ADHD
Can ABA Therapy Be Used for ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a common mental disorder affecting both children and adults. Researchers estimate that 8.4% of children and 2.5% of adults have ADHD.

 

Below, you’ll find information on the different types of ADHD and new information on Applied Behavioral Analysis (ABA) as a possible treatment for the disorder.

 

What is ADHD?  

ADHD is one of the most common neurodevelopmental disorders of childhood. While children are typically diagnosed at a young age (when they display symptoms in the classroom), it also may be diagnosed in adulthood as well.

 

Children with ADHD may display the following common symptoms:

          Inattention– Trouble paying attention or staying focused on a task 

          Impulsivity– The inability to control impulsive behaviors and therefore acting hastily without giving thought to the consequences 

          Hyperactivity– Excessive physical movement and the inability to sit still 

 

Other symptoms include forgetfulness, talking too much, and difficulty getting along with others.

Not everyone who has ADHD will display all of these symptoms.

 

3 Types of ADHD

There are three main types of ADHD, and a different dominant trait characterizes each.

 

  •         Inattention – Those who have a predominantly inattentive presentation often have a hard time organizing their time, finishing tasks, keeping their attention on one thing at a time, paying attention to detail, and following instructions. Their inability to focus may cause them to be so easily distracted that they may have difficulty following conversations and even forget details of their daily routines.  

 

  •         Hyperactivity and Impulsivity – In some people, ADHD manifests itself in fidgeting, squirming, and a general inability to sit still. Impulsivity can mean anything from interrupting people often or speaking at inappropriate times to being unable to wait their turn.

 

  •       Combined – Most people with ADHD have a combination of these two types. However, ADHD can change over time. So, a child might be hyperactive and impulsive but learn to control it as an adult while still suffering from the inability to focus.

 

What is ABA therapy?

Applied Behavioral Analysis (ABA) is a treatment used for children on the autism spectrum. It helps them develop cognitive, social, language, and daily living skills. ABA also helps reduce problematic behaviors.

 

This approach is personalized and is designed to help counselors and loved ones understand how a child’s behavior is affected by their environment and the circumstances under which they learn new skills. Ideally, it helps increase communication by improving language skills, improves attention and focus, and uses positive reinforcement to encourage positive behavioral change.

 

Is ABA therapy effective for children with ADHD?

The CDC lists behavioral therapy as a helpful option to reduce problematic behaviors in children with ADHD as well as those with autism. Research indicates that a combination of medication and ABA therapy is the best course of action for most children. Still, some young children may be too young for medication. Parents who practice ABA techniques can help manage problem behaviors early on in these cases.

 

ABA therapy has a long history and has changed dramatically over time. Most notably, it no longer encourages punishment for poor behavior and focuses primarily on rewarding and encouraging good habits. While the therapy doesn’t “cure” autism or ADHD, it does help people with the conditions live their best and most independent lives.

 

What ABA techniques can help those with ADHD?

ABA therapy is designed to bring about meaningful change in an individual’s actions by looking at behavior as a 3-step ABC process: the antecedent (a cue or instruction), the behavior, and the consequence. The ABA techniques generally focus on one or more of these moments and how they influence the others.

 

There are many ABA techniques a parent or therapist can use to encourage more functional behaviors in children with ADHD. These include:

 

·         Differential Reinforcement of Behaviors

This strategy is designed to reinforce good behavior by rewarding positive interactions. While punishment was once used to discourage negative actions, nowadays, the therapist or parent simply withholds positive reinforcement.

 

·         Discrete Trial Training (DTT)/Task Analysis

This method involves breaking down complex lessons into simple “discrete” components. It uses tangible rewards to show the positive consequences of good behavior.

 

·         Pivotal Response Training (PRT)

The child initiates this play-based therapy. It targets the “pivotal” areas of a child’s development in an attempt to improve social skills, communication, behavior, and learning.

Motivation strategies are neutral in PRT training – that is, they relate directly to the behavior exhibited by the child. For example, if a child makes a meaningful request for something (such as a toy), the therapist or parent provides it. No unrelated treats or toys are used to motivate good behavior.

 

·         Self-Management Training

This method is often used with older children and adults. It involves creating a plan that they can follow through on in order to manage their own behavior. In order to teach self-regulation skills, the therapist provides them with ways of rewarding themselves (including positive self-talk) when they’re proud of their behavior. It also teaches people to become aware of their own negative behaviors.

These therapies work well for ADHD patients because they are designed to help with regulating one’s behavior. Children with ADHD have trouble with impulse control. They are often disruptive, not understanding how others interpret their behavior. 

ABA therapy helps give them a sense of socially responsible ways to act. However, it cannot change their brain chemistry.

While children who receive ABA therapy for ADHD often use less medication later in life, it’s important to remember that the condition is not one of self-control. It is the result of a significant difference in brain chemistry and cannot simply be “trained out” of someone. 

However, learning good behavior is the first step. The more a child practices and is rewarded for it, the more the positive actions may become their reflex.

If you are interested in learning more about ABA techniques to treat a child with ADHD, it’s important to find a professionally trained and licensed counselor with direct training in these methods.

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ABA Therapy
Can Medicaid Cover ABA Therapy for Your Autistic Child?

If you have a child with autism, you may have heard of ABA therapy and how effective it is at helping work through behavioral issues. This article will help you understand the benefits of ABA therapy. If you live in New Jersey, it will also help you determine if your child is eligible to have ABA therapy covered by Medicaid.

What Is Medicaid?

Medicaid is a healthcare plan that can help partially, or fully, cover certain medical expenses. The program is subsidized by the federal government; however, it is provided by each state. The specific rules, qualification standards, and coverages change slightly by state. 

In New Jersey, this health insurance can be used by pregnant women, parents, caretakers of dependent children, blind individuals, the elderly, and the disabled. It can pay for many health services, including hospital stays, doctors, medications, and even home care.

To qualify you’ll need to be an American citizen and meet specific financial benchmarks that prove your need for government assistance.

What Is ABA Therapy?

ABA, or applied behavior analysis, is a kind of behavioral therapy. It teaches autistic children functional skills, like how to complete simple tasks. It can also encourage positive behaviors and can help your autistic child become better at interacting with others. These are big goals, but they are met by breaking them down into smaller pieces that are easier to understand and master.

How Does ABA Therapy Work?

This therapy can help an autistic child with a wide range of skills. First, a therapist will work with you and the child to pinpoint where your child needs the most help. After that, an ABA plan can be made for them. 

What this plan may include?

This plan can help your child work through language and communication issues. Through reinforcement methods, you can also help promote positive behaviors in your child, while the negative behaviors become less prevalent. 

ABA therapy can also help your child learn how to do simple tasks, like getting dressed and ready in the morning, which are often difficult for autistic children.

Overall, with these new skills and confidence, your child will be better equipped for social interactions, they will know how to complete basic life skills and have the know-how to acquire new skills independently.

You’ll make a schedule with your therapist that fits into your lifestyle. They’ll work with you to ensure the therapy takes place in an environment that your child is comfortable in. This can include at school, daycare, or even at home. Once therapy begins, the real work starts and you’ll be there to support your child through the processes!

How Much Does ABA Therapy Cost in New Jersey?

This will depend on where you live and what therapist you turn to. Typically, though, a single hour of ABA therapy will cost around $120. The costs will quickly add up with multiple sessions, and this estimate does not cover initial appointment and analysis costs.

Don’t forgo this vital therapy because your family is under financial strain. After all, it can help your child live a more fulfilling, self-reliant, and successful life. Finding alternative ways to cover the cost if you don’t have insurance, like through Medicaid, will be a great benefit to your autistic child and your family.

Is ABA Therapy Covered by Medicaid in New Jersey?

For many years, Medicaid did not cover autism therapy treatments like ABA. However, as of April 1, 2020, the state of New Jersey now offers Medicaid assistance for numerous services that can help autistic children.

These services include nearly everything, including physical, occupational, and speech therapies. Along with that, all the assessments that will be done on your child to create an effective ABA therapeutic strategy are also covered by New Jersey Medicaid.

Approximately 40% of autistic children in New Jersey need ABA therapy, and Medicaid makes it more accessible for those who would have difficulty giving their child this help without assistance. Any autistic children who need ABA therapy will get reimbursed for the costs associated with this therapy if they are protected under a Medicaid plan.

How to Get Medicaid Coverage for ABA Therapy in New Jersey

As for any other medical assistance you’d like to seek from the state, you must be enrolled in Medicaid to get these benefits. If you are not already enrolled for Medicaid, reach out to your County Welfare Agency to see if you’re eligible or screen for your own eligibility at NJ Helps

You will also need to have your child taken to a doctor and officially diagnosed with autism spectrum disorder (ASD). Without an ASD diagnosis, you won’t get access to these benefits, even if your child needs them. 

The physician may also recommend a treatment plan for your child or direct you to a specialized person who is better equipped to make a treatment plan. This will hopefully lead you to an ABA therapy service that fits your child’s needs.

After getting your child diagnosed with ASD and finding the right treatment plan, get in touch with different ABA services to see if they accept Medicaid assistance. Once you find the right service provider, treatment can begin and your child can start receiving the benefits of ABA therapy. 

Medicaid Can Help

If you have a child with autism, you are not alone. Skilled therapists are waiting to help you and your child. They can help prepare your child for the world by using ABA therapy techniques to teach them important skills and encourage beneficial behaviors that they’ll use their whole life.

