Helping Parents of Children with Autism Better Engage and Communicate with Their Children

This episode was pre recorded as part of a live continuing education webinar on demand. CEUs are still available for this presentation through all CEUs register@allceus.com counselortoolbox you I'd like to welcome everybody to today's presentation on helping parents of children with autism better engage their children. I am Dr. Donnelly Snipes in this presentation. Now this is just going to give you a really, really high level overview of some things that we can do. There is so much information in the autism realm that I couldn't begin to touch on even the majority of stuff. So I want to put that out there at the beginning. But I really want us to start moving from a deficit space to a differences based approach to interaction. Instead of seeing people with autism as having deficits that need to be remediated, they interact differently with the world and that's really important for people with autism to interact. Integrate into their self esteem that they are not broken, they are not deficient in some way, they are just different. We are going to describe the unique interpersonal needs of people with autism spectrum disorders. The characteristics necessary to form secure attachment, which is really what we want to do, is help parents develop that secure attachment and be able to be more responsive to their children and communicate more effectively and provide at least five different practices that caregivers and or teachers can use to improve the connection and communication with children on the autism spectrum or even people. I shouldn't just say children. So I want you to just kind of bear with me for a second and think about a time that you were totally overstimulated. I flew into LaGuardia Airport one time and I'm not a big flyer to begin with and I flew into LaGuardia. It was Christmas time, it was absolutely a madhouse and I was completely overstimulated. People were bumping into me, it was noisy, I couldn't figure out where my gate was. Totally overwhelmed. Another example, if you've never been in LaGuardia, might be if you were, you know, the day of your wedding before you getting ready to walk down the aisle, you've got, you know, the florist, you've got your mother, you've got your mother in law, you've got, you know, your bridesmaids, whatever. Everybody's wanting something or saying something and it's just like, oh my gosh, too much input. Okay, now this is in a very minor comparison. You know, it pales in comparison, but it's the best I can do for people with autism. You know, they are Much more aware and have much more difficulty filtering out extraneous stimuli. So the neurotypical world, that we'll call it our world, so to speak, can be very, very overstimulating to people who are on the spectrum. Think about another time that you were exposed to high levels of sensory input, like a concert or somebody. You got into an office building or an elevator, and somebody's cologne was just, oh, my gosh, could have knocked you over. Or even. There was a daycare that my kids used to go to that was great. It was cheerful. But you walked in there, and every wall was this vibrant, bright color. Purples and yellows and oranges and everywhere, it was just color noise. Very, very noisy and stimulating, which is great for some children. But for children with ADHD or who are on the spectrum, or even just for children who deal well with that level of stimulation, it was totally overwhelming. And it made it more difficult for some children to function because it was exhausting having that level of input constantly. The third thing I want you to kind of think of and put yourself into the. Into the shoes of somebody who's on the spectrum. Think about a time that you had something wrong but couldn't seem to expect it. Right. I have that problem with my computer a lot, and God help him, my IT guy is also my husband. So you can have a lot of empathy for him, I guess. But he will come in here and I'll be like, it's not working. And he's like, well, what's not working? When I click, it just doesn't do what it's supposed to. And we will go around in circles because I cannot articulate exactly what I did or exactly what's going on that is causing me problems. I've learned to screenshot, and he's just like, until you can tell me what's wrong, I can't help you. And you can have the same problem with your car. You go into the mechanic and you say, it makes this squeaky sound intermittently. And the mechanics like, well, intermittently doesn't do me any good. If you can't recreate it, I can't fix it. Or a time when you've just been overwhelmed, but you really can't put your finger on why. You know, you wake up or you're at work and you're just feeling like you're walking a tightrope and you're not sure why, but you're off that day. And people with autism often have difficulty identifying their internal sensations and communicating those to the outside world, which Means it's harder for people in their life to be responsive to them because we can't read their minds. But in those situations, I want you to think, when you were overstimulated, did you feel completely safe? How was your mood? Were you just happy? Go lucky. Yeah, you know, no problem. I'm overstimulated. Bump into me all you want. No, you're probably a little bit irritable, cranky, frustrated at times you may have felt like you wanted to have a total meltdown. Your concentration, you know, it's hard. Like if you're in LaGuardia, I'll just keep using that example. And people are bouncing into you and you're trying to figure out where your gate is and you keep getting distracted. It's hard to concentrate. Which can make it more difficult to communicate what you're needing or to remember what you're needing. Because every time you start to get on a mental path, you get distracted. And then think about what your thoughts are like during those periods of time. You may be frustrated, overwhelmed, irritated at other people for not understanding, just wanting people to go away. It's like, okay, think about the Grinch and how he used to say, the noise. Oh, the noise, noise, noise, noise. And he wanted the. What were they called? The who's it, whatever. It's been a while since I watched that from, from the Grinch. But he wanted them to be more quiet. The who's. Thank you, Deborah. Because he was overstimulated and it was just. It was more than he could take. There are some people who would posit that a neurotypical world can be very traumatiz for people who are neuro atypical. Just consider it from the perspective of a little person, you know, somebody who's 2, 3, 4, 8, who is having difficulty filtering stimuli in this world where we're just constantly inundated and or may have difficulty communicating their needs or knowing how to react. What we want to do in this presentation is figure out some ways to