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One of the most difficult things that a parent may face with a child with Autism Spectrum Disorder or another disorder is self-injurious behaviors. These may include head banging, hitting oneself, biting oneself, or picking at skin.

These behaviors can be tricky to deal with and emotionally and physically draining. There are many potential causes for such behaviors, so every situation is a little bit different, but there are a few common ones that can be helped through behavioral therapy and intervention.

Some of these causes may include a deficit in communication, attention seeking, and avoidance or escape from a non-preferred activity or task. While these behaviors can be tricky to treat, here are some tips for each of these causes.

First, your behavior analyst will create treatment programs that help your child communicate more easily. Be aware of these programs and try to implement them at home. Ask questions, try things out, and don’t be afraid to mess up every once in a while. As you try to do these things at home it will help your child communicate more easily and readily and decrease self-injurious behaviors at home.

Second, when your child has a self-injurious behavior, their safety is the number one priority. If you need to block the behavior from occurring do so safely or, if necessary, seek training to help you safely hold or restrain your child. Sometimes these behaviors are increased by attention, but it is often not possible to ignore such behaviors. Instead, try and give positive attention and praise when your child does not participate in these behaviors. The more attention you can give to safe coping mechanisms, the more likely they are to use those instead of self-injurious behaviors for attention.

And finally, sometimes self-injurious behaviors are used to get out of completing a task or an activity. When this occurs, make sure that you keep your child safe and allow them to calm down. Offer breaks from tasks or activities and time for them to move away from the task. After they are calm it is important that you do your best to help them complete the original task given to them. This helps them to learn that self-injurious behaviors will not help them escape from tasks and non-preferred activities.

With these behaviors, as with all others, feel free to discuss them with your BCBA and RBTs in order to help you know what to do best. We are all a team working for the best interest of your child and will do our best to help them to be safe and happy.

Written by: Charlie Flint, Registered Behavior Technician

As the weather changes and our attention turns to the upcoming holidays, thoughts of family connection and fun might be on most people’s minds. For many special-needs families, however, the holidays can usher in a season of hypervigilance and stress. Less familiar sights, sounds, smells and interactions can cause tension and overstimulation for our most sensory sensitive family members. But navigating the holidays does not need to be exhausting or upsetting. While special needs families may not move through these activities like others; communication, preparation, and gratitude are three points of intervention that can go a long way towards cultivating that spirit of connection and fun we all crave.

Communication

Sometimes we can inadvertently create more stress for ourselves and our children when we impose unnecessary or unrealistic expectations. Adjusting our expectations for what our child’s participation in holiday activities would look like can help both immediate caregivers and extended family members avoid surprises and potential disappointments.

While some family members may already have a strong connection with our child, some will need loving reminders/introductions about what to expect. Our little one may not be able to carry a brief conversation like other children or may need extra help at the dinner table, limiting our ability to participate in regular conversations. A large group at normal volume may be too loud and necessitate a retreat to another room. A brief explanation beforehand or having a trusted family member explain in our absence can help build understanding and empathy.

Families of special needs children should not fear communicating their needs or their child’s needs with extended family members. While some extended families might be more supportive than others with making adjustments to activities that benefit an individual, knowing what to expect ahead of time and making our needs known can go a long way towards mitigating roadblocks to connection.

Preparation

Using social stories, visual schedules, and picture cards of less familiar family members can help children with special needs transition to new, holiday settings more easily. If a child can anticipate the new sensory input they are about the experience, they can be better equipped to handle these changes.

Planning brief, preferred activities for our child to do with a trusted relative at family gatherings is a great way to both increase connection among family members and give us opportunities to take small breaks. Caring for our child’s needs can be overwhelming, so creating pockets of time for us to enjoy some time among family is important as well.

In the event of possible meltdowns, working in some breaks to go outside for fresh air or to another less stimulating room as well as bringing along a comfort item, can help children regulate if the environmental demands become too overwhelming. Simple things like communicating the schedule in simple language, making sure clothing is not too itchy or hot, talking about the people they are about to meet, describing the sights and sounds that will be new, can also help to minimize sensory overload and keep those meltdowns at bay.

