Christopher Camarena – BCBA
Interview with Christopher Camarena – BCBA
  • What drove you to the ABA Therapist profession?  As a professional working in the field of ABA, I have always had a passion for helping those with disabilities. I discovered this passion while working in the field as a behavior therapist during my undergraduate program. My joy is seeing the client’s growth. It is that growth that has helped me stay motivated throughout the years working in this field. 
  • How has Golden Care helped you in your career development? Golden Care truly feels like a work family. With the amount of support and resources offered, I have learned to navigate new information, ask questions when uncertain, and develop my ongoing clinical skills as a BCBA. 
  • What advice do you have for prospective Golden Care candidates? I would advise that Golden Care candidates takes advantage of asking questions when unsure about certain topics, save all the tools and resources that are supplied for staff so they can cross reference the information at any time, and work on organizing yourself so one can stay ahead when it comes to completing daily objectives and work requirements.   
  • What drew you to Golden Care originally? And how has Golden Care changed since? What drew me to Golden Care was the company’s positive reviews on ongoing support from staff as well as client reviews on staff genuinely showing care about their child and their development as they work through their ABA journey. 
  • What’s the best advice you’ve ever been given? The best advice I was ever given was that no question is ever a bad question. In many cases, especially in a group setting, one person may ask a question that others feel reluctant to ask due to judgment. I learned never to shy away from asking questions as this field is always evolving and learning is limitless. 
  • What’s the one thing you’d tell your younger self? One thing I would tell my younger self is to push through obstacles that may seem difficult in the beginning. Eventually when you keep pushing, you will build enough confidence to achieve it!
  • What is one thing that you wished people knew about your jobOne thing that I wish people knew about my job is that we are not babysitters! From an outside perspective of someone who is not familiar with ABA, I can see how they may view this field as “hanging out” or “babysitting”. ABA is much more and can apply in a multitude of settings not just within the field but in anyone’s life. If there is a particular behavior people want to change about themselves, ABA can be implemented to help that person achieve their goals. 
  • What does the day to day of your job look like? As a BCBA, I feel that I can speak for most behavior analysts and say that we love seeing data! As a BCBA, it is my responsibility to ensure that program and skill development is ongoing, and implementation of programs are being targeted correctly. I provide ongoing support for both the therapist as well as the parent (this may also include the complete treatment team such as school staff) to ensure everyone is on the same page. Consistency is key especially when implementing strategies to help the client learn to sustain proactive behaviors through their development with ABA services. 

 

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Katherine K
Interview With Katherine Klausner, BT

My job as an ABA therapist involves working with a client in the home and school setting. I was able to shadow the clients previous ABA therapist before starting in May, and I found that very helpful!

I have always enjoyed working with children on the Autism Spectrum. I have worked in schools and for companies that focus on providing services that require a knowledge and understanding of autism and other diagnosis. I find that I gravitated to this field after going to college for education and teaching.

In order to balance my career and family life, I am always planning ahead for the week. I try to adjust my schedule around appointments and personal commitments. I find that the flexibility in this career makes the life/work balance easier.

Golden Care has helped with my career development by allowing me to work with BCBAs and other therapists. I have learned so much from the collaboration I’ve had with other professionals in the company!

For prospective Golden Care candidates, my best advice is to learn from your mistakes and be open and willing to grow. I have found that being open to feedback and new ideas has helped me so much. Also, I suggest new candidates ask questions!

My favorite part of working for Golden Care is being able to connect with the clients and families. I have grown very fond of my clients and the opportunity to watch them change and excel! ABA has worked to assist my clients and decrease behaviors. It is very rewarding!

The day to day of my job involves meeting my client at their school and spending the day with them there. On the day my client does not go to school, I go to their home and travel with them to speech therapy. I enjoy my schedule and the home/school therapy I can provide.

I would tell my younger self to practice self love and kindness towards oneself in the face of challenges.

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Discrete Trial Training

This article is part of our ABA therapy techniques series where we explore the different techniques used by ABA therapists.

Discrete trial training (DTT) is an evidence-based intervention that helps children with autism improve their social communication and other skills. This article provides an overview of the discrete trial training technique and explains how it’s being implemented in ABA therapy.

What is DTT? 

Discrete trial training or discrete trial teaching (DTT) is a highly structured ABA training where skills are broken into smaller, easily taught components. For example, the therapist may work with a child on pronouncing a specific sound or learning the name of one color at a time. Children are rewarded for every achievement, which encourages them to continue learning.

 

DTT can help build confidence in children who struggle with developmental skills and in particular those who are on the low end of the autism spectrum. This technique is also beneficial in situations where other methods of ABA therapy are not able to help a child adopt a new behavior. DTT typically targets children on the autism spectrum aged 2-6 years, although it can be used with children of any age.

 

Discrete trial training is characterized by:

 

  • Clear structure and a highly predictable learning framework
  • Short and focused sessions that require increased attention
  • The flexibility of use in different settings(home, school, outdoors)
  • Interactive learning that keeps the child motivated and engaged
  • A natural progression from simple to complex tasks.

 

DTT is an intensive therapy that can be extremely demanding and time consuming. Sessions are usually scheduled for 5-7 days a week and may take up to 40 hours per week. 

How does it work 

Discrete trial training consists of one-on-one sessions with a therapist. It is typically done in a controlled environment that encourages focused work, such as sitting at a table. Each session is composed of several trials with short breaks in between. 

 

The key technique used to motivate the child to learn during a DTT session is positive reinforcement. Whenever the child gives the correct response, he or she is offered a reward to positively reinforce that behavior, for example, praise, a treat, or getting the opportunity to play with a favorite toy. When the child offers an inappropriate response, the therapist responds with a gentle correction and repeats the trial.

 

Much of DTT training involves basic repetitions until the child starts using the desired skill and learns how to engage in appropriate behavior without being prompted. The ultimate goal is to have learning generalized to all settings and environments. 

Areas Where DTT Helps Children with Autism

Discrete trial training can help children with autism learn and maintain a variety of basic and advanced skills that will lead to improved quality of life. These include: 

 

  • Cognitive skills
  • Speech and language skills
  • Social communication skills
  • Skills needed for using sign language or communication devices
  • Play skills
  • Daily living skills
  • Following instructions
  • Learning new behaviors
  • Self help.

