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A therapist sent a message asking for ideas after one pre-teen landed in the hospital with dehydration after refusing to eat or drink after her favorite “sippy” cup broke. The situation is becoming so serious there is consideration of inserting a g-button. This is a last resort, of course, but, if it becomes necessary, there is some concern that the youngster will yank it out. Below are some ideas I shared with the family, therapist, and medical team.
1. I’m assuming the parents have purchased a new cup. In most cases, the transition to a new object can only work if the new cup or utensil is the same brand, same shape, and same color. Change – even in small details – can be very frustrating for some of our friends with autism.
2. Sometimes my friends who have these issues are tied to the smell of the object. I’m guessing just the bottom part of the cup broke, so, if the parents still have access to the top of the old cup, they might be able to put the old lid on the new cup to bring back the familiar smell.
3. They can also wash a new cup a number of times using the same type of washing they used with the old cup – dishwasher or hand washing or whatever using the same type of soap – to bring back that familiar feel and smell. I would also encourage them to fill it with the liquid the youngster usually drinks, then pour it out before washing then filling and washing over and over. (Think of breaking in a new blanket or pillow or seasoning a new cast iron skillet.)
4. Sometimes we tend to “make a big deal” over these types of transitions. It may work better to be matter-of-fact, saying nothing about the new cup and following the same routine for meals as usual – same time of day, same chair & table, same food, same atmosphere and conversation, etc.
5. Even if it doesn’t seem as if the youngster understands the conversations, it is absolutely critical that no one discuss her stubbornness, her refusal to eat or drink, or any other aspect of this situation in front of her, when she is asleep, or at any time or place with a remote chance of her overhearing the conversation/debate.
Because this situation is seriously threatening the health and well being of this youngster, it is critical to come up with a solution to get her back in the habit of eating and drinking. Then it would be good to start a specific program to slowly help her tolerate transition and change. For example, if the family is, indeed, able to acclimate the youngster to a new cup, they will want to purchase and “season” 5 or 6 cups to rotate in and out every day.
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me a confidential email at talk@FAQautism.com with your thoughts or challenging situations or innovative solution. And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
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Autism is complex, and requires on-going assessment and monitoring of individual strengths and deficits. We cannot assume, for example, a non-verbal high school student with autism is unable to read or to understand physics. We cannot assume a college graduate and successful professional with autism is toilet-trained.
The Autism Society of America describes the uneven and unpredictable nature of autism by stating “although autism is defined by a certain set of behaviors, children and adults with autism can exhibit any combination of these behaviors in any degree of severity. Two children, both with the same diagnosis, can act completely different from one another and have varying capabilities” (Characteristics of Autism, 2008).
Teachers, parents, therapists, and others interested in the well-being of a person with autism might want to look at a wide variety of options for addressing the unique needs of that individual. We should take into consideration the unique combination of characteristics of each person when developing personalized strategies and interventions, thereby maximizing each person’s potential and impacting their quality of life. Sometimes that involves combining features of various approaches to autism rather than following just one specific program.
Autism Fact Sheet. Washington, DC: National Institute of Neurological Disorders and Stroke. Retrieved October 15, 2010, from http://www.ninds.nih.gov/disorders/autism/detail_autism.htm#155613082
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.-text rev.). Washington, DC: Author.
Characteristics of autism. Autism Society of America. Retreived October 15, 2010, from http://www.autism-society.org/site/PageServer?pagename=about_whatis_char
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me a confidential email at talk@FAQautism.com with your thoughts or challenging situations or innovative solution. And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
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I could actually write a whole book about this topic, but we try to make our FAQautism podcasts and e-mail posts short and sweet, so let us look at three key issues.
(1) ROUTINE. These days everyone in the family sort of grabs some food before basketball or in the middle of homework or when their favorite television show is over. This improvisational style may seem the best route until you find yourself dealing with behavior issues daily around meal time. Most individuals with autism thrive on routine, so consider picking a certain time for dinner each night and for breakfast each morning. This regular suppertime routine and breakfast will probably help everyone in the long run, but it will make a world of difference for your friend with autism.
(2) NO INTERRUPTIONS. Again, the new lifestyle involves constant pings, rings, bells, vibrating phones, and at least one television blaring. For just 15-minutes, turn it all off. You will be amazed how much that one act of courtesy will calm your friend with autism. And you will be amazed at the fun conversations that will erupt around the table.
