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Empowering Autism Families

Empowering Autism Families: The Indispensable Role of Parental Support in Applied Behavior Analysis

Empowering Autism Families: The Indispensable Role of Parental Support in Applied Behavior Analysis 599 399 bh360

Empowering Autism Families: The Indispensable Role of Parental Support in Applied Behavior Analysis

Empowering Autism Families

When you become a parent, it is equal parts exciting and terrifying. Many parents have broad or specific hopes and dreams for their children. Yet, at the end of the day, all you want is the best for your child and their future. Therefore, when a child is diagnosed with autism spectrum disorder (ASD), it can feel like your hopes and dreams have been dashed. However, your parental support makes you instrumental in giving your child tools to live their best life.

Feeling scared about an ASD diagnosis is not unusual or wrong; it takes time to adjust to life changes. However, you are not alone in figuring out how to navigate your new life. With support, you can build the tools you need to support your child’s long-term well-being. At 360 Behavioral Health, we offer parental support through parent and caregiver training to help you navigate the challenges of caring for a child with ASD.

While there are challenges you did not anticipate for your child, there are many rewards this new path can offer. Parental support is an opportunity to give your child and family tools to build a rewarding and meaningful life together. Now, you may wonder what parental support is. How can parental support help your child and family?

Impact of Autism Diagnosis on Parents

Whether it is getting a baby to sleep through the night or the first day of school, parenthood can be filled with joy and stress. Right now, you may feel sad and stressed, but with support, you can work through those feelings for your betterment. We know coming to terms with your child’s diagnosis does not happen overnight. However, taking steps to work through your feelings can be vital to your child’s long-term success.

If emotional distress is left unaddressed, it can fester and grow into unhealthy coping strategies. For example, you may focus on challenges, discount successes, negative self-talk, or withdraw from your support network. Many of the negative feelings associated with an ASD diagnosis often stem from negative perceptions about autism. Thus, tools for parental support can help you better understand that autism is truly a spectrum.

There is no one way to have autism. Your child’s challenges and strengths are unique to them, so their treatment should be customized to match their needs. With support, your child can learn and grow into the best version of themselves. Therefore, deeper awareness through parental support can help you dismantle those negative perceptions of ASD.

Building a more positive and accurate picture of what ASD looks like for your child can support your well-being. When you can reduce feelings of distress, it improves your resilience to whatever challenges life tries to throw at you. In addition, parental support training provides practical education for effective learning and growth for you and your child’s daily lives. While access to clinical support is important for your child’s treatment, your active participation as parental support is equally valuable.

Understanding your child’s unique experiences can increase your acceptance and recognition of your meaningful position as a source of support.

The Value of Acceptance and Education for Parents

Taking that first step toward accepting your child’s ASD diagnosis can feel difficult to imagine. However, acceptance can support the effectiveness of parental support training for you and your child. The many benefits of acceptance as a healthy coping strategy include reduced depressive symptoms and stress. In addition, acceptance can help parents and caregivers connect with each other and work together to navigate ASD treatment.

Leaning into acceptance gives you more space to respond to the challenges and the stress of life with more resilience. If you feel less overwhelmed by the idea of ASD, you can discover how powerful your parental support can be in your child’s day-to-day life. As Pediatric Medicine notes, your child is the primary target for early interventions, but they can also support you as a caregiver. Access to educational tools like parent-mediated interventions (PMIs) fosters support to address your child’s specific needs.

With training, you can increase your understanding of ASD. Moreover, through training, you can learn techniques to help your child improve their social, communication, and behavioral skills. Whether in a clinical setting, at home, or at the grocery store, parent and caregiver training can give you the support you need to help your child thrive. With access to education, your parental support grows as you learn, adapt, and fully engage in ASD interventions.

Now, you may wonder what parental support looks like in your family’s daily life. How can you use PMIs to empower your child to live their best life?

Benefits of Parental Support for Children

Sometimes, you just want to take your child to the store or make appointments a less distressing experience for them. PMIs teach you how to use reinforcement techniques with your child in your family’s daily life. There are a variety of PMIs you can learn to customize treatment to support your child’s specific needs. With therapeutic tools like PMIs, you truly can make everyday life more comfortable and manageable for your whole family.

Through PMIs, you can provide consistent reinforcement of your child’s training in their everyday life. In addition, PMIs can enable your child’s ability to apply the tools they learn to their real life. Through home and community settings, your child can engage in ways that apply to your family’s daily life. That consistent training allows you to provide parental support that can help your child today, tomorrow, and well into their future as they continue to grow.

Listed below are some of the different parental support PMIs that can be customized to support your child:

  • Joint attention therapy
    • Difficulty sharing focus on an object or area with another person
      • Following another person’s gaze or following a pointed finger to look at something
    • Therapy supports communication and language learning
      • Supports specific shared attention skills such as pointing, showing, and coordinating looks between person and object
  • Social communication therapy
    • Increases ability to communicate and interact with others
      • Verbal communication skills
        • Increase ability to name people and things correctly
        • Improved formation of words and sentences
        • Improvements in speech rate and rhythm
        • Able to express and explain emotions and feelings
      • Nonverbal communication skills
        • Learn sign language
        • Utilize hand signals
        • The use of picture symbols
      • Social skills and behavior
        • Learning how to engage in conversations
        • Able to exhibit wanted behaviors during playtime with others
          • Being a good sport when they lose a game
          • Acting as a good host during play dates
          • Adaptive response to teasing
        • Learn how to make and maintain eye contact with others
        • Able to maintain a socially accepted distance from others in social settings
  • Behavioral therapy
    • Focuses on reinforcing wanted behaviors and reducing unwanted behaviors
    • Provides parental support on how to address maladaptive behaviors before, during, after, and between episodes
  • Daily living skills
    • Supports the ability to develop adaptive functioning skills to navigate daily life
      • Hygiene
      • Toileting
      • Dressing
      • Household safety
      • Doing chores
      • Preparing food
      • Safety outside the home
      • Telling time
      • Time management
      • Managing money

In addition to PMIs to reinforce social, communication, and behavior skills, parental support can strengthen the parent-child relationship. Learning new terms and techniques for ASD can be overwhelming. You may even wonder if you know what is best for your child. Yet, in reality, you are the perfect person to provide the support your child needs to thrive.

You spend the most time with your child, so you know better than anyone what your child’s day-to-day needs are. Thus, increasing your education and treatment participation can support your child and deepen your connection to each other. A deeper awareness of ASD and the ability to connect to your child’s needs can help you feel more equipped to support your child. Listed below are some of the ways access to parental support tools can increase your confidence:

  • Didactic instruction
    • A lecture style or discussion teaching format
      • Parents and caregivers are taught strategies and interventions to address childcare
      • Gives parents and caregivers the space to ask questions and form an open discussion about their concerns
  • Role-playing
    • An intervention strategy to support children in building wanted behavioral skills
      • Parents and caregivers are able to practice the intervention with clinicians
      • Gives parents and caregivers coaching and feedback to support competence in applying the intervention
  • Parent coaching and supervision
    • Focuses on teaching proper implementation of interventions
      • Supports parents and caregivers in real time to improve the application of interventions and strategies
  • Practice assignments and handouts
  • Supportive in-person and virtual home visits

Feeling more competent in your ability to support your child can be empowering. PMIs put the power back in your hands to be a source of parental support you want to be for your child. Therefore, feeling more confident in your knowledge of ASD treatments gives you more space for parenting. When you can parent without being burdened by limited information, you can foster the fulfilling parent-child relationship you and your child deserve.

Improving the Parent-Child Relationship With Parental Support

From the terrible twos to pre-teens testing the boundaries of their independence, raising children has its ups and downs. While being a parent can be stressful, it is also one of the most rewarding things you can do with your life. Being the parent of a child with ASD has additional challenges like:

  • ASD symptoms
  • Co-occurring behavioral issues
  • Navigating education and healthcare systems
  • The financial cost of care resources
  • Stigmatization
  • Low community support resources

However, watching your child learn and grow can make even the most difficult moments well worth it. Seeing your child achieve skills that will support their independence and self-advocacy as they grow up is possible because of your parental support. In the same way that taking steps to learn about your child’s specific needs supports your well-being, it supports your child, too. Being surrounded by people who believe in them and hard work is instrumental to your child’s success.