Don’t let your child fall behind. With the new Medicaid services available in New Jersey, your child can get the therapy they need without you having to worry about the cost.

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child assessment
Functional Behavior Assessment (FBA)

Functional behavior assessment (FBA) is a method of determining the causes of negative behaviors in children that may interfere with their education. Once the driving force behind an unwanted behavior is identified, a therapist can propose solutions for improvement. Read on to learn more about how ABA therapists use functional behavior assessment. 

What Is a Functional Behavior Assessment? 

Functional behavior assessment (FBA) is a process of identifying challenging behaviors, particularly within a classroom setting. Negative behaviors, such as refusing to work on a task, responding in an inappropriate way, or having angry outbursts, may get in the way of the child’s ability to learn and hinder the academic progress of other students. 

 

The purpose of conducting a functional behavior assessment is to better understand the relationship between the inappropriate behavior and the environment in order to develop strategies for improvement.

How does it work?

Functional behavior assessment is based on the belief that every behavior serves a specific purpose or a function. The most common functions of a child’s behavior are:

  • Escaping a situation
  • Seeking attention
  • Gaining access to something 
  • Automatic reinforcement.

In functional behavior assessment, a behavior is never simply labeled as “bad.” By understanding why a child behaves in a certain way, it is possible to develop effective improvement strategies.

Functional behavior assessment can be done at school, at home, or another place where the child receives mental health services. 

When is it used?

Functional behavior assessment is used when typical school interventions are not effective in controlling the child’s problematic behavior. The method is employed with both regular and special education students, and may serve as confirmation of a child’s disability. Functional behavior assessments are also the starting point for creating positive behavior support plans for children in special education and applied behavior analysis (ABA) autism treatment plans.

The assessment can be completed at school, at home, or in another setting where the child receives mental health services. 

Below, we explain how ABA therapists use this method when working with autistic children with behavioral challenges.

How Do ABA Therapists Use Functional Behavior Assessments?

A functional behavior assessment is typically conducted by a licensed professional such as an applied behavior analysis (ABA) therapist. The therapist may work together with the school counselor, the child’s teacher, and parents to create a treatment plan.

 

The therapist starts by analyzing the child’s behavior and making a hypothesis about the functions that the behavior serves. Consequently, they can create a targeted intervention plan that will help modify the negative behavior.

 

Through functional behavior assessment, an ABA therapist: 

 

  • Identifies interventions necessary to reduce the undesirable behavior
  • Proposes alternative behaviors that the child can use instead of the unwanted ones
  • Determines the appropriate placements and services.

 

Continue reading to learn more about the different stages of a functional behavior assessment.

Steps of an FBA

A functional behavior assessment takes about 30 days to complete. It consists of the following steps:

  • Define the challenging behavior
  • Gather and analyze information
  • Find out the reason for the negative behavior
  • Make a plan to encourage positive behavior.

Define the challenging behavior

The first step of an FBA is to observe and describe the challenging behavior. The observation must be fact-based and should not represent an assumption about the child’s feelings. For example, the therapist may note that the child throws objects in the classroom instead of stating that the child is not interested in the lesson. 

Gather and analyze information

During the second stage of an FBA, the therapist will try to answer the following questions:

  • When does the behavior occur?
  • Where does the behavior occur? 
  • In what circumstances does the behavior not occur?
  • How often does the behavior occur?
  • Who is around when it occurs (peers, adults)?
  • What triggers the behavior?
  • What happens after the behavior occurs?
  • What more acceptable behavior can be used as an alternative?

Therapists use various methods to gather the information that will help them analyze the behavior, for example: 

 

  • Direct observation of the behavior
  • Questionnaires and interviews
  • ABC charts that help collect data about:
    • Antecedent (what happens before)
    • Behavior (describing the behavior itself)
    • Consequences (what happens after).
  • Charts that track the frequency, duration, and intensity of the behavior.

Find out the reason for negative behavior

Using the information that was collected in the second FBA stage, the therapist will outline a hypothesis about the causes and functions of the behavior. 

 

The hypothesis must be accompanied by a detailed report that includes:

 

  • Information and data gathered about the behavior
  • A description of the analysis procedures that were used
  • Comprehensive recommendations on how to reduce negative behaviors.

Make a plan to encourage positive behavior 

The final step of an FBA is creating a Behavior Intervention Plan (BIP). This document explains how to reduce negative behaviors and replace them with more appropriate ones. 

 

The plan must include the following elements: 

 

  • Specific changes that are necessary in order to reduce or eliminate problematic behaviors, for example:
    • Modifications in the physical environment
    • Changes in the way the information is presented to the student
    • Introducing other consequences for the unwanted behavior
  • Replacement behaviors that will serve the same function for the child
  • Skills training the child needs for using the appropriate behaviors
  • Support the child needs for using appropriate behaviors
  • The person who will be in charge of carrying out the plan.

 

If new information is obtained along the way, the therapist will adjust the intervention plan. 

 

In the following section, we explain the two main types of functional behavior assessments. 

Direct vs Indirect FBA

Functional behavior assessments can be direct or indirect, depending on the nature of the behavior that needs improvement. 

Direct FBA

A direct functional behavior assessment is an objective way of gathering information. It is a thorough evaluation used to identify and replace severe, persisting, and frequent negative behaviors. Direct FBA is also used to verify a disability, make placement decisions, or choose intensive or intrusive intervention methods.

 

In this type of assessment, a therapist directly observes a child’s challenging behavior on several different occasions and takes note of the following: 

 

  • Circumstances surrounding the behavior
  • The frequency and duration of the behavior
  • The time of day when the behavior occurs
  • The location where the child usually displays the behavior
  • Activities related to the behavior
  • People present.

 

This method is also known as an ABC functional assessment because the gathered data is analyzed based on the ABCs of behavior: antecedents, behaviors, and consequences.

Indirect FBA

An indirect functional behavior assessment is used to assess behaviors that are less frequent and less severe. It consists of gathering information about the challenging behavior from parents, teachers, service providers, and other individuals who closely work with the child. 

 

To help identify the target behavior and its function, indirect FBAs rely on using tools such as: 

 

  • Rating scales
  • Questionnaires
  • Interviews
  • Discussions

 

The indirect approach is not as technical as the direct one, it uses simpler language, and is less time consuming. That’s why it is typically used in urgent situations that require immediate action and when there is no time to do a more detailed assessment. If needed, the therapist will suggest a more comprehensive direct FBA.

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autism
Low Functioning Autism

Autism is a spectrum disorder with a range of severity levels. Children diagnosed with low functioning autism have greater challenges with communicating and social interactions and need more support than other autistic children. This article will help you gain a better understanding of low functioning autism and available treatment options. 

What Is Low Functioning Autism?

Children with low functioning autism have the most severe symptoms of the condition and often suffer from some form of intellectual disability. They are usually unable to live independently and require intensive therapy and round-the-clock support with basic activities.

What is the difference between low functioning and high functioning autism? 

Low functioning autism is a term that describes children diagnosed with level 3 of autism spectrum disorder, the most severe form of the condition. Their symptoms are more pronounced and severe than in other children with autism. In addition, they have more difficulties coping with and controlling these symptoms. 

 

Children with high functioning autism, on the other hand, are diagnosed with level 1 autism spectrum disorder. Unlike children with severe autism, they don’t have any intellectual disabilities. Although they may still experience significant challenges when it comes to communication and social interaction, they can learn how to overcome or control their symptoms and lead independent lives. 

 

There appears to be a much higher prevalence in boys at the high-functioning end of the autism spectrum where the condition is three to four times more likely to affect boys than girls. At the same time, the ratio is closer to 1:1 at the low-functioning end of the spectrum.

Children with autism are often described as being either high or low-functioning, however, these are not official diagnoses within autism spectrum disorder. Most autistic children fall somewhere in between the two categories, which means that they are low functioning in some areas and high functioning in others.

In the following section, we focus on the common signs of low functioning autism. 

Signs of Low Functioning Autism 

The signs of low functioning autism can include some or all of the typical autism symptoms, such as: 

  • Impaired social interaction
  • Communication difficulties
  • Obsessive and repetitive behaviours
  • Aggressive behaviours
  • Sensory processing difficulties 

However, these symptoms are more pronounced and severe than in other children on the spectrum. 

Impaired social interaction

For children with low functioning autism, social interactions are extremely difficult and they may never develop social skills. They typically show: 

  • Difficulty expressing empathy
  • Inappropriate responses, for example, laughing when someone is in pain
  • Lack of social responsiveness, such as not smiling
  • Avoidance of eye contact
  • Difficulty understanding gestures and facial expressions

Communication difficulties

While many autistic children have some challenges with communication, those with low functioning autism more often experience speech delays and speech regression. They may speak with a monotone voice or singsong rhythm, or repeat the same words or phrases without understanding what they mean. 

 

In addition, they may struggle with: 

  • Following directions
  • Building a vocabulary 
  • Understanding the purpose of small talk
  • Inability to understand and respond to others
  • Understanding symbolic language.

A large percentage of children with severe autism remain nonverbal and have to learn alternative ways to communicate.

