Monday, September 19, 2011

ACTIVITIES ON THE ANGLE: Rewards and Motivation

Reward systems, praise and motivation are not always a perfect match for individuals with autism.  Using rewards that are more understandable and meaningful can take a little creativity and patience.  A few things to keep in mind when making these systems more understandable can go a long way.  We talked previously about behavior difficulties that can occur with those on the spectrum.  We want to go more in depth with the motivation so that some of these difficulties can be avoided. 

Tips for rewarding: 
Make it Visual:  Show through pictures, objects or short written information. 

More Immediate:  Make sure the time from the reinforcement (such as TV time at home) is not too far from when the action (such as cleaning up at school) occurred.  There are a lot of students that can understand rewards at the end of the day or week but there are just as many that do not make this connection. 

Individualize the Reward:  We aren't all motivated by the same thing and it can change for all of us as well.  Stay on top of what is the current interest to help things from getting stale. 

Don't Take Away:  Removing rewards that are earned are not recommended.  It is confusing enough trying to make the connection between what 'to do' and the end result. 

Systems to Use:

First-Then Sequence
Through pictures, objects or words (depending on your child's current level of understanding), you can visually show first 'this' happens and then you receive 'this'.  Starting out very slow with contingencies is important, in other words, we want the child to understand that this behavior = this outcome.  We don't want to jump to complex reward systems that may be confusing and therefore not meaningful. 

First brush teeth, then TV time

First put your jacket on, then you can play outside

Puzzle Pieces
This system can be used for TV time, toy or other treat.  Simply cutting up a picture of a specific item of interest can help create a reward system that is specific to that child's motivation.

This child earns pieces of a tractor and then gets to go visit his Grandfather's farm.

This chart is earning 3 pieces of a treasure box and then the individual gets to chose one item out of the treasure box.
Reward Charts
Lot of samples can be found of these online.  Specific characters can be used to help motivate the individual.  Whether it is 'Thomas the Train', 'Dora' or 'Sponge Bob', charts can be found at various sites to incorporate the interest. 
-A few sites we have found:

Token System 'I Did My Chores' 
I lucked out finding this at a consignment sale.  This system is like a token system/economy.  It can be too complex for some students, so use a system that you have assessed to make sure it is understandable to the individual. 

This system can be purchased online:

Choice Board
Also, using choices of rewards allows for flexibility with what is available but also giving the individual control over what they want. 

Creating motivation for your child or student can greatly increase compliance, interest and enjoyment.  We are looking forward to finding new ways to motivate individuals on the spectrum and always looking for new ideas!


Sunday, September 11, 2011

Moving from an Object to a Picture Schedule

Abby recently posted on object schedules (go to post) and stressed the importance of using a schedule that is sensitive to the child's understanding at the current moment. She's right, we often jump too quickly to using an icon/word schedule with children who might not yet be identifying pictures, so how do we know when they're ready to use pictures?

  • One way to access a child's understanding of pictures is to see if they can match them.
  • Start with actual photographs first. This is less abstract than icons and may be more easily understood. See if your child can match exact photographs to each other
  • Also see if your child receptively understands the picture. So, you may want to sit him/her at a table (to help with focus) and ask your child to "point to the playground," for example to see if they can identify that photograph and distinguish it from others. Some children may still recognize that the picture represents a place, however, so even if he/she cannot identify the picture of the play room by pointing to the picture, if they still take that picture to the area and recognize that play time is next, than that's o.k. The key here is to look at what your child understands independently (without anyone having to lead them to the area on the schedule item).
  •  If your child is showing skills in this area, then you may want to start using photographs. In this transition you can also put the actual photograph on the object and then gradually just use the photograph.
  • Similarly, with icons start by seeing if your child can match icons to each other and identify the picture. For beginning readers, you can also include the word on the picture but if your child is still very young and not yet recognizing letters, then it's not necessary to have the word on the picture.

Using pictures for a schedule can certainly be overwhelming for parents in knowing where to start and where to find these resources. Just remember, it does not need to be beautiful, it just needs to be visual. So, if you can easily sketch a picture on a sticky note, that's perfect! For me personally, I can barely draw a stick-figure so it makes things a bit complicated..... so, where can you go for easy and free pictures?
Here are a few websites:

Examples of icons on Do2Learn Website

Google Images-- (click on images and just type in what you want to find). Especially if your child understands photographs better, this is a great site and even if your child is using icons (at school, for example) and understands those, it's still o.k to use actual exact images-- they will still be understandable! You can easily print out schedule items that you are likely to use on a daily or weekly basis, such as errands you run (Target, Grocery Store etc) or activities at home, like Dinner Time, Getting Dressed, etc.  