The 5 Principles of Discrete Trial Teaching

Discrete trial training is based on five main principles:

  1. Skills are broken down into smaller “discrete” tasks. This process is referred to as chaining.
  2. The therapist teaches each task until the child masters it before they move on to another skill.
  3. Discrete trial training sessions are intensive.
  4. The therapist begins by using prompts whenever needed to then gradually decrease their use.
  5. Learning is reinforced by incentives. A reward is offered as soon as the child successfully accomplishes the task. 

Steps of DTT

Discrete trial training is done in several steps: 

 

  • Discriminative stimulus
  • The prompt
  • Child response and consequence
  • Inter-trial interval

Discriminative Stimulus 

A discriminative stimulus is a signal indicating that a positive response will be reinforced. It can be an object, a verbal instruction or a picture, an action, or a cue from the natural environment. 

For example, placing hands under water is a discriminative stimulus to wash hands, and rain is a discriminative stimulus to take an umbrella before leaving the house.

 

Once the child has established a basic understanding of discriminative stimulus, the therapist can start applying this concept in a more advanced way.

The prompt 

The therapist may need to use prompts to help the child find the correct response to a discriminative stimulus. In other words, the therapist has to show the child the correct response in order to guide their behavior, for example, tap the object the child should point to.

Prompts can have two different forms: full gestural and partial gestural.

When using a full gestural prompt, the therapist offers a verbal cue and at the same time models the behavior that leads to the reinforcement. For example, the therapist instructs “point to blue” and then immediately points to the blue item. 

 

When using a partial gestural prompt, the therapist only partially indicates the item. Because the therapist has modeled the desired skill and there is the expectation of reinforcement, the child understands that pointing at the blue item will lead to receiving a reward.

The goal of DTT training is to reach the point where prompts are no longer necessary. The child will know how to select the correct items based exclusively on the verbal cue offered by the therapist. 

Child response and consequence

The child’s response to a discriminative stimulus during DTT trials can be correct or incorrect. If the response is correct, the therapist will immediately reinforce it with a reward, such as verbal praise, a treat, or a token. After a while, the child will learn that engaging in a positive behavior or giving the correct response to the stimulus will be followed by reinforcement.

On the other hand, when the child provides an incorrect response, the therapist remains neutral and gives no reinforcement or punishment. The child is gently corrected or simply ignored. 

Inter-trial interval

The last step of the discrete trial training is inter-trial interval. It refers to the short period of time after the consequence that indicates the end of one trial and the start of another. This interval must be very short (typically only a few seconds) to ensure the continuity of the learning process.

 

If you are ready to work with the best ABA therapy provider in Indiana, New Jersey, or New York, give us a call at (732) 402-0297. Our dedicated team is ready to help and we will treat you like family. 

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mom brushing daughters hair
Autism and Hair Brushing

Children with autism have trouble with many sensory items. Therefore, brushing hair can be a challenge for these kids. In this article, we’ll go over the basics of autism and hair brushing to better understand children with autism and prepare a quality experience for them.

Why Is Brushing Hair A Challenge for A Child with Autism?

Children with autism typically suffer from a challenge known as sensory processing disorder. This trouble makes brushing the hair a particular challenge. The way the brush feels and sounds in the hair may cause frustration and trigger a child with autism.

 

It might seem like an overreaction to outsiders but brushing the hair on a child with autism can feel like the end of the world. It’s critical to consider sensory processing disorders before brushing to determine how the activity might feel to them.

What Is Sensory Processing Disorder?

Sensory processing disorder is common in children with autism. It’s a condition that affects how the brain takes in and processes sensory information. Most of the time, the sense can be too extreme for individuals with autism.

 

Sensory information includes items that you can:

 

  • See, such as a bright light or a car on the road
  • Hear, such as a fire alarm or a bird in the sky
  • Smell, such as burning toast or a rotten egg
  • Taste, such as a spicy chip or a sweet ice cream treat
  • Touch, such as a hot stove or a soft kitten

 

They come into the brain differently with a sensory processing disorder.

 

Stimuli include items like bright lights or a loud noise. Something normal to a child without autism may sound far more intense to a child with autism. Hair brushing involves the seeing, hearing, and touching senses.

Tips For Brushing a Child with Autism’s Hair

If you have a child with autism, you need to brush their hair. Of course, this process is easier said than done. We have a few tips to keep in mind to better the brushing experience for you and your child with autism.

 

Here are a few tips to keep in mind for the process. Consider the following for an ideal experience:

 

  •     Determine the cause: Attempt to determine the root of the discomfort with the brushing. Is it the sound? The feel?
  •     Acknowledge the discomfort: Note that you understand their hurt and empathize with them. Ensure your child does not feel isolated in their pain.
  •     Avoid the most challenging parts: Keep clear of items that can cause difficulties. For example, if they don’t like traditional shampoo, try dry shampoo instead.
  •     Give your child control: For the most comfortable experience, allow your kid to have control of the situation. If they want to brush their hair, let them complete the task themself.
  •     Choose a low-maintenance hairstyle: Select a hairstyle that will take the least time to complete. They shouldn’t be expected to sit or handle touching for a long time if it’s uncomfortable.
  •     Not expect the child to sit still: Due to the discomfort of the situation, you can’t expect the child to remain still while you brush. Give them grace as you work on their hair.
  •     Use fidget toys: Fidget toys allow children with autism to take their mind off the brushing experience and calm themselves with a sensory device. This item can be anything from homemade slime to a plastic fidget spinner.

 

These can help get the job done and better the experience for a child with autism.

 

The experience may still be tricky with these tips, but they should make it better. The most critical items are communication and empathy. Ensure your child does not feel alone or silly if they feel uncomfortable with the brushing process – they are not alone.

Brushes For Children with Autism

Several brushes on the market work well for children with autism. They minimize the stimuli that come from contact with the head, ideal for a child with a sensory processing disorder.