Thus, the growing pains of life are made a little easier when you have a positive support system. Furthermore, when you feel less distressed and burdened by the challenges of ASD, you have more space to get to know your child. There is more space for affection, sensitivity to your child’s challenges, and engagement with your child.

Although a big part of parenting is making sure your children stay healthy and safe, it is about more than meeting their basic needs. As the American Psychological Association (APA) notes in “Parenting,” parenting is also about preparing children for life as productive adults and passing down important cultural values. The intangible inheritance of values and personality traits in parenting is made possible by healthy parent-child relationships. Thus, your use of parental support tools can help foster those positive bonds of insightfulness, acceptance, and sensitivity.

As Magda Di Renzo et al. note in “Parental Attunement, Insightfulness, and Acceptance of Child Diagnosis in Parents of Children With Autism: Clinical Implications,” parental insightfulness and acceptance go hand in hand with each other. Parental insightfulness is your ability to see things from your child’s point of view. Insightfulness coupled with acceptance allows you to be more sensitive and understanding of your child’s challenges and experiences.

Everyone wants to be understood and accepted, as your sense of belonging is often tied to your relationships with others. You can better understand your child, and they can better understand you when you have the time and space to enrich those relationships. Thus, PMIs can help contribute to your ability to guide your child and foster important connections for their well-being like:

  • Social interaction
  • Emotional security
  • Supportive structure
    • Routines
    • Social norms
    • Beliefs
    • Cultural values

Therefore, fostering healthy family dynamics has a significant position in the overall health and interactions between family members. Parental support, like PMIs, provides strategies to support positive everyday interactions between you and your child. Through positive interactions, you enhance the quality of your parent-child relationship while promoting adaptive skills for the whole family.

In various settings and relationships, like work and school or siblings and parents, you have likely seen how misunderstandings and assumptions harm well-being. Whether you are at work or having lunch with a relative, difficulties in communication can create tension that erodes those environments and relationships. Thus, embracing interventions that foster communication and social interaction skills for your child can empower the whole family. For example, PMIs like parent-child interaction therapy (PCIT) emphasize the value of supporting parent-child interaction patterns.

Through PMIs, you are giving the parental support necessary to engage your child in skills that encourage prosocial behavior in a secure and nurturing relationship.

Building Skills for Parent-Mediated Interventions at 360 Behavioral Health

At 360 Behavioral Health, we believe in providing goal-focused and evidence-driven therapy to meet your child’s specific needs. Through applied behavior analysis (ABA), we are able to offer a variety of treatment options that can be customized to meet your child where they are in their development. Meeting your child where they are is a core part of our work at 360 Behavioral Health because every child’s experiences and needs are different. Every child with ASD deserves treatment and support that is compassionate and committed to creating meaningful changes in their life.

Meaningful growth and change happen in your child’s life when you have access to parental support tools. Through our parent and caregiver training service, we are dedicated to giving you tools to help your child live their best life. Moreover, parent and caregiver training gives you access to a community of support from your child’s clinicians and other parents.

Entering a world of support services filled with abbreviations for a variety of care approaches can feel overwhelming and confusing. However, access to a community of other parents going through similar growing pains with their children reminds you that you are not alone. One of the core elements of learning and growth is support and connection. When you have access to parental support tools, you are taking steps toward a successful future for your whole family. The door to effective functioning and independence through childhood and adulthood becomes more achievable when parental support is a central part of ASD treatment.

Helping your child with autism spectrum disorder (ASD) can feel overwhelming. Your child’s difficulties with communication, social interactions, and challenging behaviors can take a toll on the whole family’s well-being. However, with parental support, you can gain the skills and strategies to address your and your child’s needs. Parent-mediated interventions (PMIs) help you learn, practice, and apply different interventions to support your child’s growth in real-time. Through PMIs, your child can improve their social and life skills and reduce unhealthy behaviors. At 360 Behavioral Health, we believe you are an instrumental tool for your child’s success, and PMIs empower you to engage with your child to live their best life. Call us at 833 CARE 4 LIFE (833) 227-3454 to learn more today.

Early Intervention for Children With ASD

Early Intervention for Children With ASD: Benefits and Techniques

Early Intervention for Children With ASD: Benefits and Techniques 599 399 bh360

Early Intervention for Children With ASD: Benefits and Techniques

Infant Development & Early Intervention

As a parent, you know your child better than anyone else. If something feels different about your child’s development, do not hesitate to reach out for support. Your instincts about your child and their needs can have a profound impact on their long-term well-being. The benefits of early intervention for autism have become more apparent as access to better diagnostic tools and awareness has grown.

As the Centers for Disease Control and Prevention (CDC) notes, one in 36 children in the U.S. are diagnosed with autism. The rise of earlier autism spectrum disorder (ASD) diagnoses has shown that early intervention can change your child’s developmental path. Early access to treatment and support offers more time to learn and build adaptive rather than maladaptive skills as your child grows up. Yet, many children with ASD still go undiagnosed.

At 360 Behavioral Health, we believe it is never too early to get a general developmental evaluation. Whether your child has ASD or not, an early evaluation can help your child find support that matches their needs. While addressing the unknown is scary, with knowledge comes the power to effect positive change in your child’s life. If your child is missing early milestones, it does not have to be the end of the road.

Despite the challenges your child may encounter, early intervention can help set them up for success. Your dedication to your child’s well-being and parental instincts can help you give your child the future they deserve. Even though fear can drive people away from their instincts, deeper awareness and knowledge can help you overcome those fears for the betterment of your whole family. You can start dismantling your fears of ASD by learning how to recognize when to seek early intervention for your child.

How Early Can Autism Spectrum Disorder Be Diagnosed?

Signs of ASD often start showing between the ages of 12 and 18 months. Although some children may have symptoms earlier than 12 months old, many are not diagnosed with ASD until after the age of three. Despite how early ASD can potentially be detected, a diagnosis is frequently not given until children have reached school age. However, you can advocate for your child by collaborating with their pediatrician to identify potential developmental delays.

Now, you may worry about potential barriers to care, like access to information and support from healthcare providers. As the CDC notes, 85% of children later identified with ASD had developmental concerns noted in their record by age three. Yet, these early records of developmental concern did not result in a developmental evaluation. Only 42% of those children identified with ASD received a developmental evaluation by the age of three.

19% of children received ASD evaluations between the ages of three and four. However, 39% of children did not receive an ASD evaluation until after the age of four. Hearing about some of the barriers to early intervention can sound and feel scary. However, acknowledging those barriers can give you insight into how you can advocate for your child’s specific needs.

Your voice is an important tool to give your child resources for success throughout their childhood. Therefore, increasing your awareness and knowledge of ASD diagnosis timing can help you work effectively with your family pediatrician. Moreover, you can see how delayed diagnosis cuts into the time that could been spent fostering your child’s skills. Now, you can use the knowledge you have gained to better recognize early signs of ASD before foundational milestones happen.

Early Signs of ASD

Some of the early signs of ASD you can look out for in your child include:

  • Difficulty making eye contact
  • Issues with following another person’s gaze or pointed finger to another object
  • Unresponsive to their name
  • Difficulties with nonverbal communication
  • Underdeveloped play skills involving pretend play and imagination
  • Delayed verbal communication
  • Regression
    • Children stop using the social skills they had previously gained
      • Language
      • Play
      • Social skills
    • Typically happens between the ages of one and two
    • Some social behaviors may regress earlier than the age of one
      • Looking at faces
      • Reciprocating smiles

Looking at the early signs of ASD showcases how important early intervention is for development. ASD affects your whole family, but access to resources can have a positive impact on how you navigate those challenges.

The Impact of ASD on Life Skills

ASD is typically characterized by impaired social skills, communication skills, repetitive actions, and behavioral difficulties. Social, communication, and behavior impairments can interfere with your child’s ability to function in different areas of life. The challenges of ASD can make it difficult to interact with others. In addition, ASD can contribute to difficulties functioning in school and work settings.