help parents more effectively connect with their children, to help them feel that attachment and that bonding that they so hope for. And communication doesn't have to necessarily be verbal. Sometimes it is communication of a touch or a lack of a touch. In certain cases, connectedness is enhanced when the child feels safe and loved. Well, that's true for all of us when caregivers do not feel at odds with the child. And parents of children with autism often struggle because what is triggering to a child in one situation or on one day may not be trigger triggering to that child in a different situation or in a different day. And we need to understand that, well, there's something different in those two situations, but we may not understand completely what it is and the child can't probably communicate that to us. So caregivers may get frustrated and think, oh my gosh, every time I go take you out in public, you have a meltdown or whatever the case may be. We want to help caregivers not feel at odds with the child so they're feeling connected instead of rejected. Connectedness is also enhanced when the child is able to articulate his or her feelings and needs. It's easier to be responsive when we know what the person needs. 2 year olds can't do that. So we have to take on that don that hat of the detective at that point in time. And some people with autism are never become very verbal. So it's important to work with that. And Jason points out that emotions cards with caricatures can help some clients articulate and express themselves. And we're going to talk about cartoon strips in a little while that can help people who have autism. People on the spectrum understand things because they tend to have difficulty interpreting auditory and verbal messages. But they do better with illustrated stories or cartoon strips that help them understand proper interactions or help them draw out what they might be needing. So yes, definitely keep an eye on that or put a pin in that on the idea of translating what we do verbally into how can you do this visually? And connectedness is also enhanced when caregivers appreciate the child for the unique person that he or she is. Most parents, you know, they have a child, they expect that they're going to have this perfect child with no problems. And you know, we know that that's probably delusional, but a lot of new parents expect that. And then when they discover that their child has autism or is somewhere on the spectrum, it can be frustrating to the parent and the parent may feel a sense of disappointment. And obviously we have to help parents work through that grief and learn to value and view the child as wonderful. And again, moving from that deficits based to a differences based appreciation of who this little person is. A secure attachment and connection helps people feel safe and loved. And we talk a lot about attachment in developmental psychology. I came up with a mnemonic that may or may not help you called Craves and made sense to me because we all crave connection. We all crave attachment. So crave stands for consistency in routines and expectations with people on the spectrum and people with ADHD and By the way, autism and ADHD co occur at a really high rate. But consistency in routines and expectations is really important. This is true even for little kids who are neurotypical. It's very helpful for them to have routines and know what's expected. R is for responsiveness. Mirror and soothing. And that means when a child is upset, we don't want to dismiss their feelings. If they're upset, we can say, oh, I can see you're really sad. Mirror that feeling and then help them develop tools to self soothe. With people with autism, they need tools to self soothe too. That's no different than a neurotypical child, although the tools may be a little different. In order to be responsive, as caregivers and teachers and whomever else is in the child's life, we need to know the child's distress triggers and cues. And like I said, those triggers can be different. If you've ever done backwards chaining, if you've done some work in DBT or behavior analysis, you know that the proximal trigger, whatever it was that seemed to trigger that child to have outburst may not have been, may have been something leading up to that that put the child in a bad space, mentally or emotionally. And then this was just sort of the straw that broke the camel's back. However, if you understand the child's distress cues, then you're going to have a good idea going into it and you're going to be able to do some early intervention before the child gets into the red zone. You're going to be able to help them start to de escalate. When they're real young, they may not be able to put all that together, but if they start learning that when I feel this way, I can de escalate my son. I've shared with some of you guys before. When he was little, he was a micro preemie. So he had some neuro atypical stuff, if you will, some integration issues early on. And he would get overstimulated very easily. We used that word with him overstimulated. And you know, I didn't think any different about it. But he, when he would get overstimulated, he would act out. And we taught him that when he was overstimulated he needed to take a timeout. And timeout was not a negative thing in our house. It was a. I just need a time to chill and get regrounded, basically. And I remember one day he was about two and a half and, and I was working on the computer in the living room and I'm not sure what exactly was going on with him. His dad was home and the dogs were around, but he walks into the living room and promptly announces to me, mommy, I'm overstimiwated. I'm going to time out. Pops his pacifier in his mouth and toddles into his room. And he had one wall that was a pure white wall. No pictures. It was just a blank wall. And he would just sit there and stare at it for a few minutes until he could get himself back together again. But even at two and a half, you know, he understood the phrase. You know, he may not have understood exactly what it meant, but he knew how to communicate. I'm overstimulated. And he had some skills and tools. So understanding what these triggers are early on, we can help children go, okay, I'm starting to feel this way. I know it's going to lead to bad stuff or a meltdown or whatever you want to say, or. So I need to take steps. We want to provide early intervention for children. And again, depending on the child, there are a lot of tools we're going to talk about that parents can have. And I even have a list of a kit that parents with children with autism, or any child for that matter, can keep with them in order to help deescalate or distract the child. If you want to use DBT terms, we're talking about distress tolerance activities when they're upset to help them kind of get out of that zone. And we want to make sure that we're responsive