 

Here are a few of our favorite choices and links for each brush:

 

  •   Tangle Teezer: This item goes for $10 on Amazon and boasts an easy-to-hold shape.
  •   Wet Brush Pro Detangle: This item goes for $10 on Amazon and has flexible, soft bristles.
  •   Knot Genie: This item goes for $13 on their site and offers a smooth way to handle knots.

 

These will get the job done and make it enjoyable.

 

Another item that can help with hair brushing is hair detanglers. Let’s go over a few of our favorite choices for children with autism next.

Hair Detanglers For Children with Autism

Hair detanglers work out knots and reduce the risk of a brush getting caught in their hair. The best product prevents pain from affecting the child as you brush their hair. There are several excellent choices on the market.

 

Here are our favorite picks for hair detanglers for children with autism:

 

 

These should clear out knots in no time.

 

With a quality brush and detangler, you will have a better time brushing your child’s hair. They won’t experience harmful stimuli or pain, and you can feel confident that they are as comfortable as possible. There are so many tools in our world to make the world a better place for children with autism.

Final Thoughts

Children with autism experience the world differently. Many have sensory processing disorders, which can make brushing hair uncomfortable. If you brush your child’s hair, ensure you empathize with them and work to make the moment as comfortable as possible. Communication is critical, as is the right hairbrush.

 

We hope this information was helpful! With proper brush and tips, you can brush your child’s hair. With time, they may grow to enjoy the time spent with you.

 

If you are ready to work with the best ABA therapy provider in New York, New Jersey or Indiana, give us a call at (732) 402-0297. Our dedicated team is ready to help and we will treat you like family.

 

 

 

 

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Psychology Test for Children - Toddler Doing Logic Test with Numbers
Manding, Requesting, and Functional Communication

This article is part of our ABA therapy techniques series where we explore the different techniques used by ABA therapists.

Autism spectrum disorder is characterized by communication impairments which can lead to challenging behaviors. In this article, we explain manding, beginner requesting, and functional communication training, techniques used in ABA therapy to help children with autism communicate more effectively.

Manding

A mand is a request for something a child wants or needs. It can be a single word, a statement, or a question. For example, a child may ask for a cookie in several different ways:

 

  • “Cookie” (single word)
  • “I want a cookie” (statement)
  • “Can I have a cookie?” (question)

 

The type and complexity of the mand used will depend on the child’s communication skills and development level. 

 

Mands can take different forms: 

  • Vocal manding or talking
  • Gestural manding, for example, pointing or reaching for the desired item or person
  • Manding through signs
  • Using Picture Exchange Communication System (PECS).

Types of mands

There are many different types of mands. Mands can be requests for: 

  • Items: toys, objects, food
  • Actions: run, jump
  • Ending an activity the child does not want to engage in: “no”, “stop, “all done”
  • Getting attention: “look”, “come”
  • Information using “wh questions”: what, where, who, which, how, and why.

How it is used in ABA therapy

Mands are among the first verbal behaviors taught in ABA therapy. Mand training starts with teaching a child to ask for a reinforcer by using a single word and then gradually building to more complex phrases, questions, and requests for actions, such as “Can I have…”.

In order to mand, a child must be motivated to gain access to an item or to get attention. It is essential that the therapist immediately provides the child with what they are asking for to reinforce the mand. This way, manding is more likely to occur again in the future.

Mand training in ABA therapy consists of the following steps:

 

  • Identify highly preferred items that are exciting enough for a child to mand for them.
  • Withhold the preferred item and prompt the mand. You should not give the item to the child unless they mand for it.
  • Give the child access to the item as soon as they made an attempt or were successful in their mand. 

Benefits of manding

Manding is a strong foundation for developing more advanced language skills in children with autism, such as labeling and identifying items. It is also a good starting point for improving social skills. Finally, children who can mand often have lower rates of challenging behavior because they are capable of communicating their needs in other, more acceptable, ways. 

Beginner requesting

Beginner requesting refers to simple one-word mands and non-verbal communication used by very young children and children who have little or no language. 

There are many types of beginner requesting and not all of them need to be verbal. Some of the ways the child can request an item include: 

  • Pointing to the object
  • Giving the object to the therapist to get help operating it, for example, a bubble maker, a spinning top toy, or a busy board
  • Requesting an item by guiding the therapist to it (pulling them by the hand)
  • Using a Picture Exchange Communication System (PECS) to show the therapist a picture of the desired item and gain access to that item.

How it is used in ABA therapy

Teaching beginner requesting in ABA therapy starts by identifying the child’s preferences through a preference assessment. Children are always more motivated to make a request for preferred items than for neutral or non-preferred ones. 

Additionally, the therapist must set up an environment that offers many opportunities for the child to communicate by requesting. For example, instead of having all the toys easily accessible to the child, some of them should be out of reach, encouraging the child to ask for them (communication temptation). 

For beginner requesting, the child only needs to learn one-word labels for the item. The goal is to have the child request an item spontaneously and eventually transition to intermediate requesting that will strengthen their communication and social skills.

Functional Communication

Functional communication training (FCT) is a differential reinforcement method that consists of finding effective replacements for undesired behaviors. Such behaviors include non-compliance, aggression, destruction, and self-harm. The replacement behavior is more appropriate, but serves the same purpose and allows the child to achieve the same goals as the challenging one.

Through functional communication, children with autism spectrum disorder learn how to use different forms of verbal and non-verbal communication including:

  • Speech
  • Gestures
  • Sign language
  • Symbols

The type of FCT depends on the child’s communication abilities. Nonverbal and nonvocal children can also benefit from a functional communication treatment as they can learn to express themselves in other ways than using spoken language. 

How it is used in ABA therapy

Functional communication training is often the first step in ABA therapy for children diagnosed with autism. It is typically used within a comprehensive ABA program in combination with other therapies.

