Our Struggles and Our Triumphs

The Denver Post has asked parents and providers to share their stories and their perspectives on the less-than-easy task it has been to get insurance companies to provide the necessary support and funding for autism services. This is our response...

Our struggles will eventually become our triumphs! 

A week doesn't go by where we are approached by a family who is struggling with their insurance company to achieve the appropriate funding for their child with autism. It's heart breaking to listen to a parent's quivering voice as they shed tears feeling lost and stuck. 

Less than a year ago, this community was celebrating the Capitol's victory of the passing of a bill that required insurance companies to provide the support and funding we've all fought so hard to get. It's never been an easy task to get funding for individuals with autism and related disabilities. Fighting the good fight has become part of our DNA as a community, but now we find ourselves amidst a battle. This battle, this fight, is different-one in which many families are losing at the expense of their child's health and development. We want families to know we haven't given up, we won't give up, don't lose hope, don't lose the fight! 

Insurance companies should be ashamed of themselves. They are not only ignoring the law, finding loophole after loophole, but they are neglecting their social responsibility. Not if, but when insurance companies are finally forced to give in and provide the appropriate and necessary support and funding hundreds of Colorado families need, we are committed to fighting the good fight!

Garden | Autism Services of Colorado was founded to support, empower and advocate on behalf of Colorado families affected by autism and related disabilities. It is because of this HIMAT hazard that we have decided to provide 50% of our services at no charge to families; families who are either on a Medicaid waiting list or denied by their insurance companies. We are proud to be a part of this community, it's stronger than ever and we have faith that our families will prevail!

Thank you for listening!

I Wish My Child Would Stop Doing That!

How to Respond to Undesirable Behaviors

A Review of Positive Parenting Practices for Young Children with Autism by the LEAP Outreach Project (2003)

Like most parents of a child with autism or related disability, you probably find yourself asking, "Why does my child do that?" on a continual basis. Think about something your child does that you don't like...Can you remember the very first time it happened? Chances are you can't. There are many reasons why a child initiates a particular behavior. Children are active learners, constantly developing through play, exploration and interaction with others. In the process, they try a lot of things including good and not-so-good behaviors. Whether it's by frustration, accident, play, exploration or communication we probably don't consider a particular behavior a problem until it begins to occur again and again. Today we will take a look into ways to respond to these undesirable behaviors.

Typical behaviors that parents are usually concerned about:

• A behavior that is dangerous or may result in the child hurting themselves or others.
• A behavior that may result in objects, toys, furniture, or other materials being damaged or destroyed.
• A behavior that interferes with the child's or another person's learning. 
• A behavior that is annoying or disruptive to the parent or other people.

Step One: Find out what is reinforcing the behavior

Often times it is not a simple task, but it's important to try to figure out what is reinforcing your child's behavior. Once you determine this, you will be able to decide how to respond accordingly in the future when the behavior is exhibited. Using an ABC chart is very helpful here.

Typical Behavior Reinforcers:

• Attention
• Receiving a reward
• Getting out of something unpleasant or escaping from a task
• Self-reinforcing

Step Two: Reinforce to increase desired behavior

"For every behavior you would like your child to do less often, there is a desired behavior to take its place[...]Whenever you identify a behavior you would like your child to do less often, think about what you can begin to reward to teach that will take its place. Sometimes the only plan for changing a behavior you would like to decrease is to teach your child how to perform a skill or communicate a need," (The LEAP Outreach Project, 2003).

• Identify an alternative behavior to replace the undesired one
• Teach or reinforce the alternative behavior
• Be aware of the environment and brainstorm ways in which you may manipulate it so to prevent the behavior from happening

Step Three: Respond to undesirable behaviors

Simply replacing and reinforcing a desired behavior may not completely rid the undesired behavior. These three strategies will allow you to respond to undesirable behaviors in a manner that has proven to produce results.

• Interrupt your child's undesirable behavior
• Redirect your child to do the desired (replaced) behavior
• Praise (reinforce) your child for doing (or even attempting) the preferred behavior

Step Four: Explore alternative methods

An applied behavioral strategy used to reduce behaviors that have been previously rewarded with attention is called extinction. This method involves the parent completely ignoring the child when the behavior occurs. Simply put, "when your child's behavior has been rewarded with attention in the past and you stop giving the attention, the behavior will decrease," (The LEAP Outreach Project, 2003).