in accommodating the child's learning style and environmental preferences. Most of our classrooms in elementary school, you know, they do do a lot of workbook stuff, but there's also a lot of talking. And children who are on the spectrum, as I said earlier, often have difficulty with auditory processing. We need to understand that and we need to be sensitive to what they may need. In terms of environmental preferences, think about if you have difficulty filtering out stimuli, how exhausting and distracting and hard to pay attention. It would be in a classroom where you've got a hamster over here who's just cute as can be running on a wheel. And you've got windows over here and you, you can see people outside playing and you've got people in passing, period in the hallway that you can hear outside, the teacher's talking, somebody behind you is talking. That child is going to be, you know, kind of at their wit's end potentially. And sometimes in those rooms in well meaning teachers and to accommodate other children will have lots of Stuff on the walls. Wait. When I walk into an elementary school classroom, I often see posters and pictures and alphabets and stuff everywhere. And it can be very distracting for a child who has difficulty filtering out. Figuring out what children need and how to help them accommodate that is really important. Okay, so that's the R in responsiveness. A is for attention. We want to make sure that we're paying attention to them. Sometimes children with autism because. Because the world can be so overstimulating, they just kind of want to withdraw and they don't want interaction, and they may not ask for what they need or be able to ask for what they need. We need to pay attention to what's going on and praise the positive. Praise them when they do things helpful or right, but also praise them for just being who they are as wonderful little people. That whole unconditional positive regard thing, you know, you're awesome. Even if you do have a meltdown in the middle of the store, you know, I still love you, and you're still my little prince or whatever it is. V stands for validation of feelings, thoughts, and needs. Whatever that child is feeling, even, you know, if we don't quite understand it, if they are angry, you know. Okay. And Sean, bless his heart, again, I'll share time. We were at work, and he had come to work with me. I had to stop by the office for something, and I had no idea what set him off. He was a little older by that point. He was probably, you know, three. He wasn't four yet. And we were walking down the hall, and all of a sudden he just looks at me and he goes, mommy, I'm so angry. Okay, well, why don't you tell me about that? So we stopped and we talked about it, about what was going on with him. And he couldn't really tell me why he was angry, but we talked about what he could do with those feelings and validating that. I have no idea what you're upset about, but I am going to validate the fact that you've identified you're angry. So, okay, it doesn't matter if I think there's a good reason you're angry. What do we do about it? If a child feels that an environment is disempowering, is overstimulating or whatever, we need to validate their needs. Remembering people who are on the spectrum may have hypersensitivity or hyposensitivity to sensory stimuli. Sights, sounds, smells. If they need special things, if they need sunglasses because the lights are too bright, if they need noise Canceling headphones. We need to validate that. Okay. You know, that's how you're built and that's okay. We need to have empathy for the challenges that they face, not only internally not being able to communicate what they want or not understanding what's going on, but also how the world perceives and reacts with them. And S stands for solutions, identifying ways to prevent and mitigate distress for them. And each person with autism is going to be different. When you've met a person with autism, you've met a person with autism, you haven't necessarily. You can't generalize what works for Tom to what will work for Sally. A crave stands for consistency, responsiveness, attention, validation of feelings, thoughts and needs, empathy and solutions. I'm going to go real quickly through their special needs because a lot of people are well aware of their special needs. But I did want to touch on those for those of you who aren't as familia. But while I'm doing this, I want you to think about how these needs or differences that someone with autism has can affect their ability to get consistent care and consistency from the people in their environment. Responsiveness from the people in their environment. Attention, validation, empathy and solutions. How does it affect their ability to attach and develop the secure attachments and that feeling of being safe and loved? The language and speech needs. Many people who are on the spectrum may have slow speech development or not talk at all. They have trouble or inability to start a conversation or keep it going. Again, thinking about how this affects the interactions, the parent, child interactions. Even if the child doesn't interact, parents may feel like the child doesn't like them. Parents may take it personally. Parents may, you know, have difficulty. So we need to help them with that and help them just recognize that this is a difference in your child. They may not be one who's going to be a little chatterbox. On the other hand, you have people who are on a different end of the spectrum who have Asperger's who may want to talk a lot. They have a constant repetition of certain words or phrases sometimes. Many people on the spectrum have difficulty expressing and communicating their desires and needs. Sometimes because they don't have the words, sometimes because they are too upset to communicate it. By the time they realize what they need, they're just in distress. And sometimes because they just don't know, they fail to understand humor and may take things too literally, which makes it difficult for them to appreciate some of the things that we find humorous. And they may fail to understand simple questions or sentences and have slow processing. Remember again that auditory language is difficult for a lot of people on the spectrum, so they need more time. They're not dumb. You know, many have very good, if not high, IQs. However, that taking in that auditory, that spoken word, understanding it and figuring out what to do with it takes a little bit more time. So we need to give them. We need to practice the pause and get away from our American tendencies to try to fill every gap with some sort of sound. Social interactions, failing to understand and respect other people's personal space, difficulty understanding other people's gestures, body language, reactions and feelings, not responding to one's name being called, lack of desire to interact with other people, difficulty