Biting, Hitting and Pushing: Bad Behavior or Sensory Processing Disorder?

As a pediatric occupational therapist, I often have teachers and parents ask me if a child’s sensory Blog-Bad-Behavior-or-SPD-Main-Landscapeprocessing is causing them to behave badly in school. In kindergarten especially, we often see “bad behavior” manifest in many ways: kicking or hitting peers, biting friends, spitting, or yelling at others. In some cases, the child’s sensory system may be to blame. In others, bad behavior could be contributed to the child seeking out attention, or avoiding work or non-preferred play. Read below to help identify and understand the difference between the two.

Sensory Processing:

When a child’s nervous system cannot respond logically to incoming sensory input (such as loud talking in the cafeteria), the result may cause the child to appear disorganized, clumsy, or disobedient. Oftentimes, children who are seeking out movement (vestibular input) or body position (proprioceptive input) are often the children who crave bear hugs or body squeezes. These are the climbers, the explorers, and the daredevils as they are attempting to seek out extra information from the environment to feel more organized. When they are not given these opportunities, they may resort to inefficient ways to help seek out information which may manifest into tackling, hitting or biting friends. When these children are given ways to regulate efficiently, such as 10 minutes of heavy work activities on the playground, or intense proprioceptive or vestibular input before sitting down at the table to complete the day’s activities, they are much better able to respond and attend to the activities.

Behavior:

Behavior, which can be defined as the way in which one acts or conducts oneself, especially toward others, often is the result of a conglomeration of events. For example, a child’s bad behavior may be a response to a negative sensory experience, or it may be the child’s way of receiving more attention from parents, teachers and friends, or it may be both. A child with sensory concerns who often tackles peers or siblings may be attempting to receive feedback from the environment. However, it’s also possible he is looking for ways to get attention from others in his environment. When this is the case, it is important to follow up with a strategic plan. Experts recommend attempting to ignore the behavior as much as possible (not overreacting to the situation, ensuring the child follows through on the task required of them no matter what behavior they are exhibiting, ignoring disrespectful behavior and not responding until the child appropriately requests for help). Rewarding good behavior via a positive reinforcement chart, acknowledgement of a job well done, and praise for completing the task at hand are all examples of ways to reward good behavior.

There is no easy solution for recognizing the difference between bad behavior and sensory processing disorder. Oftentimes, parents and teachers may need to take each event on a case-by-case basis to determine whether or not the breakdown occurred as a result of a sensory processing difficulty. To help decipher the difference between the two, I recommend keeping track of the specific behaviors in a journal to help identify any triggers or common events that provoke the child and cause the disruption.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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5 Benefits of Working with a BCBA for Your Child with Autism

Knowing what kind of services and how to navigate the ABA world can be hard, confusing and Blog-BCBA-Main-Landscapeexhausting. When looking at an ABA program, you will always want a Board Certified Behavior Analyst on your team.

Here are 5 benefits to working with a BCBA and a team approach:

  1.  A BCBA has passed an exam that ensures he or she knows how to change behavior (both increase skills and decrease behavior) according to the principles of behavior – evidence based approach.
  1.  Working with a team typically results in creating a large and strong support system for the child, parents, and the entire family.
  1.  Working with a team helps to promote generalization of skills across people.
  1.  Working with a team allows a child to receive several hours (20-30) of therapy a week with 3-4 different therapists, which helps keep sessions fun, new, and entertaining.
  1.  Working with a team allows for different ideas to make progress across different skills and targets, especially when a child gets “stuck” on a target.

Things to keep in mind when using a team: all team members should be addressing behaviors the same way as well as teaching new skills the same way. Communication between team members is key for success. Lastly, therapists are different but implementation should be the same!

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

What is the Function of My Child’s Behavior?

As a Board Certified Behavior Analyst (BCBA) who continues to work with the pediatric population, I have often heard parents or loved one’s say, “I have no idea why he/she does this” or “It just happens out of nowhere,” when describing a specific behavior their child engages in. Blog-Behavior-Functions-Main-Landscape

Unfortunately, I can tell you that all behavior does in fact have a function, whether that behavior is an undesirable behavior or an appropriate behavior. More importantly, identifying that behavior function is an important part of effective behavior change.

