Autism Awareness and Safety

By Kelly McKinnon-Bermingham, director of behavior intervention and Anna Laakman, director of education and training, at The Center for Autism and Neurodevelopmental Disorders

April is Autism Awareness Month. According to the Center for Disease Control, one in 68 children has been identified with autism spectrum disorder (ASD). The Center for Autism & Neurodevelopmental Disorders has made safety one of our priorities for our families.  That means that there are over 45,000 people living in Orange County with autism. As our temperatures start to warm up, there are a few things we should be thinking about when it comes to safety and kids with ASD.

Individuals with ASD often present a unique set of skills as well as challenges. One of those challenges is safety. There are so many important safety considerations that parents, caregivers, providers and schools need to be aware of when interacting with or helping an individual with ASD.  Nearly half of all children with ASD will wander away from a safe environment at some point during their lives. Of those, roughly a third are non-verbal. We also know that individuals with ASD are often drawn to roadways, trains, and water. In past years, accidental drowning accounted for 91 percent of deaths reported in children with ASD age 14 and younger who went missing.  There are resources available to help prevent wandering and related accidents. Autism Speaks has several tools and tips for parents, schools and communities to help support individuals with autism.

To help prevent wandering, you can:

Secure your home

  • Make sure you secure entries and exits to your home in a way that an individual with ASD cannot easily leave on their own. Motion detection systems are also an option so family members are alerted if someone is leaving a safe space.
  • Place STOP signs at exits and doorways. Practice stopping and waiting to hear “Go”.

Consider tracking devices

  • There are many GPS devices that families can purchase and utilize with individuals with ASD who may be at a higher risk for wandering. Many devices can be synced with your cell phone or tablets so that you can easily locate an individual and you are alerted if they leave an expected location.

Consider ID bracelets

  • If an individual wanders from a safe space, it is helpful to have some basic identifying information so that people know who to contact.
  • Label or write name and phone numbers into your child’s clothing.

Teach your child to swim

  • We know that many individuals on the spectrum are drawn to water and it is crucial that they be able to swim.
  • Most cities offer swimming lessons or aquatics programs that can be found on the city’s website.
  • Use social stories with your child to explain when and where they can and cannot swim.

Alert your neighbors

  • Informing close and familiar neighbors regarding your child’s safety concerns can help set up phone trees and provide other families that may be on the look out for your child with necessary information.

Alert first responders

  • Your local police department or fire department may have additional resources and tips that you can use to help support your child with ASD. You may also alert your local police department of your address and your child’s unique needs, especially wandering. Police departments will want to know places your child may like to frequent, their interests and any other unique communication concerns your child may have.

Together, we can help prevent wandering. Learn more about additional safety resources.

CHOC Children’s is a member of The Center for Autism and Neurodevelopmental Disorders, in collaboration with UC Irvine.

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Using Technology to Promote Social Skills in Children with Autism

By Dr. Julie Youssef, developmental-behavioral pediatrician and assistant clinical professor at The Center for Autism and Neurodevelopmental Disorders

Every child with an autism spectrum disorder (ASD) has unique strengths and weaknesses that change throughout their lifespan. One therapeutic approach many families consider is social skills intervention programs. Often led by behavioral specialists, these programs offer an opportunity for individuals with ASD to practice their social skills with each other and/or typical peers on a regular basis.

The Center for Autism and Neurodevelopmental Disorders

The Center for Autism and Neurodevelopmental Disorders recently held a unique four-week robotics camp targeting children with ASD. Robotics camps are ideal platforms to engage students in science, technology, engineering and mathematics (STEM). They aim to teach children about the technical aspects of STEM, along with skills related to teamwork, leadership and design.

The technical components were led by a robotics researcher, while a team of behavioral specialists worked with the participants to encourage proper social skills. Participants worked in a team to construct a robot and program it to perform complex tasks.

The robotics camp is an exciting step toward developing further technology-based social interventions for children with ASD in our community. Here are a few more ways to promote social skills in children with autism:

  • Identify peers with strong social skills and pair the child with ASD with them so that he has good models for social interaction.
  • Provide prompting for socially appropriate behavior as needed and set up opportunities to practice these behaviors.
  • Celebrate a child’s strengths and use these to motivate interest in social interactions, or to give a child a chance to excel in front of peers. Use preferred activities to create opportunities to play with peers.

Learn more about ASD, including helpful classes and resources.

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Play as a Means to Improved Social Skill Development

social skill developmentIn recognition of national autism awareness month, check out these tips from Kelly McKinnon-Bermingham, director of behavior intervention at The Center for Autism & Neurodevelopmental Disorders, to include more interactive and educational play in your child’s routine.

Social play is the core of social development for children. Delayed or undeveloped social skills are often a component of Autism Spectrum Disorder (ASD). As a result, children on the autism spectrum often end up frustrated and socially isolated. Research shows that children with autism may be even more likely to experience loneliness and poor quality friendships than their typical developing peers.

Further, in the age of technology, the definition of and ways that children play have changed. Some technology is often a one-sided experience that does not provide children the chance to learn the subtleties of human interaction such as non-verbal cues, voice tone or inflection and body language. As adults, we have often forgotten how to play. Taking the time to bring out the child in you may help your child to develop their social play skills.