Functional communication training consists of the following steps:

  • Determine the targeted behavior, for example, a tendency to self-injury when presented with a challenging task.
  • Determine the function of the target behavior, that is, identify its reason and purpose. This is done by completing a functional assessment through observation and data collection. 
  • Decide what communication system works best for the child. This could be either spoken language, sign language, PECS, or a speech-generating device. 
  • Choose an alternative, functionally equivalent phrase that the child could use. For example, the therapist can teach the child to say “I don’t want to” verbally or using pictures and signs instead of displaying aggressive behaviors.
  • Practice and reinforce functional communication. Each time the child uses the phrases given by the therapist instead of engaging in the unwanted behavior, they should be reinforced. At the same time, problem behaviors are systematically ignored. 
  • Prompt or remind the child to use the newly acquired skill whenever appropriate. 
  • Once the child can use simple phrases independently and spontaneously, the therapist can start working on more advanced communication skills. 

 

If you are ready to work with the best ABA therapy provider in New York, New Jersey or Indiana, give us a call at (732) 402-0297. Our dedicated team is ready to help and we will treat you like family.

 

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Mom and her little son visiting the dentist
The Challenges For Children with Autism Brushing Teeth

Neurodivergent children, especially those with autism, can face a massive challenge when brushing their teeth. Autistic children often feel sensations differently from other kids. As a result, the feeling of toothpaste foaming and bristles scrubbing over their teeth can be stressful. 

 

Below, we’ll explore the challenges children with autism face when cleaning their teeth and ways of overcoming these challenges. 

Why is Brushing Teeth a Challenge for a Child with Autism? 

Children with autism can face challenges in many different aspects of life. Some children with autism may struggle in loud environments, while others may find social situations distressing. Another common struggle for children with autism is sensitivity. 

 

Children diagnosed with autism can experience the sense of touch differently from other kids. As a result, some sensations, such as the feel of a toothbrush in your mouth, may feel different, causing the child to become anxious. 

 

The feeling of having your teeth brushed is more than just the feeling of the brush rubbing against your teeth. You also have the strong flavor of the toothpaste as well as a foaming sensation. This can all be a little too much for children on the autistic spectrum, posing challenges when it comes to brushing your child with autism’s teeth. 

Hyposensitivity or Hypersensitivity 

70% of children with autism have sensory processing disorder (SPD), and as high as 95% of children on the autistic spectrum have atypical responsivity to sensations. In other words, most children with autism experience things like taste and touch differently. 

 

Some children with autism have hyposensitivity, which means a reduced sense of feeling. This can result in a numb sensation, which is often confusing and uncomfortable. Causing your child anxiety about the brushing process. 

 

Other children on the autistic spectrum have hypersensitivity. This leaves them with a heightened awareness of sensation. This can trigger overstimulation during brushing, which is unpleasant for your child. However, the process becomes less stressful when brushing is performed with care. 

 

Tips for Brushing a Child with Autism’s Teeth

Brushing your child with autism’s  teeth is an essential but often challenging task. As a result, many children with autism develop subpar oral hygiene, which can lead to issues later in life. To prevent this from happening to your child, you need to know a few hacks that make the process less challenging. 

 

Remember these tips when brushing your autistic child’s teeth:

 

  • Choose a Suitable Toothbrush 
  • Get the Right Toothpaste 
  • Try to Floss 
  • Teach the Child How to Brush Their Own Teeth 
  • Use Incentives and Rewards 
  • Do It in a Comfortable Setting 

 

See below for more information on the tips mentioned above. 

Choose a Suitable Toothbrush 

Not all toothbrushes are the same. Some toothbrushes have stiff bristles for removing plaque from teeth. While others have softer bristles to prevent damage to gums and to reduce the feeling for people with hypersensitivity. You may want to try various toothbrushes to find one that works for your child, but softer bristles are likely the better option. 

Get the Right Toothpaste 

The majority of toothpaste has a strong minty flavor and foams during the brushing process. Both of these sensations can cause your child discomfort. As a result, you should consider trying fluoride-free and unflavored toothpaste to eliminate the feeling causing them distress.  

Try to Floss 

Flossing is an essential step in a dental hygiene routine and prevents the development of gum disease. However, getting your children to floss can be challenging, especially when your child has hyposensitivity or hypersensitivity. So don’t stress if flossing is too much for your child, but it’s worth a try. 

Teach Your Child How to Brush Their Own Teeth 

Teaching and trusting your child to brush their own teeth is an excellent way of teaching independence. Independence is a brilliant motivator and can inspire your child to take care of oral hygiene. When your child is brushing their own teeth, it can also alleviate some of the associated anxiety as they are in control of the process. 

 

Use Incentives and Rewards 

Incentives and rewards are a great way to buy your child’s cooperation when brushing your child’s teeth. You could offer your child a treat, extra time to play games, or anything else that they love to do if they let you brush their teeth. Just remember that any incentives or rewards you offer will likely be expected after every tooth brushing. 

Do It in a Comfortable Setting 

Children on the autistic spectrum can find brushing their teeth uncomfortable and overwhelming. Therefore, if you want to make the process easier, you need to find ways to make the process more comfortable. One way of achieving this is by brushing their teeth in a more relaxed setting like your child’s bedroom. 

Correct Way to Brush Teeth

There is a right and wrong way to do everything, including brushing your kid’s teeth. If you don’t follow the correct way of brushing, it’s likely that some teeth will be missed, or the entire cleaning process will take far too much time. 

 

So, save yourself the time and hassle by following these steps;

 

  1. Starting with the top front teeth, brush the inside, outside, and chewing surfaces five times each
  2. Brush the bottom front teeth next, with five brushes on both the inside and outside of the teeth
  3. Then move to the bottom back teeth and perform five brushes on the inside, outside, and top of the teeth. 
  4. Move up to the top back teeth next, again brushing the inside, outside, and chewing surface five times.
  5. Brush the top and bottom incisors five times on the inside and outside of each tooth. 
  6. Lastly, give all the surfaces a quick once-over before rinsing with water or a mild mouthwash. 

Toothpaste to Try 

Multi-Sensory World: Unflavored Toothpaste is a toothpaste specially formulated for people who are sensitive to strong flavors. This product is also non-foaming, yet it still contains the recommended amount of fluoride to still be effective as a teeth cleaner. 

 

Dr. Bob Unflavored Toothpaste is SLS-free (non-foaming), free from artificial flavorings, free from dyes, and free from strong flavors. This affordable toothpaste was designed for young children and for children with atypical sensitivity. 