Listed below are some of the difficulties a child with ASD may experience:

  • Social interaction
    • Verbal and nonverbal communication
      • Understanding and using nonverbal social cues
        • Eye contact
        • Facial expressions
        • Gestures
        • Body language
      • Difficulty expressing feelings in appropriate ways
      • Impairment in understanding others’ feelings
  • Daily living skills
    • Self-care
      • Personal hygiene/grooming
      • Toilet hygiene
      • Bathing/showering
      • Dressing
      • Sleep schedule
      • Health maintenance
        • Planning, setting, and managing appointments
        • Exercise
    • Home management
      • Cleaning
      • Washing clothes
      • House maintenance
        • Changing light bulbs and filters
        • Lawn care
        • Cleaning gutters
        • Checking plumbing
    • Food preparation
      • Cooking
      • Planning meals
      • Purchasing food
      • Understanding nutrition needs
    • Time management
      • Organization
      • Prioritization
      • Planning
      • Setting goals
      • Communication
    • Money management
      • Counting money
      • Budgeting
      • Organizing expenses
      • Problem-solving

When social, communication, and behavioral difficulties of ASD are left unaddressed, it can have a lasting impact on life satisfaction. Through childhood and adulthood, unsupported ASD can make it more difficult to:

  • Establish and maintain relationships
  • Reciprocate social interactions
  • Communicate with others
  • Connect with family members and their community
  • Gain academic skills
  • Form a positive sense of self-worth
  • Establish independence

Difficulties with ASD can sound daunting, but your child can improve and overcome challenges to lead their best life. With support and access to early intervention, treatment can be customized to meet your child’s specific needs. Through individualized support, you can work in collaboration with your pediatrician and clinicians to build a plan of care that fits your child and your family’s life. Now, you may question why more opportunities for early intervention have not been used more to support children with ASD.

There are a variety of factors that can contribute to fewer opportunities for early intervention. A big barrier or factor in finding beneficial support in many sectors of life is awareness and knowledge. For example, you can be aware of diabetes and anxiety but not have detailed information on how they work or can impact your well-being. Therefore, self-education can be a powerful tool for self-advocacy and increased support for your child’s well-being.

Everyone faces obstacles, but those challenges do not have to prevent your child from achieving life goals.

The Power of Knowledge in Early Intervention

Understanding barriers to care for ASD can deepen your awareness of your child’s needs. Moreover, recognizing potential barriers to early intervention can help you build tools to advocate for your child and their future. Building advocacy skills can also teach your child how to engage in self-advocacy as they grow up.

Listed below are some of the potential barriers to care for ASD:

  • Health care services
    • Fewer specialists in urban areas compared to metropolitan areas
      • The impact on services, families, and clinicians
        • Creates a service supply shortage
        • Increased wait time for diagnosis and treatment
        • Fewer opportunities for early intervention
  • Physican Expertise
    • Many primary care physicians lack the specialized knowledge to support individuals with ASD
      • Screenings
      • Diagnostics
      • Make referrals for specialists and ASD services
    • Some primary physicians feel ill-equipped to treat individuals with ASD
      • Insufficient communication with parents and caregivers
  • Parent and Caregiver Familiarity
    • Some families are unaware of the signs and symptoms of ASD
    • Families are unaware of available care services
    • First-time parents are less likely to recognize developmental delays compared to experienced parents
      • Less familiarity with typical developmental milestones
    • Low awareness of ASD and care services impacts particular groups
      • Individuals and families with low socioeconomic status
      • Less education
      • Limited or nonexistent access to healthcare professionals and services
  • Language
    • Barriers in language make it difficult for families to access and navigate the healthcare system
      • Difficulties communicating with physicians
      • Issues interpreting and responding to administrative forms

In addition, barriers to diagnosis and treatment services can be distinctive for certain age groups:

  • Childhood and Adolescence
    • Infants to 17 years old
      • Severity of symptoms
        • Symptoms are diverse and can range from mild to severe
          • More difficulty identifying early signs of developmental delays
          • Mild symptoms of ASD may not be detected until later in life
      • Co-occurring health conditions
        • Individuals with ASD are more likely to have comorbid conditions
        • Overlap in symptoms can lead to complicated, delayed, or misdiagnosis
        • Difficulty integrating different care systems
          • Co-occurring health conditions are typically treated within the healthcare system
          • Developmental disabilities, including ASD, are typically supported through social services and education systems
      • Different expressions of ASD symptoms
        • Females and males typically have different clinical expressions of ASD
        • Males and females are typically assessed for development delays at the same age
          • However, ASD diagnosis for females is often delayed until later in life
  • Transitioning into adulthood
    • 16 to 25 years old
      • Young people transitioning into adulthood are less likely to seek support
        • Poor self-advocacy skills
        • Low awareness of resources and where to seek care
      • Individuals with ASD do not consistently receive healthcare transition services (HTS) to foster a smooth transition from pediatrics to adult care
        • Lack of information sharing leaves families unaware of HTS
          • Outpatient and inpatient visits decrease while emergency services increase
            • Increases with co-occurring conditions
        • Primary physicians do not present adaptive HTS to support different levels of ASD symptom severity
  • Adulthood
    • 18 years old and older
      • Adults with ASD may have difficulties finding support services that address co-occurring conditions
      • Misconceptions about ASD may lead primary physicians to over-attribute behaviors to ASD rather than other conditions
        • Primary physicians may be less likely to recommend key health procedures based on assumptions
          • Reproductive health exams

Although barriers to care may feel overwhelming, understanding those challenges opens the door to better support. Many people experience barriers in life, from school and work to health care and social resources. However, knowing those barriers are there encourages resiliency and dedication to building connections for a brighter future. When you engage in self-advocacy, you increase your child’s ability to advocate for themselves and foster independence throughout their life.

You can start taking steps toward giving yourself and your child tools to build a fulfilling life with early intervention. The long-term benefits of increased awareness and knowledge, coupled with early intervention, can be life-changing for your whole family.

Benefits of Early Intervention for ASD

Early intervention can be a game changer for your child’s development and long-term success. You can take steps to give your child the tools and resources for a life that encourages and builds on their unique strengths. The steps you take to increase your child’s self-esteem, independence, and satisfaction in life can start as early as preschool. Moreover, early intervention is particularly valuable in early life because your child’s brain is still forming.

Since your child’s brain is still forming, their brain is more malleable and able to take in information and adapt to different skills more easily. A more adaptable brain increases the effectiveness of treatment plans that can be changed and molded to fit your child’s needs as they grow up. Therefore, providing support in infancy and early toddlerhood can be an instrumental period for the development and improvement of a variety of skills that can help your child reach their full potential.

Through early intervention, your child can learn thinking, social, emotional, communication, and physical skills for their long-term well-being. The skills your child starts learning in early intervention can be invaluable to improvements in different areas of life like daily living, social behavior, cognition, language, and adaptive behavior skills. In addition, for many children with higher IQ, language, and motor skills, early intervention has led them to no longer meet the criteria for ASD. Thus, early intervention can be a remarkable tool to support you in giving your child the opportunity to live their best life.

Building Skills for Long-Term Support at 360 Behavioral Health

At 360 Behavioral Health, we believe early intervention can lead to better outcomes for your child now and across their life. While a delayed milestone does not necessarily mean your child has ASD, addressing delays can make a big difference in your child’s life. ASD is truly a spectrum. Access to comprehensive support early on gives your child the opportunity to engage in individualized treatment that meets their specific needs as they grow and change. Every child deserves access to support that considers their unique needs for their lifelong wellness.

Early intervention is not only a source of support for your child’s well-being but the wellness of the whole family. The challenges of ASD and health care systems can leave you feeling ill-equipped to support and advocate for your child’s best interest. However, early intervention can be a source of empowerment as you deepen your awareness and expand your knowledge of ASD to nurture your child’s growth. You are a vital source of support and advocacy for your child. Your dedication and efforts act as a guide for your child through their life.