(3) PITCH IN. One of the best gifts you can give your child, teen, or adult family member with autism is that of increased self-reliance. So everyone pitch in at the end of the meal to help with clean-up. Give your friend a different job each day, so he can enjoy the routine of clearing table on Mondays, emptying dishwasher on Tuesdays, taking out trash on Wednesdays, and so on.
TIP FOR THE DAY: All of these strategies may seem like a burden to the rest of the family, but just introduce the new routines quietly and cheerfully, accepting no grumbling, arguments, or drama. Most families and group homes that follow these three tips have commented on the increased calmness, decreased tantrums, and general contentment for their friend with autism. So, give it a try.
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me a confidential email at talk@FAQautism.com with your thoughts or challenging situations or innovative solution. And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
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Volunteer work has a number of advantages, not the least of which is life satisfaction. Volunteering also gives some structure to daily schedules, purpose to life, and opportunities to meet and interact with new people. Working as a volunteer gives a person opportunities to make connections with their extended community and to build on their repertoire of job-related skills. Over time, a person may be able to move from being a volunteer into a paying job as they develop new skills and make connections with potential employers through their volunteer efforts.
Sometimes we need to think creatively to find an appropriate volunteer “job,” but the benefits are worth the effort. A volunteer can lend a helping hand for as little as twenty minutes a week or as much as five hours s a day. Some of my friends help fold bulletins at church, file medical records at the clinic, run the vacuum cleaner at the day care, help deliver Meals on Wheels, or helping an elderly neighbor put clothes in and out of a washer and dryer. Volunteer opportunities can range from helping feed animals at a shelter to playing piano during lunchtime at a nursing home. Attention to detail helps some of our friends with autism excel at tasks such as inputting data, sorting papers or mail, putting library books on shelves, or filing records. Even individuals with very limited skills can help water plants, push a grocery basket, or put newspapers on the porch for their neighbors.
TIP FOR THE DAY. Keep a sharp eye for volunteer opportunities that match the skills and interests of your friends with autism. All of our lives are enriched when people are given a chance to lend a helping hand.
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me a confidential email at talk@FAQautism.com with your thoughts or challenging situations or innovative solution. And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
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Off-limit snacks. Some individuals with autism have dietary restrictions that make some foods off-limits.The only way to effectively stop our friends from eating off-limits foods it to simply remove them from the house. Without any comments, announcements, or fanfare, simply quit purchasing those foods. So, for example, if a teen has dietary restrictions related to sugar, then cookies, ice cream, chips, sugared pop, candy, and other sugar snacks must not be in the house.
Limited portions. The other critical step in decreasing the volume of snack consumption is to decrease the size of portions. Rather than having a big box of snack crackers, nuts, or seasoned pretzels on the shelf, break the package into small portions. The smaller snack-sized zip-lock bags work well for this.
Nagging. Whether your youngster has autism or not, nagging is not an effective behavior management tool. We tend to say things like, “You don’t get any more Oreos because they aren’t on your diet,” or “No more snacks for you, young man. They are bad for your health and ruining your dinner,” or “Starting tomorrow, you are going on a diet. No more ice cream or cookies for you.”
Choices. Instead, have a box with a variety of allowable in snack-sized ziplocks. Let the youngster pick his choice periodically, and avoid limiting snacks too harshly.
Stealing. There is only one fool-proof way to stop stealing – any foods that are off-limits must be totally unavailable. If a youngster cannot eat sugared foods, for example, it is not appropriate to have a half-gallon of ice cream or a package of Oreo cookies reserved in the kitchen for other family members.
TIP FOR THE DAY: The only effective way to decrease stealing and unhealthy eating is to completely remove the temptation by making off-limits snacks inaccessible. And remember to have a choice of healthy snacks readily available for your friend to enjoy.
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me a confidential email at talk@FAQautism.com with your thoughts or challenging situations or innovative solution. And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
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BUILD ON STRENGTHS. Some of my friends with autism really thrive on daily routines and rituals. Unlike most of us, they actually enjoy mundane, routine tasks. One of my friends rather obsessively picks up lint or other small objects off the floor. Others file away books or put music instruments in their rightful places when waiting for their music therapy session. One young lady is thrilled when I give her permission to put away the clean dishes in my kitchen, and another loves swiffing my wood floors. I’ve encouraged their families, teachers, and job coaches to find daily chores that allow these individuals to lend a helping hand.