In the field of Applied Behavior Analysis (ABA), behavior can be defined as having one of these four functions:

  1. Attention: This function is a means of gaining attention from another person or people and can take many forms. It can be provided by eye contact, a facial expression, telling someone “no,” laughter, or specific comments about a behavior. It is important to note that telling a child, “No,” “Stop,” or “I’m ignoring you,” after engaging in an inappropriate behavior is still in fact attending to the behavior despite the content of the words.
  2. Access to tangibles: This function is maintained by gaining access to a specific item or activity. Access to these preferred items may be for a leisure purpose (e.g. playing with a toy, going to the park, etc.) or a functional purpose (e.g. accessing a toothbrush to brush your teeth).
  3. Automatic: This function is maintained by automatic reinforcement in that the behavior in itself provides the reinforcement. Some examples of these behaviors may be thumb sucking or nail biting. If a child enjoys the oral sensation that is produced from these behaviors, you may see an increase in that behavior.
  4. Escape or Avoidance: This function is to escape or avoid an unwanted event or activity. Often behaviors of non-compliance may post-pone or even terminate the completion of an unwanted task, putting your hands over your ears may terminate the sound of a non-preferred noise, or scratching your skin may terminate the pain of an itch.

It is important to note that all individuals engage in behavior despite physical or intellectual capabilities. As previously mentioned, that behavior does in fact have a function, and it is through the relationship between the behavior and its environment (people, places, things) to which that function is identified.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Resource:

Cooper, J. O., Heron, T.E., & Heward, W. L. (2007). Applied behavior analysis (2nd ed.). New Jersey: Pearson Education, Inc.

My Child Chews on Their Shirt

Many children chew on various things such as clothing, toys, and other household items. Blog-Chew-Main-PortraitThis can be a way of your child exploring his environment, fulfilling a sensory need, or it is being used as a calming strategy. Chewing on items is very common in children with autism as well as some typically developing children. Shirts are most often the item that gets chewed on because it is always available and easily accessible.

Below are a few tips on how to properly address children who chew:

  • Replace the shirt with a chewing toy. These items will allow your child to get that oral input of chewing without destroying their clothing. Chewing toys come in many forms such as tubes, necklaces, bracelets and shapes, and they are widely available on many therapeutic websites. Make sure this chewing toy is always accessible, and if you see your child begin to chew on his shirt, immediately give him the chewing item, or better yet have your child wear the chewing item so it is easily accessible.
  • If the chewing is something your child does when he is nervous, begin to explore other calming techniques in an attempt to replace the chewing with something more socially appropriate.
  • Reinforce your child during times when he is not chewing on his shirt.
  • Taking chewing breaks throughout the day. Engage your child in very fun and reinforcing activities, but let them know the chewing item needs to be put aside while they engage in the activity. Activities can include swinging, going to the park, playing a game on a tablet, singing songs, or whatever activity is really reinforcing to your child.
  • Engage your child in various oral exercises such as singing, blowing bubbles, making different sounds with their mouth, etc. Be creative and make these exercises fun and enjoyable.
  • If it seems like your child is in pain while he is chewing on items, it is important to seek the opinion of a medical professional to rule out any medical or dental issues.

If the chewing does not decrease over time or begins to worsen, there are a variety of therapists that are able to help with this behavior. These therapists can include Board Certified Behavior Analysts, Speech Therapists, Occupational Therapists, or Social Workers. Once the function of the behavior is determined, your child could begin one of the above therapies to assist in decreasing the behavior.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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Puberty for Children With Autism

One of the most popular questions I get asked from parents of young children with autism is, “What is my child’s future going to look like?” While early intervention is a crucial part of the treatment of autism, thinking ahead to what puberty and the teenage years might look like is an important consideration, as well. Puberty and adolescence are difficult times for every pre-teen, and adding the challenges that come from having a diagnosis of autism can feel overwhelming to you, your child, and your family. It is important to go into this time with tools and strategies to help your child feel as comfortable and confident as possible, while also finding ways for your child to increase their independence in these areas.

Self-Care Skills for children with AutismBlog-Autism-Purberty-Main-Landscape

Self-care skills such as bathing, using deodorant, brushing teeth, and general cleanliness are topics that arise for every pre-teen. For children with autism, simply just stating about what needs to happen may not be enough. Saying, “You need to go take a shower,” may not have the same effect as, “It’s really important to take showers everyday so that our bodies are clean and smell fresh. This way we feel comfortable and healthy, and other people around us do too.”

Using specifics such as this may help children with autism clue in to the “whys” of cleanliness. Additionally, providing visual schedules on the steps of showering, hand-washing, teeth brushing, dressing, etc., can help your child ensure that they are completing each step of the process, while still practicing more independence than if they had a parent or caregiver walking them through the routine.

Friendships/Social Skills

Fostering friendships and forming appropriate relationships with peers and adults at the time of adolescence can be extremely challenging. At this point in life, each child is starting to develop at different times, while interests and abilities are forming at different times and in unique ways. One highly effective strategy to help children with autism understand and participate in social situations are, the very aptly named, social stories.