Gratitude

As caregivers, it can be difficult to make space for our own emotions regarding family obligations around the holidays. If you are feeling sad, depressed, or even resentful of how easily others may enjoy the holidays, it’s okay. As much as we love our children and rejoice in having them in our lives, no one plans on becoming a special needs parent. We must find our own way and that journey will inevitably lead to moments of sadness and stress. In these moments, expressing gratitude for what is going well is a highly recommended emotional resilience strategy.

By focusing on what we are grateful for and verbalizing that gratitude around our children, we can effectively model stress reduction strategies that can yield long-lasting emotional wellness. Laughter is another wonderful strategy to use around the holidays. Laugh where you can. The energy you create around the holidays will be contagious and your family will take note.

By expressing gratitude, being prepared for holiday activities, and communicating our needs, families can look forward to more fun and more connection. As a special needs parent, you have great instincts – don’t ignore them.

Wishing all our Kids Who Count family members a joyous, safe, and regulated holiday season.

Written by: Nancy and Jonathan Miramontes

Kids with special needs—especially autism—can struggle with the many transitions they have to make throughout the day. Kids tend to hyper-focus on what they are interested in or what they are doing, and don’t welcome disruptions or abrupt changes. Attention shifts require flexible thinking—something that can be challenging for kids.

Children who have autism also have trouble with nonverbal cues, so they may not pick up on things that other children do to prepare them for transitions. That’s why it’s especially important to spell things out clearly and give them visual cues as well as verbal ones.

By helping your child prepare for transition during their day, they will gain a sense of predictability rather than disruption to their routine. Here are a few ideas to make their day go more smoothly.

Create Visuals: Use visual prompts like a timer to let your child know the current activity will be ending soon. You can add visual clues like turning off the light or audio clues like a chime. You can also make a poster with pictures of a day’s activities so your child can follow along.

Plan More Time: Don’t rush their transitions. Allowing more time during the transitions that are difficult will make them go more smoothly. You can also add a sensory break like jumping, skipping, wiggling, or dancing for a couple of minutes between activities.

Establish Routines: There is no guarantee that things will always go perfectly to plan, but setting a daily schedule can help your child feel safe and secure, which helps keep their emotions (and meltdowns) in check. As much as possible, try to stick with the schedule you have laid out. When your child gets fair warning for transitions they don’t feel as pushed around, so they will naturally be more cooperative.

Use Social Stories: For children who have a particularly hard time with transitions, preparing them with relevant social stories ahead of time can be beneficial. These short, simple stories illustrate what will be happening and will help your child understand how to deal with it. These stories allow kids to mentally “practice” the transition in a calm, non-threatening way.

Give two choices: Offering your child a choice can make them more cooperative. Instead of saying: “Do you want to put on your shirt?” say, “Would you like to put on the red shirt or the green shirt?”

Offer Praise: Children will really respond when you tell them they are doing a good job. Don’t forget to recognize when the transitions go well. Be specific with your praise and offer a reward–even something simple like saying, “Great job putting away your toys and brushing your teeth. Now we have more time to read.”

With the right support and strategies, children can learn to change gears without resorting to whining or tantrums. And you can transition to a reward of your own!

Written by Nate Lyon, MS, BCBA, LBA

Many children with special needs, especially autism, have sensory sensitivities. Because of this, your child may be reluctant to wear a mask.

The American Academy of Pediatrics recommends children 2 years old and older wear cloth face coverings when they are unable to socially distance in school and other community settings. The guidance also states that children under age 2 and children who are unable to remove a face covering without assistance should not wear masks.

Here are some ideas that may help your child adapt better to mask wearing for their protection and the safety of others.

Tell them a story. You can find several good children’s book online about wearing a mask. Many of them explain why we wear them (to keep away germs and keep all of us healthy). Or, you can make up your own story—often called a “social story” for kids with autism—and describe how we wear a mask using pictures, visuals, or a doll/stuffed animal to show the behavior.

Make practicing fun. Start slowly and make incremental steps. First, have your child hold the mask in their hand while doing an activity they enjoy and offer a reward and gradually increase the time. Second, have them wear it on their hand with the ear loops on their thumb and pinky and again offer a reward when you increase the time. Next, you could have them brush the mask on their cheek, then face. Place the ear loop on one ear only for a while and then move to the other ear. Eventually, you can try to move to wearing the mask for short spurts, setting a timer and offering rewards.

