Disciplining 2 & 3y/o ASD

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Registered: 03-26-2003
Disciplining 2 & 3y/o ASD
5
Sat, 07-23-2005 - 2:49pm

After recent birthdays, the boys are now 2 and 3. austin (2) is pdd-nos and displaying very typical 2 behavior. with him, i am now putting him in a time out chair (old highchair) for bad behavior.

matt (3) has moderate autism. i don't know what to do. if i raise my voice, he will lash out and scratch or pull hair. even if i change my tone without raising voice to austin, he reacts this way. he won't understand time out--i would have to hold him in it and it would escalate way past what the original offense is.

most problems with matt arise because of something austin does.

any suggestions? valerie

~Valerie
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Registered: 12-24-2004
Sat, 07-23-2005 - 3:36pm

Valerie,

I have found 2 basic principles to be true in dealing with Cassian, and most of the books I have read about ASD's back me up on this. Here is my take on disciplining kids with ASD's:

1) focus on front-end, rather than back-end discipline (preparation, prevention, etc., rather than consequences)

2) when you do use consequences, expect that the child will need LOTS of repetition of the same series of events over and over ad nauseum; the literature says most kids with autism need 50 to 100 repetitions to make a connection, and when some aspect of the situation is changed that seems trivial to you, this may prevent them from seeing the situation as "the same" so they don't make a connection then

Even kids who have good language development and high IQ, like my son, still need this kind of repetition and a focus on front-end discipline. We are finding that IQ and language are quite separate from the core autism attributes, which a hamper a person's learning in any real-life situation.

I don't use time-out much, but I do use procedures that help Cassian regain control (deep pressure, chanting, etc.). I now ask Cassian, as he begins to escalate, whether he needs to leave a given situation that is making him upset, and he can usually give me an intelligent answer about what he needs to do. It has taken us many years to get to this point, however. So my focus is on achieving behavioral regulation and then getting him to make an intelligent decision if possible. Eventually, I want him to be able to do this on his own, but for now, I have to be his guide.

Sometimes, there are certain discipline situations that reoccur, and I have ended up designing teaching methods to work on these skills. For example, I use dramatic play to help Cassian prepare for new experiences or difficult situations with peers (pretend the puppet won't share and guide him through solving the social problem). Running into the street and not coming back when we called was a recurrent issue that we are just now getting some results on. I played many sessions of squashing playdough people with toy cars, running with Cassian to the edge of the road and stopping with him as DH called for him to stop, etc. We just worked and worked on stopping your body when an authority figure tells you to do so. It took MANY repetitions. You just don't see the light go on for these kids for a LONG time when you are disciplining them, so setting up lots of practice sessions may be one way for you to go.

Cassian does respond to rewards, but I don't think he is motivated by them very much yet. It is more like the reward is a nice afterthought for him. I instituted a token economy system a few months ago to help him make this kind of connection better. So what we are teaching right now with the token economy system is more like the basic idea that if you do something to please someone or if you do something Mommy asks, you can get a reward. Cassian gets a sticker for some things he does, and 20 stickers add up to getting a puppet he has chosen (he has a collection started). We put the stickers on the calendar in our kitchen. My hope is that with a lot of repetition, Cassian will eventually start thinking ahead and getting motivated to do things for stickers. So far, he does respond if I tell him he can earn a sticker for doing something, but he doesn't initiate these plans himself. He also doesn't spend much time looking at his collection of stickers and deciding what to do next. This is all executive planning stuff, which is typically delayed and kids with ASD's, so it kind of makes sense that the system hasn't totally clicked with him yet.

We also do a lot of written and pictorial presentations to help Cassian review and gain better understanding of situations. For example, a few mos ago, he became very upset when he lost a book. We decided to order the book from Amazon.com, but Cassian was still very anxious about where the new book was and when he would get it. I wrote a sequence on our dry erase board to explain what had happened and how we were solving the problem. This was much like a social story that Cassian could read anytime he was worried about the book. With kids who cannot yet read or even speak well, you can draw pictures of stick figures doing things, like a cartoon that takes them through the steps of solving a problem. When we find children's books that address poignant topics, these work pretty well too. Often we will dramatic play solving the problems after reading the books to make them even more understandable, and Cassian now shows he can generalize from these scripts by changing the names of the characters to more closely fit our family or his friends.

That's what we do in our house. Last year, Cassian's teachers at school had the same problem getting results with time out that you are having, so I had them include a lot of front-end procedures in part of his IEP where we mapped out how to deal with tantrumming. The Explosive Child may be a good book for you to pick up and peruse at some point, although you will have to translate what you read in it into dealing with ASD children. I found the examples of kids in The Explosive Child to be older and too high functioning to apply to Cassian right now. Still, I made some adjustments and the basic philosophies seemed fit better than using only behavior mod (consequences).