Social stories can be custom tailored to each individual/situation, and break down any topic clearly using pictures and simple words. For example, a child who struggles with approaching peers in a group could benefit from a social story that focuses on what to say when approaching a group, what to do after saying, “Hi,” how to engage in a simple conversation, and how to say goodbye. These steps would be broken down using pictures (either real or found online), and simple sentences that match the child’s level of understanding. At the age of adolescence, it can be very powerful to have the child themselves be a part of creating the social story so they feel ownership and understand the content on a deeper level.

In addition to social stories, engaging in role-play with peers, adults, siblings, etc., can be very beneficial in helping a child with autism know what to expect in social situations. Practicing scenarios that are likely to happen in real life can help reduce or eliminate some of the anxiety and fear surrounding peers and socialization. For example, having a child practice what to do if someone says something unkind to them, or what to do when they are invited to a birthday party can set the child up for a successful interaction, rather than a situation where they might feel apprehensive or uncomfortable.

Functional Living Skills

By the time a child reaches the age of puberty, there are certain skills that we hope to see them engage in independently. This might be taking on simple chores around the house, making themselves a snack, or taking care of a pet. For all children, including those with autism, it is important that they have exposure to these types of functional living skills, as these will benefit them throughout their lives.

Using the aforementioned social stories, visual schedules, and explaining why we wipe the tables or feed the dog are all helpful strategies, but sometimes those are not enough. Using reinforcement strategies such as token charts/reinforcement systems can be a helpful tool to ensure that your child is participating in the functional activities of the home. For example, a child may be able to earn a star or token for each expected chore completed. Once all tokens have been earned, the child can have access to a highly preferred item such as a video game or special activity.

This token system should start with a few demands, which can be increased as the child shows success. This gives a tangible means of connecting the completion of functional/expected activities to earning a desired effect.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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Applying ABA at Home

Does your child struggle with stereotypical or problem behaviors in your home? Are youBlogABAHome-Main-Landscape exhausted from constant redirection and monitoring? Do you need a change? Can parents utilize the basic principles of ABA at home with their kids? Yes! Here are some quick tips and tricks to help behavior management in your home by applying ABA.

Give Behavior Specific Praise

Always praise appropriate behaviors! Providing this type of positive reinforcement for good behavior will not only increase your child’s motivation but will also allow you to see more of those behaviors in the future. Throwing in a specific praise statement gives the child feedback on the exact behavior you want to see increased. For example, saying “Nice job!” is good, but saying, “Nice job packing your back pack!” is even better and you’re likely to see them packing their backpack the next day.

Offer Choices

Whenever possible offer your child choices. This can range from choosing when they take their bath to what shirt they wear for school and everything in between. Offering choices allows your child to be part of the decision making process, making transitions or undesired activities less of a hassle. The more choices, the better.

Provide Clear Expectations & Follow Through

Set clear, concise expectations for your child and follow through with them! Stating expectations before engaging in a specific activity gives the child a set of rules to follow. As a parent you’re able to refer back to these expectations as reminders throughout the activity. Once you set an expectation it should be followed no matter what (this is key!). Remember to provide attention and praise for followed expectations.

Don’t Prompt Too Soon

When your child is engaging in any daily living skills (tooth brushing, setting the table, tying shoes, etc.) allow them to perform the task independently before you assist them. This teaches independence and problem solving. If your child is struggling after 3-5 seconds of attempting, then provide prompting to help them complete the skill. We don’t want to see inappropriate prompt dependency.

Provide directive statements as opposed to questions

Make sure you’re communicating directions clearly. Instead of providing a question, give a directive statement that your child needs to follow. Sometimes we don’t even realize that we’re asking questions instead of directive statements. When asking a question, it gives the child the opportunity to respond with their choice; however, providing a statement only has one appropriate outcome. Changing, “are you ready for dinner?” to “it’s time for dinner” is a quick fix.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Beyond Time-Outs – What to do When Your Toddler Acts Out

When your child takes the crayons out of the closet and draws on the living Time-Out-Main-Landscaperoom walls, a common reaction would be to put him or her in time-out. After the time-out, your child goes back and draws on the walls again. What is happening? Sometimes, time-outs aren’t the best way to show your child what’s appropriate or inappropriate.

What is a time-out?

A time-out is a procedure that is used to decrease future occurrences of a specific behavior (e.g., drawing on the walls with crayons). There are many types of time-out procedures that can be utilized.

