Review of: A Buffet of Sensory Interventions: Solutions for Middle and High School Students with Autism Spectrum Disorders (by Susan Culp)

How a text of only 150 pages (including supplemental information and appendices) can be so informative is a wonderful thing! This text will be one to keep on the shelf and reference regularly throughout consultation with parents and families, as well as adolescents as a Behavior Analyst. This book also stresses the importance of including adolescents in their own treatment plan and provides ideas to gain access to adolescent’s thoughts and needs. The core of this book provides information on each sensory system, what a hypersensitivity would look like, and what a hyposensitivity would look like. Additionally, each sensory system chapter indentifies tasks that may be challenging and possible replacement behaviors. The book also stresses the value of involving an Occupational Therapist on a treatment team, which is a relevant piece of advice as several professionals are currently involved in legal action for practicing outside their realm of training. The text also discusses the fact that sensory replacement behaviors can be suggested by any member of the team- parent, child, or professional- although insight from a trained OT is valuable. Working in largely rural areas where access to sensory-trained occupational therapists may be limited and sensory diets often consist of rarely implemented bean or rice boxes, this book offers a valuable perspective on integrating a child or adolescent’s needs into their daily schedule.

This book provides insightful knowledge in differences in sensory processing challenges related to older students for parents and professionals. This text spends the entire first chapter (40 pages!) reviewing differences between Sensory Modulation Disorder, Sensory-Based Motor Disorder, and Sensory Discrimination Disorder. General information provided is detailed, but understandable for professionals without a sensory background, as well as family members. Processing time for different sensory systems is reviewed, helping in developing understanding of why activities may influence someone so many hours later.

Assessments (both formal and informal) and valuable practical information on scheduling and planning appropriate interventions for middle and high school aged individuals are included as well. Even though the focus of this book is on this challenging age,  information could easily generalize to an older or younger population. Although young children may not mind a peer who is behaving differently to meet their sensory needs, I have unfortunately, worked with many adults in the classroom who misunderstand a child’s sensory needs. Providing more appropriate replacement behaviors in any scenario, regardless of an individual’s age, is a key to meeting treatment needs and decreasing less-desirable behaviors.

This book is written in clearly, with visual support and utilizes the “Sensory Gang” characters to develop understanding of sensory challenges and needs. I have used these characters to help explain a child’s behavior to parents, other professionals, and siblings of children with sensory needs and/or Autism Spectrum Disorders. As an added benefit, copies of report forms and communication tools for school or community activities are included in the Appendix of the book. Most importantly, the text is readable, clearly understood, and focused enough that it can be read rapidly, and in the limited time that parents and professionals have available. Just what is expected from the publishers of Asperger Syndrome and Sensory Issues (2000). While the previous text provides information on the relation of behavior to sensory issues, this text focuses on clear strategies to implement with older students, namely middle school, high school, and beyond.

You can view an excerpt of text through Amazon.

*Please note that this review was not sponsored or endorsed and is only the opinion of this professional. This book was purchased at a professional conference. Please also note that any purchases through Amazon Affiliate link do provide financial support to continue BehaviorRescue.com. Thank you!

Posted in Reviews, Sensory

Tips for Dealing with Summer Heat and Behaviors

With much of the US reporting record highs and temperatures with a heat index of over 100° (109° last week in PA!), it is important to be aware of hot weather safety. Adding to the challenge is the temperature dysregulation that is often prevalent for individuals with special needs and sensory challenges, often making it difficult to determine if someone may be presenting symptoms of heat exhaustion.

Individuals with heat intolerance may present reactions to the heat that are physical (flushing, fatigue, seizures, muscle cramps) or behavioral (irritability, non-compliance, hyperactivity) in nature and everyone should be monitored for such. Although experts recommend modifying plans to limit exposure to temperatures for those with heat intolerance, often times the summer is spent in Extended School Year, camp placements, respite, or Summer Therapeutic Activity Programs (STAP).

As a behavioral consultant, I would also advise monitoring any behavioral changes. Remember that stress often relates to behavioral changes, and heat and extreme weather can be a source of stress. Some teachers report students becoming lethargic or irritable and recommend offering relaxing activities, largely based on sensory preferences. Please remember that some individuals, even those who are verbal, may have difficulty identifying the heat as the source of their behavior or discomfort. As the body begins to demonstrate heat-related symptoms, confusion and communication challenges may be seen in anyone. If a change in behavior is noted, regardless of the heat index value, consider whether temperature may be influencing the individual. What one individual perceives as too hot, may vary widely from person to person.

MitoAction.org provides recommendations to help those with heat sensitivities in the summer temperatures. Although the list was developed for those with mitochondrial disease, it is helpful to keep in mind for anyone with heat sensitivities or intolerance.

Some recommendations include:

  • Stay hydrated, including eating fruits and vegetables.
  • Provide misting fans or squirt bottles and inexpensive box fans, when air-conditioning is not available (these clip on to a belt loop!)
  • Consider options such as cooling vests to aid evaporation. This company, Silver Eagle Outfitters, offers options that can be customized to work around those who need physical accommodations.

Regardless of cause, if behavioral changes, or physiological signs of heat-related illness are noted, the CDC recommends:

  • Drink water
  • Wear loose-fitting and light-colored clothing
  • Schedule strenuous activities for cooler times of the day

A few additional, behavioral, recommendations for dealing with the heat:

  • Provide structured breaks or visual prompts for individuals to get a drink (i.e., “take a drink” included in a visual schedule)
  • Ensure proper cooling and ventilation in any set “break” or “cool down” areas provided (i.e., a sensory corner or time out area)
  • Add a space on behavioral graphs or daily camp notes for temperature to be written, even a daily average may provide insight on an individual’s temperature tolerance
  • Modify activities to encourage cooling (i.e., freeze washcloths/water bombs to play “Get Out of My Backyard” or keep an individual’s Chewelry in a cooler, if ice is not available)
  • Have an emergency response plan in place for everyone present- including staff

Of course, if symptoms of heat exhaustion or heat stroke are present, or if dramatic changes in behavior are noted, seek medical attention.

