Try a whole-person approach for making life easier with autism
By Deborah Jeanne Sergeant
Nothing reverses autism. However, a few holistic strategies can help their children cope in a world that can be hard for them to understand and deal with.
Tips from Courtney R. Mauzy IV, Ph.D., research instructor at Upstate Pediatrics, Golisano Center for Special Needs
• “Provide choices when possible. For a lot of individuals, providing choices can instill a sense of independence, assent and control over their environment that can really help a lot of individuals. This can apply in a lot of different contexts. From choosing what reward or activity you want to work for, to choosing between which homework subject you are going to do first or choosing between which vegetable you have to eat, simply providing choices can often be an easy-to-use and highly effective strategy.
• “Schedule and give clear expectations. This kind of goes back to my first point about trying to plan the most preferred or fun activities to happen after the really fun activities. For example, I often sit down with caregivers who struggle with challenging behavior in the evenings after their children get home from school. The first thing we do is go through their typical schedule in the afternoon and usually parents will report that kids get home from school, they get a snack and some free time to relax and then they have dinner and then they have to do their homework. Going from free time and dinner to doing homework is one of those high-preferred transitions to a low-preferred activity and is not surprising that a lot of individuals struggle to get started with their homework without challenging behavior. But simply re-arranging the typical schedule to have homework come before free time can be really helpful.
• “There’s a difference between ‘bribing’ and ‘providing reinforcement.’ Reinforcement strategies have a very robust research history showing their effectiveness in the treatment of challenging behavior. But I have often heard ‘I don’t want to bribe my child with rewards all the time’ or ‘I shouldn’t need to bribe my child to behave at the doctor’s office.’ There is a clear difference between what is a bribe and what is setting up a reinforcement strategy and the research has shown bribing is likely to make behavior worse in the future while reinforcement is an extremely effective strategy. A bribe is when you ask your child to do something, they respond by being noncompliant or start engaging in challenging behavior and then you offer them a reward for complying. In a bribe, the opportunity to earn a reinforcer or reward only happens once the individual starts engaging in challenging behavior, thus teaching the child in the future ‘Hey, if I want to earn this, I should just start being noncompliant.’ However, when you set up a reinforcement strategy, the rule or contingency is made clear from the start and is stated prior to any noncompliance or challenging behavior. ‘Today we are going to the doctor’s office. If you go the whole visit with safe hands, we will stop at Chick-Fil-A on the way home.’ This way it is clear that only the ‘positive’ behaviors are what produces the reinforcer. That may have been a little bit of a soap box but it applies both to doctor’s visits and in general.”
Tips from Cathy Leogrande, Ph.D., professor in the education department at Purcell School of Professional Studies at Le Moyne College
• “Don’t look on the internet. I do think that one thing that it does well is connect parents who were maybe the only one in their sphere of life. Now they can read what other people are doing. They may read something that doesn’t fit their child, but they’ll try it. One thing that came out of the internet is parent advocacy and information. Other parents are helpful. They’re in the same situation and are one of your best resources. Or a teacher may recommend things to do at home.
• “A low-processed food diet is not going to hurt and might help. But it’s problematic when parents read it and think ‘My kid is going to be cured.’ Your child will never be different, but they’ll gain strategies to be more independent.”
Tips from Lisa M. Latten, whose son, Ian, is on the autism spectrum, clinical administrator for the division of developmental and behavioral pediatrics at University of Rochester Medical Center.
• “Keep a regular bedtime. At 19 we still do shower and bed at 8. It works better for him and for us as a family. The routine is so critical. Visual schedules work well for him. We have a magnetic calendar weekly on the fridge. He has yoga, piano lessons and any doctor or dental appointments so he can see his week in advance or anything special at school so there are no surprises. You need to tell him before you put it on the calendar. He likes to know beforehand what we’re doing.
• “If there’s a family event, he likes to know who will be there. He likes to see photos of the hotel if we’re going on vacation. He has particular toys and objects he likes to take with him. My husband and I joke that he has an old cookie monster plastic toy we found when he was 3 and a Leapfrog drum toy. He sets them up in a line at the hotel or Airbnb. The TV has to be on The Weather Channel. I have to make sure the place has cable TV.
• “It takes lots of planning. Preplan everything. We don’t have the luxury of doing anything at the drop of a hat.”