 

Jack N’ Jill Natural Kids Toothpaste is vegan toothpaste that contains zero fluorides. This toothpaste contains no harsh chemicals, gluten, or dairy and is made from natural ingredients. As a result, this toothpaste is even safe to swallow during brushing. 

Toothbrushes for Autistic Kids

bA1 Sensory – 3-Sided Autism Toothbrush for Special Needs Kids is a soft brush clinically proven to make teeth cleaning more manageable and less stressful for autistic and special needs children. The brush achieves this by covering twice as much surface area with every stroke, drastically reducing the time needed to brush your child’s teeth. 

 

Bright Autism Special Needs Toothbrush is a brush specially designed for children with sensitive gums. The bristles on this toothbrush curve across into an arch as opposed to sticking out straight from the brush. This reduces the sensation of brushing and can make a significant difference in brushing your kid’s teeth. 

 

Happi Teeth 360 Degree Electric Toothbrush is an automatic toothbrush equipped with ultrasound brushing and thousands of bristles. The Happi Teeth brush also comes with sounds and a singalong voice to make the brushing engaging for children. To top it off, this toothbrush is shaped like a mouthguard, and it cleans all your teeth in under a minute with minimal effort. 

Final Thoughts 

Children with autism often have hyposensitivity (lack of stimulation), or hypersensitivity (too much stimulation), making oral hygiene a challenge. However, if you brush your autistic child’s teeth gently, follow the correct procedure, and implement some strategies like offering incentives, you can alleviate the anxiety associated with brushing your child’s teeth. 

 

If you are ready to work with the best ABA therapy provider in New York, New Jersey or Indiana, give us a call at (732) 402-0297. Our dedicated team is ready to help and we will treat you like family.

 

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Functions of Behavior

ABA therapists rely on the functions of behaviors to determine the reasons behind challenging behaviors in children with autism and devise suitable treatment plans. Keep reading to learn more about the different types of functions of behavior and how they are used in ABA therapy.

What Are the Four Functions of Behavior?

Applied behavior analysis (ABA) therapy is based on the assumption that all behavior serves a function or purpose. When a child with autism behaves in a disruptive way, it is because this behavior meets that child’s specific need.

Identifying and understanding the functions of behaviors can help ABA therapists prevent challenging behaviors in children with autism and teach them other, more appropriate ways to have their needs met. 

ABA distinguishes among four main functions of behavior: 

  • Escape
  • Attention
  • Access to tangibles or activities
  • Sensory stimulation 

Escape

Children with autism engage in escape behaviors to delay or avoid undesirable activities or interactions with others. Escape behaviors often result from a lack of motivation or ability to perform a complex task.

Typical escape behaviors include:

  • Running away when asked to do a difficult task
  • Hiding when confronted with a challenging situation
  • Tantrums or physical aggression when faced with an uncomfortable situation 
  • Throwing objects on the floor to escape an activity
  • Avoiding certain people or situations
  • Self-injurious behavior

While all children occasionally engage in escape behaviors, children with autism show much higher rates and greater intensity of these behaviors than their neurotypical peers. 

Attention

Children on the autism spectrum engage in attention-seeking behaviors to force others to pay attention to them or to provoke certain reactions. These reactions can be positive, for example, seeking recognition for doing something good, or negative, such as eliciting anger or scolding from parents and teachers.

Dysfunctional attention-seeking behaviors include:

  • Raising voice
  • Crying
  • Whining
  • Throwing a tantrum
  • Aggression towards others (hitting, kicking, or biting)
  • Self harm

When managing attention-seeking behaviors in children with autism, it is essential to consider safety as these behaviors can be dangerous, either to the self or others. 

Access to tangible items or activities

A child with autism may behave in a certain way to gain access to a preferred toy, food item, or activity. In this case, the child is not trying to avoid a situation, but is actively doing something in order to get what he or she considers to be a reward. 

Access behaviors include:

  • Throwing a tantrum
  • Crying
  • Whining
  • Aggression
  • Taking the desired object away from someone else
  • Self-injurious behavior

Unlike escape and attention-seeking behaviors, behaviors whose main function is access are often positive. For example, a child might get dressed or do their chores quickly to be allowed to play outside. 

Sensory stimulation

The sensory behavior function refers to the child’s repetitive body movement or sounds whose purpose is to provide a calming feeling, reduce sensory overload, or remove an uncomfortable internal sensation, like pain or itching. Contrary to escape, attention seeking, and access to tangibles, the purpose of this function of behavior is not to gain attention from others. 

Behaviors that have sensory stimulation as a function include:

  • Rocking back and forth
  • Scratching
  • Picking at hair or skin
  • Cracking knuckles
  • Hand flapping
  • Twisting hair
  • Humming 

Although some of these actions may appear as self harm, this is not the goal of sensory behaviors. They are not necessarily negative, unless they hurt the child, like severe hand biting, or affect their attention to the outside world. 

Can a Single Behavior Have More than One Function at Once? 

A single behavior can have more than one function. For example, a child may throw a tantrum in class both in order to gain attention from a teacher and to escape from completing a difficult task. What’s more, some behaviors serve all four functions at once—they can be used for attention, escape, access, and sensory stimulation. 

 

In ABA therapy, behaviors that have more than one function are referred to as multiply controlled behaviors. They usually have a primary and a secondary function. The primary function occurs more often and with more intensity than the secondary one.

How Aba Works with the Four Functions of Behavior

A therapist will start by observing the child in their environment to determine what happens before and after the problem behavior occurs. Once the therapist understands why the child engages in disruptive behavior, he or she can develop an intervention strategy and teach a replacement behavior. It is essential that this behavior can meet the same need as the negative behavior, but in a more socially acceptable way.

Positive reinforcement technique

ABA therapists use the positive reinforcement technique to reduce problematic behaviors. To do so, they first need to identify the consequence that is reinforcing the behavior and remove it, a process referred to as extinction. For example, if a child yells out to get the teacher’s attention in the classroom, the teacher has to stop giving attention to avoid reinforcing the negative behavior.

The therapist will also use aspects of reinforcement to replace negative behaviors with positive ones. If the child is using disruptive behavior as means of obtaining attention, not only does this behavior need to be discontinued, but the child also has to learn how to get attention in a more appropriate way, for example, by raising a hand before speaking.