Suzi

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Registered: 03-26-2003
Sat, 07-23-2005 - 4:03pm

suzi,

thank you for your reply, i appreciate it. i see where alot of those things may help austin, especially as he continues to progress. i also don't like punishments, but i feel after a few months of doing everything but with him, this is what i'm left with.

however, i still feel lost with matthew. i hope i don't sound like i am selling my child short of his abilities, but i truly don't feel he can understand most of your suggestions. i don't think he can understand drawn pictures. he does not have spoken language. how can you help a child whose receptive language is still quite impaired. i am in the process of emailing our DIR psych about this as well. but any further suggestions would be appreciated,

thx, valerie

~Valerie
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Registered: 06-25-2003
Sat, 07-23-2005 - 4:42pm

Valerie,

Deja vu! Peter used to go crazy at a raised voice (started at about 2.5 and we still need to work on this sometimes). If another child was scolded nearby, he would attack the "scolder"; be it me, Dad, a teacher, a therapist, a stranger in the supermarket or the New York Aquarium (FUN!); *Anyone*, big, small, fat, thin, mean- or tough- looking. He didn't care!!!!

Something I learned to do if he did start to 'go for' a stranger: Ask the stranger's name. If he was introduced to Agnes, or Lorenzo, he seemed to see them in a different light, and woudl call off the dogs, so to speak (yes. he actually used to growl at them and sometimes lash out with fists).

Token systems of rewards worked well for us. If Peter lasted x # of minutes and behaved well, he would get a token (a sticker on a piece of paper, later a button in a bag). If he did anything laudable on his own, he automatically got a token (i.e. if he used words, not hands; waited his turn, etc etc). We went through a lot of stickers, but it was worth it.

I also used my kids natural competitiveness to my advantage. If I praised one child, the other was motivated to get the same praise. It's a trick I learned at special school and it worked a treat! "Siobhan, you are sitting so very nicely and quietly (eatng very nicely... using your fork..." the list is endless), usually inspired Sir Peter to work on his behaviour.

We learned to try and separate them if at all possible if we were to disicipline one of them (not easy).

Timeouts didn't work for us, either. However at the time,he was unnaturally attached to a pooh bear and his Thomas trains, so I would put one of them in "timeout" for a few minutes. *That* got the message more quickly than putting him in a room or restraining him. I was careful to warn him of the consequences and then follow through.

We used a timer for transitions and a lot of the techniques Suzi mentioned - an ounce of prevention beats a pound of cure.

The "123 magic" book helped me a lot. I still count backward from 5 to get the monsters in line and that usually works a treat (although Peter always pushes it past "4".

((((((Hugs)))))

I know how difficult it can be.

-Paula

-Paula

visit my blog at www.onesickmother.com
iVillage Member
Registered: 12-24-2004
Sat, 07-23-2005 - 4:51pm

Valerie,

When Cassian didn't understand spoken language well, we just had to protect him and prepare a lot for various situations. I did a lot of calming and removing him from things that upset him. Chanting and deep pressure were my usual strategies. It was really more like dealing with an infant than a toddler or preschooler. We were not able to use real discipline with Cassian until he was about 4.5 yrs old because he didn't reason or understand well enough. It seemed like we could just say "no" over and over and it had no effect. Consequences had no effect either. He just screamed in distress and didn't understand what was going on.

Your DIR provider obviously will know Matthew, whereas I do not. So perhaps this person can make better suggestions than I can. All I can say is, I know it was harder for us even a year ago, dealing with Cassian's discipline issues. We just had to childproof everything, try to anticipate situations, etc. - - it's all the usual stuff they tell you about dealing with a one year old, but Cassian was 3 yrs old, autistic, could read, do math, recite lots of information, etc. His size made it harder sometimes because I had to try to apply deep pressure by nearly lying down on him. As I said, things just didn't get better until he was about 4.5 yrs old or so.

Suzi

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Registered: 03-26-2003
Sat, 07-23-2005 - 8:25pm

Valerie,

Would you consider doing a more eclectic approach with your therapists? I think Matt would really beneifit from a full functional analysis assessment and positive behavior intervention plan. This is typically best written by someone who is really good at ABA approaches, and I DO NOT mean discrete trial. I mean positive behavior intervention.

All schools (per IDEA) should have a psychologist who can write these. If not done by the beginning fo the school year, look into requesting having someone come in and help you write a specific behavior plan.

You are right. Currently, Matt probably doesn't understand most typical behavioral approaches and you need something more specialized that he can understand. There are a great many different type programs that can reinforce the correct behavior as well as teach replacement behaviors.

In the mean time, the best thing for you to do is pick one behavior to start with that you want to change. Then you need to analyze that particular behavior and find out why, when, in what situations the behavior is occuring. I know you have some ideas, but it is really a good idea to keep data for a few days as an objective thing. You will be surprised at what you learn. Then you can come up with ideas for what to do. I have written behavior plans for lots of kids on different levels. I would have to look up some old info but if you would like some direction I would be glad to help. I think I have some old data sheets some where that you could use to collect data. Definitely front end proactive stuff is best. I know you do that. Maybe some data could give you some ideas for what to do.

On a quick behavior idea for aggressions would be a quick response. For instance, choose 1 phrase you will use like "nice hands", "no hitting", or even "no" etc. Then every time his does aggress what I would do is just put you hands over his to stop the aggression and firmly but neutrally tell him that phrase. Then walk away. No more attention. Same response every time.

Renee

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