Obsessive and repetitive behaviors

Children with low functioning autism frequently engage in obsessive and repetitive behaviors, for example:

  • Categorizing or lining up toys rather than playing with them
  • Having an intense fixation on activity to the point of obsession 
  • Engaging in repetitive activities, motions, and stimming
  • Engaging in self-injurious behaviors such as skin-picking, pinching, or head-banging.

Aggressive behaviors

Aggressive behaviors are common in children with severe autism. Typical behavioral issues include: 

 

  • Poor impulse control
  • Having meltdowns accompanied with crying and shouting
  • Overreacting to changes in routine and transitioning into a new situation
  • Self-harming behaviors, for example, head banging and hair pulling
  • Aggressive behaviors towards others such as biting, smashing, hitting, kicking, or scratching.

Sensory processing difficulties

Almost all autistic children have some degree of sensory processing difficulties. Children with low functioning autism often find physical touch distressing and become overwhelmed when exposed to bright lights, crowds, or loud noises. In addition, their movements can be clumsy, stiff, or exaggerated, due to their hyper-awareness of movement and sensation.

Does Autism Worsen With Age?

There are very few scientific studies that have examined whether autism improves, stays the same, or worsens with age. According to one large study on the subject, about 10% of autistic children showed significant improvements of their symptoms over time. This was particularly the case with children with a high IQ who received intensive therapy. At the same time, approximately 80% of the children showed little or no change at all. 

In other words, it is uncommon for autism symptoms to worsen over time. On the contrary, with early intervention, suitable therapies such as ABA therapy, and increased parental engagement, symptoms can usually improve with age.

When Should You Have Your Child Screened for Autism? 

Children with autism spectrum disorder don’t meet neurodevelopmental milestones on time and experience severe communication and behavioral challenges from a very young age. That’s why it is often possible to identify autism symptoms already in infancy or early childhood. 

Some clear, early signs that an infant or toddler may have autism include: 

  • Not smiling at 6 months
  • Not communicating with others through sounds, movement, or expressions at 9 months
  • Not responding to their name at 12 months
  • Not babbling or pointing at 12 months
  • Having no language at 16 months
  • Not speaking in meaningful phrases by 24 months. 

In older children, typical signs of autism include:

  • Impaired speech and understanding
  • Avoidance of social situations
  • Inappropriate behaviors
  • Repetitive actions
  • Difficulty communicating their wants and needs. 

You should get your child screened for autism if you notice two or more symptoms, regardless of their age. The earlier a child is diagnosed and starts receiving therapy, the more likely it is that their symptoms will improve.

How is autism diagnosed?

The doctor will usually start by observing your child’s behavior and using a questionnaire to assess their verbal and nonverbal communication skills.

Low functioning autism is diagnosed based on three criteria:

  • The child’s ability to communicate, including both verbal and non-verbal skills
  • The child’s behavior, with particular focus on stimming, self-injurious, and repetitive behaviors
  • The daily impact of the child’s communication and behavioral difficulties.

How early can autism be diagnosed?

In some cases, it is possible to detect autism in children as young as 18 months. However, most children get tested around the age of 2 and receive the final diagnosis when they are older. An autism diagnosis is usually reliable for children who are age 2 or older.

How is the level of autism determined?

There is no specific test that would show with certainty a child’s level of autism. Doctors and psychologists have to spend time with the child to observe their behavior, so that they can determine the level of their emotional and social development. 

What Are the Most Common Comorbid Conditions for a Low Functioning Autistic Child?

Children with low functioning autism often have other health challenges, referred to as comorbid conditions. Physical and psychological comorbid disorders in children with autism can range from asthma and allergies to epilepsy, sleeping problems, and some genetic disorders. These conditions can present additional challenges, such as further developmental delays, speech and language issues, motor skill problems, and reduced cognitive abilities. 

Anxiety 

Anxiety is common in children with ASD. Research has shown that up to 40% of young people with autism suffer from high levels of anxiety and have some type of anxiety disorder. The severity of this condition depends on the child’s age, level of cognitive function, and degree of social impairment. 

Depression

Depression is one of the most common comorbid ASD disorders, particularly among adolescents. Up to 70% of children with autism are estimated to suffer from depression, however, the condition often manifests itself as insomnia and restlessness, rather than the feeling of sadness.

Epilepsy

Epilepsy is a disorder that involves seizures due to abnormal brain electrical activity. A long-term study has demonstrated that 22% of autistic children aged 10 or older develop seizure activity. Girls with low functioning autism and weak verbal skills experience the most seizures.

Digestive disorders

Around one in four children with autism experience gastrointestinal problems, such as abdominal pain, diarrhea, constipation, and bloating. This may also be due to nutritionally poor diets, as many children with autism eat only a few foods (known as selective eating) or prefer highly processed foods to fresh fruits and vegetables. 

Obsessive-compulsive disorder (OCD)

Obsessive-compulsive disorder is characterized by the presence of obsessive thoughts and the compulsion to perform certain actions. Approximately 30% of autistic children have a comorbid OCD diagnosis. They typically become upset and aggressive if someone attempts to prevent these behaviors.

Sleeping disorders

Sleep disorders are common in children with autism, possibly due to abnormalities in circadian rhythms and melatonin production in the brain. Children with low functioning autism may suffer from insomnia, difficulty falling asleep, waking frequently during the night, and sleep apnea. 

Asthma

Children with autism are at least twice as likely to suffer from asthma than children with no developmental disabilities. Some researchers believe that asthma and autism may have some common genetic underpinning.

Allergies 

Allergies are found to be more common in children with autism than in their neurotypical peers. Autistic children are more likely to have skin, respiratory, or food allergies, although no common cause has been found behind these conditions.

Non-verbal learning disorder

Non-verbal learning disorder, characterized by difficulties with motor, visuo-spatial, and social skills, often overlaps with an autism diagnosis. 

Schizophrenia

Childhood-onset schizophrenia or abnormal interpretation of reality, as well as some other types of psychoses, are often preceded by a diagnosis of autism spectrum disorder. 

Sensory disorders

Most children who are diagnosed with autism have unusual responses to sensory stimulation and suffer from sensory disorders. They are either oversensitive or undersensitive to noise, bright lights, touch, smell, or taste. 

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD, a condition that involves hyperactivity and difficulty maintaining focus and attention, commonly co-occurs with autism.

Neuropathy 

Neuropathy is nerve damage that causes weakness, pain, or numbness in the extremities. It often appears as a comorbid condition with autism spectrum disorder.

Fragile X syndrome

Fragile X syndrome is a genetic condition that affects development and is often associated with learning disabilities. Symptoms include language delays, anxiety, hyperactivity, and lack of impulse control. Around one-third of children diagnosed with fragile X syndrome also receive an autism spectrum disorder diagnosis. 

Tuberous sclerosis

Tuberous sclerosis, a rare genetic disorder that causes the development of benign tumors in the brain and other organs, has a strong correlation with autism. Children with low functioning autism are more likely to have this comorbid condition than others.

Neurofibromatosis type 1 

Children with autism are at a higher risk of having neurofibromatosis type 1, a multi-system disorder caused by a genetic mutation, than neurotypical children. This disorder is also a known cause of ADHD.

ABA Therapy Help for Low Functioning Autistic Children 

Applied Behavioral Analysis (ABA) therapy is one of the most successful interventions for teaching children with autism desired behaviors. It can help them acquire and maintain basic skills, learn how to manage some of their symptoms, and perform daily life tasks, for example:

  • Self-care skills (grooming, dressing, going to the bathroom)
  • Learning and academic skills
  • Verbal and nonverbal communication
  • Assistive communication technology if the child is nonverbal
  • Social skills
  • Gross and fine motor skills
  • Play abilities
  • Reducing negative and unsafe behaviors.

 

Early intervention is the key to helping children with autism improve their symptoms regardless of the functioning level. However, progress in children with low-functioning autism can be extremely slow and demand a lot of effort and patience. Children with severe autism may require up to 40 hours of ABA therapy per week for several months and even years before you can see any significant progress. 

How does it work?

Golden Care Therapy is a team of dedicated and experienced ABA therapists who provide service to children diagnosed with autism spectrum disorder and their families throughout the state of New Jersey. Our use of scientifically proven ABA methods will make a positive difference in the life of your child with severe autism. Our numerous five-star reviews and success stories are here to prove it.

Assessment

ABA is a highly adaptable and flexible intervention tailored for the specific needs of each child with autism. To begin with, an ABA therapist will spend some time with your child, analyze their behaviors, and determine their strengths and challenges, before making an assessment that will serve as the basis for the intervention. The therapist can then create a custom treatment plan that will meet your child’s goals. 

Treatment

Your child will be assigned a team of certified BCBA and ABA therapists who will work together to provide comprehensive, personalized treatment. Therapists will also track your child’s progress along the way and make adaptations to the plan as necessary. At Golden Care Therapy, we make modifications as the child changes and grows to ensure that they’re always ready to achieve the next level of success.

Techniques

ABA therapists use a range of different techniques to help children with low functioning autism improve their symptoms:

 

  • Positive reinforcement consists in motivating the child to display appropriate behaviors through the use of reinforcers such as a favorite toy or activity, or a simple praise. Negative behaviors such as aggressive outbursts are ignored unless they are harmful to the child or the others. 
  • Neutral redirection is another technique commonly used by ABA therapists. They encourage children to use socially acceptable behaviors to express their needs instead of impulsive ones. 
  • Introducing alternative behaviors. Once the child learns more appropriate ways to communicate, they can avoid the frustration resulting from an inability to describe their needs.
  • Proactive intervention. This technique focuses on creating calm and predictable surroundings to minimize triggers in the environment and prevent your child from becoming overwhelmed and frustrated in the first place.
  • Modeling technique. This technique is designed to encourage children with autism to learn positive behaviors through copying others. They may imitate characters in a video, the therapist, or other children. 
  • Positive feedback and praise are provided as soon as the child displays appropriate behavior. This technique is based on the belief that negative feedback can reinforce undesired behavior. 