Start with simple, closed-ended activities. Toys that have a clear beginning and ending, such as puzzles, stacking a tower of blocks or lacing beads, is a great place to start because your child will know when to start and when to stop. Play several of these activities in a row to increase the amount of time your child is engaged in a functional play activity.

Pretend play skills often develop from a child’s personal experiences. Act out the day’s events, such as playing school, make-believe fireman or tea or birthday party. Add in some technology by making videos of your play to watch and rehearse. This can make for a fun, motivating play experience.

Supplement your play ideas by using books as a guide. Many books guide children through play experiences. A book on what a veterinarian does, for example, can be used to play veterinarian and follow along!

Additionally, literature suggests several variables that may be important to add in the facilitation of play dates:
1. Use of toys that are of interest to your child
2. Short, structured play experiences
3. Find a consistent, same or slightly older peer for your child to practice and play with

Schedule time to play with your child. Make it a routine and part of your day!

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Tips for a Stress-Free Holiday Season with Your Kids

While this time of year comes with many wonderful events, it can also be an undeniably stressful time for many families. Here are a few tips to support an “environment for success” with your children during the holidays:stress free holiday

  • Maintain as much routine as possible: Holiday breaks often mean big changes in schedules and routines, which results in things becoming much less predictable. This can often result in the child being more anxious, less able to tolerate frustration, changes in eating/sleeping patterns, as well as impacting a variety of other triggers that may result in challenging behaviors. At the very least, try to maintain a child’s standard bedtime and mealtime routines.
  • Warn/prepare children for change: Of course it is unrealistic to think that every routine can be maintained at all times during the holidays. Preparing children ahead of time for things that are predictable can be a very effective way to minimize anxiety (theirs and yours) while improving their ability to tolerate change.
  • Review rules ahead of time and be consistent in applying them: Whether you are hosting an event or being hosted, remind children of the rules and expectations before the chaos of company ensues. Describe the behaviors you expect to see (i.e. “share”, “follow directions”) rather than focusing on the “no/don’t” behaviors (i.e. “no running in the house”, “don’t yell”).
  • Have a three-step plan in place: 1) “catch them being good” and reinforce those positive behaviors; 2) catch and redirect potential problems early; and 3) follow through with costs and/or escape plans when problems do arise. Make sure the overall plan follows this order of progression.
  • Priceless doesn’t mean pricey!: Given the financial stress that this time of year places on many families, it’s always a good time to remind your kids about the long lasting value of shared time and relationships versus costly gifts.
  • Maintain perspective: Don’t let the chaos of the holidays overpower the true meaning of this time of year. Embrace it, have fun and enjoy this time with your children and families!

By Dr. Brett Patterson, a psychologist and program director for Child Behavior Pathways (CBP), a program of The Center for Autism & Neurodevelopmental Disorders. CBP is a CHOC Children’s and UC Irvine collaborative offering evidence-based classes for parents with children ages 0-5, who are looking for support managing impulsive and oppositional behaviors. Click here for more information on upcoming parent support services.

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What to Expect from an Autism Assessment

By Rachel Fenning, PhD, assistant clinical professor at The Center for Autism & Neurodevelopmental Disorders

The experience of having a child evaluated for a developmental concern may feel overwhelming, but the assessment process can provide clarity and guidance. If your child does receive a diagnosis of autism spectrum disorder (ASD), the assessment represents a vital first step in securing important treatments for your child.

A diagnosis of ASD is based on direct assessment of the child and clinical information gathered from key individuals in the child’s life. A physician or clinical psychologist typically performs the initial diagnostic evaluation, which may include:

• A complete history, including a detailed interview about your child’s current and past experiences and behaviors.

You will be asked to recall specifics about your child’s history. Many families find it useful to reference their child’s baby book or other notes. For instance, creating a timeline of events, including developmental milestones, behavioral changes, and the emergence of any concerns may be helpful. It is also important to be prepared to talk about family medical history, too.

• Careful observation and interaction with your child during the appointment.

Many professionals use specific tools to evaluate symptoms of ASD. The Autism Diagnostic Observation Schedule-2 (ADOS-2) is among the most widely used and most respected instruments. However, results from any diagnostic tool should  always be used in combination with other information to inform clinical decisions.

Many experts further recommend a multi-disciplinary assessment approach in order to better understand a child’s functioning and to guide recommendations. This may include several visits with different specialists. You should feel comfortable inquiring about the need for any or all the following:

• A thorough medical assessment, including a general physical and neurological exam, hearing and vision testing, and laboratory testing.

• A psychological assessment, including measures of cognitive functioning, social-emotional skills and adaptive behavior, and possibly academic skills.

• A speech and language assessment, including tests of language comprehension, expression, and everyday language use.

• An occupational or physical therapy assessment, including measures of motor functioning and sensory processing.

Depending on the assessment results, your provider may suggest a range of possible interventions, such as intensive behavior intervention (applied behavior analysis), counseling, speech and language therapy, educational interventions, occupational and physical therapy, and related supports. You will have an opportunity to ask questions, and it may help to have a few in mind ahead of time. It is also important to establish ways to follow up with your provider about any future concerns.

Finally, know that by engaging in the assessment process, you are taking an important step toward gaining understanding and support for you and your child.

Learn more about CHOC’s partner, The Center for Autism & Neurodevelopmental Disorders.

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