START EARLY. Nearly every person I know with autism clings to interests and habits from their early childhood. It is important that we teach all children to help themselves as much as possible and to pitch in around the house, but autism adds urgency. Even toddlers can pitch in with daily chores around the house to some extent. Approach chores with a positive attitude, and include kids in the process.
ENCOURAGE SELF-SUFFICIENCY. Busy schedules and looming deadlines can keep us from taking the time necessary to teach our youngster with autism to be self-sufficient. It is certainly quicker and easier to simply pick out clothes, tie shoes, gather up schoolbooks, or set the table for supper. If your life is like a pressure-cooker, relax and take just five minutes a day to focus on teaching your child just one task a week or so. Be patient, allow them time, and do not expect perfection. It is the effort that counts.
TIP FOR THE DAY. Granted, it is certainly easier for us to do things ourselves. But we can make a real difference in the long run if we make a pledge to take time each day to allow our child to participate in daily chores.
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me a confidential email at talk@FAQautism.com with your thoughts or challenging situations or innovative solution. And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
Nov 18, 2009
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Take a few minutes to do a few routine tasks so you don’t have to deal with them in the chaos of the morning rush. Back when I was a young, harried mother, I found myself stomping around bellowing orders and empty threats as I tried to get the kids in bed. I kept thinking of all the things that needed my attention. As my stress level rose, I made everyone around me miserable. So, I’m suggesting an alternate plan. Make an effort to remain calm in spite of the loud sound of looming deadlines. You can’t control every aspect of family life, and you can’t make everything perfect, so just relax. Establish the Evening Round-Up as a regular routine to get ahead of the flood, thinking of it as an “investment in contentment” rather than a “time thief.”
Here’s a sample Evening Round-Up checklist to get you started. Without nagging, spend some time calmly help your youngsters get their checklists completed.
1. CLOTHES. Does each person have a set of clean clothes? Do they need gym clothes or after school clothes or basketball league clothes? What about shoes, socks, underwear, coats, hats, etc.?
2. BODY. Clean head to toe in the evenings to prevent a morning rush. That means shower or bathe, wash hair, brush teeth, and even shave if needed.
3. BACK PACK. Put all work supplies and/or books, permission slips, lunch money, and other necessary items in back pack before going to bed.
4. CONNECTION. Take a few minutes for quiet interaction with your youngster with autism. This is important even if your youngster is non-verbal or does not seem to participate in the conversation. Read a story or talk about their day to help them make an emotional connection with you and wind down. Take time to review the schedule for the upcoming day, to discuss concerns, and to review rules and/or expectations – whether they seem to understand or not. And don’t forget to remind your youngsters of your love and support.
TIP FOR THE DAY: Remember, perfection is not the goal here. You just want to make an investment of 30 minutes every night to increase contentment. Believe me, your efforts will pay off big time for all involved.
And take a bit of time to learn new ways to systematically address challenging issues that can arise in the lives of our friends with autism. Click on the Toolkit tab on our webiste for great resources; http://FAQautism.com
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me a confidential email at talk@FAQautism.com with your thoughts or challenging situations or innovative solution. And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
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First, let’s take a look at the issue of respecting privacy. I often hear family members, teachers, and other caregivers say to an individual with autism, “Let’s go change your diaper” or “Go pee-pee before you have an accident.” I hear comments like that spoken loudly in public forums such as classrooms, family gatherings, and dinner tables. Even if our friend with autism does not appear to be embarrassed or even if he is just four years old, it would certainly be more respectful to say quietly, “Please come with me,” or “Let’s go wash our hands.”
Another issue that arises is confusion over the different terms used for the restroom. Among other things, toilets are called a bathroom, a restroom, the ladies room, the men’s room, or the john. The very nature of communication deficits related to autism stands in the way of making quick shifts between terms. One of my young adult friends with autism was asked by a friend if he needed to go to the bathroom. Taking that term very literally, the young man replied, “No, I took a bath last night.”
And, speaking of terms, parents might want to consider avoiding childish terms to describe “going to the restroom.” If a youngster with autism learns to say “pee-pee” or “Let’s go potty” when he is three years old, he is likely to use that same term when he is fifty-three.