Yet, you are not alone in supporting your child’s well-being. Forming a good parent-professional relationship with your child’s pediatrician and clinicians can provide a foundation of support to help you and your child successfully navigate through every stage of their development. We are a source of support you can lean on and work in collaboration with to guide your child and family through the diagnosis and treatment process. While your life may be different from how you envisioned it, leaning into expanding your awareness and knowledge offers opportunities for joy, success, and independence.

Knowing what resources are available to support your child with ASD can feel overwhelming. Low awareness coupled with primary physician misconceptions can make it more difficult to access treatment for your child. However, you can increase your awareness and knowledge of early signs and evaluations to advocate for your child’s success. Through early intervention, your child can improve social, communication, and behavior skills for long-term success. When children are diagnosed earlier in life, interventions can be more effective because their brains are more pliable for learning and growth. At 360 Behavioral Health, we believe that early intervention can give your child the comprehensive and customizable support they need to live their best life. Call us at (833) 227-3454 today.

Infant Development & Early Intervention

Red Flags for Autism

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Infant Development & Early Intervention

Red Flags for Autism

Roxana Rabadi, PsyD, LCP

There is no greater joy than watching your baby develop as a little person, hearing them laugh and babble, and seeing them explore their surroundings.

Some babies take a little longer than others to achieve expected milestones, from crawling to feeding themselves, and that’s not necessarily a problem; children develop at their own pace.

But there are specific behaviors that can be indicative of a developmental disability such as autism. Autism can be difficult to diagnose because the symptoms and severity are different for every child. There are a broad range of conditions within the autism spectrum that can impair a child’s development and have lifelong effects on their ability to thrive in our complex world.

According to The Centers for Disease Control and Prevention (CDC), “Autism is four to five times more common among boys than girls and 1 in 59 American children are on the autism spectrum.” It is important to monitor your child’s developmental milestones and bring up any concerns to your child’s pediatrician.

Could your child have autism? Review the warning signs to learn more about the red flags for autism

  1. Children with autism may exhibit delays in developing speech and language skills, and inability to understand meaningful nonverbal communication. There may be a problem if:
    • By 12 months, there is no babbling or “baby talk.”
    • By 16 months, your baby has not spoken a word.
    • By age 2, there have been no meaningful two-word phrases.
    • Your child is displaying jargon speech (made-up language), or is imitating what caregivers say, and repeating it over and over.
    • Your baby has poor eye contact and won’t look at you when you are feeding him or her or smiling at him or her.
    • Your baby seems unable to understand or use hand gestures, including pointing and waving.
    • Your baby does not imitate anyone else’s movement and does not seem to notice other people’s facial expressions.
    • Your baby does not seem to recognize or respond to their name being called.
  2. Children with autism tend to lack social understanding and interest in interaction. They may:
    • Appear disinterested or unaware of those around them.
    • Not know how to connect with others, seek out play, or make friends, or how to establish or maintain age-appropriate relationships.
    • Not show enthusiasm/enjoyment during interactions or do not display shared enjoyment.
    • Display aggression toward others.
  3. Children with autism may exhibit rigidity, inflexibility and certain types of repetitive behavior such as:
    • Insistence on following a specific routine.
    • Having difficulty accepting changes in the schedule.
    • A strong preoccupation with a particular interest.
    • Having an unusual attachment to a toy or other object.
    • Lining up or arranging items in a certain order.
    • Repeating the same actions or movements over and over again.
    • Examining objects closely or from the corner of the eye.
    • Fascination with spinning objects and his or her reflection in the mirror.
    • Rocking, hand-flapping, twirling and finger-flicking.
    • Self-directed aggression, such as head-banging.
  4. Children with certain types of autism also have a sensory hypersensitivity that is shown by:
    • Resistance to touch and cuddling – your baby doesn’t reach out to be picked up.
    • Unusual reactions to light, taste, smells, textures, and sounds.
    • Hypersensitivity to loud noise.

If you recognize any of these behaviors, know that there’s no need to despair. An early diagnosis and specialized treatment can help.

If you believe your child may need care and you aren’t sure where to start, call us at 833.227.3454, email us at [email protected], or visit our website to Request a Consultation.

About the Author

Dr. Roxana Rabadi is a clinical psychologist who specializes in diagnosing and working with children and adults with autism and related developmental disorders.

Dr. Roxana Rabad
Roxana Rabadi, PsyD, LCP
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Evaluation and diagnostics – also known as psychodiagnostics – is the first step necessary to diagnose and clarify concerns regarding behavior, personality traits, mood, emotional functioning,
and cognitive processes.

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Our infant development and early intervention program helps babies and toddlers with developmental delays or disabilities learn key skills that typically develop very early in life. Early intervention can contribute to a child’s success at home, in school, the workplace, and community — and can make a positive impact on a child’s development and accomplishments well into adulthood.

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How Social Skills Training Can Help Children, Teens and Young Adults with Autism

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Telehealth Benefits for Autism

How Social Skills Training Can Help Children, Teens and Young Adults with Autism

Iris Chiang, M.Ed., BCBA

We all need to be able to socialize to be successful in life — to accomplish day-to-day activities of living, maintain a job, create friendships and intimate relationships, and build a family, if we choose to pursue one. These are core values of being happy for many people. They require a level of interaction and understanding between people.

But socializing can be challenging. It’s particularly tough for those with autism spectrum disorder (ASD) because some of the emotional and intellectual deficits typically associated with autism can make social interaction difficult.

Fortunately, those with autism can get help learning and developing social skills. The benefits are immediate and long-lasting: not just improved daily functioning but higher enjoyment and satisfaction, with lower incidence of isolation, depression and suicide.

Challenging Behaviors that Social Skills Training Can Address

Social skills training can help individuals with autism who:

  • Avoid other people and prefer to hang out by themselves
  • Prefer to be with adults, or with people who are younger
  • Have a difficult time making eye contact with others
  • Won’t engage in conversation with other people, or walk away from people who try to engage them
  • Get aggressive (loud, physical or violent) when approached by other people
  • Have a hard time sharing their stuff, who dominate conversation, who don’t follow rules of sportsmanship, or who are overly bossy
  • Have boundary issues — they get too close to other people or avoid closeness with others
  • Are too accommodating and may be taken advantage of, such as by peers who ask them to do their homework or give them their lunch money

If your child has ASD and demonstrates some or all of these behaviors, they could likely benefit from social skills training.

What Can Be Learned from Social Skills Training?

Social skills training most often is a complement to behavioral therapy based on principles of applied behavior analysis. The two go hand in hand.

Behavioral therapy with an individualized treatment plan identifies specific areas and issues that can be addressed through a customized program designed to modify challenging behaviors and improve functional living and quality of life. Social skills training offers the opportunity to put the skills learned in therapy to work in a group setting, while also developing skills that can only be learned in a group.

For younger kids, social skills training focuses on following group instructions, joining in group behavior, greeting group members, sharing and taking turns, conflict resolution, identification of different emotions, and initiating interaction; in other words, how to approach and communicate with other people in group settings.

For pre-teens and teenagers, social skills training focuses on joining a group, how to use verbal and nonverbal communication and behavior to determine if the group is open to being joined, how to start a conversation, how to be aware of certain behaviors that might seem unusual to others, problem-solving, conflict resolution, assertiveness training, and how to identify other people’s intentions. For young adults, social skills training can continue to further develop these skills.

A common thread in the training is teaching self-preservation skills including assertiveness, so kids learn how to stand up for themselves and, as they get older, how to recognize and respond to bullying including cyber-bullying.

Another Benefit of Social Skills Training: Support

Everyone responds to social skills training differently, largely based on their age and level of functioning. Some need more repetition (more practice); others learn more quickly.

For most, the training is actually fun because they experience the benefits in real-time … they get to engage with and form bonds with their peers. As a result, the learned behaviors become self-reinforcing and group members get support from each other. That’s the benefit of positive social interaction, which can be fulfilling in and of itself.