making friends with kids of the same age, avoiding eye contact, not enjoying situations and events that kids usually love, and not showing interest in other people's interests. Okay, so let's skip the first couple for a minute and look at not responding to your name being called, lack of desire to interact, difficulty making friends. Well, let's think about it. Little kids have enough difficulty interacting with one another if they are both neurotypical. When you have someone who's neuroatypical, it's harder for other kids to understand and communicate in the same way and respect boundaries. So it may be difficult to make friends with kids of the same age because some of their differences. It doesn't mean it's impossible. It just means that it has to be done a little more slowly and potentially carefully. A lack of desire to interact with other people. Well, if other people are constantly saying things you don't understand and overwhelming you and bombarding you, then yeah, you know, you may think, I can't, I just, I can't. Situations and events that kids usually love, like going to the zoo and the playground and those sorts of things, those are overstimulating. For, for me as a parent, I would go there and by the time I left, I hadn't done any exercise and I was exhausted. For children who are neuro atypical, it can be the noises and the movement and the colors and everything else can be just completely overwhelming. Because of some of these differences in social interactions, again, it's going to be hard to get understanding. And when they cannot articulate what their needs are, then it's harder for people to be consistent and responsive behaviorally. People on the spectrum may have some repetitive movements, which is called stimming, short for stimulation. And stimming can happen when somebody is overstimulated or understimulated. Do want to just point that out being obsessively interested in one area or topic, like trains or dinosaurs. Now, most kids go through a period where they are just obsessed with something, but this tends to go on longer than you would expect. Playing with toys in a repetitive way. For example, lining the blocks all up instead of building with them or sorting them. All the yellow ones, all the red ones, all the green ones. Insisting on a certain or familiar routine or order. Having unusual sensory manifestations like sniffing toys or people being hypersensitive to certain textures, sounds or lights and textures is something I didn't mentioned earlier. But for some people on the spectrum, certain textures can be extremely aversive, and that includes foods as well as clothes and sheets and being sensitive to touch and reacting negatively to it. Their proprioceptive sensors can be basically on hyperdrive. What do we need to know? We know these children are different in the way they interface with the world. We know that they perceive the world very differently because they may notice more things than we do because they have difficulty filtering out, or they may be understimulated because their senses aren't as responsive. So we want to focus on the positive. Praise what is good. Be specific, and praise not only behaviors, but who they are when they do something. Instead of saying, you did really good at grandma's today, you know, you want to be more specific saying, I was really proud of you for eating your entire meal when we were at grandma's today. Use positive discipline and redirection. There was a child that was in one of the daycares that I worked with that was on the spectrum. And when he would get upset, when he would get overwhelmed, he would just start throwing things and become very distressed and screaming. And, you know, it was. It was very obvious he was in distress. But we did find out that one thing that helped him, and this is not necessarily generalizable to other people on the spectrum, but for him, tearing paper was very soothing. And we were able to just. This was back when phone books existed, we were able to give him old phone books, and he would just tear the pages out and then tear them into strips. And that was very calming for him. So when he started to get overwhelmed, he had that option to him, when he would come into the daycare, he would be reminded that the tearing paper was over here, and. And he was able to go over there. And teachers became more aware of when he started to get antsy, for lack of a better word, and they could redirect him over to the tearing paper to see if that's what he wanted. And if he didn't want to tear, then that was fine. But most of the time he would, and that would be, that would be fine. And he would just sit there for a little while until he felt calmer. And generally that coincided when with other kids were bouncing off the walls for some reason. Stay consistent and on a schedule. Children who are neuroatypical really like that structure. They like the predictability and it helps set their circadian rhythms and everything else. Have routines to ease notification or ease transitions. Whether it's going from eating breakfast to getting changed or leaving the park or whatever it is, different routines can help give them a heads up, we're leaving in five minutes. If they have a watch, you know, a big watch on that, you can set a notification. So at five minutes you go over, you set the notification and it starts counting down the five minutes or however long it is until it's time to leave. And then the child can look at that. Then when it's time to leave, it starts. A gentle vibration, even a gentle vibration can be really overwhelming for some people on the spectrum. So you need to figure out what kind of notification works for that particular person. But that helps ease the transition they know ahead of time and they can start getting into that groove. Take children who are on the spectrum with you during everyday activities. And for a lot of parents this seems overwhelming because it's like every time we go to the store, they have a meltdown, they get overwhelmed, yada yada. Okay, well let's start doing this and let's scaffold it. So instead of going to the grocery store at 5 o' clock on a Friday when you know it's going to be a madhouse, you know, maybe go at 7 o' clock in the morning, there's probably two other people in the grocery store, so it's less overstimulating. Obviously the cereal aisle is a whole different ball game. But for children that is less overwhelming. And mom or dad, whoever is taking them to the store, may also feel less stress and tension. So it's a win win for both. And then once the child is able to run some errands and do those things when there's not a lot of people, then maybe start doing it at times that may be a little bit more convenient. But this helps the child get used to interfacing with the neurotypical world and not getting totally overwhelmed by it. You can think of it as sort of a systematic