Additional therapies

Children with low functioning autism may require one or more supplementary treatments in conjunction with ABA therapy to help them complete daily activities, cope with sensory issues, and improve their language and communication skills.

 

In addition to ABA therapy, your child’s treatment plan may include:

  • Occupational therapy
  • Sensory integration therapy
  • Speech therapy
  • The use of assistive technology if the child is nonverbal
  • Medications to address specific symptoms
  • Nutrition plans
  • Complementary or holistic approaches
  • Medical interventions to manage any co-occurring disorders
  • Family training, counseling, and support.

If you would like to learn more about the benefits of ABA therapy or schedule a consultation, call us at 732-624-6475 or send us an email at info@goldencaretherapy.com

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play
Activities for Autistic Kids

Creative activities are not only fun for autistic children but can also help them develop motor skills, increase attention span, and practice communication and social interactions. Continue reading to find out how your child with autism can learn new skills through play. 

Sensory Games for Autistic Children

Sensory bottle

Making a sensory bottle is a fun activity suitable for children with autism of all ages. Everyone from preschoolers to adolescents will appreciate having a colorful bottle to help them with long waits or calm them down after a meltdown. Making a sensory bottle will also keep your child engaged and focused on the task at hand and help increase their attention span. 

How to make it

To make a sensory bottle, wash an old plastic water or soda bottle and fill it halfway with water. Add some glitter glue, food coloring, sand, rice, or small beads, using any colors that appeal to your child. Close the lid or glue it in place using a hot glue gun. As your child shakes the bottle, the glitter and beads will twirl and spin through the bottle until they eventually settle on the bottom.

More inspiration

Edible jewelry

If your child has delayed development of fine motor skills, making edible jewelry is the perfect opportunity to practice intricate hand and finger movements. You can also use this fun activity to teach your child to follow instructions, count, and recognize colors. 

How to make it

To make an edible necklace or bracelet, you need a piece of string and an assortment of edible items, such as Fruit Loops, Lifesavers Gummies, marshmallows, or edible play dough that your child can form into beads. Make sure that the string is long enough to fit over your child’s head or wrist when tied. Then simply have your child thread the candy on the string and tie it together. 

More inspiration

Tactile collage

Most children with autism have sensory issues. They may find the sensation of different textures overwhelming, a condition known as tactile defensiveness. Creating a tactile collage is a good way to introduce your child to new textures and at the same time have them practice their fine motor skills. 

How to make it

Cut a piece of cardboard out of a cereal box and pour some glue into a small jar. Ask your child to glue pre-cut pieces of fabric, aluminum foil, string, or felt onto the cardboard. Your child can apply the glue with a brush to prevent any sensory issues due to getting their hands sticky.

More inspiration

  • Crafty Thinking. Plenty of tactile sensory art projects for children.
  • The Art of Autism. How to make tactile collage and other art projects for children with autism.

Brain Activities for Autistic Kids

Matching games

Matching games where your child needs to connect words with corresponding pictures are useful for teaching vocabulary, colors, and numbers. You can easily make your own matching game, download a free template, or purchase ready-made games. 

More inspiration

Smell game

Many children with autism are sensitive to smells. While some children experience smells very intensely, others are under-responsive to odors. In either case, playing a smell game will allow your child to get used to a variety of olfactory sensations and, as an added bonus, help them improve memory and communication skills. 

How to make it

Take several small containers, such as jam jars, and fill them with fragrant ingredients. You can use anything from lemon or orange slices to herbs like rosemary or mint, lavender, cinnamon sticks, coffee, rose petals, and vanilla essence. Ask your child to identify each of the smells. Make sure to avoid using any fragrances that you know your child dislikes or is sensitive to. 

More inspiration

  • The Inspired TreeHouse. Twenty fun activities for children to explore the sense of smell. 
  • PreKinders. Scented hunt game for preschoolers, including free printables.

Building Social Skills for an Autistic Child

Reading books

Children with autism spectrum disorder frequently experience difficulties when it comes to reading and understanding written language. While your child may have no trouble identifying individual words, understanding a text may still be challenging. Reading books together will not only help your child better grasp the meaning of the text, but also develop vocabulary and improve their cognitive skills and concentration. 

Tips

  • Start with books that have lots of pictures and little text to get your child interested in reading. 
  • To keep your child engaged, choose books about their favorite subject, for example, trains or insects. 
  • To make reading more fun, encourage your child to enact the characters while reading. 

More inspiration

  • Book Riot. Some of the best books for children with autism of all ages.
  • Happily Ever Elephants. Books featuring neurodiverse protagonists, including empowering books for autistic children.

Sharing time

Many children with autism have little or no interest in the world around them and prefer to be left alone. Spending time with your child is essential for teaching interaction and communication skills while having fun. A shared moment will also encourage your child to take turns, share toys, engage in role play, and regulate emotions. 

More inspiration

Calming Activities for a Child with Autism

Fidget toys

Fidgets toys are self-regulation toys that help children with autism focus and remain calm in stressful environments and whenever they are experiencing sensory overload. Fidgets are also useful for easing a transition into new situations or activities and dealing with routine changes. 

Tips 

  • There is an endless choice of fidget toys in all shapes and forms on the market, including tangle toys, stress-less gel balls, koosh balls, magic snakes, and many more. 
  • Make sure to choose a fidget toy that isn’t too distracting and that doesn’t draw your child’s attention away completely.

Where to buy

  • National Autism Resources. A wide range of fidget toys and stress balls for children with autism.
  • Sensory Direct. Fidget toys and tactile tangles for children with sensory and concentration issues.

Coloring pages

Coloring pages are great tools that will help your child focus, build fine motor skills, and learn new words. And that’s not all. Coloring according to directions will help your child learn to recognize colors and numbers, follow instructions, and work on task completion. 

Tips

  • Choose coloring pages with the subject that your child is interested in, whether it’s a superhero, stars and planets, or animals.
  • If your child has difficulties with fine motor skills, large or triangular-shaped crayons may be easier to use than regular ones. 

More inspiration

  • All Kids Network. Free coloring pages organized by category.
  • Autism Coloring Book: I See Things Differently With My Superhero Brain (Amazon). 

Constructive Play For an Autistic Kid

Puzzles

Puzzles are another good way to help your child with autism improve focus and fine motor skills. If you’re completing a puzzle together, ask them to tell you about what they’re doing. This will help enhance their vocabulary and communication skills, and practice interacting with others. 

Tips

  • Puzzles can have a calming effect when your child is feeling restless or overwhelmed. 
  • Make sure to choose a puzzle with a suitable difficulty level, otherwise, your child may quickly lose interest. 

Where to buy

Building blocks

Children with autism appreciate structured and predictable activities. Playing with building blocks is the ideal activity for autistic kids as the blocks come in limited shapes and sizes and the building process requires repetitive movements. This activity can help improve your child’s fine motor skills, in addition to encouraging them to practice verbal and nonverbal communication, sharing, taking turns, and problem solving.

Where to buy

Physical Play For an Autistic Child

Dancing

Dancing is a fun and relaxing activity for children with autism. It is beneficial not only for boosting body image and self awareness, but also for improving concentration and memory, enhancing communication skills, increasing empathy, and developing the ability to adapt to different situations. 

Tips

  • To encourage your child to dance, let them start with free movement and move to the music any way they wish. 
  • Do movement prompt exercises where you ask your child to freeze when the music stops, move only one part of the body, or make large or small movements. 
  • Children love dancing to songs with actions like “If You’re Happy and You Know It” or “Hokey Pokey.” This is also a good way to practice following instructions and improve gross motor skills.

More inspiration

Exercise

Many children with autism have limited gross motor function, strength, and coordination. Engaging in regular physical activity will not only allow your child to improve motor skills and overall health, but also to enjoy a variety of activities together with family and friends. 

 

Physical activity has been shown to enhance a general feeling of well-being and counterbalance depression and anxiety in children with autism, in addition to improving their learning and social skills. What’s more, exercising can also decrease repetitive behaviors, such as body rocking, spinning, and head-nodding. 

Tips

  • Ideally, your child should be doing at least an hour of physical activity every day. 
  • Start with short exercises to then gradually expand the amount of time your child spends doing physical activities. 
  • Make exercising fun by playing games that encourage your child to move in different ways, for example, run, jump, hop, and skip.
  • A simple way to add some physical activity into your child’s daily routine is to walk to school and make daily trips to the playground. 

More inspiration

Obstacle courses

Obstacle courses are one of the best ways for your child to practice their gross motor skills, balance, strength, and coordination, while having fun. If your child has challenges with motor planning and sequencing, this activity will provide them with an opportunity to work on completing a task.