For more information about social skills training, visit our social skills information page or Request a Consultation for a complimentary 30 minute in-person or phone consultation to discuss social skills training available in your area.

About the Author

Iris Chiang is a Board-Certified Behavior Analyst (BCBA) with 13+ years of experience providing applied behavior analysis (ABA)-based treatment to children and young adults with developmental disabilities.  Her specific areas of interest in ABA include social skills training and staff training.  Iris also holds a school counseling credential and received formal training in PECS (picture exchange communication system), PEAK, ACT (Acceptance Commitment Therapy), CBT (Cognitive Behavioral Therapy), and PEERS.  Iris currently serves as the Director of Clinical Services for California Psychcare in Long Beach.

Personal interests include spending time with her husband and 2 daughters, with a third daughter on the way, practicing mindfulness, and trying new recipes as an amateur chef.

Iris Chang
Iris Chiang, M.Ed., BCBA

Director of Clinical Services
California Psychcare

social therapy
Social Skills Training

Our social skills training help individuals function more effectively in social situations and cultivates skills needed to create positive interactions with others. Delivered at one of our behavioral health treatment centers, we offer age-based groups for kids, preteens, teens, and young adults. Our groups are conducted in a comfortable setting where individuals with developmental disabilities can develop and practice their social skills with peers on a regular basis.

Telehealth Benefits for Autism

Benefits of Telehealth for People with Autism

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Telehealth Benefits for Autism

Benefits of Telehealth for People with Autism

Kate Sheldon-Princi, M.Ed., BCBA

Telehealth is used throughout healthcare, allowing patients to connect to many kinds of practitioners. Telehealth is rapidly growing in the field of applied behavior analysis (ABA) and may improve access to care for individuals diagnosed with autism spectrum disorder (ASD) or other developmental disabilities. Telehealth can be as simple as using a phone, tablet or computer to connect face-to-face with your healthcare provider, similar to how you may chat with family or friends who may live out-of-town.

California already had legislation in place that supported the use of telehealth – such as the Telehealth Advancement Act of 2011 – and support for telehealth was expanded in 2019 when Governor Gavin Newsom signed AB 744 into law.  This new legislation will make telehealth services more widely available to many Californians – including those needing behavioral therapy services. While the new law doesn’t mandate telehealth coverage until 2021, many insurance providers already offer the coverage — you may just need to ask for it.

Benefits of Telehealth in ABA-Based Behavioral Therapy

Expanding access to ABA-based behavioral therapy services through telehealth will benefit individuals with ASD and other developmental disabilities in many ways. The benefits of telehealth services for this type of care includes:

  • Increased Supervision and Communication
    In ABA-based behavioral therapy, a Board-Certified Behavior Analyst (BCBA) oversees treatment of a patient with autism or other developmental disability, with direct support typically provided in the home by a behavior interventionist (BI). The BCBA provides this oversight through in-home supervisory visits with the BI.  During these supervisory visits, the BCBA works with the BI and the patient to ensure that the treatment plan is being followed and that the prescribed therapy is moving the patient toward established goals.In some situations, the BCBA may only be able to travel to an in-home therapy session once a month, but by using telehealth, the BCBA can remotely join sessions more often. This allows the BCBA to observe the patient, speak with the parents or other caregivers and address issues, questions, progress and goals more frequently. When using telehealth, it’s important to note that this approach doesn’t replace the behavior interventionists who provide the hands-on care during in-home ABA sessions or the in-home supervision visits by the BCBA, but instead is a way for the BCBA to provide additional supervision hours to supplement the time they spend providing in-home supervision.
  • Expanded Geographical Areas Served
    Without telehealth, autism service providers often find they cannot accept referred patients who live outside of their BCBAs’ travel areas. Alternatively, some families need to drive hours from their homes so their children can access services. By providing BCBA supervision using telehealth, patients can receive care from local behavior interventionists with the BCBA supervision provided remotely most of the time. This is a major benefit to people who live in more isolated communities or areas underserved by BCBAs.
  • Improved Patient Outcomes and Satisfaction
    By increasing the frequency of supervision and communication with patients and caregivers, BCBAs can modify treatment plans and interventions more frequently, as well as regularly conduct trainings with direct-support professionals. As a result, the pace of treatment and progress may accelerate, with patient outcomes and satisfaction improved.

The Bottom Line

Before beginning the use of telehealth, a patient’s supervising BCBA must deem telehealth as clinically appropriate for the patient’s specific needs, and the patient and/or their family must give approval. Telehealth is not suitable in all cases. Protocols, procedures and technology that are proven effective and that maintain confidentiality and privacy are already in place. Success stories have been well documented, and service providers are preparing to expand the service to meet the needs of more patients.

If you think ABA-based behavior therapy services delivered via telehealth may be beneficial for you and you’d like to learn more, please request a consultation to schedule a complimentary 30-minute telephone or in-person consultation or visit our ABA-based therapies page.

About the Author

Kate Sheldon-Princi is a Board-Certified Behavior Analyst (BCBA) who has been a member of the 360 Behavioral Health family since 2012. Kate has provided and supervised applied behavior analysis (ABA)-based treatments to individuals of all ages and abilities, both in-home and via telehealth. Kate currently serves as the Director of Clinical Development for 360 Behavioral Health’s family of providers including California Psychcare and Behavior Respite in Action.

In her current position, Kate supports the development and integration of new services across the organization, which includes California Psychcare’s Telehealth services. Kate has been involved with California Psychcare’s telehealth program from advocacy for inclusion in legislation, to conducting trainings for clinicians, and the countless stages in-between. Kate, along with the rest of the 360 Behavioral Health team, is optimistic about the benefits that patients will experience as telehealth access is expanded.

Kate Sheldon-Princi, M.Ed., BCBA

Senior Director of Managed Care & Clinical Development
360 Behavioral Health

aba home-based therapy icon
Applied Behavior Analysis (ABA) / Behavioral Therapy – Home Based

Applied Behavior Analysis, or ABA, refers to a variety of treatment options that are based on the principles of behavior analysis. ABA uses scientifically-based techniques for understanding and changing behavior, and is the most widely accepted approach to assess and intervene with individuals with autism spectrum disorder (ASD) or other developmental challenges or delays. This type of therapy is conducted one-on-one, is customized for each person, and is appropriate for individuals of all ages.

little girl hugging mother's pregnant belly

How to Prepare a Child with Autism for a New Sister or Brother

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little girl hugging mother's pregnant belly

How to Prepare a Child with Autism for a New Sister or Brother

April MacPherson, MA, BCBA

The arrival of a new baby is a joyful occasion for any family. Mom and Dad are bringing a new person into the world, and their kids are getting a new sibling.

The arrival of a new child also brings anxiety and maybe even some fear. How will family life change? How will the household be affected? What will be the demands of the new child? There is uncertainty.

The stress may be particularly acute for a child with autism spectrum disorder (ASD). What’s the best way to prepare a child with autism for the arrival of a new sibling? There is no one-size-fits-all approach because every child with autism is different. But there are some steps caregivers can take to prepare the child for change.