The same can be true when we use anatomically correct words to label parts of the body. Sometimes folks with autism are unable to distinguish between words that are “o.k.” at home talking to parents and words that are more appropriate in social situations. A good rule of thumb is to use words at home that can also be said loudly in earshot of strangers in a restaurant or grocery store.
So, these are just some ideas to consider when dealing with private issues. It is up to us to set the tone for privacy and respect.
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me a confidential email at talk@FAQautism.com with your thoughts or challenging situations or innovative solution. And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
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(1) Self-Care. Options for employment expand if an individual is able to take care of her basic needs independently or with minimal assistance. Teaching basic self-care skills such as toileting, lunch and snacks, washing hands, and taking care of personal items such as a backpack or nametag as independently as possible is a good place to start.
(2) Focus. Most jobs require that an employee focus on the task at hand. It is also important that a person focuses on the directions given by a boss or supervisor and to focus on any important announcements or on safety drills. But, most importantly, a person who can focus on a task for an extended period of time without reminders will have more job opportunities.
(3) Follow. Compliance is another critical skill in employment situations. An individual with autism will be much more productive in any job if she can and will follow directions with minimal assistance. If she has deficits in processing verbal instructions, she can be taught to use a visual schedule so employers and job coaches can successfully communicate the information she needs to complete a task or a job sequence. If she is rather strong-willed or uncooperative, we can gradually shape a more cooperative outlook and a willingness to follow directions and job procedures.
(4) Finish. Even when jobs are broken down into a series of smaller tasks, some individuals with autism are unable to complete those tasks without prompting. A person’s employment will be much more successful if he can learn to finish tasks or job sequences with less and less prompting from a supervisor or job coach. It is up to us to help our friends with autism become less prompt-dependent.
(5) Flexible. The nature of autism causes some individuals to be intolerant to changes in routine. Our friends will have a much more successful job experience by learning to be more flexible and to “go with the flow.”
TIP FOR THE DAY: These are just a few of the core skills necessary for employment. It is good to start early in teaching and shaping these skills since some are rather stubborn natural characteristics of autism.
We can also benefit from shaping our own skills so we can systematically address challenging issues that can arise in the lives of our friends with autism. Click on the Toolkit tab on our webiste for great resources; http://FAQautism.com
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me a confidential email at talk@FAQautism.com with your thoughts or challenging situations or innovative solution. And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
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At least a week before school starts, parents of a youngster with autism who is attending a different school this fall might want to ask a counselor or other staff member to give their child an informal, low-key, personalized “welcome tour” helping them learn the location of their book locker and gym locker and classes. It would be good to help them pre-plan their daily route so they can get from class to class on time with all the necessary supplies and books.
Purposeful, casual, one-to-one instruction about some of the school traditions, procedures, and expected behaviors would certainly make transition MUCH smoother for individuals with autism, many of whom are visual learners and simply may not process all the verbal instructions given during orientation in a large all-school assembly.
So, before the first day of school, make arrangements for a “welcome tour” to help students with autism learn about (1) emergency drills and procedures, (2) expected behavior during morning announcements, (3) location of restrooms, (4) expected behavior in the hallways between classes and during classes (5) procedure for riding the school bus, (6) lunchroom procedures, (7) expected behavior during pep rally and other group gatherings, (8) procedures for dressing out in gym class, and (9) who to contact with questions or problems. I encourage parents to tag along if appropriate so they can help remind their youngster of the new routines if needed.
We welcome your input. Share challenges and ideas based on your experiences or intuition. Just click on the comments button or send an e-mail to talk@FAQautism.com.
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me an email with your thoughts or challenging situations or innovative solution. Send email to talk@FAQautism.com And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
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CIRCLE TIME. Teacher-directed group activities require youngsters to come to the area of the activity and to stay in the area of the activity. Participation requires a child to pay attention to the teacher’s words and actions as well as multiple visual and social cues. Circle Time activities also call for some measure of impulse control – waiting for the teacher, taking turns, keeping hands to self, following directions, and tolerating lots of sounds, sights, and people.
FREE TIME. Many children love recess, but sometimes our friends with autism really struggle with the lack of structure inherent in free-time play. Free time requires them to make decisions about filling that time, to share space and objects with other kids, to play cooperatively or at least tolerate the presence of other kids, and to play independently with minimal supervision and direction from adults. To some extent, the popular technique of having independent play centers or independent learning centers in early childhood classrooms can raise some of the same challenges for youngsters with autism.