Children with autism thrive on predictability and with consistent practice, they will learn that problematic behaviors are not useful and will engage in them less often. Because every child with autism is different, ABA therapists work with the child and parents to find the best approach for addressing the challenging behavior.

ABC in ABA

The ABC method is one of the techniques used by ABA therapists to identify functions of behavior in children with autism.

 

ABC stands for:

 

  • A – Antecedent
  • B – Behavior
  • C – Consequence

Antecedent

Antecedent or what happens right before the child engages in the target behavior. In some cases, the antecedent is the root cause of the behavior of the child. For example, the child hasn’t had a cookie in a while.

Behavior

Behavior follows the antecedent, for instance, the child asks for a cookie.

Consequence

The consequence is what happens directly after a behavior. For example, the child gets a cookie after pointing at the cookie jar. Repeated consequences will reinforce the behavior.

 

Seeing behavior as a logical chain of progression allows therapists to better understand why a child is acting in a certain way.

Recording ABC data

Recording in-depth ABC data helps determine what factors lead to a child’s behavior and hypothesize its function. This way, the therapist can estimate what environmental triggers may cause the negative behavior, at what time of day it is more likely to occur, and how long it may last.

 

ABA therapists use ABC data sheets to map out specific behaviors and examine the function of behavior. They observe and record all instances of behavior, as well as what happened right before the behavior (antecedent), what happened immediately after the behavior (consequence), and what outcome did the child achieve (the function of the target behavior). 

 

By looking at the entire cycle of behavior, the therapist can gain a greater understanding of a child’s behavioral patterns and, as a result, create a comprehensive treatment plan.

 

If you are ready to work with the best ABA therapy provider in New York, New Jersey or Indiana, give us a call at (732) 402-0297. Our dedicated team is ready to help and we will treat you like family.

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Signs and Symptoms of Autism

Autism spectrum disorder (ASD) or autism is a developmental disability that is both very common and highly misunderstood. ASD is caused by differences in the brain and can often lead to challenges with social interactions, learning, moving, paying attention and other life skills.

However, sometimes it can be difficult to diagnose this disability. Here are some of the signs and symptoms to look for.

Causes of Autism

The exact cause of ASD is still unknown, and most experts agree there is no single cause. However, there are certain risk factors that may lead to autism, including genetics. Autism can run in families or be caused by a fragile X syndrome.

There are other factors commonly linked to ASD including:

          Being born to older parents

          Low birth weight

          Metabolic imbalances

          Exposure to environmental toxins and heavy metals

          Maternal history of viral infections.

Essentially, experts believe that both genetics and environment can impact a person’s chances of developing ASD.

Symptoms of Autism

The symptoms of autism can vary from person-to-person, but these are the most common signs to look for across different ages.

Babies

It can be difficult to diagnose babies with autism, as so many of the common signs and symptoms don’t present until children are old enough to socially interact with adults. The most common symptom of autism in babies is a lack of eye contact.

Other symptoms that may indicate autism include:

          Showing no or less response to a parent’s smile

          Not looking at objects that parents point to or look at

          Failing to point at objects

          Abnormal facial expressions

          Not talking by 15 months

However, a lack of eye contact isn’t the only sign or symptom to look for, so make sure to talk to your pediatrician first.

Children

Individuals with autism are most commonly diagnosed when they are children. There are several signs that may indicate your child should be checked for autism. This includes:

          Not responding to their name

          Not smiling when they look at you

          Repetitive body movements

          Not interacting with other children

          Difficulty making and keeping fiends

          Not showing empathy

If you have noticed these symptoms in your child, then you should contact your doctor for more information.

Adults

Even though many individuals are diagnosed with autism before they reach adulthood, this isn’t always the case. There are many adults who aren’t diagnosed until later in life. Some of the signs and symptoms of autism in adults include:

          Difficulty regulating emotions

          Frequently stating monologues on the same subject

          Difficulty reading other people’s emotions

          Trouble maintaining conversations

          Discomfort during eye contact

          Extreme interests in only one topic

          Difficulty making or maintaining close friendships

          Getting too close to other people

          Getting upset if someone touches or gets too close to them

These types of social challenges in adults can be an indicator of undiagnosed autism.

Areas That Autism Can Affect

If you aren’t already familiar with autism, then it may be difficult to determine which areas of life this disorder can impact. While autism is a spectrum and can influence different people in different ways, these are some of the most common ways this condition can impact individuals in their day-to-day life.

Social Interactions

This is perhaps the most recognizable way autism can impact older children and adults. It can be very difficult for someone with autism to understand boundaries, social “rules” like not talking over people, or how to make and keep friends.

Repetitive Behaviors

Repetitive behaviors are one of the hallmark features of ASD. Many individuals with this condition engage in repetitive motor movements such as hand flapping, fidgeting or rocking. Some individuals with autism will also say certain words on repeat or have repetitive vocalizations.

Anxiety or Excess Worry

Anxiety is a lesser-known impact for those with ASD, but generalized anxiety is actually one of the most common comorbid conditions associated with autism. When anxiety is able to be treated in those with autism, it can actually help with some social challenges and repetitive behaviors.

Delayed Cognitive Skills

Some children with autism have delayed cognitive skills, many of which are similar to those seen in children with attention deficit hyperactivity disorder or ADHD. However, even though some children with autism have certain learning challenges particularly with paying attention, they often also have cognitive strengths, such as an acute attention to detail.

Unusual Eating or Sleeping Habits

Many individuals with autism will possess unusual eating habits including limited food preferences and hypersensitivity to food textures and temperatures. Sleeping also tends to be a challenge, as many individuals with Autism struggle to fall asleep and stay asleep on a nightly basis.

How ABA Therapy Can Help Your Kid With Autism

Identifying the signs and signals of Autism is only half the battle. Parents of children with Autism should also be exploring some of the different therapies available. The right therapy can help individuals with Autism overcome some of their challenges and learn to thrive in their day to day lives.

The key is not “curing” autism, as there is no cure, but helping those with ASD possess the skills they need to limit autism’s impact on their lives.