How to make it

To make an obstacle course, you can use anything from mats and foam shapes to chairs, ladders, and hula hoops, or any other objects you may find in your home or garden. Make sure to incorporate a variety of activities such as bean bag tossing, throwing and catching a ball, and jumping ropes. Your child can try walking on an uneven surface, stand or hop on one foot, push or pull heavy items, do push ups or sit ups, do jumping jacks, or run around cones.

Tips 

  • Always explain the obstacle course to your child in advance and give it a practice run to let them know what to expect and avoid frustration. 
  • An obstacle course can be designed to target specific motor and cognitive skills that your child needs to practice. Activities can range from simple to more challenging, depending on your child’s developmental level.

More inspiration

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bracelet
Autism Bracelets

Autism bracelets are important identification tools for children on the spectrum. They provide the necessary information in difficult social situations and emergencies, but also promote the acceptance of autism. Here’s what you need to keep in mind when choosing an autism bracelet for your child. 

What Is an Autism Bracelet?

An autism bracelet is a medical ID for individuals with autism. The main purpose of the bracelet is to let other people know that your child is on the autism spectrum. It can be helpful in social settings, during meltdowns in public, as well as in emergency situations, especially if your child can’t communicate. 

The bracelet typically includes the following information: 

  • The child’s name
  • Emergency contact information (parents, doctors)
  • Information about the child’s autism
  • Special considerations, for example, that the child is non-verbal
  • Other medical information, such as allergies, epilepsy, or ADHD. 

Autism bracelets and other medical IDs are recommended by many ASD associations. Read on to learn more about why they are important.

Why Are Autism Bracelets Important?

Autism bracelets serve several purposes. Most importantly, they facilitate communication. If your child becomes anxious or behaves inappropriately in public, the autism bracelet will show to others that the child is not acting out but experiencing distress. 

The bracelet will also ensure that your child’s autism symptoms are not misdiagnosed by medical professionals in an emergency. For example, repetitive behavior and trouble communicating could be easily mistaken for a shock. 

Besides, the chaos of an emergency situation can quickly lead to sensory overload, causing even greater challenges for your child. The bracelet will inform the first responders that your child has autism, so that they can be taken to a calm environment where it will be easier to focus and communicate.

There are many different types of autism bracelets to choose from. Here is what you should keep in mind before setting out to buy one. 

Tips for Buying Autism Bracelets

  • It can be difficult to convince your child to wear an autism bracelet. Choose a model and a color that your child likes so they will be more likely to use it.
  • Look for a bracelet made of durable materials like silicone or leather. Your child will be wearing the bracelet every day, so quality and comfort are essential.
  • Other than contact details and medical information, autism bracelets can indicate your child’s special interests, for example, “John loves trains.” Not only will the bracelet feel more personal, but this information may help others reassure your child.
  • Choose a bracelet that has the universal medical symbol (a short staff entwined by two serpents) on the front.
  • Buy more than one bracelet to make sure you have a replacement on hand.
  • Measure your child’s wrist before purchasing a bracelet. In general, the bracelet should be 1/2″-3/4″ larger than the child’s wrist size, however, some styles have alternative sizing recommendations.
  • Some engravings are easier to read than others. It is essential that the information on the bracelet is visible and that it doesn’t fade over time. 
  • Size and line limits can vary greatly between styles. Choose the bracelet that allows for enough engraving space to include all the information you need. Some bracelets can be engraved on both sides. 
  • When you purchase autism bracelets from top brands, you’ll get more customization options and other features necessary to keep your child safe.
  • Children should start using medical alert bracelets as early as possible. The sooner they get used to the bracelet, the faster wearing it will become a habit.

Below, we list some of the most popular brands of autism bracelets for children.

Best Brands of Autism Bracelets

idtagsonline.com 

idtagsonline.com offers a collection of stainless-steel medical ID bracelets with adjustable wristbands that fit children’s wrist sizes of up to 6.5″. Contact information is engraved on a durable metal tag that doesn’t come in contact with the skin to avoid sensory issues. Each bracelet comes with a complimentary medical ID emergency card that contains the child’s essential medical information.

ROAD iD

Personalized ROAD iD medical bracelets are a great option for children with autism. The tags allow up to five lines of custom text and have a lifetime guarantee. Comfortable silicone bands stretch easily over the hand, making them easy to put on and take off. Each bracelet comes with a medical alert badge.

Medical ID Fashions

Autism bracelets for children from Medical ID Fashions are made from painted ceramic and pewter beads and are available in many fashionable designs that will appeal to children. The ID tag has four customizable lines for your child’s emergency contact, medical, and other information. Bracelets feature non removable clasps that require two hands to open, so that children can’t remove them on their own. 

Alert Me Bands

Alert Me Bands is one of the most popular autism bracelet brands. There are dozens of options to choose from, allowing your child to pick the style they like. Several designs are intended specifically for children with autism.

 

Alert Me Bands bracelets are made of high-quality materials suitable for children with tactile sensitivities. Wristbands are lightweight, waterproof, and chew proof. In addition, the bracelets are one-size-fits-all, fully adjustable, and impossible to remove without assistance.

MedicAlert ID

MedicAlert ID offers a wide range of medical ID jewelry for children and teens, from silicone sports band collections to rugged paracord bracelet styles, and even special medical ID bands that can be used with Apple Watches. The rust-resistant titanium emblem is suitable for kids who are sensitive to nickel. 

MedicAlert ID lets you select the information you want to engrave on the bracelet from a comprehensive database of conditions validated by health professionals. This prevents spelling and other mistakes that would make it more difficult for emergency responders to understand.

When you enroll your child into the MedicAlert program, you’ll also benefit from the 24/7 Wandering Support Program—if your child gets lost, the MedicAlert Foundation will work together with law enforcement to search for them.

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potty train
Potty Training a Child With Autism

Children with autism can be potty trained, but the process may take a lot of time and effort. In addition to communication delays, most autistic children have sensory issues that cause resistance to using the toilet. In this article, we answer the most common questions about autism and potty training.

Can a Child With Autism Be Potty Trained?

For children diagnosed with autism spectrum disorder, transitioning from diapers to using a toilet can be extremely challenging. But just like any other skill, potty training can be successfully taught with lots of persistence and patience. 

 

It is essential to take time to potty train your autistic child. Not only will it help them avoid the physical discomfort of wearing diapers, but will boost their self confidence and improve their quality of life. 

Before you start

Before you start potty training your child, you should consult a pediatrician to rule out any medical issues. Some underlying conditions may prevent your child from effective toilet training despite your best efforts. 

 

Although most children on the autism spectrum eventually learn to use the toilet, the process may take a long time. The average age when children with autism become potty trained is 3.3 years, compared to 2.5 years for children with other developmental disabilities and 2.3 years for neurotypical children.

 

Let’s see when is the best time to start potty training.

At What Age Should You Potty Train Your Autistic Child?

As a general rule, you should start potty training as soon as you feel that your child is ready. 

Here are some signs to watch for.

What Are the Signs That a Child With Autism Is Ready to Be Potty Trained? 

If your child shows some or all of the following signs, it’s time to start with potty training: 

 

  • Your child has acquired gross and fine motor skills necessary for using the toilet, such as maintaining balance and stability and unfastening the clothes.
  • Your child can sit on the toilet, a potty, or a toilet training seat without assistance.
  • Your child is able to follow simple instructions like “sit on the toilet.”
  • Your child knows where the bathroom is located in your home.
  • Your child stays dry for at least two consecutive hours during the day as well as after naps. This is an indicator of sufficient bladder and bowel control. 
  • Your child dislikes the feeling of a wet diaper and shows it either by pulling off the diaper or gesturing that the diaper is wet or soiled. 
  • Your child sits on the toilet or flushes the toilet without being prompted to do so. 
  • Your child lets you know when to change the diaper, for example, by leading you to the bathroom to get a clean diaper. 

Teaching your autistic child to use the toilet requires careful planning. It is recommended to proceed with the training in several phases to make the transition as seamless as possible for your child. Continue reading to learn more. 

How to Potty Train an Autistic Child?

Effective potty training of an autistic child is done in three phases: planning phase, setup phase, and implementation phase. 

Planning phase

The planning phase consists in preparing everything you’ll need for potty training, for example: 

  • Toilet training seat or a transitional potty
  • A footstool if your child needs support
  • A timer
  • Toilet paper or flushable toilet wipes which are easier to use
  • Two weeks’ worth of underwear
  • A basket filled with fun activities and toys to keep the child entertained 
  • A reinforcement basket with rewards like your child’s favorite toys, stickers, and treats 
  • Visual support such as picture cards, potty training books, and social stories
  • Toilet training data sheet where you will track the success of toilet training. You can purchase data sheets for download here.

Setting up phase

When you have all the items ready, you can start setting up the bathroom. If you have more than one bathroom in your home, designate the one that your child feels most comfortable using for training. Here’s what you should do:

  • Position a toilet training seat on the toilet 
  • Alternatively, place a transitional potty in the bathroom.
  • Place your child’s underwear, toilet wipes, and the timer in the bathroom.
  • Place the activity basket within reach of your child. It is important that your child has easy access to books and toys without having to get up from the toilet.
  • Hide the reinforcement bin so that your child can’t see the rewards.
  • Display picture cards or other visual support close to the toilet where your child can easily see them.
  • Tape the toilet training data sheet on the wall outside of the bathroom.