Before thinking about how to prepare your child with ASD, it helps to remember what his or her deficits or challenges are so you can plan to address those issues specifically. If you need help identifying your child’s problem areas and coming up with interventions to address these concerns, it’s best to consult a board-certified or licensed professional who follows evidence-based practices, including the science of applied behavior analysis (ABA). Then, you’re ready to prepare with these tips:

  1. If the child is particularly sensitive to changes in the home environment, check in with your ABA team to discuss changes you should start making before the new sibling arrives. For example, a plan might be put in place to introduce a bassinette and crib into the home, and potentially move the bassinette around so the child begins to adjust to the new furnishings and a constantly changing environment. It is never too early to introduce visuals that involve all things baby to your child so they can become familiarized with what babies look like and all the baby items that will soon be in their home.
  2. Some children may respond well to introducing a baby doll into the environment and treating the doll as you might a child — holding it, feeding it, pretending to change its diapers, and certainly have it sleep in the bassinette and the crib. This not only might give them a small glimpse of what to expect, but it can also increase pretend play and social skills.
  3. If the child has stronger verbal skills, explain what’s coming and how you feel, so he or she begins to understand that this is a positive development. You can read stories to the child about new babies coming home from the hospital. There are some good children’s books out there, and an ABA team can create specific social stories with visuals that are personalized to the child and the family’s unique situation.
  4. If the child is highly dependent on a particular caregiver such as Mom, consider having helping hands (e.g. friends, family, babysitters) develop a strong relationship and rapport with the child before the new baby arrives. This may allow the child to get more comfortable being in another person’s care, which could also increase their flexibility to new people or situations, as well as not require the primary caregivers’ full attention at all times.
  5. If the child is sensitive to noise, consult with a professional about how to effectively address this concern. Environments with babies can often have noises that a sensitive child may not be accustomed to. It would be ideal for the child to be more comfortable, relaxed and familiar with the sound of baby cries before baby comes. At the very least, it would be beneficial for them to have support systems in place to allow them to tolerate such noise – like special headphones – which should be established before the arrival of baby.
  6. Many children with ASD are highly sensitive to even the slightest changes in common daily routines. Taking a different route home from school or switching the order of an activity in a way that the child is not used to can possibly trigger an unwanted behavioral episode. This can be a challenging obstacle when a new baby is added to the environment, as babies are often unpredictable with their many needs. If this is concern in any household, it is important to receive professional support to ensure that a plan is put in place to gradually increase the child’s ability to adapt to unexpected or sudden changes in common routines. The goal would be to ensure the child is more flexible and adaptable to varied routines prior to baby’s arrival.
  7. Children who display aggression or other unsafe behaviors should have this concern addressed sooner rather than later. This is critical and will help minimize risk of injury. An effective behavior intervention plan that is tailored to the individual can make all the difference in the world. When seeking professional help, it is important that a Board-Certified Behavior Analyst (BCBA) is there to collaborate and create the behavior plan.

Remember that every child with autism is different, and each will react differently to a new sibling. At one extreme, some children will be affected by every change in the home, be it environmental or sensory. On the other extreme, some children may seem unaware and even oblivious to the new child, especially at first.

If you think you need help preparing your child with autism for a new sibling or would like more information about ABA-based therapy and how it might help, learn more about in-home ABA services or schedule a complimentary 30-minute phone or in-person consultation.

About the Author

April MacPherson is a Board-Certified Behavior Analyst (BCBA) who has provided applied behavior analysis (ABA)-based treatment to children and young adults with developmental disabilities since 2007. She currently serves as the Director of Clinical Services for California Psychcare’s Palmdale center. April spends her time supervising and mentoring her team of BCBA colleagues and staff who are looking to grow in the field of applied behavior analysis, as well supporting families in need in and around the entire Antelope Valley area.

April spent several years teaching kids how to ride horses and develop skills necessary for teamwork and equine-care before making the jump into the field of applied behavior analysis that primarily serves the ASD population.

Outside of work April enjoys spending quality family time with her husband and 2 kids in their home, which also includes 2 horses, 2 cats, and 2 dogs. Her family also loves to take hikes together whenever possible. April hopes to return to competing on equestrian drill teams and attending rock concerts again when her boys are a bit older and she has more time on her hands.

image of April MacPherson
April MacPherson, MA, BCBA

Director of Clinical Services
California Psychcare

aba home-based therapy icon
Applied Behavior Analysis (ABA) / Behavioral Therapy – Home Based

Applied Behavior Analysis, or ABA, refers to a variety of treatment options that are based on the principles of behavior analysis. ABA uses scientifically-based techniques for understanding and changing behavior, and is the most widely accepted approach to assess and intervene with individuals with autism spectrum disorder (ASD) or other developmental challenges or delays. This type of therapy is conducted one-on-one, is customized for each person, and is appropriate for individuals of all ages.

Challenges with Children with ASD Who Are Growing Up Bilingual

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Challenges with Children with ASD Who Are Growing Up Bilingual

By Maria Sanchez, MA, BCBA and Crystal Herrera, MA


Growing up in a bilingual family can be a gift.

Children and parents all can benefit from the exposure to two different languages, cultures and family traditions — old and new — that accompany life in different places. It’s very apparent here in California, where so many families also have roots from different countries.
Over time, as family members become more proficient speaking English in addition to native languages, children and parents can help each other communicate, and understand and take advantage of different opportunities.

But for families with a child who has autism spectrum disorder (ASD), a bilingual home environment can also be a struggle. Language issues, in particular, can be a problem, especially since some amount of English is necessary to access many services and resources, and since so many healthcare and education professionals in the U.S. speak just English.

Language isn’t the only issue. Based on our experience providing healthcare services to people with autism, we’ve observed three challenges faced by many bilingual households.

Challenge #1: Culture
In many cultures there can be resistance to acknowledging that a child has a developmental disorder, be it autism or something else. Some family members may want to believe that the child is just going through a phase and will grow out of it, even when the evidence — such as challenging behaviors or limited language skills — persists. Some cultures have stubbornness or self-consciousness built in, which can delay or even prevent diagnosis and treatment.

In other ways culture can interfere with the delivery and follow-through of a treatment program. For example, if a child with autism is prone to tantrums, the therapy may advise that the child be left alone – if only briefly – while the outbursts run their course.

In some cultures, however, it is considered rude, disrespectful or uncaring to ignore a child who is acting out. In these cases it’s important that parents understand that often the most helpful response is the opposite of what they may think, because the “natural” response may be interpreted by the child as a reward for his or her behavior. The consequence is that the child doesn’t learn new or replacement behaviors and instead repeats the problematic behavior because he or she is rewarded for it with attention.

Behavioral therapists, including healthcare professionals trained in applied behavior analysis, can explain and teach this to parents as part of the program.

Challenge #2: Coordination of Care
Many healthcare providers and school teachers speak only English, so it can be difficult to access and coordinate care for a disabled child, especially when the predominant caregiver in a family does not speak English or when the child is very young and may not be able to speak.

Picture a situation where Mom speaks only Spanish, Dad works full time, and Mom is responsible for the child’s care. In this case Mom needs help understanding the situation so she can secure resources for the child. Explanations about how a treatment program works and what she should do to support the program with her child can be very beneficial and can help the child and parents get on the right track.

There can also be issues with doctors and medications. Imagine a situation where a child is not yet talking, and also happens not to be sleeping well. Mom and the child go to see the doctor. Because of language issues, the child’s health history is not fully explained to the doctor, who thus has a lack of understanding of the situation. In that case, the doctor’s treatment — maybe it is medication—may not be best for the situation. Or maybe Mom leaves the doctor’s office not understanding what a medication is for or how it works, so she is unable to fully support the child’s treatment because she doesn’t know what the medication is for and can’t explain the importance of it to the child.

Similar situations and outcomes can occur with other healthcare professionals, such as speech therapists, and at the child’s school with teachers and administration officials.

Challenge #3: Knowledge of Available Resources
Most communities have resources available for families, but not everyone is aware of how to gain access to these resources. Not being familiar with the predominant language causes a barrier to accessing the resources. For example, a family that is searching for speech therapy might not know where to apply, fill out the required forms or communicate the needs of the child.

Fortunately, there is help available for parents and children with ASD, including service providers who are bilingual and can help parents access care, coordinate care, and overcome some cultural obstacles to successful therapy and training. There also are resources for parents to learn English, which can help in so many ways.

If you think your child needs care and you are not sure where to begin, contact us to schedule a complimentary 30-minute in person or phone consultation. If you need a consultation in Spanish, be sure to add that into the notes in the “comments” section of the form.

About the Author

Maria Sanchez is a Board-Certified Behavior Analyst (BCBA) who is providing applied behavior analysis (ABA)-based treatment to children and adults with developmental disabilities.

Maria grew up in a predominantly Spanish speaking household and experienced, firsthand, the struggles of growing up in a predominantly English speaking country. At a young age Maria’s family depended on her to translate, navigate and communicate information about community events and resources. Maria started her career educating Spanish speaking families on proper nutrition while attending University of California Los Angeles. She currently serves as the Director of Clinical Services for California Psychcare and works with Spanish and English speaking families.