A time-out can be beneficial when the “cause” of the behavior is determined. A child engages in these behaviors to communicate his or her wants/needs. For example, if Jessie is playing on the playground with her peers and kicks David, Jessie may be attempting to remove David from playing on the jungle gym or gain attention from David to play with him. It’s important to pay attention to what happens right before and right after the behaviors occurs to help determine what your child is communicating to you.

Time-outs can be harmful when the person implementing the procedure overuses it and it becomes his or her “go-to” method for all target behaviors. Since time-outs are used to remove reinforcement for a portion of time, the procedure does not teach positive behaviors that the child can engage in instead.

There is evidence that time-out procedures are effective, however; other less restrictive methods, such as reinforcement, can be just as effective in isolation or in combination with time-outs.

What can you do other than a time-out?

Since time-outs can be very restrictive, interventions that include reinforcement and proactive procedures can help decrease the future occurrences of a problem behavior. They can also help reduce the need to use time-outs. Here are a few strategies that can help reduce problem behaviors:

Proactive Procedures (procedures that occur before a behavior):

  • Provide choices for activities/items (when possible): Select between two and three choices at one time to avoid overwhelming the child.
    • Example: If Johnny is about to eat dinner, you can provide him the choice of which vegetables to eat by saying, “Would you like carrots or peas with dinner?” This may decrease Johnny’s refusal behavior by allowing him to make his own choice, rather than being instructed to do something.
  • Give frequent reminders and expectations throughout the day: This can be in the form of vocal or visual displays (e.g., speaking to your child or showing him or her pictures of the expectations).
    • Example: If Debbie has a doctor’s appointment at 3 p.m., you can say, “Remember, you have a doctor’s appointing at 3 p.m., then we can get ice cream at your favorite store!” You can provide this reminder every two hours until 3 p.m.

Reactive Procedures (procedures that occur after a behavior):

  • Provide specific praise for appropriate behaviors: Specific praise includes the particular action that the child did in addition to the positive words (e.g., “Wow!” “Great job”) or actions (e.g., high fives, hugs) provided.
    • Example: If your child is politely asking his sibling for a toy she’s playing with instead of kicking her to gain access to the toy, say, “Awesome job asking your sister for the toy. That was really nice of you Billy.”
  • Ignore the problem behavior and only attend to the appropriate behaviors (if there is no immediate danger): You can help your child engage in the appropriate behavior by modeling or prompting the response.
    • Example: If your child is screaming to access the cookies on the top shelf, you can ignore the screaming and tell him, “If you want the cookies, you can say, ‘Can I have one cookie please?’” Then you can provide attention and praise when he complies with politely asking for the cookies instead of screaming.

Providing attention and praise to your child’s appropriate behaviors may help decrease the frequency of problem behaviors and need to use time-outs. To help with the use of time-outs and other intervention strategies to treat both appropriate and problem behaviors, contact a Board Certified Behavior Analyst in your area.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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Teach Your Child to Pay it Forward

Teach Your Child to Pay It Forward

I get comments all the time like, “You are so mature for your age.” or “You have an old soul.” or “I can’t believe you’re a millennial!” Apparently someone in their 20s doing something kind or responsible comes as a big shock these days. It’s kind of sad. I’m living in a generation known as “Millennials,” but now the stereotype has grown to the point that we are also referred to as “The Entitlement Generation.” Children need to be taught about citizenship, community, and caring for others. Let’s work on bettering ourselves and our communities while teaching our children in the process.

Be the change you want to see in the World! – Mahatma Gandhi

Let’s show our kids how much good there is in the world, and how they can pay it forward. Random Acts of Kindness make the world a better place.

Ways to Teach Your Child to Pay it Forward:

  1. Lead by Example – Kids love “monkey see, monkey do” for a reason. They love to emulate thoseTeach Your Child To Pay It Forward that they look up to. Be the person you want your kids to respect. Show someone around you some kindness, and your kids will follow suit.
  2. Start Small – Let someone with a couple items in front of you in the checkout line, or hold a door for someone. Give someone a compliment or a nice note.
  3. Teach Empathy and Awareness – Watch a sad movie, read some books, or bring your kids to volunteer somewhere. Have a discussion afterwords about how thankful you are for the things you have and how life must be hard for the person or characters. When you go to the store or the mall, teach your kids to be aware of people around them. Something so simple can make a huge impact. Many people who act “entitled” may have just never learned to look at the world around them and see how their actions impact others.
  4. Help a Cause your Child Cares About – Is your little boy fascinated by firemen? Bake some cookies together and bring them to your local fire station. Your little one can meet his idols and may even get to slide down the firepole. Does your daughter want to be a doctor when she grows up? Look for a volunteer opportunity at a children’s hospital or your local pediatrician’s office. Does your child love GI Joe? Help him create a nice care package to send a random soldier. You can even find supplies at your local dollar store. – These are just a few examples, but there are so many possibilities. Keying  into your child’s interest will ensure he remembers it for a long time to come.
  5. Pass It Along – Encourage your child to go through his old toys to find things he doesn’t use anymore and donate them. Have a closet raiding “party” as a family and look for unused clothes or pantry item to donate.
  6. Make a Commitment – Work together as a family to come up with “pay it forward” ideas and goals. A good one might be that each family members agrees to find a way to pay it forward by the end of the week. At the end of the week everyone can share what they did, and how the experience made them feel.
  7. Keep a Balance – It’s good for your children to be happy when they help someone out, but make sure they learn the difference between doing something for someone else and doing it for themselves. If they want to do something for the praise they get afterward, then they haven’t really gotten the message. Paying it forward is about helping the other person. Doing this naturally feels good!

Pay it Forward has really become a movement in the last few years. I see stories every day about children asking for pet food donations to their local shelter instead of birthday presents, an endless line of people paying it forward in a Starbucks line, or people choosing to honor the memory of a loved one by holding a “Pay It Forward” day. It is so great to see these stories. They constantly inspire me to pay it forward myself, and hopefully this blog will help your family to do the same – to be the change!

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Help Your Child Thrive

5 Ways To Help Your Child Thrive

The brain is divided into two hemispheres with each side having its own unique functions.  The left side is logical, literal, linguistic, and linear (the four L’s).   The right side is holistic, non-verbal, and focuses on the emotions and experiences of relationships.  When it comes to development, very young children tend to be right brain dominant!  This is especially true during the first three years of life when they live completely in the moment and have not mastered the ability to use words and logic to express their feelings.

When can you determine a change to using both side of the brain?  Once your toddler begins askingHelp Your Child Thrive “why?” all the time! This is because the left brain strives to know linear cause-effect relationships and uses language to express logic.

The following are some strategies that parents can use to help their children survive and thrive through the challenges of childhood.  However, these strategies are not just for parents.  Anyone who plays a significant role in a child’s life, whether you’re a grandparent, relative, teacher, or babysitter/nanny, can use these strategies in nurturing whole-brain development.

Strategies to Help Your Children Thrive!

  1. Connect & Redirect: Surfing Emotional Waves: First, connecting with the right brain means acknowledging your child’s feelings.  Regardless of how illogical and frustrating your child’s feelings may seem to you at the moment, they are real and important to your child.  Using nonverbal signals, such as physical touch, empathetic facial expressions, a nurturing tone of voice, and nonjudgmental listening are great ways to connect and communicate with your child’s right brain.  Once your child’s brain is back in balance, you can move to step 2 to integrate the left and right brain.  Next, after responding to your child’s right brain, you can now redirect with the left brain through logical explanation, planning, and discussing misbehavior and consequences.
  1. Name It to Tame It: Telling Stories to Calm Big Emotions: Help your child retell the story of a frightening or painful experience.  Allow your child to retell the story as much as he can and help fill in any details, including lingering feelings since the experience.  You and your child can retell the story several times, with the aim to lessen his fears or pain.  Also, this technique will help your child bring the left and right brain together and make sense of their experience.
  1. Engage, Don’t Enrage: Instead of presenting ultimatums, direct your child to use more precise and specific words for how he/she is feeling.  Then, give your child the opportunity to practice problem solving and decision making.  Also, this will help your child consider appropriate behaviors and consequences, and assist them in thinking about the wants and feelings of others.
  1. Move It or Lose It: Moving the Body to Avoid Losing the Mind: Research has shown that movement directly affects brain chemistry.  Therefore, physical activity is a powerful way to help your child regain balance and change his emotional state.  This could be in the form of yoga, going to the park, blowing/popping bubbles (who doesn’t love that), or a bike ride.
  1. Increase the Family Fun Factor: Making a Point to Enjoy Each Other: Sometimes, with all the hustle and bustle of life, it’s easy to forget to have fun with your family.  As such, “playful parenting” gives your children positive experiences to prepare them for relationships and encourage them to connect with others.  Some great ways to have fun as a family include, playing improv games, telling jokes, being silly, playing board games, family bike rides, and making cookies.  Lastly, don’t forget to take interest in things they care about.

More strategies and information can be found in the book The Whole-Brain Child by Daniel J. Siegel, M.D. and Tina Payne Bryson, Ph.D.

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NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!