Implementation phase

The implementation phase of potty training a child with autism takes a lot of time and patience. Here are some rules to follow: 

Be consistent

Take your child to the bathroom every twenty minutes and ask them to sit on the toilet for only five minutes. You can keep the child entertained by reading books or letting them play with the toys from the activity basket. Repeat this process throughout the day. At night, your child can continue using a diaper.

Gradually decrease the frequency of bathroom visits

After some time, your child will start peeing or pooping more either in the morning or afternoon. This is when you can decrease the frequency of bathroom visits to every thirty minutes, and then an hour. 

Keep the same task sequence

Most children on the autism spectrum are dependent on routines and it is essential to keep the same task sequence to avoid confusion and frustration. 

Provide clear instructions 

Using specific language will make it easier for your child to understand what they are supposed to do. What’s more, all family members should use the same word to refer to going to the toilet, such as potty or bathroom.

Use praise and rewards

Positive reinforcement in the form of rewards is an efficient method for toilet training children with autism. The rewards, ranging from a praise, a hug, or a favorite activity, must be immediate and consistent in order for your child to understand that they are related to a specific behavior. 

Useful tips for potty training

  • Using a potty will require an additional transition to toilet training. It is often easier to immediately start putting your child on the toilet or using a toilet training seat. This way, you will avoid introducing more changes during the toilet training process, which may be confusing for your child.
  • It is essential that everyone who participates in your child’s potty training follows the same routine to ensure efficient training.
  • Try not to focus on accidents and only briefly remind your child to use the toilet next time.
  • Make sure that your child uses underwear as soon as you start potty training. Your child will associate accidents with wetness and discomfort and be motivated to use the toilet.
  • In the first weeks of potty training, encourage your child to eat salty foods so that he or she drinks more fluids throughout the day.
  • Sitting on the toilet may be difficult for a child with sensory issues. If this is the case, ask your child to practice a few minutes each day until using the toilet becomes less overwhelming. 
  • Peeing and pooping should be two separate parts of toilet training. Once your child has learned to pee in the toilet, you can start with poop training.
  • Toilet training will take time. Try to stay calm and positive and don’t rush the process. As long as your child is positive toward potty training and is making progress, you can continue with the training. 
  • The more your child practices, the easier the process will become. Your child will eventually become more positive towards using the toilet.

Visual supports for potty training

Many children with autism are visual learners. Using visual cues and prompts such as picture cards, social stories, or toilet training books, is an excellent way to motivate your child during potty training.

Picture cards

Picture cards can help your child visualize the sequence of actions that are required for going to the toilet, for example: 

 

  • Pull pants down
  • Pull underwear down
  • Sit on the toilet
  • Pee or poop in the toilet
  • Wipe
  • Pull underwear up
  • Pull pants up
  • Flush the toilet. 

You can download and print toilet training picture cards for free, for example, this potty training visual schedule and these toilet picture cards. 

PECS icons

You can also create a step-by-step visual sequence of the toilet routine for your child with the help of Picture Exchange Communication System (PECS) icons.

Social stories

Toilet training involves many steps that your child may find confusing. Personalized social stories can help your child cope with the new situation. Social stories are written from the child’s perspective and explain in detail what are the actions they are expected to take. Read the story with your child several times every day until the process becomes easier.

If you need assistance with creating a potty training social story, your child’s speech or occupational therapist can help you make one.

Toilet training books 

Books about potty training are helpful in visualizing the process. Below, we list books suitable for children with autism: 

  • Life… with a Side of Autism: Teaching My Autistic Child How to Use the Potty (Amazon)
  • Time to Pee (Amazon)
  • On Top of the Potty (Amazon)
  • Ready, Set, Potty!: Toilet Training for Children with Autism and Other Developmental Disorders (Amazon)
  • Bear in the Big Blue House – Potty Time With Bear (Amazon)

Toilet training apps

If your child is non-verbal, toilet training apps can be a useful and fun tool for potty training. 

 

When To Take a Break From Potty Training

Sometimes, your child is simply not ready for potty training and it’s better to take a break and try again in a couple of weeks. You should stop toilet training if you notice that: 

 

  • Your child is very resistant to potty training
  • Going to the bathroom is regularly accompanied by tears and meltdowns
  • Your child is having lots of accidents during the day
  • There is no sign of progress for several weeks.

 

You should wait until your child becomes ready to make sure that toilet training is a positive experience. If you need additional support, you can consult your child’s occupational therapist or early intervention service, like your child’s ABA therapist.

 

However, if there’s no improvement for a few weeks, it is advisable to see your child’s pediatrician. There may be an underlying medical issue behind your child’s resistance to going to the toilet, such as constipation or urinary tract infection. 

Issues That Parents Face When Potty Training Their Autistic Child

When potty training your child with autism, you can expect to meet many challenges. Here are some of the most common issues:

What if my child is afraid of the toilet?

Some autistic children are afraid of the toilet to the point that they refuse to enter the bathroom. If this is the case with your child, start the training by using a potty placed in another room. The transition into the bathroom can happen gradually. Alternatively, ask your child to sit on the toilet with the seat down at first and then on a training seat. 

What if my child is afraid to have a bowel movement?

It is quite common for autistic children to hold in bowel movements when they are being potty trained. If your child is afraid of bowel movement, you can ask the child to poop in the diaper while in the bathroom. Then they can slowly transition to pooping in the diaper when sitting on the toilet and eventually sitting on the toilet with the diaper off.

What if my child is afraid of flushing the toilet?

Autistic children with sensory issues may get overwhelmed by the sound of flushing the toilet. Tell your child in advance that you are going to flush the toilet and make this task a part of the visual support. To start with, you can let your child leave the bathroom when you flush the toilet. Once the child becomes more confident, he or she can stay in the bathroom while using earplugs or headphones and then eventually try flushing on their own. 

What if my child has an excessive interest in flushing the toilet?

Not all autistic children are afraid of the sound of flushing. On the contrary, some are fascinated by it and it may be difficult to get them to leave the bathroom. Explain to your child that flushing can be done once when there is pee or poop in the toilet. Some parents choose to put a visual stop sign on the toilet or keep the bathroom door closed to prevent the child from entering.

What if my child wants to play with the toilet water?

Explain to your child that playing with the toilet water is not acceptable. Instead, divert their attention from the toilet and let your child play with water in the sink or bathtub and place safety catches on the toilet. 

What if my child wants to play with toilet paper?

Start by telling your child that toilet paper can be used only for wiping after going to the toilet. You can also keep the toilet paper out of the child’s reach and use tissues or wipes instead

Teaching a Child to Ask to Use the Bathroom

Teaching your child to communicate the need to use the bathroom will make the potty training process much easier. If your child has limited verbal abilities, encourage communication through signing or PECS cards, for example. Children who use assisted communication devices need to have a picture of a toilet that they can press to indicate that they want to go to the bathroom. 

Hand Washing 

Washing hands is the last step in the potty training routine. Just like you did when teaching your child to use the toilet, you should follow the same sequence of tasks each time: 

  • Turn on the water
  • Wet the hands
  • Rub the soap into hands
  • Rinse hands
  • Turn off the water
  • Dry hands. 

You can also create a step-by-step visual sequence of the hand washing routine using the PECS icons. Just make sure to place them at the child’s eye level near the sink. 

Should hand washing be taught at the same time or will it confuse your child?

Hand washing should be taught separately from potty training. Autistic children often have difficulties concentrating on multiple tasks and learning potty training and hand washing at the same time can be confusing.

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payment
ABA Therapy Payment Options in New Jersey

If your child has been diagnosed with autism spectrum disorder, you want to ensure that you have access to the best treatments available.

However, your child may require up to 40 weekly hours of ABA therapy and the cost can quickly add up.

Fortunately, several resources are available to help you cover the cost of the treatment. 

In this article we will break down the different payment options for ABA therapy in NJ.

What Is ABA Therapy?

Applied behavior analysis (ABA) therapy is currently the most effective form of autism treatment. ABA is a targeted intervention based on the child’s strengths and weaknesses. It uses positive reinforcement strategies to teach and reinforce skills such as: 

  • Language and communication skills
  • Non-verbal communication skills
  • Social skills
  • Following instructions
  • Initiating conversations
  • Improving attention and focus
  • Fine motor skills and dexterity
  • Reducing problematic behaviors such as anger and meltdowns
  • Pre-academic and academic skills.

Over 90% of children with autism who go through ABA therapy make substantial improvements, while close to 50% reach a development stage where they are indistinguishable from neurotypical children.

How Much Does ABA THerapy Cost?

The cost of ABA therapy depends on several factors, including: 

  • Your child’s needs
  • The severity of your child’s condition
  • The type of program you choose
  • The location where therapy takes place
  • The provider and the qualifications of the therapist.

On average, one hour of ABA therapy provided by a board-certified ABA therapist costs $120. Therapists who are not board certified may provide treatment at lower rates, however, for best results it is highly recommended to work only with certified therapists.

It is important to keep in mind that ABA is a long-term treatment. Although most ABA therapists work with children with autism between 10 and 20 hours per week, some children require up to 40 weekly hours of therapy for several years to see improvement.

If your child receives 40 hours of therapy per week, intensive treatment can cost $4,800 per week or $250,000 per year without insurance

Does Medicaid Cover ABA Therapy in New Jersey?

Yes. As of April 2020, NJ FamilyCare Medicaid reimburses Medicaid-enrolled ABA therapy providers for autism treatment services, including:

  • Behavior identification assessments
  • Supporting assessments
  • Adaptive behavior treatment
  • Individual and group treatment
  • Family adaptive behavior treatment. 