In her free time, Maria enjoys watching movies, hiking, and traveling with her family.

Maria Sanchez, MA, BCBA

Director of Clinical Services
California Psychcare

a boy and a girl doing a fist bump

Enhancing Sibling Relationships in Families with Kids with Autism

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a boy and a girl doing a fist bump

Enhancing Sibling Relationships in Families with Kids with Autism

Alfredo Arciniega, M.A., M.S., LMFT, BCBA

The relationship between siblings is significant in human development. The bond between siblings can provide love and support across a lifetime, and can reinforce social and developmental skills and positive behavior in childhood. Healthy sibling relationships can increase happiness and can contribute to a strong family unit.

Life for an individual with a brother or sister with autism is much like life in any other family. But siblings of kids with autism and similar conditions also face unique challenges. These kids experience a wide variety of emotions and experiences as a result of the situation. Younger kids are sometimes puzzled with questions such as “what is wrong with my brother or sister?” and “why aren’t the rules the same?” Teenagers may display a high level of concern about their brother or sister having a meltdown, especially in public settings. Young adults wonder if they will be the expected to caretake for their brother or sister in the future. All of these questions are important and should be discussed.

When parents are confronted with the intense demand for caring for their child with autism – along with all of the other family and life obligations – they may struggle with understanding when and how to address unique challenges that other children in the family may be facing. Parents can help siblings respond to their experiences of having a brother or sister with autism and can help them develop skills that build and maintain meaningful relationships that can lead to greater balance within the entire family.

Parents need to be aware that it is not easy for many children to express their worries about their brother or sister with autism, so it’s essential that parents foster an atmosphere of open communication, and that they initiate dialogue and provide support. Specialists trained in ABA-based therapy can help facilitate conversations and can provide resources and tools that can help develop strong sibling relationships.

Where to Start:

  • One-on-one time: Spending time with your child is a great way to make sure he or she doesn’t get lost in the shuffle of the daily routine and all of the appointments. Start with a few one-on-one activities, they will add up throughout the week.
  • Teach your son or daughter about autism: Depending on the age of your child, there are a variety of resources to help children understand autism, including books, support groups, movies, etc. A good starting point is to teach them the word “autism” and what it means. But don’t get caught up with limitations. Keep it short and simple.
  • Acknowledge his/her feelings: There has probably been a time when you felt frustrated or embarrassed about a meltdown. Your child may sometimes feel this same kind of frustration or embarrassment. Make it okay for your child to express his/her feelings about all of the ups and down they have with their brother or sister – without the worries of consequences.
  • Use positive praise: Don’t forget to praise and give your child attention . . . frequently. Start with the small victories and work your way up. If it doesn’t come easily, try using statements like “I like how you…”, “great job with…” or “it makes me so happy when you…”.
  • Have reasonable expectations: Are you perfect? None of us are. Be okay with things not always going according to plan. Kids are going to be kids, they are going to make mistakes, they’re going to misbehave. It’s is all part of the learning process.
  • Encourage family activities: Find moments throughout the week to schedule activities that are fun and safe for everyone. Promoting these activities can strengthen relationships with the entire family.
  • Support Groups: Sometimes it is comforting to know you aren’t alone or the only one with unique concerns. A sibling support group offers the opportunities for brothers and sisters with a loved one with autism to learn that there are other children they can share and connect with who “get it.” Find out where in your community you can connect.

If you think you need help with a child with autism or his / her sibling or siblings, learn more about in-home ABA services or schedule a complementary 30-minute in-person or phone consultation.

About the Author

Alfredo Arciniega is a bilingual Licensed Marriage & Family Therapist (114063) and a Board-Certified Behavior Analyst. In 2013, he started his career at California Psychcare working with children on the autism spectrum. This is where he discovered his passion to help and support children and their families. He earned two master’s degrees, which contribute to his skillset of providing an integrated treatment approach. His first M.S. degree is from the University of Phoenix and is in Marriage, Family and Child Therapy. The second M.A. degree is from Florida Institute of Technology and is in Professional Behavior Analysis.

Currently, Alfredo is a director of clinical services for the Laguna Hills | Orange County branch of California Psychcare, where he leads a team of behavior interventionists. He lives in Costa Mesa with his husky dog and partner. He takes great pleasure in spending time with his loved ones and enjoys hobbies such as hiking, surfing, and snowboarding. Alfredo hopes to continue to support families by utilizing his background in applied behavior analysis and providing a best practice approach.

photo of Alfredo Arciniega
Alfredo Arciniega, M.A., M.S., LMFT, BCBA

Director of Clinical Services
Laguna Hills | Orange County, California Psychcare

aba home-based therapy icon
Applied Behavior Analysis (ABA) / Behavioral Therapy – Home Based

Applied Behavior Analysis, or ABA, refers to a variety of treatment options that are based on the principles of behavior analysis. ABA uses scientifically-based techniques for understanding and changing behavior, and is the most widely accepted approach to assess and intervene with individuals with autism spectrum disorder (ASD) or other developmental challenges or delays.

Toilet Training Your Child with Autism: Seven Tips for Parents

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child toilet training

Toilet Training Your Child with Autism: Seven Tips for Parents

Shana Williams, MA, BCBA

Training your child to use the toilet can be tough. It takes patience and time. But it’s an important part of helping him or her learn about the body and develop skills necessary for life. It’s also needed to start school. Many pre-schools won’t accept children who are not toilet trained.

There are many books and websites for new parents to help teach kids how to go “potty.” For a child with autism or other developmental disabilities, toilet training can be more difficult because of how they may perceive or react to the different sensations related to toileting. Additional difficulties can arise if there are communication challenges or if the child requires more time to learn a new skill. A parent can usually toilet train their child, but sometimes professional help is needed.

Here are seven tips to help toilet train your child with autism or another developmental disability:

  1. Wait until the child is ready.

    There is no magic age or perfect time to potty train. Kids generally show readiness between the ages of two and four, but sometimes a child isn’t ready then. If that’s the case, wait. There’s no shame in waiting a little longer, and no reason for a parent or child to be embarrassed.

    You know your child is ready to be potty trained when they show some or all of these signs:
    • The child can pull up and down their pants
    • The child is hiding to poop
    • The child is showing discomfort when wet

    These signs indicate the child is capable of going potty on their own, and that they realize, on some level, that soiling themselves is not quite right.
  2. Get the diapers out of the house and get your child into underwear.

    Kids in general should be switched to underwear at the time of toilet training. For kids with autism, this is even more important because the shift from diapers to underwear may create different sensations for the child, and it may take a little time for them to get comfortable in underwear.

    If this is the case, accept it, and recognize that the child may poop or pee in their underwear at first, but that’s okay. Take time to allow the child to become comfortable wearing underwear prior to starting toilet training, if that works better. Then, once the child is comfortable in underwear, begin toilet training. Have the child pick out underwear that is fun and interesting to them – perhaps a style with cartoons or other characters. It’s also okay to target daytime training first and then target night time once the child shows more independence on the toilet.
  3. Set aside time, ideally a week, when you and your child can be at home together.

    Toilet training generally takes about a week if a parent and child are home together every day to do the training. This is important so you can monitor your child and when there is the urge to go potty or initial signs of wetness, you can run your child right to the bathroom so he or she understands that’s where they are supposed to go. You are literally showing your child what to do and teaching them a new skill triggered by their having to pee or poop. Some children require less time and some children require more time, and that is okay too. Just be sure to set up a system that allows consistency with the child’s new routine.

    If it’s not possible to be home with your child for a week, it may take longer to teach the behavior, or you may need to call a professional to help with the process.
  4. Make toilet training fun and rewarding.

    Have the child pick out a fun toilet seat with cartoons or other characters, same as with underwear. Make going into the bathroom a party: sing, dance, have balloons in the bathroom, celebrate being in the bathroom with your child. Make peeing or pooping rewarding for the child, perhaps with a piece of candy or cookie after they have peed or pooped. Cheer your child’s success!