desensitization. Select playmates with similar language and physical skills. And that is going to depend on the child and where they are on the spectrum. If you have a child that is totally mute, then pairing them with another child who is extremely verbal, probably not going to be the best match. Generally there are support groups you can pair children up, even children on the spectrum who may understand each other a little bit better. Invite only one or two people over at a time at first and probably one. And have a zero tolerance policy for hitting, pushing, yelling, yada yada. And if the child starts to seem to get uncomfortable or overwhelmed, make sure that they have an outlet, you know, they have a safe place that they can go to take a have a calm down if you will. Encourage the child to play and reward good behaviors often and immediately. Not all children with who are on the spectrum are going to want to play with other children, but if they play, you know, encourage them to do that. If they are willing to play next to you, you know, with blocks or whatever, that's awesome. If they are playing nicely, that's awesome. Let's reward good behaviors. Whatever they're doing, that's good. We need to remember to reward that instead of going well, that's good, but I prefer if that's good, end of sentence, that's good, let's reward it. You can role play or use comic strip conversations to help the child learn social rules that others learn more naturally in comic strip conversations. And this is an actual for sale activity, you can google it. But bubbles representing a conversation can bump into or overlap one another to interact. Illustrate interrupting and thought bubbles can show others thoughts during conversation. So you can have thought bubbles coming out of somebody's head while some while another person is talking. And it helps children who are on the spectrum kind of understand all those things that are going on and understand the interactions. There are also books that are out there that can help children understand what it's going to be like to go to the doctor, what's the doctor going to say? And it can ease some anxieties going into it because when children on the spectrum or not are stressed out, they're going to have more difficulty connecting and communicating. And what we're really trying to do with connection is help the child feel safe and love for who he or she is, which will enhance that bonding and relationship between parent between child and caregiver skills. For autism spectrum disorders and adhd, like I said, they co occur at a really high rate structure and routine. Again, stay organized, everything has a place and that can help children who have the co occurring issues deal with both of them. Stay a Little bit organized and learn how to manage. Use clocks, timers and transitions. Simplify the schedule, try to keep it, you know, again, structure and routine, but don't have them. Go from this therapist to that therapist to the other therapist for eight solid hours and then have no downtime. Have clear expectations and rules. With children who are on the spectrum and younger children who are not, visual guides are really helpful. Pictures. This is what you're expected to do when it's time for bed. You come in and there's a picture of Sally walking into the bathroom and you brush your teeth. Toothbrush and then shows putting toothpaste on the toothbrush. You know how it goes. Obviously you need to break it down more in smaller increments. For younger children, older children, you're not going to have to remind them to put toothpaste on their toothbrush. But visual guides are really helpful. And visual guides you can take with you if you have a notebook, a three ring binder and you laminate the visual guides to review expectations for how to behave at the park or review expectations for what church is going to be like so you can go through them really quickly before you get out of the car if it's necessary with that child. Create a sanctuary place for that child somewhere where they can go in the house, at school, where they can decompress, where they're not going to be bombarded with some sort of stimuli and noise. For children who are overstimulated by auditory or visual input, again, sunglasses can be very helpful. Just a plain blank white wall or plain blank black wall can be really helpful. And noise canceling headphones encourage movement using fidget spinners and little toys. We're going to talk about those and stability balls. Some children have difficulty sitting still, especially with adhd. If you have a stability ball, and I should have remembered to have mine available, I have one in my office and I notice when I sit on it and I'm doing my work, I'm just bouncing back and forth. I'm a little bit high strung. But children with ADHD can appreciate this because they have difficulty sitting still and they have difficulty containing themselves. But a lot of times they can contain themselves within reason if they're sitting on a stability ball because it gives them the freedom of movement, so to speak. Ensure adequate quality sleep because sleep deprivation is going to contribute to low frustration tolerance and and more situations in which the parent and the child are at odds instead of in sync. Children who are on the spectrum may have again those sensory issues if their hearing is more acute. If you want to say that noise canceling headphones or earplugs may be helpful to help them get to sleep. Weighted blankets have been shown to be very helpful for children because it gives them a sense of security. Light. If light is bothering to them, a sleep mask may be helpful. On the other side of that, the touch from the sleep mask may keep them awake. So it's going to be figuring out what works for that child. But sleep is so, so important for everybody, but especially for children with ASD and adhd. Ensure regular, healthy nutrition. Even with picky eaters, people on the spectrum may have issues with certain textures. Paying attention to that, but also making sure that they're getting adequate nutrition and working with an occupational therapist to help them broaden their selection of foods that they're willing to eat. Healthy nutrition helps the body make those neurotransmitters that help them stay focused and calm. And you know, they need to get that tryptophan for serotonin and dopamine and the glutamine for GABA creation. Both of those are proteins and Maintain a positive attitude. Not every day is going to be an a day. However, almost every day, if not every day, will have a moments and you want to focus on those positive moments even if the day has had some bumps. Role play various scenarios with the child and trade roles often and try to make it fun. Depending on where the person is on the spectrum, this may work. It may not if they are non verbal or you know, have other differences in their abilities. Role