New Jersey’s Mandate of Autism Coverage

The New Jersey Mandate of Autism Coverage signed in 2009 requires specified health insurance policies to provide benefits for the treatment of autism spectrum disorder and other developmental disabilities. Coverage includes medically necessary occupational therapy, physical therapy, and speech therapy prescribed through a treatment plan.

Autism diagnosis

In New Jersey, the Mandate requires that a diagnosis of autism spectrum disorder be made by a physician. What’s more, services must be provided only if autism is your child’s primary diagnosis and if the physician indicates that the services are medically necessary to treat the condition.

Treatment plan prescription

The Mandate specifies that therapy must be prescribed through a treatment plan created by the child’s physician. However, many New Jersey insurers allow and some even require Board Certified Behavior Analysts (BCBAs) and other therapy providers to create the treatment plan. Check your insurer’s guidelines to determine whether the plan must be prepared by a physician or it can be created by a provider. Insurers may only request an updated treatment plan once every six months.

How To Get Coverage for ABA Therapy?

Certain insurance plans are exempt from state mandates. The New Jersey Mandate of Autism Coverage only applies to state-regulated insurance plans and plans that cover state workers, including most teachers.

State-regulated insurance plans

If you have a state-regulated insurance plan, the Mandate:

  • Requires screening and diagnosis of autism and other developmental disabilities
  • Requires coverage for expenses for any occupational, physical, and speech therapy that is medically necessary
  • Requires coverage for medically necessary ABA therapy as prescribed through a treatment plan to treat autism
  • Prohibits denial of coverage based on the fact that therapy is not restorative.

The Mandate will usually apply to your insurance plan if your employer is based in New Jersey and has less than 50 employees. 

New Jersey regulations also require your insurance card to state if your plan is state-regulated or self-funded. You can contact your insurance provider and send them the documentation from your child’s physician to see how much coverage they will provide.

Self-funded insurance plans

The New Jersey Mandate of Autism Coverage doesn’t apply to self-funded insurance plans because these plans are governed by federal rather than state law. However, insurance coverage for therapies needed by children with autism may be ensured through the Affordable Care Act and the New Jersey Mental Health Parity Act. 

The Affordable Care Act (ACA)

The Affordable Care Act prohibits insurance providers from placing annual or lifetime limits as well as rejecting coverage for pre-existing medical conditions.

The New Jersey Mental Health Parity Act

In New Jersey, children with autism are also protected by the New Jersey Mental Health Parity Act. It prohibits insurers from imposing more restrictions on mental health treatments than on other medical treatments. In other words, insurers are not allowed to place limitations on autism therapies if no such limitations exist for the treatment of other medical conditions.

Does New Jersey Have Caps on ABA Coverage?

The New Jersey Mandate on Autism Coverage originally allowed insurers to impose a $36,000 limit on ABA therapy for children with a primary diagnosis of ASD up to the age of 21. Since the enactment of the Affordable Care Act that imposes federal mental health parity requirements on most insurance plans, the Mandate for Autism has no longer monetary or age limitations. These changes were effective as of January 2015.

What Insurance Plans Does Golden Care Accept?

We are currently in-network with the following providers.

  • Aetna
  • Cigna
  • Horizon
  • Blue Cross Blue Shield (BCBS)

Charities that can help pay for ABA therapy in New Jersey

If you don’t have insurance, the charities listed below can provide financial assistance for ABA therapy for your child. 

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Geniuses With Autism

Many people think that autism spectrum disorder is linked to intellectual disability. But although individuals with autism may lack communication and social skills, they don’t necessarily have learning difficulties. 

 

In fact, many are high functioning and use their unique way of seeing the world to accomplish great things. In this article, we’re shining a spotlight on famous people with autism through history.

What Is an Autistic Savant?

A savant is a person with a developmental disability who is gifted in one particular area such as mathematics, music, or art. Approximately half of all savants are diagnosed with autism. These individuals are known as autistic savants. 

 

Below, we list some of the most famous historical figures and celebrities with autism. Some of them have an official diagnosis, others have lived before the condition was known, while some are self-diagnosed as autistic.

30 Famous Geniuses With Autism

  1. Wolfgang Amadeus Mozart

Mozart was known for his repetitive movements, sensitivity to noise, and poor social skills, leading some experts to conclude that he was on the autism spectrum.

  1. Michelangelo

Many experts have speculated that Michelangelo, one of the greatest influencers of Western art, was autistic because of his narrow interests, eccentric behaviors, and adherence to routine. 

  1. Charles Darwin

Charles Darwin, the father of evolutionary biology, may also have been on the spectrum. He avoided social interactions and preferred to communicate by writing.

  1. Emily Dickinson

Some experts believe that Emily Dickinson, a famous classical poet, would today qualify as being on the autism spectrum. She led a reclusive life and strictly followed fixed habits, such as only wearing white. 

  1. Albert Einstein

While he was not formally diagnosed, leading psychiatrists believe that Einstein was autistic due to his tendency to repeat phrases, difficulties with social interactions, and extreme focus on his work.

  1. Nikola Tesla

Nikola Tesla, the inventor of the alternating-current electrical system, showed many signs of autism, such as several phobias, sensitivity to light and sound, obsession with number three, and social ineptitude.

  1. William Butler Yeats

William Butler Yeats, a modernist Irish writer who won the Nobel Prize for literature in 1923, claimed that he had little talent for interpersonal relations and displayed obsessions common among people on the autism spectrum.

  1. Thomas Jefferson

Several autism researchers believe that the president of the United States and the author of the Declaration of Independence, Thomas Jefferson, was autistic. His main ASD symptoms included adherence to routines, sound sensitivity, and fear of public speaking. 

  1. Hans Christian Andersen

Danish author best known for writing children’s stories, Hans Christian Andersen had narrow interests, followed strict routines, and had speech and social difficulties. If he had lived today, he may have been diagnosed with autism. 

  1. Lewis Carroll

The famous author of Alice in Wonderland, Lewis Carroll, may have exhibited some characteristics typical for people with autism, such as poor social skills and speech difficulties.

  1. Isaac Newton

Isaac Newton is another historical figure who was retrospectively diagnosed with autism. He was known for adhering to rigid routines and avoiding social interactions.

  1. Ludwig Wittgenstein

Ludwig Wittgenstein, one of the greatest philosophers of the 20th century may also have been on the autism spectrum. Researchers believe that his social and communication impairments and single-minded focus indicated a potential link to autism.

  1. Marie Curie

Marie Curie, famous for her research on radioactivity, may have suffered from Asperger’s syndrome, which falls under the autism umbrella. Curie was extremely systematic, reserved by nature, and struggled to engage in conversations.

  1. Andy Warhol

Autism experts have pointed to the repetitive nature of Andy Warhol’s work as a possible sign of autism. Warhol was also known for providing monosyllabic responses to interview questions and other behavioral quirks.

  1. Dan Aykroyd

Famous actor and filmmaker, Dan Aykroyd has been open about his autism diagnosis. He believes that his obsession with ghosts and law enforcement enabled him to develop his famous Ghostbusters character. 

  1. Woody Allen

Although he has never been officially diagnosed, Woody Allen believes that he is likely on the autism spectrum due to his unorthodox ways of thinking. 

  1. Elon Musk

Elon Musk revealed his autism diagnosis while he was hosting the Saturday Night Live show in May 2021. One of his autistic traits is a lack of tonality and intonation in his speech. 

  1. Daryl Hannah

Actress and environmental activist, Daryl Hannah has been coping with autism since she was a child. While she found acting to be an escape from her condition, she avoided movie premiere events and interviews due to her social anxiety. 

  1. Temple Grandin

Temple Grandin was diagnosed with autism at the age of four. In spite of significant challenges, she became Professor at Colorado State University, a leading force in the animal sciences, and a prolific author. Her book Emergence: Labeled Autistic is considered the first real insight into the thoughts of a person with autism.

  1. Jerry Seinfeld

Comedian Jerry Seinfeld has stated on several occasions that he might have a mild form of autism due to his social challenges and literal thinking.

  1. Anthony Hopkins

Anthony Hopkins was diagnosed with Asperger’s syndrome, a form of autism, as a child. Some of his autistic traits include obsessive thinking and difficulty maintaining social relationships. 

  1. Greta Thunberg

Greta Thunberg, Swedish environmental activist and the public face of the school climate strike movement, talked publicly about her Asperger’s syndrome which she considers to be her superpower.

  1. Satoshi Tajiri

Famous video game designer and the mastermind behind Pokémon, Satoshi Tajiri, is also on the autism spectrum. His condition is characterized by his fixations with bugs and gaming.

  1. Bobby Fischer

According to experts, chess grandmaster Bobby Fischer was autistic. He was obsessed with chess, didn’t like unstructured experiences, and had problems interacting with others.

  1. Stanley Kubrick

Stanley Kubrick, one of the most famous directors of all time, is thought by some to have been on the autism spectrum because of his inflexibility, literal thinking, narrow interests, and poor social skills.

  1. Tim Burton

Director Tim Burton hasn’t been formally diagnosed with autism but identifies with the condition. After watching a documentary about autism he thought that he felt the same way as a child, spending time alone drawing, painting, and watching movies.