TRANSITION. Dealing with the transition between self-directed and teacher-directed activities is a fine art that requires some expertise. A youngster needs to learn to stop what they are doing and come when called, to stand and wait in line, to follow classroom routines without much supervision, to deal with multiple directions, to follow the social cues of their fellow students and of their teachers, and to focus on a task and complete it with minimal assistance.
Yikes! This list makes it sound more challenging to start pre-school than to start graduate school! We will discuss some fun and effective ways to help your pre-schooler with autism learn these classroom survival skills in upcoming podcasts. Meanwhile, just relax and remember that pre-school can be a great adventure in spite of some rocky paths and landslides. A wise person once said, “If a mountain were smooth, you couldn’t climb it.”
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me an email with your thoughts or challenging situations or innovative solution. Send email to talk@FAQautism.com And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
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If we notice a delay in these situations, we might want to make certain we are allowing our friends enough time to process the directions and to formulate a response. Even a person with very sophisticated language comprehension can have a processing delay. Several different factors can contribute to a delay in processing the words of a direction.
(1) Meaning of Words. Sometimes individuals with autism need a bit of extra time to sort through the meanings of words or phrases. For example, if a teacher tells the youngster to “run on out to the bus,” he might need to stop and think for a minute to determine if the teacher wants him to actually run, or if she is speaking figuratively.
(2) Train of Thought. Without meaning to do so, we often interrupt a person’s train of thought by repeating a direction or making another comment. The most effective strategy is to state a direction in concrete, positive terms, then look expectantly at the person, remaining silent to give them time to process the direction.
(3) Quick Response. Most of us are guilty of impatience. We expect instant responses to our directions. If a person has a processing delay, it is impossible for them to listen to the words, to decode the words, and to formulate a response within three seconds.
Granted, there are other reasons for delays in following instructions. Individuals may not be paying attention or they may be distracted. Background noise or other conversations may keep them from hearing the direction in the first place. A person may be purposefully ignoring you or they may be openly defiant. But we need to also consider the possibility of language processing delays.
We welcome your thoughts about this issue. Just click on the comment button or send us a message
talk@FAQautism.com.
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me an email with your thoughts or challenging situations or innovative solution. Send email to talk@FAQautism.com And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
Published on: Feb 25, 2008
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It is certainly challenging to monitor what a person is doing 24/7. Many families, school personnel, and residential staff face similar situations and are searching for solutions. Every individual and every living situation is different, but any effective strategy will require a three-prong approach that (1) removes temptation and opportunity, (2) provides a safe place that doesn’t need monitoring, and (3) systematically teaches an alternative for destructive or harmful behavior. Today’s podcast will focus on the first step in the process, removing temptation. Tomorrow’s podcast, “Safe Haven,” will discuss the second prong of this strategy, and our “Hands Off” podcast will focus on training more appropriate behavior.
Inaccessibility is the key to success until your son learns to leave items alone. For the time being, it would probably be best to put all fragile or potentially dangerous items in a place where they are out of reach of your son. This strategy might involve putting a lockable door on the kitchen and on bedrooms of other family members. You might also need to store computers, printers, television and VCR, remotes, and other electronic equipment in lockable cabinets or in separate rooms that can be locked. Breakable knick-knacks, pictures, or other valuables can be displayed in glass-front cabinets or displayed in a separate lockable room. If you have two bathrooms, you can store all cleaning supplies, medications, mirrors, hair dryers, and other potentially dangerous items in one lockable bathroom and only allow your son access to the second, virtually empty bathroom. Your garage also needs attention. Store dog food, tools, plant food, and potentially dangerous items in locked storage areas. These same guidelines for removing the opportunity to touch or move items apply to every single corner of your house and yard that can be accessed by your son. Not every person needs such extreme measures, so you can customize this “removing temptation” strategy to your son’s situation.
Check out our podcasts for the next two days, “Safe Haven” and “Hands Off,” for more strategies and tips for decreasing your need to constantly monitor your son to prevent him from touching items that are fragile, irreplaceable, or potentially harmful.
