Autism, often referred to as Autism Spectrum Disorder (ASD), is a neurological condition that affects how individuals perceive and interact with the world around them. Despite the fact that autism is relatively common, there is still misunderstanding and misinformation about it. In this blog post, I aim to provide an overview of autism by shedding light on what it is, describing its characteristics, and underscoring the importance of accepting and supporting individuals with ASD. .

Autism is a complex developmental disorder that typically emerges in early childhood. It is characterized by a wide range of symptoms and challenges, which is why it is often referred to as a “spectrum” disorder. This means that individuals with autism can have varying degrees of impairment and strengths, making each person’s experience of autism unique.

While the autism spectrum is broad, there are some common characteristics often associated with it. Individuals with autism may struggle with social interactions, such as making eye contact, understanding social cues, or forming friendships.They may experience difficulties in speech and language development. Some may use alternative methods of communication, such as sign language or picture communication systems. They often engage in repetitive behaviors or routines, which can provide comfort and predictability in their lives. Individuals with autism may be hyper- or hyposensitive to sensory stimuli, such as light, sound, touch, or taste. Many individuals with autism have intense interests or hobbies that they focus on extensively.

It’s important to emphasize that autism is not a disease or something that needs to be “cured.” Instead, it’s a neurological difference that should be respected and supported.
It’s important to accept individuals with autism for who they are. Embrace their unique qualities and interests, just as you would with anyone else. Encourage inclusivity in schools, workplaces, and communities. Ensure that people with autism have the same opportunities and access to resources as everyone else. Offer help when needed, and be patient and understanding. Educate yourself about autism so that you can help those around an autistic person reduce stereotypes and misconceptions. Lastly, know that families and individuals with autism often benefit from support networks and services.

Autism is a diverse and multifaceted condition that affects millions of individuals worldwide. By fostering acceptance, raising awareness, and providing support, we can create a more inclusive society, where people with autism can thrive and contribute their unique perspectives and talents to the world. Remember that autism is just one aspect of a person’s identity, and we should celebrate the diversity that makes our world richer and more beautiful.

Sleep

(see attached article)

Toilet training

Toilet training can be very anxiety provoking for many families. That said, we find the following tips helpful to achieve this important milestone. To help determine if your child is “ready for toilet training”, change them into underwear for a period of 2 weeks. Wearing pull-ups or diapers can slow toilet training down or prevent training from being successful.
Take your child to the bathroom every 2 1/2 -3 hours during the day to sit on the toilet for 2-5 minutes. Incentives can be used to help make this enjoyable. Taking a child too frequently to the bathroom slows toilet training and can make it impossible for some children to learn how to hold their urine. Document any accidents and successes over the 2-week period. Accidents are an important part of training and should not be avoided. It is important to change your child, standing up, in the bathroom after an accident and limit the attention you give to your child during this time. If your child is ready for toilet training we should see a trend towards fewer accidents and more successes over the 2 week period. If no improvement is noted then go back into pull-ups and wait a few months and try again. Avoid being in a constant state of toilet training by testing the waters every few months and only “trying” during the 2 week test periods. If you see success continue, but if not, don’t be afraid to wait a few months and try again. Having trouble? Give us a call and set up a visit to discuss your individual situation.

Behavior: Targets for Intervention : What should we be working on”

A core component to any successful treatment package is ensuring that targets are socially significant to the individual and those around them. Every so often a team can easily become hyper-focused with assessment scores, milestones, or targets and lose sight of the big picture – how is this going to better the life of my child? Treatment teams must look at gains at both the micro and macro level to ensure there is real and significant change for that individual. A strong treatment team will also be able to differentiate between when an individual meets a milestone or assessment score and when the child has successfully acquired an essential skill. Further pitfalls can be avoided by ensuring all team members are mindful of the fact that although assessments and curriculum help guide us through treatment, they are not the only measure of success. The treatment team should assess additional measures of success by reviewing items related to generalization or by asking questions such as: Will the individual be able to display this skill in any environment? With people they will typically encounter? Are they likely to have opportunities in their day-to-day lives to practice this skill? Just asking these few simple questions can help guide a team to more efficient treatment outcomes and promote gains that are truly important to you.

Social Skills
Social Skills Groups are gaining in popularity and research has shown that participation in certain social skills programming can significantly enhance a child’s social growth. A social skills group is typically made up of a small group of similarly-aged individuals. The focus of these groups is to learn and practice skills needed for interacting with others and making friends. Areas of focus can include conversation skills, problem-solving skills, emotional regulation skills and perspective taking. Within your community, there are often programs or groups available and it can be difficult for many parents to decide if their child is a good candidate for a social skills group, as well as how to choose the best group for their child’s needs and interests.
When selecting a program, it can be helpful for the parent to visit the group ahead of time and preview it for their child. The number one thing to consider is, “Will my child enjoy this experience?” A good social skills program will be tailored to the strengths and interests of the individuals participating: after all socializing, especially in childhood, is supposed to be positive and fun. We all socialize around our interests and activities we enjoy, so a social skills program should not be any different. If your child is enjoying the experience with other people, they will naturally be more motivated to be more social and take more social risks.
When selecting a social skills program, in addition to the fun factor, parents should consider the support used to maximize their child’s comfort and confidence within this experience. Look for supports that are designed to make the social skills group structured and predictable such as visual schedules, clear expectations, and consistent routines. Also look at the methods the program uses to teach social skills and be sure there is plenty of opportunity for your child to learn ‘in the moment’, while practicing social skills within typical, fun activities. Here at Meliora we offer social skills support using state of the art virtual reality technology which can be a fun way to master skills before trying them in other settings such as home or school. In case you were wondering, social skills interventions are supported in evidence-based practices which means it is scientifically proven to help.