One of the most researched and effective forms of therapy for individuals with autism is known as Applied Behavior Analysis, or ABA, therapy. This therapy teaches individuals with ASD functional behaviors and new skills by promoting appropriate behaviors and discouraging inappropriate ones.

Here at Golden Care Therapy, we provide in-home autism services to children and their families utilizing ABA therapy. Our goal is to help children with Autism to possess the mental, physical and emotional skills they need to live their best lives possible. 

If you are ready to work with the best ABA therapy provider in Indiana, New Jersey, or New York, give us a call at (732) 402-0297. Our dedicated team is ready to help and we will treat you like family. 

 

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Autism and Bathing Issues

Bathing is an essential aspect of our personal hygiene. While baths are famous for their unique soothing effect, children with autism often find this activity challenging for a variety of reasons. 

 

In this article, we will look at why children with autism may struggle with bathing and how to make bath time fun for them.

Why May Someone with Autism Have a Bathing Issue?

Bathing may come as second nature to many of us. A closer look, however, reveals that a bath may be more complicated than it seems on the surface, explaining why bath time can be overwhelming for kids on the spectrum.

 

It is quite common for children with autism spectrum disorder to be unwilling to engage in activities related to personal hygiene. And this issue often leaves parents feeling helpless and mentally stressed. But fortunately, it is a challenge you can overcome with your younger one. 

 

The first step in addressing the bathing issue in your autistic child is becoming aware of and understanding the underlying causes of the difficulties they face in the tub or shower.

 

The following are ASD characteristics that might influence your kid’s aversion to bath time.

 

  • The tendency to get upset by slight alterations.
  • The desire to stick to certain routines and schedules.
  • Specific repetitive motions like hand flapping, body rocking, and so on.
  • Unpleasant reactions to how surrounding items appear, smell, sound, feel, or even taste.
  • Hyperactive and impulsive behavior.

 

While these ASD characteristics can contribute to your child’s unwillingness to bathe, there is always the small matter of heightened senses.

Heightened Sensory Issues

Children on the spectrum are often hypersensitive to environmental stimuli. And considering that bathing involves several simultaneous actions, it can be confusing and emotionally stressful for them. This distress could be intensified in an autistic kid with sensory processing disorder (SPD) – a condition that affects how the brain comprehends sensory information (stimuli).

 

Here are some things or conditions that may trigger your autistic child’s heightened senses during bath time.

 

  • The feeling of water on the skin, hair, or face.
  • The sounds of splashing and running water.
  • Water temperature and water level in the tub.
  • Bright bathroom lights.
  • Reflecting illumination from mirrors.
  • The feeling of soap on their skin and shampoo in their hair.
  • The smell of bathing soaps and hair shampoos.
  • The feeling of being wrapped in a towel.
  • The slippery texture of the bathtub’s surface. 

 

Because of their limited emotional capacity, processing all of the aforementioned sensory stimulations at once can be particularly difficult for children with autism. This may result in a child’s resistance, meltdown, or complete refusal to cooperate.

Fear of Getting Soap in their Eyes

Your child on the spectrum may also have issues with bath time due to the fear of getting soap or shampoo in their eyes.

 

As we advance, we’ll discuss how you can help someone with autism deal with their bathing issues.

Tips for Bathing Someone with Autism

While bathing your autistic child can be mentally exhausting for them, it can also leave you feeling confused and helpless. For this reason, we’ve devised various means to make bath time enjoyable for both you and your kid. 

 

Below are practical tips for bathing your loved one on the autism spectrum.

Pick a time that works for them

For children with ASD, routine gives a sense of stability in a somewhat unstable environment. So, if bath time happens at the same time and in the same way every day, your autistic child may start to feel less anxious about an unexpected event in the tub or shower.

Prepare the bath in advance

After figuring out the reasons behind your loved one’s bathing issue, the next step is to ensure that the shower or tub is prepared to suit their sensitivity and safety. For instance, if your child is sensitive to sound, you should try using a bathtub and ensure it is filled in their absence.

 

Additionally, you should consider the temperature of the bath water and its level in the tub. Remember, the purpose of this preparation is to ensure your autistic kid is comfortable – or at least less anxious – during bath time.

Make a to-do list

Your level of preparedness – as a parent – can influence how smoothly your child’s bath time will go. While preparing to bathe your autistic child, a checklist of things to do may come in handy.

 

Moreover, if someone else has to bathe your loved one, your to-do list should assist them in keeping the bathing session as routine as possible.

Minimize fragrances

Since you can’t predict how your child with autism will react to unfamiliar smells, it is best to keep the bathroom fragrance-free. You can achieve a fragrance-free bathroom by avoiding air fresheners and scented bathing soaps.

Decide if a shower or bath is better

You should choose between a shower and a bath based on your child’s preference and level of water sensitivity. Before making a decision, try both a tub and shower with your autistic kid while ensuring to follow a routine, prepare in advance, and minimize bathroom fragrances.

Toys for Bath Time 

Toys can be used as a distraction for children with ASD during bath time. Moreover, toys will make bathing a fun activity to look forward to. Below are a few items you can use while bathing your autistic loved one.

Sensory Sponges

This 14-piece sponge set will surely meet the tactile and sensory preferences of your child on the spectrum. With various sponge textures, there are enough options for your loved one to choose from.

Bath Crayons

If your autistic child enjoys drawing or painting but dislikes shower time, these washable bath crayons should be a good distraction. Your child can use the crayons to scribble or draw on slick surfaces without making a mess.

PipSquigz 

This 3-piece toy set is made from high-quality silicone with aesthetically pleasing colors. The PipSquigz can provide an all-in-one sensory experience to your child during the bath.

 

Besides toys and other distractions, you must also pay attention to the type of shampoo and bathing soap your autistic loved one uses.

Shampoo, Body Wash, and Conditioner for Autistic Children

As inferred earlier, items like shampoos and body wash are essential to your autistic kid’s attitude towards bathing. Here are a few recommended products for bathing your child on the spectrum.

 

Nature Clean Kids Shampoo & Body Wash – It is a dual-purpose product that is safe, fragrance-free, and unlikely to cause an allergic reaction in your younger one.