Note to FAQautism.com listeners and readers: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. You can click on a button to send me an email with your thoughts or challenging situations or innovative solutions. Check out our website for a wealth of ideas and a glimpse into the world of autism. www.FAQautism.com
Published on: Oct 30, 2007
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What keeps this youngster from following directions? Is she unwilling to cooperate? Or is she unable to comply? Following directions is actually a complex task that involves focus, comprehension, processing, compliance, and action. Even if this youngster is willing to comply, many factors may stand in the way of her being able to follow directions.
Focus and Attention. Is she paying attention? Does she realize the direction is
addressed to her and not another person? Does she remember the direction long enough to formulate a response? Does she know you are talking to her? Does she know that you really mean it this time? Does she know what response you want?
Language Processing. Does she have a hearing loss? Are other noises in the room interfering with her ability to hear what you are saying? Is she able to decode the words? Does she recognize that a response is necessary?
Comprehension. Does she understand the words you are speaking? Does she understand the meaning of the words you are speaking? Has she learned different labels? For example, are you saying “Please go to the restroom” and she knows the room as the “bathroom.” Are you using too many words? Maybe she just focused on the end of the phrase e.g. “Put your shoes on so we can go to lunch.” All she hears is “Go to lunch,” so she heads out the door with bare feet.
Formulating a Response. Does she know what to do? Does she have motor-planning skills necessary to initiate a response? Can she translate the desired response into action? Are you allowing enough time for her to follow through before you start nagging her with constant reminders?
Motivation. Does she know the consequences of incompliance? Does she care about the consequences of incompliance? Is she lethargic, depressed, or distracted? Is she just content with the status quo or does she resist change?
Because following directions is a complex task, we need to scout out all the issues that interfere with compliance and help individuals with autism learn to step over those hurdles so they can be both willing and able to follow directions.
Note to FAQautism.com listeners and readers: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. You can click on a button to send me an email with your thoughts or challenging situations or innovative solutions. Check out our website for a wealth of ideas and a glimpse into the world of autism. www.FAQautism.com
Originally Published: Oct 29, 2007
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This young man’s family was perceptive enough to notice his excellent memory and to give him opportunities to use that gift in a productive way around the house. He is in charge of feeding and watering the pets, taking laundry out of the dryer, turning on all the alarm clocks, watering the plants, and locking the front door and turning out the porch light every night. His family really depends on his help.
Granted, some individuals with autism are capable of much more sophisticated tasks and others would not be able to complete even one of those tasks independently. But the key is to find the gifts of each individual, to help nurture and improve those skills, then find ways for them to use their gifts in a way that contributes to the community.
Even people with significant limitations can be productive and helpful if given the chance. It may be that they can lead their class to the lunchroom or pick out a book for circle time. Maybe they can turn out the light when the class leaves for recess or carry a lunch box for a classmate who is unable to hold the box. Maybe they can push the dust mop around the house or bring the mail in from the mailbox. Maybe they can put the clothes in the washer or pull them out of the dryer into a basket. The point is to help each person feel like they are useful and needed. If you want more ideas about how to maximize the gifts of a person you know who functions on the spectrum of autism, send us a few details and we’ll share some possibilities. Send me an e-mail to talk@faqautism.com.
Note to FAQautism.com listeners and readers: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. You can click on a button to send me an email with your thoughts or challenging situations or innovative solutions. Check out our website for a wealth of ideas and a glimpse into the world of autism. www.FAQautism.com
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SPECIFIC STRATEGY I encourage you to express your concerns to your son’s classroom teacher so she can utilize curriculum resources developed specifically for students diagnosed autism to expand the scope of his learning beyond sequencing the basic colors, numbers, and alphabet. For example, some youngsters are able to learn to read words by sight without mastering phonics and sequencing the alphabet. Some kids will never learn to answer the question, “How many apples do you see?” but they can learn to accurately follow the direction, “Please give me seven apples,” or “Get three pair of socks from your drawer.” Often youngsters with communication deficits related to autism is unable to tell a teacher the name of a color, but they can learn to follow a directs such as, “Put all the white clothes in the washer,” or “Bring the purple back pack to recess so we can play t-ball.” It is probably more critical that a youngster learn to use a calculator than to complete math problems on paper. And learning prepositions is a practical skill that allows youngsters to understand and follow directions such as “Put your notebook under your chair” or “Put your notebook on the bookshelf beside the water fountain.” Although some students diagnosed with autism may not have the fine motor skills necessary for writing with a pencil and paper, they can often learn to communicate in writing using a computer keyboard. So, if a youngster with autism seems to be stuck on one skill, it may be wise to look further down the road and change to focus, approaching the basic skill set from a different perspective. Look beyond the ABC’s – there is a whole world of possibilities waiting to be tapped.