    If your child fears the toilet, help them not to be afraid. This can be done by taking them to the bathroom and having them sit on the toilet or play around it, with the lid open or closed, with their clothes on — just to get comfortable around the toilet.
  5. Take peeing and pooping one step at a time.

    Usually a child pees first and then gets comfortable pooping in a toilet. That’s okay. If they keep having accidents, keep showing them the places where they had the accident and then walk them to the bathroom to reinforce the relationship between pooping and peeing and using the toilet. Have them say out loud at the spot of the accident “I need to go potty” and then take them to sit on the potty as well as do the toileting routine. Do this even if they have already gone at the scene of the accident. In some cases, repeating this process more than one time can be beneficial. The point is to demonstrate to the child that it is more work to be taken to the potty twice than to go to the toilet initially. This is an advanced technique that may require the help of a professional.
  6. If the child fears the flushing sound of the toilet or washing their hands after potty, avoid those triggers as part of the training.

    Don’t flush the toilet until after the child leaves the room. Don’t wash their hands in the sink — use hand wipes instead. Flushing and hand washing are behaviors that can be taught later on.
  7. If the child is not communicative, or not very communicative, use substitutions for some verbal instructions during toilet training.

    Depending on the age and functioning level of the child, you can use communication devices such as picture-exchange cards, bells or other different tools children can use to communicate non-verbally that they have to go to the bathroom. You can work with this.
Toilet training your child with autism or similar condition can be a little more challenging, but with time and patience you likely will be able to do it, and your child will learn the skills. If you need help, a licensed professional can provide individualized treatment delivered right at home.

If you are having challenges toilet training your child, learn more about how ABA-based behavioral therapy can help or schedule a complementary 30-minute phone or in person consultation.

About the Author

Shana Williams is a Board-Certified Behavior Analyst (BCBA) who has provided applied behavior analysis (ABA)-based treatment to children and young adults with developmental disabilities since 2008. She became interested in toilet training during her BCBA program through Florida Institute of Technology and working with many clients who had the need of becoming toilet trained.

Shana currently is the Director of Clinical Services with California Psychcare and is based in our Santa Barbara treatment center. She spends her time supervising and mentoring her BCBA colleagues, providing support to families in the Santa Barbara region, and running the social skills group held at the Santa Barbara treatment center each week.

Shana Williams
Shana Williams, MA, BCBA

Director of Clinical Services
California Psychcare

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Applied Behavior Analysis (ABA)

Applied Behavior Analysis, or ABA, refers to a variety of treatment options that are based on the principles of behavior analysis. ABA uses scientifically-based techniques for understanding and changing behavior, and is the most widely accepted approach to assess and intervene with individuals with autism spectrum disorder (ASD) or other developmental challenges or delays. This type of therapy is conducted one-on-one, is customized for each person, and is appropriate for individuals of all ages.

child and teacher

Getting Comfortable: The Initial Sessions of Home-Based Behavioral Treatment

Getting Comfortable: The Initial Sessions of Home-Based Behavioral Treatment 460 307 bh360

child and teacher

Getting Comfortable: The Initial Sessions of Home-Based Behavioral Treatment

Tasha Enriquez, MA, BCBA

Your child or another family member has been diagnosed with autism spectrum disorder (ASD) or a similar developmental challenge and is about to begin home-based behavioral treatment based on the principles of applied behavior analysis (ABA). Initiating this type of intensive behavior intervention is a great step forward, and everyone in the family has the potential to benefit.

Intensive behavior intervention is the most widely accepted approach to assess and intervene with people who have developmental disabilities. With treatment, problem behaviors and their triggers can be understood and addressed. At the same time, new skills can be taught to help the individual function more effectively in everyday situations.

Starting home-based behavioral treatment may feel a little intimidating. You may be wondering what it will be like or what to expect as treatment begins. Sessions are scheduled based on the number of hours recommended in the treatment plan, as well as family preference and availability. Your clinical team will guide you every step of the way and will work with you and your family to help you adjust to the new expectations of ABA services.

The initial sessions will focus on building “rapport” between the individual receiving the services and the interventionist. Rapport refers to cultivating a relationship based on trust and on developing a connection with the client and family. It’s about establishing a comfort level and simply getting to know each other.

Building rapport is critical to set up the treatment for success, as it establishes an environment where the interventionist is paired with “fun” and “access” to preferred items and activities rather than on requests or “demands” to complete specific behavior-modifying tasks. The amount of time it takes to build rapport varies depending on the situation, the individuals involved and other factors including the number of sessions conducted each week.

The Steps to Building Rapport

How does the interventionist work to build rapport? It happens in a very purposeful way:

  • First, ABA services are often initiated in the home because it’s the most familiar place and the most comfortable environment for the individual receiving services. Depending on the goal of the services, sessions may occur in other settings such as in a clinic, in the community or at school.
  • Second, the interventionist works to get to know the individual slowly, recognizing there may be some fear or anxiety about having someone new or unknown in the family environment. Initially the interventionist may appear to be just hanging out in the same room as the client or watching the client engage in activities – such as general play, watching TV, or engaging with cell phone games – from across the room.During the first few sessions, the interventionist seeks to determine the client’s preferred items (his or her “stuff”) — be it toys, games, entertainment or other objects — and preferred activities, such as drawing or building things. A lot of observation occurs during this phase.Direct interactions with the client increase gradually. For example, the interventionist may start by watching the client play with their cars from 10 feet away, perhaps while sitting on the couch. Then they may move closer, say three to five feet away, and make comments or car sounds such as “VROOMMMM, BEEP BEEP, Crash them together!” to engage the client. Next, the interventionist might ask if they can play with a car, too. Each step is carefully navigated based on the client’s response to the prior step, with the interventionist making adjustments as needed to accommodate the client.
  • Third, parents or other caregivers are always around during the sessions, either present and participating or acting as observers.The interventionist may request that a caregiver or other family members be involved in activities during session. If the client loves to play bubbles with dad, as an example, the interventionist will “pair” with dad and bubbles. If the client likes to go outside to race his brother on a slide in the backyard, the interventionist will join this activity. The interventionist also will ask about activities and interactions the client doesn’t like, so these can be known and avoided, at least initially, and about boundaries, including off-limit areas or activities at home.

After rapport has been established, there usually is a sense of trust and fun between the interventionist and the client. This means there’s a greater likelihood that as client goals are introduced, the client will want to participate and work together with the interventionist to achieve the goals of treatment, even when challenging. Over time, many clients come to view their interventionist as a coach — a helpful authority figure — and look forward to the sessions.

To learn more about our ABA-based services or how they may help someone in your family, please visit Applied Behavior Analysis (ABA). Or visit our Request a Consultation page to schedule a complimentary 30-minute phone or in-person consultation.

About the Author

Tasha Enriquez is a Board-Certified Behavior Analyst (BCBA) who has provided applied behavior analysis (ABA)-based treatment to children and adults with developmental disabilities since 2008. Tasha’s interest in behavior analysis started following volunteer work at a ranch where children and adults with developmental disabilities were taught to ride horses.

Tasha currently serves as the training manager for 360 Behavioral Health University, where she develops and provides training for new staff and current staff on topics in behavior analysis and clinical case management. Tasha is also a clinical supervisor for California Psychcare, where she provides direct supervision services for her clients and mentors trainees who aspire to be BCBAs.

Aside from her love of behavior analysis, Tasha also has 5 horses and enjoys spending time with her family. 

Tasha Enriquez
Tasha Enriquez, MA, BCBA

Training Manager | Clinical Supervisor
360 Behavioral Health | California Psychcare

aba home-based therapy icon
Applied Behavior Analysis (ABA)

Applied Behavior Analysis, or ABA, refers to a variety of treatment options that are based on the principles of behavior analysis. ABA uses scientifically-based techniques for understanding and changing behavior, and is the most widely accepted approach to assess and intervene with individuals with autism spectrum disorder (ASD) or other developmental challenges or delays. This type of therapy is conducted one-on-one, is customized for each person, and is appropriate for individuals of all ages.