 

Suave Sensitive Skin 3-in-1 Shampoo, Conditioner, Body Wash – This three-in-one product takes care of both skin and hair. It is perfect for kids with sensitive skin.

 

Babi Botanicals Sensitive Baby Fragrance Free Shampoo & Wash – This fragrance-free organic product cleans sensitive skin perfectly. It is also suitable for your kid’s hair.

 

If you are ready to work with the best ABA therapy provider in Indiana, New Jersey, or New York, give us a call at (732) 402-0297. Our dedicated team is ready to help and we will treat you like family. 

 

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Differential Reinforcement

Differential Reinforcement

This article is part of our ABA therapy techniques series where we explore the different techniques used by ABA therapists.

 

Differential reinforcement is one of the most important tools used in ABA therapy. This technique can help improve unwanted behaviors and strengthen the desired ones in children with autism. Continue reading to find out more about differential reinforcement and how it works. 

What Is Differential Reinforcement?

Differential reinforcement is the preferred method for encouraging appropriate behaviors and reducing disruptive ones in children with autism spectrum disorder and other developmental disabilities. This technique can be used both by parents, teachers, and applied behavior analysis (ABA) therapists.

 

The differential reinforcement procedure is based on the belief that reinforcement strengthens the association between a behavior and receiving a reward. In other words, children tend to repeat rewarded behaviors and are less likely to pursue those that are being ignored. 

The Goal of Differential Reinforcement

The goal of the differential reinforcement technique in ABA therapy is to reduce unwanted behaviors in children with autism and replace them with desirable ones. 

How Does It Work?

Differential reinforcement consists of two main components:

  • Reinforcing the appropriate behavior, and
  • Withholding reinforcement of the inappropriate behavior

Reinforcing the appropriate behavior

Reinforcement consists of rewarding a child after displaying the desired behavior in order to increase the probability that the same behavior will occur again in the future. For example, each time a child plays appropriately with toys instead of throwing them, he or she receives a reward. The type of reinforcement will vary depending on the child’s preferences and the situation and can be anything from a preferred snack to playing with a favorite toy, or even verbal praise.

 

For optimal results, positive reinforcement should be implemented as soon as a child performs the target behavior. A reward can also be provided for an incompatible behavior or simply the absence of the challenging behavior. 

 

On the other hand, reinforcement is not provided when the desired behavior does not occur. If a child is reinforced and given attention for both appropriate and challenging behaviors, he or she is more likely to continue engaging in the challenging behavior. 

Withholding reinforcement

Unlike traditional discipline methods which use punishment to discourage negative behaviors, the essential part of differential reinforcement is ignoring these behaviors. This means that instead of providing positive or negative reinforcement, the therapist will avoid making eye contact with the child, remain silent, or move away. If a child’s negative behavior is not reinforced over time, it will eventually cease.

It is important to keep in mind, however, that withholding reinforcement often causes the negative behavior to escalate before it starts improving. That’s why implementing this technique requires plenty of consistency and patience.

Read on to learn more about various types of differential reinforcements implemented in ABA therapy.

How to Use Differential Reinforcement?

ABA therapists use several forms of differential reinforcements, depending on the type of target behavior. The four most common ones are: 

  • Differential reinforcement of alternative behavior (DRA)
  • Differential reinforcement of incompatible behavior (DRI)
  • Differential reinforcement of other behavior (DRO)
  • Differential reinforcement of low rates (DRL)

Differential reinforcement of alternative behavior (DRA)

Differential reinforcement of alternative behavior (DRA) entails reinforcing a behavior that may serve as an alternative to the unwanted behavior. The two behaviors are not necessarily incompatible. 

 

For example, a child shouts out each time the teacher asks a question. In this case, the teacher may decide to use the DRA technique and reward the child for raising a hand to answer a question, which is more acceptable behavior. It is not incompatible with shouting out and both behaviors can occur at the same time. 

 

DRA can be successfully used in a variety of settings to simultaneously reduce problem behavior and reinforce a new skill in children with autism. At the same time, it is essential to systematically teach appropriate replacement skills in addition to reinforcing them. The alternative behavior must also be easier for the child to engage in when compared to the challenging behavior.

Differential reinforcement of incompatible behavior (DRI)

Differential reinforcement of incompatible behavior (DRI) is similar to DRA, as reinforcement is withheld for challenging behavior and provided for an appropriate replacement behavior. The main difference between the two methods is that DRA deals with behaviors that are incompatible and can’t occur at the same time.

 

For example, a child frequently leaves the seat during class. The teacher ignores this unwanted behavior, however, whenever the child remains seated, he or she is rewarded with a sticker or praise. These two behaviors are mutually exclusive and incompatible—the child can either stand up or remain seated. 

Differential reinforcement of other behavior (DRO)

Differential reinforcement of other behavior (DRO) reinforces any behavior except for the unwanted one. Reinforcement is provided if challenging behavior does not occur within a specified interval of time.

 

An example of this type of differential reinforcement is a child who repeatedly leaves the seat during dinnertime. The parent may decide to set a timer for fifteen minutes. If the child remains seated during this allotted period of time, he or she is rewarded with a favorite activity or a treat after dinner.

 

Although the DRO is a good starting point in situations where it is not possible to quickly identify an appropriate replacement behavior, this technique has some drawbacks. It does not involve systematic teaching of appropriate replacement behavior. Additionally, since only the absence of a specific challenging behavior is reinforced, the child may turn to other unwanted behaviors. 

Differential reinforcement of low rates (DRL)

Differential reinforcement of low rates (DRL) is used to reduce the frequency of challenging behaviors instead of eliminating them entirely. This technique is typically used for repetitive behaviors that are otherwise socially acceptable, such as repeatedly washing hands. 

 

Using the DRL technique, the teacher rewards the child if he or she avoids washing hands more than once before lunch. This encourages the child to reduce the frequency of behavior that is in itself positive, under the condition that it is not repetitive. 

 

If you are ready to work with the best ABA therapy provider in Indiana, New Jersey, or New York, give us a call at (732) 402-0297. Our dedicated team is ready to help and we will treat you like family. 

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