CLOSING NOTE: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. You can click on a button to send me an email with your thoughts or challenging situations or innovative solutions. Check out our website for a wealth of ideas and a glimpse into the world of autism. www.FAQautism.com
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Holding a familiar object can help make transitions easier and help instill a sense of security that can diminish anxiety and emotional outbursts for some individuals. But, as our youngsters with autism get older, the old teddy bear they have held for years gets very ragged and looks a bit out of place in a junior high school classroom. When the teddy bear begins to fall apart, it is time to make a plan so the replacement of the transition object isn’t too sudden and traumatic.
The first consideration is to determine if a transition object is necessary. Some youngsters with autism are able to gradually break away from that obsessive interest in one object. But others are much more content and move through their day more smoothly when they know they can depend on that one reliable object.
One idea for a transition object that has worked very well for people across the spectrum of autism is photographs of family members, friends, pets, and other familiar people and places. You could even use a photograph of your daughter’s dearly beloved stuffed puppy. For individuals who tend to chew on and tear up objects, you can create a soft, rather indestructible, and replaceable object by printing a few 4×6 photos on a regular piece of paper, cutting them out, and gluing back to back on a bright piece of paper. Then laminate both sides with clear Contact paper or in a laminating machine. The clear Contact paper has a neat smooth texture.
Other individuals with autism really enjoy having a small photo album with a flexible cover that holds 3×5 photos. Use copies of photographs rather than the original so the photos can be replaced. Photographs are age-appropriate, inexpensive, and replaceable, making them good choices for transition objects as well as conversation starters.
Note to FAQautism.com listeners and readers: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. You can click on a button to send me an email with your thoughts or challenging situations or innovative solutions. Check out our website for a wealth of ideas and a glimpse into the world of autism. www.FAQautism.com
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For over five years, a youngster diagnosed with autism did not appear to be paying attention to anything in his classroom. Through patient work, teachers had gradually helped him learn to sit in a chair rather than just rolling on the floor. But during the school day, he seemed to be lost in his own world, not paying attention to people or events. His teachers and parents continued to read to him, to expose him to age-appropriate academic concepts in group and individual instruction, and to guide him through the motions of p.e., computer, recess, music, and meals. He did not resist these efforts, but he seemed oblivious to the world around him. This young man seemed content in his own world – mumbling repetitive phrases and rolling objects in his hands.
Over time, the student began occasionally looking at other people when they sat close, and he held books in his hands for about a minute before dropping them on the floor. He gradually started showing some interest in the computer, so his teachers and parents searched for age-appropriate, computer-based learning experiences for school and home. After about two years of status quo at this new “computer” phase, he began saying a few purposeful words and phrases. One day, he seemed to suddenly notice his picture schedule and began moving from one activity to another with minimal assistance from his teachers. He gradually began looking at his fellow students, answering a few rote questions, and looking at the teacher when she was reading or talking. Several months later, he began reading out loud. He enjoyed reading to his class or reading books to himself.
Apparently this youngster had been “soaking up” most of what his teachers and parents had been teaching for many years. His new-found ability to read and comprehend the meaning of words and sentences confirmed the fact that he had been learning all along. Although it didn’t seem to be making a difference at the time, all of that patient teaching paid off in the long run.
Now, this is not to say that every child diagnosed with autism will eventually learn to read or talk or interact with other people. But it is an illustration of the potential benefits of patient teaching. The keys are to be persistent and to find new ways to expose youngsters to concepts and encourage learning, even if it is passive learning.
Granted, it is sometimes necessary to drop a goal or to move in another direction if, indeed, continued emphasis on learning a certain skill is not in the best interest of the person with autism and the people around him. But, generally, we can help individuals with autism reach their maximum potential by patiently and persistently giving them opportunities to take little steps forward and by making learning experiences enjoyable and interesting.