• Only ignore behaviors that have been reinforced with attention
• Be consistent
• Ignoring a behavior will only work if you are in control of everything that has been reinforcing that particular behavior
• Do not ignore behaviors if someone or something may get hurt
• When you first begin the extinction process, your child may try harder (pull out all the stops) to get your attention and do the behavior more often (this is referred to as an extinction burst)
• Always reward desired behaviors

Another method for decreasing undesirable behaviors is to take away a desired object or privilege.

• Only take away desired objects or privileges for behaviors that occur occasionally
• The desired object or privilege you take away should be reasonable and closely related to your child's undesirable behavior
• Taking away the object or privilege should occur immediately after the undesirable behavior
• Remember that some children appear to be misbehaving simply because they do not know how to appropriately play, in such a case taking away a desired object or privilege would not work
• Again, always reinforce the desired behavior you would rather have your child do

Summary

• Children continue undesirable behaviors because they are in some way rewarding
• Reinforcers which cause undesirable behaviors to continue include:
• Attention and rewards
• Escape from a task
• Self reinforcing activity
• Identifying the reinforcer that follows the undesirable behavior can help us decide what strategies to use
• Strategies for reducing undesirable behavior include:
• Interruption and redirection
• Ignoring
• Taking away a reinforcer
• Always remember to reinforce desired behaviors when you are using any strategies to decrease unwanted behavior

Until next time, BLOSSOM!

Lauren Thome, M.A.

I Know What I Like, Do You?

How to Identify What Reinforcers Behaviors: 

A review of "I Know What I Like, Do You?" by Travis Blevins, MS, BCBA

Is preference important? In one word, YES! The identification of motivating reinforcers  (preferences individuals will work to get) can be the key to effective intervention for individuals with emotional, developmental and behavioral difficulties.


Why? In the words of Susan B. Anthony, "Independence is happiness." The pursuit of a meaningful independent life involves these reinforcers, for you, for me, for our kiddos. Our goal as therapists, parents, teachers, and the like should be to assist those individuals in acquiring those preferences, those motivating reinforcers in a safe and healthy way.


First, let's begin by discussing what NOT to do when identifying a child's preference...

• Don't just ask them for a list
• Don't just ask someone who knows them
• Don't just guess
• Don't just watch them
• Don't assume what one child's preferences are relate to another's

Identifying things that motivate people is a science. In fact there's an assessment that behavioral analysts use called "Preference Assessment" or "Reinforcer Assessment." However, there are ways that one can identify the preferences of another using careful tactics and observations.

• Watch the person on multiple occasions
• Depict how they choose to spend their time
• Be aware of what they have access to and what they don't have access to as this might impact the observation
• Allow the child to choose between a combination of preferred and not preferred activities or objects
• Introduce novel activities, consumables, items and people
• Be aware that some activities, items, and people may change the preference for something
• Be creative, you will be surprised by what you find out when you go beyond the typical preferences of children

Specific questions for interviewing:

• What would you do with a million dollars?
• Would you go a whole week without video games to get that?
• What is it about this that you enjoy?
• What is the best thing you have ever eaten?
• Describe your perfect day?
• How do they spend their time?
• How do they spend their money?
• What do they do in their free time?
• Have they ever (fill in the preference item)?
• Describe the perfect day for them?
• What does a day look like without any behaviors?

What if they don't like anything? 

• Expose them to new fun things, places, food, people that they have not seen before, then ask if they want to do that again
• Remember that limited exposure to these things will decrease the preference pool, it is your job to increase their pool, increase their exposure
• Sometimes an individual has a preference for complaining about what they don't like--In other words, they LIKE being listened to by a sympathetic and empathetic ear
• Be aware of non-tangibles such as attention giving

Now what? Now that you know what is liked, help the child obtain it in a safe and healthy way. Enrich their life by teaching appropriate and positive behaviors to get what they like. It is your job to bridge free access to preferences so they have to work for it, even if that just means appropriately requesting the preferred item. It is also important to provide additional motivation for new behaviors.

What does the research say? Just because you have identified a preference does not mean that preference will motivate. The best way to identify preferences is to put it to the test!

What's our goal:

• To enrich every person's life by providing opportunities to experience fun new things
• To teach more appropriate ways of communicating needs and wants
• To support each person in attaining as much independence as they can handle, that means phasing prompts and yourself out so they can be independent

For more information on assessing preferences, please email us at info@gardencolorado.org. 

Until next time, BLOSSOM!

Lauren Thome, MA