Do2Learn-- This site has tons of printable icons for free. They are mostly in black and white and you can print them either with or without words. I love this site because it has tons of pictures for daily living skills and activities in the home and the community. It's a great resource for parents!

Autism Buddy- You will have to join this site, but it's free and then you can download many visuals and other activities. They have many clipart images that you may also be able to get on your computer.

Visual Aids for Learning- This is a great website for free images as well. You can download complete packages, such as the "Early Childhood package" or "School package", even a "Toilet Training package" with tons of images related to these categories.

Board Maker: This program is super expensive (check it out), but if you work with lots of children or for a company that would pay for it :), this is a nice program where you can type in what you're looking for and it will produce an color icon that you can then print out. I would recommend checking out the free websites before investing in such an expensive program first though!

Again, it can often be overwhelming to know where to start in using a schedule
with your child and I think picture schedules can often be the most intimidating. 
Here are some points to keep in mind that might make it easier:

  • It does NOT need to look beautiful. You do NOT need to laminate. Card stock or contact paper are other options for more sturdy cards
  • It's o.k to simply draw something out and put it on a stick note-- or use stickers, whatever is easy!
  • Get out your camera and take pictures! Digital camera make this a lot easier this day and age! 
  • If you do not have a picture handy, use an object to aid in understanding. For example, it's time to get in the car and you don't have a picture and your child is reluctant to transition. Grab your keys and hand them to your child and say, "time to go in the car."
  • You do not need to run out and buy a bunch of velcro. You can use paperclips on a sheet of paper to present the pictures in a top-bottom or left-right fashion. 
  • Don't try to initially schedule the ENTIRE day. Just start with part of it. Once the child is used to using the schedule and understands it, then just start with using a schedule at home during the most difficult times and you can always add to it!
Stay posted for future posts on why we use schedules, how much info to include on schedules, and how the person with ASD can interact with or manipulate the schedule!

- Molly

Friday, September 2, 2011

First Concerns, Signs and Red Flags of Autism

Being that we have the pleasure of working with lots of families throughout the year we are exposed to many different circumstances leading to the spectrum.  Pediatricians are often thought to be the first line of defense.  What if delays aren't recognized? 

"He's just a boy", "All children develop at different paces", "His/her older sibling just does the talking for them", "Call if there is still a problem in a year", etc are some of the things parents are being told.  Children not speaking any words at 3, 4, 5 years of age is not something that should go unnoticed but it does.  This is NOT all pediatricians or only happening only at these offices but the fact that it happens at all is concerning.  How can we help get the word out about signs?  There are subtle differences in some children that are rarely picked up until later but what about the obvious/clear delays?

Thanks to the Internet, many families have been able to seek out information on their own.  Autism Speaks Videos are a great way to see red flags at an early age to see if they apply to your child.  There are great books such Does My Child Have Autism? and even screening tools that parents can download on their own:

What a few of the red flags?
*Communication difficulties; with or without language delays
*Limited/Poor eye contact
*Echolalia; repeating other's language immediately or later on (such as repeating scripts from TV and movies)
*Little gesturing; pointing, describing by showing, etc
*Difficulties getting along with others; especially peers their own age
*Difficulties with imaginary or creative play
*Repetitive behaviors/movements
*Sensitivity to sounds, lights, clothing, food, etc.

These are only a few of the signs to look out for and should be followed up with an evaluation rather than diagnosing on your own.  Even if your child initially is labeled 'Developmentally Delayed' this can be a great way to access services.   It is concerning that recently in the news some of the Screening Tools were in the press for possible alerting too many families to autism.  We are missing many children early on, therefore, seeing screening tools as a hindrance rather than a guide is a problem. 

We have had a couple of our families share their story on our blog regarding their experiences with the diagnosis and would love to hear more.  Improving our communication among professionals is important to identify children as soon as possible.  We have added a survey to the right of the main page to find out who is alerting families.  What were your first signs?  When were you concerned?  Who helped identify red flags? 

We would love any input!!