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me an email with your thoughts or challenging situations or innovative solution. Send email to talk@FAQautism.com And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
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Even if individuals with autism do not seem to care about how others treat them or if our friends do not seem to be aware of interactions with other people, we can take purposeful steps to make certain that all we do and say is respectful. Today we will address the topic of maintaining dignity in the areas of privacy and independence.
(1) Privacy. Without realizing the full consequences, we tend to talk about people with autism or other disabilities as if they were not present. We do not need to share their problems or challenging situations in public. We can maintain confidentiality and preserve privacy by consulting with other caregivers, family members, and professionals discreetly. Privacy is also an issue when our friends with autism need some help with toileting or dressing. It is inappropriate, for example, for us to say to a teen, “Let’s go change your diaper,” or “You’d better go to the bathroom now so you don’t have an accident later.” We can also help our friends with autism by teaching them from an early age to close the door to the bathroom when toileting or bathing and to change clothes behind a closed door.
(2) Independence. It is so much easier for us to manage the details of the daily lives of individuals with autism rather than waiting patiently for them to do so. But everyone likes to have SOME control over what happens each day. Rather than taking care of every detail, let your friend with autism make some choices. Depending on their level of functioning, they might be able to choose their clothing for the day, meals and snacks, free-time activities, family events, music, books, or movies. Help people gain (or regain) some measure of control over their lives by giving them choices when possible. We can demonstrate our respect for their viewpoint by giving the person with autism the time and the means to express their opinions and choices.
We welcome your thoughts and ideas on the topics of privacy and independence. Just send us a message at talk@FAQautism.com
Note to FAQautism.com listeners and readers: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. You can click on a button to send me an email with your thoughts or challenging situations or innovative solutions. Check out our website for a wealth of ideas and a glimpse into the world of autism. www.FAQautism.com
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For a variety of reasons, some individuals with autism are obsessed with eating or chewing on one or two specific non-food objects. Others indiscriminately put nearly everything they touch into their mouths. Depending on the object, chewing or swallowing can lead to choking, poisoning, blockages or tears in the digestive tract, infections, or lack of appetite.
Constant 24/7 monitoring is next to impossible, so it is best to take some proactive steps to prevent obsessive and repetitive chewing and swallowing. For example, supply pull-over shirts without buttons for individuals who chew buttons off their shirts. Another proactive step is to provide safe oral motor sensory toys for individuals so they are less likely to put dangerous objects in their mouths. An occupational therapist can recommend the most appropriate oral motor item. Other strategies are described below.
SAFE HAVEN. Obsessive eaters need a hazard-free hangout as much as their caregivers need a few breaks from constant vigilance throughout the day. Take time to create a safe place at school and home that is cleared of all potentially hazardous objects. Survey your friend’s environment and remove anything that fits in their mouth – all buttons, beads, paper clips, hair clips, rubber bands, coins, rocks, shells, thumbtacks, bottle caps, caps to pens, staples, candles, nick nacks, soap, napkins, coins, electrical plugs, plants, dirt, and other small or harmful objects or liquids. The safety survey requires exploring every nook and cranny of the unsupervised space. Look in every drawer and closet, and under beds, bookcases, and cabinets. Put caps on electrical outlets and, if necessary, put a piece of heavy furniture in front of outlets.
SAFE BATHROOMS. A person who tends to eat Kleenex, toilet paper, paper towels, or soap needs constant supervision in the bathroom. The following plan can be implemented to allow family members to sleep without having to worry about bathroom safety throughout the night. Have only one bathroom accessible, and keep other bathrooms locked. In that accessible bathroom, keep all soap, tissues, and other potentially harmful items locked in a cabinet.
OUT OF REACH. Sometimes it is not possible or practical to remove all small items from an entire household or classroom. Some of our compulsive friends can be gradually taught to keep their hands down and to stop putting items in their mouths. But, unless they are 100% reliable, it is our responsibility to keep tempting objects and substances out of arm’s reach. It is not an option, for example, to place a youngster’s chair near a teacher’s desk, then to fuss at him for grabbing items from the desk. Keeping small objects out of reach is the only way to protect compulsive eaters and to lower the stress level for people around them.
We welcome your challenging situations or innovative solutions about this issue or others you encounter in your daily life. Just post a comment or send an e-mail to talk@FAQautism.com
NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me an email with your thoughts or challenging situations or innovative solution. Send email to talk@FAQautism.com And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com
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