Overall, monitor for any changes in behavior, as they may be heat related and engage in safe, fun, outdoor activities this summer!

What are you doing to beat this summer heat? Please leave a comment below and share your advice.

*As a note, all Amazon Affiliate links provide support to continue Behavior Rescue. All other links are not affiliate based, but link to articles or products I find relevant.

Posted in Sensory

I don’t know those words.

Language Barrier

This week has been full of friendly reminders of just how frustrating communication deficits can be. Although I may be acquainted with working in special education communities, working in a tech-savvy community, of which I am not traditionally a member, has been a challenge. Sure, I understand some of the terms used and I can even include a few in conversation, but it doesn’t mean I truly understand the intended meaning. Contacting tech support, when I’ve been notified that my email has been out of commission for three days (It’s fixed now.) is an exercise in frustration on both ends of the line. Questions that I cannot fully comprehend are asked and responses like, “I clicked the mail icon-thingy” are the only information I am capable of providing in return. As in, “I don’t know what the terms in your question mean. I hope you understand my terribly unclear response.”

Kind of makes you recognize why aggression is so often related to communication challenges.

A Simple Response

One of my favorite responses to individuals I work with is, “I don’t know those words. Can you tell me another way?” It’s a lengthy response and not appropriate for everyone, to be sure, but for some individuals I know, it works. It’s not that you aren’t speaking clearly. It’s not “use your words.” It is, in fact, that you are telling me something important/crucial/wonderful and I am the unprepared one who just doesn’t get it.

I have one child I know who is amazing with rephrasing communicative attempts. We’ve gone from having conversations (the little one in question is under the age of 5), to having minimal language, to this almost-game of sorts. The child shares information. I fail to understand. She uses as many synonyms (usually non-traditional) as possible and I try to put the meaning together, guessing as we go. She becomes very excited for me when I finally put the puzzle together and, often, we can then do the very activity she requested/described. It minimizes frustration for both of us, and builds a naturalistic interaction with multiple exchanges (aka: social reciprocity).

Research

A literature review on teaching these social reciprocity skills to individuals with Autism Spectrum Disorders, highlighted some key features of successful intervention programs. Although not evidence-based practices, features identified as ‘promising teaching strategies’ include:

  • Taking place in a fun environment
  • Using natural reinforcers for social interactions
  • Using modeling and role-play
  • Making teaching structured and predictable
  • Providing natural opportunities to practice skills

(Williams White, Keonig, & Scahill, 2007)

Although it certainly isn’t a large-scale, formal intervention. I would say that my brief, standard response to an unclear communication attempt meets the majority of these identified promising practices. It’s naturalistic and takes place in an interactive environment, using natural reinforcers as possible. I get to model an appropriate response to being confused and the other individual gets to practice responding to someone who is failing to understand without biting/hitting/screaming/crying. And my response is always the same, making it a predictable interaction.

There is Applied Verbal Behavior with mand training. There are fabulous Speech Language Pathologists with articulation objectives. There are social skills groups with structured practice. There are a million other things that are so often necessary to have a child have long-term, communication and language success. But, in addition to all of that, using one simple phrase can sometimes prompt someone to try again and offer real-world practice with communication attempts.

What are some simple strategies you use to prompt appropriate communication?

Also, for anyone interested, the reference is below but the entire article can be downloaded, for free, as a pdf file here.

Reference

Williams White, S., Keonig, K., & Scahill, L. (2007). Social skills development in children with Autism Spectrum Disorders: A review of the intervention research. Journal of Autism and Developmental Disorders, 37, 1858-1868.

Posted in Communication

An Introduction.

“Why Behavior Rescue?,” you ask.

Well, the purpose of this site is to meet several needs:

  1. Connect families and those involved in the lives of individuals with challenging behavior with understandable, research-based information on challenging behaviors and resources.

Or, to rescue these individuals from the often confusing, overwhelming abundance of costly and unproven ‘treatments’ for mental health and Autism Spectrum Disorders.

2.    Support families, schools, communities, and other professionals by providing direct assessment, consultative, and supervisory services.

3.     Provide a personal perspective, as a Board Certified Behavior Analyst, on treatment methods, supports, and behavioral concerns.

“Isn’t the term rescue a little, well, arrogant?”

There. I said it, so now you don’t have to. Or you can. I won’t be offended.

I don’t know everything. I know a little bit and in the immortal words of one of my graduate professors, who was probably quoting someone else,

“The more you know, the more you realize there is to know.”

There is a never-ending stream of information on treatments, services, and recreation for the individuals I work with and their families. Many of the families I’ve consulted with have requested “good” information.

I’ve tried to provide a professional viewpoint, while realizing that ultimately, the choice is up to them. There are many ‘unproven’ treatments for Autism, and other diagnoses, that don’t have research support but are valuable to those that use them. Each family makes their own choices regarding the most appropriate treatment for their loved ones.

That said, my goal is to provide as much quality information and perspective as I can, while encouraging a dialog discussion.

So please, share your experiences. Comment. Be involved.

I can’t wait to meet you!

(Oh, and to learn more about my professional experiences, visit the About page. Thank you!)

Posted in Uncategorized