playing may be not something that they can participate in, but if they can, it's very helpful. Choose your battles and be willing to make compromises. Each child just like all of us, some days are better than others and we pick our battles. Same thing with children, some days are going to be better than others. Obviously you know, you can work with a behaviorist so you're not rewarding inappropriate behaviors. But sometimes maybe if they don't finish all of their broccoli or whatever, it might not be worth fighting that one. Make a list of everything that's positive, valuable and unique about your child. Trust that your child can learn, change, mature and succeed and reaffirm this trust on a daily basis. As you prepare for your day. Encourage parents to do this because it can get frustrating and it can get overwhelming, but remembering and recognizing those beautiful moments, those, you know, starlight moments is really important. Scrapbooks can be helpful whatever it is they need to do so they can get in that right frame of mind to remember how awesome and special their person is. Children on the spectrum do not necessarily provide the responses that trigger parents innate impulses to care for them. If they are nonverbal, if they don't want connection and attention, you know, they're not triggering their parent. They're not crying and saying, come pick me up. So parents may not do that if they don't think of it. Some children initially don't respond much at all. Others have responses that we don't understand. And many respond differently every time the parent approaches. So the parents just like, it's a crapshoot, I don't know what to do. These unexpected response styles create confusion and a sense of inadequacy among many parents, which makes it hard for them to be responsive to the child's needs. Because if the child is not triggering those care impulses, if the child is not going, I need something, then parents may not be as attentive as they necessarily need to be. Not because they're trying to be mean or ugly. They're just, the child is playing quietly and it's fine. Remember that although children may not respond in the way expected, they're still responding. So become a detective. Discover clues for the triggers that trigger the children's behaviors. Use backward chaining. Start with what just happened. All right, let's see what led up to this that might have compounded or added to this situation that ended up in a meltdown. And always remember that children's behavior is functional in some way. It may be to tell you that I am completely overwhelmed and overstimulated and I can't take it and I'm about to bust. Or it may be to say, go away. You know, I'm going to withdraw. Because they need to get away from the stimulus in some way, shape or form. Look at it from their perspective and just ask yourself instead of, why are you doing this? What's the benefit? In what way is this helping the child feel more safe so. And secure? Joining children in their world requires caregivers to imitate and follow. So don't make demands or ask them to constantly perform. You know, what color is this? What does the cow say? We do that with a lot of children, and it's not totally overwhelming. But for children who are not verbal, it may be more difficult. Try not to direct their play. Try to let them play how they want. Talk about what you and the child are doing without asking too many questions, like just sitting next to each other and saying, boy, the designs in the carpet are really interesting. Or you really like the sound of that block banging on the table or even. It really makes me happy when you share with me just talking about what you're doing, making observations, not necessarily asking questions. Don't be afraid to add to the play with your own creations in hope that the child will someday become interested in you too. As people, we can be very overwhelming to someone who is neuroatypical because I mean we make sounds and we make movements, we make fast movements and slow movements and there's lots of stuff, you know, non verbally that we do. And it can be very overwhelming to someone who's neuroatypical. Blocks don't move, you know, they can, they're in their world. It's not that the child necessarily isn't interested in us. It may be that we are too overwhelming for the child. So letting the child direct the play. If the child has limited awareness of others, you can try creating situations to get the child to notice you. If he's building with blocks, you might build a complimentary section or ask him to help you do the same thing. It's like that is really, really pretty. Pretty. Can you help me do that? I don't know how. And the child may go about showing you. Label the children's feelings so they can start developing an emotional vocabulary and reduce frustration. Let children develop their special capabilities and keep your expectations in check. Remember that you are wanting or we are wanting the parents to love the child for being the best version of them that they can be. They may not be the next Albert Einstein or they may, I don't know. But we want to appreciate the child for who they are. Use scaffolding. As I talked about before, let the child do what they can do up to the point that they can do it. And then when they start struggling, step in. But don't do things just for the child. Work with them to help enhance their sense of self efficacy. And sometimes you've got to endure a little suffering with children so they can grow. They've got to get to that point of frustration and it's hard to let them. Let them try and fail sometimes. But even children who are on the spectrum need to be able to have those challenges so they can experience success. Many children with special needs have problems with sequencing and are processing auditory and or verbal information. So it's important to learn about the child's different way of learning. Do they learn better visually, auditorily by hearing or kinesthetically by doing? And are they reflective or active? And I will tell you, most people on the spectrum, especially when you're talking about verbal learning are going to be more reflective. They need to take in the information, process it, figure out what to do with it, and then they'll respond. So don't expect them to, you know, be Johnny on the spot in the classroom, always raising their hand. Many children with autism take longer to register an interaction, so learn to wait for children's responses before repeating yourself, because that will make them feel. If you're constantly repeating yourself, it may make the child feel dumb or not happy. Give them time to process it. If a parent complains that the child doesn't pay attention to what they're saying, make sure to help the parents remember to always use the child's name at the beginning so the child knows you're talking to them. Make sure they're paying attention before you