minutes."
Aidan: "2 minutes"
Dad: "Good job!!!"

We used this teaching style to address my child's picky eating habit. We had him "pick" from two choices of his not-so-favorite items like, "Do you want broccoli or corn?" and "No, French fries are not a choice."

(4) Priming; Advising the child about what is going to happen in the future
Priming: Advising the child about what is going to happen in the future

Rational: By providing the child with an advance warning, the child can better prepare himself mentally and emotionally. No one likes surprises, especially our children who have issues with transitions.

Example:
This child is having a transition issue when having to leave the playground. Before going to the playground, you explain to him "we are going to the playground to play and when we are all done, you will leave the playground nicely."

Once at the playground, give him a warning 10 minutes before leaving, saying "You've been great. We are leaving in 10 minutes." After 5 minutes, give him another warning by saying "5 more minutes." Then you can give a one minute warning. When the time is up, let him know it's time to go. If he does so nicely, give him immediate feedback, "I am so proud you are going home nicely, you did such a great job!" If he does act up, you must follow through by taking his hand and leading him out of the playground.

(5) Accentuate the positives
Rationale: children often filter out the words in the sentence and tend to focus on the verb.

Instead of saying "Don't WHINE", say "use a NICE VOICE."
Instead of saying "Don't SLOUCH", say "show me GOOD SITTING."
Instead of saying "Stop CRYING", say "I want to see your HAPPY FACE."

Instead of saying "if you do X, you will get PUNISHED", say "if you do Y, you will get a REWARD".
(Example: Instead of saying "If you hit your brother again, you will get a time-out. Say, "If you behave nice, we will go swimming later.")

(6) Incidental teaching and generalization
Skills learned in the therapy session must be generalized outside the therapy room to be "real" and be useful in the real life. The ABA team will devote a portion of the therapy sessions to generalize skills. As parents, we must make the generalization happen all the time, thus further ensuring the child's success. Generalization can begin around the house, in the back yard, walking around the neighborhood, and other social settings such as the market, school, and birthday parties so the child can "practice" his skills with different people in different settings.

Example:
If a child is learning colors, you can go through different colored clothes with him during laundry folding sessions and later while taking a stroll in the neighborhood together. If a child is learning different shapes, you can survey the house for differently shaped household items and go over them with her and do the same while grocery shopping. If a child is learning to greet, you can have her practice the skills with the mail man, cashier at the market, next door neighbors, etc.

Last but not the least:
Treat your therapists with respect: A majority of the therapists are college/graduate students who work part-time as therapists while attending school. Others have been in the field for many years and have made this a career. Most of them work for ABA agencies and what they take home is not much after the taxes, insurance, car maintenance, etc. Most of them I have interacted with are young professionals with their hearts in the right place; they want to make a difference in our children's lives. As such, we must treat them like professionals, not baby sitters or nannies. Let them know that you appreciate them coming to your house to work with your child. Ask if they want something to drink, or if there is anything you can help with so she can better help your child. A simple thank-you goes long way, and realize that keeping them happy is in your child's best interest.




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