  1. Robbie Williams

Singer Robbie Williams believes that he has Asperger’s syndrome due to his compulsive thinking. He has spoken publicly about battling depression and anxiety that may be part of the condition.

  1. Susan Boyles

Scottish singer and celebrity was diagnosed with Asperger Syndrome as a child but has only recently started accepting her condition and considering it an asset rather than a disability.

  1. Bill Gates

Although his diagnosis hasn’t been confirmed, autism experts agree that Bill Gates may be on the autism spectrum. He has a monotone speech pattern and avoids eye contact, two common characteristics of individuals with autism.

  1. Steve Jobs

There’s speculation that the late CEO of Apple Steve Jobs had autism. He was known for perfectionism, single-minded focus, and thinking outside of the box. 

How ABA Therapy Can Help Autistic Geniuses

Research shows that more than half of all autistic individuals have an above-average IQ, while roughly 16% have an IQ higher than 130. But having high intelligence doesn’t mean that autistic individuals don’t experience some challenges associated with the diagnosis. For example, they may have communication difficulties, problems with social interactions, as well as sensory issues. 

 

Applied Behavioral Analysis (ABA) therapy is an effective treatment that can help your child with autism learn skills that they may lack despite having a high IQ, for example:

  • Verbal and nonverbal communication skills
  • Initiating conversations
  • Attention and focus
  • Following instructions 
  • Reducing problematic behaviors such as aggressivity and meltdowns.

ABA therapy can help your child maximize their potential regardless of their functioning level. With early intervention, close to 50% of autistic children who go through ABA therapy will reach a development stage where they are indistinguishable from their neurotypical peers.

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Autistic child putting on shoes
How Do You Get an Autistic Child to Keep Their Shoes On

Many autistic children have difficulties putting their shoes on and keeping them on their feet. 

But why should something as simple as wearing shoes lead to tears, angry outbursts, and meltdowns? 

In this article, we’ll explain why children with autism have a hard time with their shoes and what are the best ways to help them keep their shoes on.

Why Autistic Children Have a Hard Time with Their Shoes

Several factors, such as sensory issues, stress, and foot pain may contribute to your child’s aversion to shoes. 

Sensory issues

Sensory processing disorder is one of the main reasons why autistic children dislike wearing shoes. This condition affects the way the brain processes sensory information and may cause hypersensitivity to different elements in the environment, including socks and shoes. Most children with autism have some type of sensory processing disorder.

Stress

Due to delays in fine motor skills, many autistic children find it difficult to tie shoelaces. Putting on their shoes often turns into a stressful situation that may trigger an angry outburst or meltdown. 

Foot pain

In addition to sensory issues and stress, your child may also refuse to wear shoes due to foot pain. The pain can result from injury, a medical condition, or the use of an ankle-foot orthosis that limits foot movement. 

 

Don’t worry we are not just listing the issues that autistic children have with wearing their shoes. Here are some ways you can help your child with their shoe wearing experience. 

How Do You Get an Autistic Child to Keep Their Shoes On? 

Know the right measurements

It is essential that your child’s shoes are the correct size. Ill-fitting or tight shoes are not only painful to wear, but they can damage your child’s feet and prevent optimal growth. If your child finds a particular pair of shoes too constricting, opt for wider models or loose-fitting sandals. 

Find alternatives to laces 

Your child may dislike wearing shoes because tying laces is too challenging. Fortunately, there are several alternatives to laces, such as hook-and-loop fastenings and quick-release or no-tie elastic laces by Lock Laces, Greeper Laces, or Xpand.

Choose sensory-friendly socks

Children who suffer from sensory processing disorder are often sensitive to the seams or fabric of their socks. You can try switching to special sensory-friendly socks that are more comfortable for sensitive feet. Several brands, including Sockabu, CalmCare, EZ Sox, and SmartKnit Kids, carry seamless socks and socks with non-skid bottoms and pull-up loops to make it easier for children to put them on and off. Soft fabrics such as cotton, bamboo, or silk usually work best for autistic children with sensory issues.

Check whether your child needs orthotics

If your child suffers from foot pain or has walking difficulties, a podiatrist can assess whether they need additional support for their feet. Some children with autism have to use special shoe inserts called orthotics or foot orthoses to improve their foot posture. In this case, they will also need to wear suitable orthopedic shoes.

Buy adaptive shoes 

Adaptive shoes are designed for children and adults with special needs. Besides being very comfortable, they come with pull tabs and adjustable straps which make them easier to put on and take off than regular shoes. In addition, most adaptive shoes are orthotics-friendly.

Now that we’ve seen what you should keep in mind when choosing shoes, here are some tips on how to make the shoe shopping experience more pleasant for your child. 

Going to a Shoe Store with Your Autistic Child 

Autistic children with sensory sensitivities often find busy and bright stores overwhelming. That’s why shopping for shoes can be extremely stressful and trigger anxiety and disruptive behaviors. However, if you are well prepared, you will be able to create a more pleasant shoe shopping experience for your child. 

Measure your child’s feet

If you know that going to a store will be challenging, measure your child’s feet at home. You can use a special measuring device such as RITZ Stick or Brannock, for example. Alternatively, make a simple insole by drawing around your child’s foot on a piece of cardboard and cutting out the shape. This will make your trip more efficient and your child will avoid the stress of having their feet touched while at the store. 

Buy several pairs of shoes

If your child finds it hard to focus while you’re in the store, you can purchase more than one pair of shoes and have your child try them on at home. Keep the ones your child finds the most comfortable and return the rest. Just make sure to check the store’s return policy before you buy. 

Bring a soothing item for your child

Don’t forget to bring your child’s favorite sensory item, such as a fidget toy or blanket. It will help soothe your child if shoe shopping gets too overwhelming. 

Prepare your child for the trip to the shoe store

Children with autism spectrum disorder can cope better in stressful situations if they are well prepared and know what to expect. Show your child some photos of the store, take a virtual drive using Google Maps, and talk to them about the upcoming trip. You can also create a social story to help your child understand what they’re expected to do, how the trip will unfold, and how long it will last.

Visit during the store’s quiet time

Contact the shoe store in advance to find out what their least busy times are. This way, you will reduce the chances of your child getting overwhelmed and stressed. Some stores even offer “quiet hours” for people with autism, with low activity and no music or bright lights.

Identify your child’s triggers

Try to identify triggers that could provoke your child’s anxiety in a shoe store. This way, you will be able to prepare and minimize their discomfort. For example, if your child is sensitive to loud sounds, you can bring headphones and if bright lights are a problem, your child can wear sunglasses or a baseball hat for protection. 

Reward good behavior

Reward your child with a treat or a fun activity for successfully completing the shopping trip. It is essential to provide lots of praise to show that they are doing a good job. 

 

Continue reading to find out what are the best adaptive shoes for children with autism. 

The Best Adaptive Shoes for Autistic Children

Keeping Pace Orthopedic Footwear

Keeping Pace shoes are specifically designed to be worn with ankle-foot orthoses. The brand offers a variety of styles and models ranging from toddler size 4 to adult size 10. 

Hatchbacks Footwear

Hatchbacks Footwear specializes in adaptive shoes that easily open from the back to fit over ankle-foot orthoses. 

BILLY Footwear 

BILLY Footwear has many types of stylish adaptive shoes with zippers that allow them to open and fold over completely. The brand focuses on a universal footwear design that is accessible to children and adults of all ability levels. 

Tsukihoshi

Tsukihoshi shoes offers flexible and comfortable footwear ideal for children with autism. Most models feature no-tie stretchy laces, in addition to being latex free, washable, and compatible with ankle-foot orthoses. 

Pediped 

Pediped has a vast selection of sensory-inclusive styles for babies, toddlers, and older children. The shoes are made to encourage natural movement and support healthy foot development. All models feature convenient hook-and-loop closure.

Friendly Shoes

Friendly Shoes come with a patented zipper system, anti-slip custom outsole for increased flexibility and safety, and sensory-friendly memory foam footbeds to reduce pain. Most styles are wide and lightweight, some weighing as little as 5 ounces. 

Plae 

Plae handcrafted shoes are flexible, machine washable, and come in a variety of fun patterns and colors. They are a perfect option for children who wear ankle-foot orthoses. Once your child has outgrown the shoes, you can resell them through the Plae-Kidizen REWEAR program.

Stride Rite

Stride Rite has a variety of extra wide adaptive shoes with soft memory foam footbeds, flexible soles, and hook-and-loop fasteners. Here you’ll find everything from boots to school shoes, sandals, water shoes, and light-up sneakers for children with foot issues.

Steve Madden Adaptive Shoes

Steve Madden offers a small selection of adaptive shoes for children. Features include dual zippers with long pull tabs, elastic laces, and removable socks for extra space.

Nike FlyEase 

The Nike FlyEase sneakers are lace-free adaptive shoes with responsive foam that automatically adapts to the movement. This makes them extremely comfortable and an ideal choice for your child with autism.

Skechers

Many Skechers models feature Velcro straps or a pull-top loop so that your child won’t have any difficulties putting them on and taking them off. The gel-infused memory foam guarantees increased comfort. 

Vans Autism Acceptance collection

Vans autism acceptance shoes are designed for children who have sensory processing issues. Your child can easily slip them on with pull-tabs or close them with hook-and-loop fasteners. As an added bonus, they come in muted colors that will appeal to children with sensory issues.

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