Try super soft fabric. Try lining the mask with the fabric your child prefers. For example, some kids love silky fabrics while others enjoy burying their faces in the soft fur of a teddy bear.

Start with a cool mask. If your child feels that their mask feels hot, you can keep their masks in the freezer so they start out cold. Or, try a bandana type mask or a neck wrap that pulls up from below

Model mask wearing. You can make it more normal for a child to wear a mask if you wear one yourself at home while you are practicing. The exposure to seeing masks will help normalize the experience for them.

Give plenty of positive reinforcement. Praise your child for each step they make toward wearing a mask. Try high fives, hugs, or other reactions that your child enjoys. Make sure they know how proud you are of them for wearing a mask!

Are you trying to teach your child two languages at the same time? Is your child not really showing a lot of progress and, in fact, showing that he or she is regressing or not really talking? Trying to teach your child a foreign language plus keeping up with the home language can be an overwhelming task!

What is the “silent period” and why is it important?

The Silent Period is a concept developed by Stephen Krashen and it simply refers to the period before a child starts speaking a second language in which he or she spends time watching and listening to people using the language. During this time, it might appear that your child is just passively sitting there or that he or she is showing a language delay. In fact, although the child is not verbally participating or interacting with others, or rarely does so, she or he is actually absorbing the structures and vocabulary of the second language. Learning is definitely happening and their brain is certainly working hard!

This stage of second language learning is also called the pre-production stage. The silent period is a crucial time that must happen before a child can speak another language; our brain must learn to process things before we can speak. The length of the silent period varies from child to child, depending on different factors like personality, culture background, support received, etc. But, no worries! Your child will speak when he or she is ready! Studies show that the secret to a child learning a second language is the frequency in which that child is exposed to the new language.

Do not worry, there is help! Here are some activities to help during the silent period:

Repetition and Labeling: Talk to your child as much as possible. Describe what you are doing throughout the day. Label and emphasize main objects and/or actions in both languages. For instance, if you are teaching your child Spanish, you might say “Oh, you want the blue car, el carro azul, the blue car”.

Singing and Reading in Both Languages: Sing simple songs and fingerplays in both languages. Do the same actions for both. For example, “The Itsy, Bitsy Spider” or “Happy Birthday to You!” have versions in other languages. When reading, point at simple pictures and label them in both languages. You may also find a variation of bilingual books at your local library.

Modeling During Play: Play pretend with another family member like waiving and saying “Hi” in both languages, or eating different items as you name them in both languages. Use exclamation in your voice and include different sounds and expressions used in the two languages. For example, in Portuguese, you may say, “Mmmm, yummy”, “Que gostoso!”

Support Your Home Language: If you live in the United States and your home language is something other than English, focus on using mostly your home language. This is an important concept since your child will have plenty of opportunities to be exposed to the English language (school, friends, TV, etc.)

Helping bilingual children go through the silent period can be an arduous task. However, with the proper support and strategies, it will become an easier thing—part of your daily life. Have fun with it! Enjoy those magical learning moments with your little ones. Then, learning a second language can be a rewarding experience.

By Virginia Di Stefano, Child Development Specialist at Kids Who Count

Resource: The ESL Nexus “Integrating Language and Context for Academic Success”https://www.theeslnexus.com/2017/10/what-is-silent-period-and-why-is-it.html

Raising a family blessed with a special needs child is uniquely overwhelming. Special needs families understand multitasking, joy, heartache, and stress in ways that transcend common understanding. Disruptions to any child’s routine can sometimes be difficult, but disruptions in the routines of special needs children can usher in weeks, if not months, of challenging behaviors, regression, and incredible amounts of stress.

Prioritizing our emotional well-being under this new COVID reality feels particularly important. Children are excellent observers. They tend to model their parents’ behaviors, including those related to managing stress. Parents who deal with stress in unhealthy ways may inadvertently risk passing those behaviors on to their children. Intentional parenting, on the other hand, can help parents model healthy coping behaviors that will contribute to their child’s overall self-confidence, sense of safety, and management of anxious/stress responses.