ask a question or give instructions. Remember, with people on the spectrum, eye contact may be very difficult or overwhelming. Expect that you're going to have that eye contact that you may have with a neurotypical child, but make sure they're paying attention. You can use their special interest or the activity they're currently doing to engage them by saying something like, I see you're having fun playing in the sandbox. We have to leave in the park in five minutes, so we're acknowledging what they're doing. They're like, yeah, I'm in the sandbox. I'm having fun. And then they kind of hear the rest of it once they're engaged. Or you can say something like, you're making such good choices today. I know it has been very stimulating. I bet you'll be happy to get home and pet Susie, assuming Susie's a dog. So this is a special interest they have. If they love petting their dog because it's calming, then you can. When you talk about Susie, that's probably going to get their attention. If children find it hard to process what you say, encourage parents to find ways to communicate in ways that are meaningful to the child. Pay attention to the other sources of external input. You know what else is going on that may be distracting them and keeping them from being able to process it. But also internally, what may be going on with that child that's distracting them? Are they hungry? Are they tired? Are they sitting scared? Are they overwhelmed already? Say less and say it slowly. Don't talk like you're talking down to them, but when you say something, you know, say a sentence, take a break, say another sentence, pause between sentences to give the person time to process what you've said. Avoid asking Too many questions. And use less non verbal communication with when the person is showing signs of anxiety. Because that nonverbal communication, a lot of people on the spectrum have difficulty understanding it. So that's just like extraneous input that they don't know what to do with. Consider using visual support such as pictures and timetables if the child struggles with open ended questions. Keep your questions short. Ask only the most necessary ones. Structure your questions to offer options or choices. Would you like a peanut butter sandwich or a bologna sandwich for lunch? And be specific. So instead of saying how was your day? Say did you enjoy your lunch? Or what did you learn in math today? If children are just resistant to asking for any help, which you know, a lot of children are, you can also give them a visual help card to use that reminds them when they hit this roadblock, this is what they need to do. If they're disinterested in other people, it may be too overwhelming, but it's also possible that they just haven't started developing those skills yet. It's important to get interested in their interests instead of wanting them to be interested in yours. And get involved in groups that foster positive peer relationships and social skills development appropriate for that child wherever they are on the spectrum. Children on the spectrum or people on the spectrum may ask a lot of questions and paraphrase to ensure understanding. So it's important to be patient when communicating with them because they're going to want to make sure they're getting it before they provide a response and they take things literally. So avoid using irony, sarcasm or figurative language. They tend to be frank, honest and matter of fact, which can be interpreted as blunt or rude, and that's not what they're intending. A lot of people make the mistake of trying to grimace or make a facial expression to go, oh, that wasn't appropriate. People on the spectrum probably are not going to pick up on that. So it's important to tell the individual in a matter of fact but helpful way that that choice of words or behaviors wasn't appropriate and help them learn or identify a better expression. If they react badly when they're told no about something, it could be because they're confused about why you said no. So if it's an activity that they can do later on that week, try showing them in a timetable. No, we're not going to the park today. The park is on Thursday. If it's a safety issue, look at ways of explaining danger and safety. For example, you know, kids like to play hide and seek in stores. That's not safe. We want to figure out how to explain that to them. If you're saying no because they're behaving inappropriately, a calm reaction with redirection may help to decrease that behavior. If you're saying no, we're not going to go get ice cream after the park because you didn't behave appropriately, not getting upset, being very matter of fact about it. The child is not dumb. The child understands what you're saying. They may not like it, but in most cases the intellectual capacity is not impaired at all. If it's something you've allowed before, explain the reason why it's no longer okay. If you've allowed them to have candy before dinner before, why can't they have it today? That gets a little bit more confusing. Set clear boundaries and explain why and where it's acceptable and not acceptable to behave in certain ways, just like you would do with any neurotypical kid. If they hit when they don't want to do something, keep a log to identify what's triggering or maintaining the behavior. When children hit, what's the function? It gives them power, it pushes you away, it, you know, protects them in some way. So think about in what way was that functional to them. Keep a log to identify what's triggering or maintaining the behavior and include antecedents like sleep, nutrition, time of day, current stressors, and whether this is a regular or a unique experience. Ask yourself what else might have happened that added to this stimulation or distress and what are the benefits in this situation of the child hitting me? If you tell your child to clean their bedroom and they hit you, no, I'm not going to do that. Okay, where'd that come from? So thinking about what else is going on, whether there's some sort of stress in the family, in the environment, something bad happened at point some school, try to understand what that behavior means. The child is obviously feeling out of control or disempowered and somehow. So we want to figure that out. Unless of course, they've been rewarded for hitting before. And then we want to figure out how to address that behavior. Okay, so some tools really quick, and I know we're running short on time. Help children identify what they're feeling and offer other ways of expressing no or stop when they're feeling overwhelmed, especially if they are wanting to hit one place. I read they used a calm down couch instead of timeout. They were reframing the couch as a place where you go to calm down. And then we're going to talk about what happened. A stability Ball was suggested by an occupational therapist because the child wouldn't sit and sit still