Picky eating
“Chicken nuggets, french fries, chips, cookies, and juice. Chicken nuggets, french fries, chips, cookies, and juice. The cycle repeats over and over again; breakfast, lunch, and dinner. Day after day after day. Sometimes, you’ll try to switch out the regular chocolate chip cookies with reduced sugar or regular potato chips with veggie chips to try to get some nutritional value into your child’s diet. But you don’t succeed. He’d rather not eat anything for days, than even taste anything new. And going out to eat… Forget it! There has to be some solution to this problem, but all my pediatrician says is give it some time, he’ll grow out of it.
Below are some myths about picky eating and tips for how to try to treat it from a behavioral perspective.
Feeding Myths
Myth #1: If you withhold food from your child, they will eventually come around and eat anything you offer them.
Truth: Children diagnosed with Autism Spectrum Disorder that experience feeding problems are not motivated by food and sometimes don’t feel hunger. Withholding food from a child is a very dangerous, inappropriate, and ineffective strategy to fixing feeding problems.
Myth #2: If my child tries something and doesn’t like it, they will never like it.
Truth: Research shows that it takes 10-20 tastes of a food to determine preference. Tasting a food means chewing it fully and swallowing it (Birch & Marlin, 1982).
Myth #3: Feeding problems are all about oral motor skill deficits and sensory sensitivity.
Truth: Although some children exhibit oral motor skill delays or oral sensitivity, which may have led to a reduction in food variety, oftentimes there’s a behavioral component which needs to be addressed prior to working on desensitization and skill acquisition.
90% of children diagnosed with Autism Spectrum Disorder have feeding problems. (Kodak & Piazza, 2008)
How Can We Fix Picky Eating?
Tip #1: Set a schedule for meals and snacks (NO SNACKING IN BETWEEN). This will increase the motivation of eating foods presented during meal and snack times because the child will have time to build up his appetite. On the same note, if the child is thirsty, offer water, not juice or milk. Anything other than water could become too filling and ruin his/her appetite.
Tip #2: Minimize distractions. Present meals and snacks in a location that is away from any distraction (e.g., toys, TV, etc.). If the child is not concentrating on the food and is constantly running around or engaged in another activity, he/she is less likely to eat everything presented to him/her or will not be receptive to any interventions you may want to try.
Tip #3: Model foods that you want your child to eat. If he/she sees you eating, he/she may be more willing to try it.
Tip #4: Eating is a demand! A lot of times, parents will ask the children if they want to eat or what they want to eat. It has become a vicious cycle of trying to avoid tantrums over foods. It’s easier to keep the peace and avoid the tantrum. But are you helping your child in the long run? Sometimes we must withstand a few tantrums to show that eating is a demand and if they comply with the demand (or follow our directions) they will get something fun.
Tip #5: Tap into motivation. Children who have feeding problems oftentimes will not feel hunger or find food motivating or rewarding. For that reason, we need to find something that they really enjoy doing or playing with and reserve that object or activity until after they have followed your direction to eat. Some examples of current powerful reinforcers (motivators) include iPads, bubbles, stickers, coloring, etc. Each child’s reinforcers will be different so it’s important to pick out the right one. Just remember, they can’t have access to the fun toy any other time or else motivation will be lost.
Tip 6: Reward > Demand. Start out slow. Make it really easy for them to earn their reward. You want them to be successful! It could be as simple as eating 1 bite of a new food for 30 minutes of their favorite iPad game or a piece of their favorite dessert. Once you are getting successful bites, build on that success and increase the demand (e.g., 2 bites = 15 minutes of iPad time). Usually, the demand will need to be reduced when the next new food is introduced. It’s like starting all over again.
‘

When Reinforcement isn’t working
“When trying to increase a behavior, many individuals will say that “reinforcement is not working.” However, by definition, reinforcement increases behavior. If it’s not working, it’s because the reward is not an effective reinforcer. This could be due to the behavior being too effortful to engage in for the reward you’re offering, the reward being assumed to be preferred to the learner when it really isn’t, the reward not being delivered in great enough quantities or in long enough duration, or several other factors.
Don’t be afraid to change reinforcement systems when they’re not working. Ensure that the learner prefers the reward they’re working for enough to evoke the behavior you’re trying to increase. Allow the learner to try new rewards without working for them, then allow him or her to pick which reward he or she would like to have without requiring work. When in doubt, offer a greater amount of the reward than you think is needed to get the learner to engage in the behavior, and deliver it more frequently than you think is necessary. Once the behavior is happening frequently or long enough, then begin to reduce the amount of the reward given for the behavior. Always pair rewards with praise and more natural rewards so that unnatural rewards can be faded out over time.