Investing in our emotional well-being is a worthwhile endeavor. Self-compassion involves giving ourselves the same kindness that we would offer to others. As special needs families, our unique superpower is empathy. We understand how difficult, how long the days can be. We understand the loneliness. We understand the grief. We also understand the joy and the beauty in those quiet moments when your baby finally responds to your efforts. We feel everything so deeply. We can exercise an incredible about of compassion when we see others on similar journeys. Our hearts knit almost instantly. Exercising self-compassion means reserving some of that empathic superpower for ourselves.

Our families deserve an intentional effort to stay healthy. Here are a few helpful ways that families can manage stress in this post-COVID era:

Identify Stressors.

Stressors are different than stress itself. Stressors are situations that are experienced as a perceived threat. They activate the body’s stress response and we respond by either fighting, running, or hiding. Stressors are unique to every individual and family unit. The stress response that one member in our family can have to a particular stressor can impact the family as a whole if that individual family member’s stress response is an unhealthy one. For example, a dirty kitchen might be a stressor for one member of the family but not for others. If the family member affected by the stressor responds by fighting, then those in the immediate vicinity of that situation might experience the negative repercussions of that stress response. By managing our stressors (i.e., working together to keep a clean kitchen as in our example) families can mitigate unhealthy stress responses and lower the overall stress of the family. If you can name the stressor you can work as a team to change it.

Make a Plan.

Some stressors are within our control, others are not. The loss of a family’s main income, or the sudden injury or illness of a family member, for example, are life events that we can plan for, but little we can do in terms of prevention. When life stressors like these arise, it is important that we are prepared not only for our physical needs but also for our emotional needs. Our bodies naturally find ways to cope and we tend to gravitate to those things that have worked in the past. Making a coping plan means thinking through how we manage stress and ensuring that our bodies are reaching for healthy responses. For example, if our stress response is to turn to food (guilty party of one here), managing our portions and balancing between a good mix of healthy and more comforting foods can help us feel better long-term. Other healthy ways to cope with stress can include: creative or artistic activities, going for a walk outside (vitamin D from the sun is difficult to supplement, our bodies need time outside), listening to calming or inspirational music, meditation or yoga, and serving someone in your community (human connection can have a wonderful, calming effect). You can engage in these as a family to help the family unit as a whole cope with a sudden stressor. If we already have a healthy go-to plan in place, we are more likely to recover quickly from the perceived or real threat.

Change One Thing at a Time.

No need to swallow the entire elephant at once! Stress will always be part of our lives. Managing stress is a marathon, not a sprint. Focusing on improving one thing at a time will help us navigate this task in a healthy way. Working towards changing one thing at a time can also help us avoid burnout and will likely keep us more motivated. If we can successfully change one thing, we are more likely to approach more and more tasks with the same enthusiasm and success. Even if you choose something small to change, if you are consistent in your progress you are likely to see big, cumulative changes. Consistency will always be more powerful in the long run. Remember, progress is more important than perfection.

Focus on Connection.

If all else fails (or even when it does not), focus on connection. There are some days, weeks, perhaps even months that are simply too overwhelming to do anything well. When those heavy moments hit, engaging in activities that will bring you closer together as a family will be worth the investment. Our children need us to be okay in order to feel secure and they are more likely to remember the happy times playing a game or spending time as a family than the days when mom or dad’s to-do list was completed flawlessly. Stealing away quiet moments to connect with family members individually is another positive way to grow your family connection. If you are making mistakes along the way that just means you are trying. Our homes should be places of refuge and peace. Focusing on connections can contribute to building homes of respite.

Stress is a Constant—a Fact of Life.

We cannot eliminate stress completely, but we can manage it in healthy and productive ways. Our mental health is a continuum, sometimes we are in crisis other times we are excelling. The key is to manage our responses to life’s stressors, be prepared for when stress rises, and connect with the people in our lives that are most important.

By Nancy Y. Miramontes

Nancy Y. Miramontes, Ed.S., NCSP (she/her/hers), is a Kids Who Count Board Member. She is the Internship & Practicum Coordinator at Brigham Young University, and is an Assistant Clinical Professor —School Psychology, Counseling Psychology, and Special Education.