in timeout. They kept fidgeting and moving around and the OT said, you know, they're staying in timeout though. They're not leaving timeout, they're just not sitting still. So a stability ball gives the child something to bounce on. Thinking putty gives them something that's somewhat rhythmic to do sometimes if they're stretching out playdough, basically you can have a drawing corner where they go to draw out what they're feeling or thinking. And then you can talk about the drawing. The dragon breather I really liked and you make a cup and you put little, you know, dragon fire out of felt on it. And then the child can breathe through that and make the felt flap in the breeze. But that helps them deep breathe. And that's obviously appropriate for really young children. But it can be really helpful to help them start de escalating. Harmonicas also get that breathing going. And some kids just like the noise or belly breathing. Some children will understand putting their hand on their belly and feeling it go in and out. Punishing autism driven behaviors will not extinguish them. Understanding what's driving the behavior and the early warning signs will help you and the person with autism cope or adapt. So it's important to know their distress signals and for them to know their distress signals as they get older. It's important to examine the motivation for the behavior. Look for sensory input that may be overstimulating or bothersome. Overstimulation can lead to behavioral issues. Out of self preservation under stimulation can also lead to stimming behaviors because they're feeling bored, understimulated and stimming behaviors can help them feel alive. Basically reinforce positive behaviors in the moment. These things will help reduce tantrums. Your portable toolkit timer for transitions. So if you want to say we're going to be in the store for 20 minutes and they have their mobile device, you set it for 20 minutes and they can watch that timer countdown. They know they just have to hold it together for that time. 20 minutes or we're leaving in five minutes. You can set it so they can see that their time is running out. Keep that schedule or activity book with you so you can show the child what's getting ready to happen. Keep sunglasses with you. If visual stimuli or if light is bothersome. A weighted lap pad or a shawl that they can put over their shoulders can help them feel more calm. Noise canceling headphones. A crunchy snack, interestingly will Help reground Some people who are on the spectrum unscented hand wipes or handkerchief if they touch something that is bothersome to them. My son used to really freak out every time he touched a present ribbon. You know those little ribbons that you stick on presents. He would shudder from head to toe and just start crying hysterically. So if a person who's on the spectrum touches something that is aversive to them, holding a hand wipe or a handkerchief can help them get that unpleasant feeling out of their sensory awareness. A fidget toy Anything that they can fidget with their hands with a spinner paper can be a fidget toy. They can fold it, they can crumple it. A tennis ball they can bounce back and forth in their hands. An ink pen they can click in, click out, play doh. A sand or a liquid timer that they can watch. You know, something that vibrates. For some, a stuffed animal or a small blanket that they can pet or stroke can be calming to some. For others, scented hand lotion or a spritz, atomizer or sachet with calming essential oils. And essential oils that have been identified for people who are on the spectrum as being helpful for calming include mandarin, mandarin orange, lavender, cedarwood and frankincense. There are others out there, but those were the ones that came up highest. And even a tablet for some a game like Tetris can be very soothing as they're just watching the blocks fall and putting them into place. Parenting styles that Don't Work Helicopter parenting keeps children on the spectrum from learning through experience. So don't step in and do things for them that they can do for themselves. Free range parenting doesn't work because children with autism need regular focused parental engagement. Otherwise they are likely to become increasingly withdrawn and self focused and frenetic. Parenting, where parents frantically search for more therapies and activities to fix the child, can overwhelm the child and they don't get to be a kid which can lead to them feeling overwhelmed. In summary consistency have rules, routines and be consistent in your reactions to their behaviors. Be responsive to individual needs and preferences. Pay attention and give them attention for being lovable. Validate their thoughts, feelings and way of being in the world. Have empathy for how their sensory and neurological differences impact them emotionally, cognitively, interpersonally and physically and help them find solutions to become more mindful and mitigate or prevent triggers or unwanted behaviors and help them find solutions to develop the skills needed to engage with a neurotypical world. And in answer to Lisa's question, I believe it was Lisa's if a child has repetitive movements, there is a chance that they're on the spectrum, but that's not necessarily, that's not a defining feature that is exclusive to being on the spectrum. Definitely something to take a look at, you know, what is leading to those behaviors. Any other questions? There is a resource at the end of the PowerPoint 10 tips on how to Communicate with Autistic People that was written by a person with autism. Found it very helpful, strongly advised reading it if you work with people who are neuroatypical. And then there's a whole boatload of other resources that you can look into. And these were ones that I read and referenced throughout the presentation. But they'll provide you some more information. And yes, a lot of these tips would work with anyone who is neuroatypical. Obviously if they are living independently and neuro atypical, they can have their own portable toolkit that they keep with them that gives them tools that they can use when they need to get regrounded and use it as distress tolerance skills or distress tolerance tools. So obviously, you know, upgrade it to be more adult in its, in its content. But yeah, a lot of these will work very well with adults on the spectrum. Alrighty everybody have an awesome day. And we actually do. I did this kind of backwards. I do have a Understanding Autism 101 presentation coming up in a couple of weeks, but this one had been requested by a student a couple of months ago, so I wanted to get it in there as quickly as possible. Everybody have a great day and Missy will be with you on Thursday because I'm presenting at the Innovations and Behavioral Healthcare Conference in Nashville, but then I will be back on Tuesday. 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