*Names have been changed in this article to protect the privacy of our clients.
Parenting a child with autism can be extremely challenging. Depending on the situation, children with autism can be non-verbal and aggressive to various degrees. They can’t tell the adults in their life how they’re feeling or what they want, so they act out in ways that can leave parents exhausted and discouraged.
So, when we received this note from one of our clients, it absolutely made our day:
“We are proud to inform everyone that my child won a silver medal today in Special Olympics softball throw. His success was not possible without the effort and continued support provided by you all. Special thanks to the therapists for putting so much effort into our son and making him a better person every day.”
When Tyler’s mother first contacted Cornerstones, the family was at loose ends trying to deal with their son’s extreme behavioral problems. Although he was elementary school age, he couldn’t dress or use utensils to eat, was constantly stealing food, would not sit still, and was often aggressive, hitting and kicking those around him. They couldn’t take him places for fear he would run away. It was a challenging situation, to say the least.
We sat down with Cornerstones Clinical Director Ginny Nikiforos and asked her what her and her team did to help a child with such difficult behavior problems get to the place where they could participate on a Special Olympics softball team, and win a silver medal in only a year.
Here’s how the Cornerstones team helped turn the situation around.
Cornerstones: When you first met Tyler and his family, what was the situation? What challenges were you and your team facing?
Ginny: The family was in a near constant state of distress because they just didn’t know how to deal with Tyler’s behavior. He had a lot of food issues – constantly stealing food and refusing to eat with utensils. He wouldn’t sit, or stand still. And he acted out in very aggressive ways, hitting and kicking those around him. It got pretty bad at times.
Cornerstones: What was the first thing your team did to begin working with Tyler and his family?
Ginny: The first thing we do with any child is an assessment. We assess their skill level across communication, social and individual play, and behavior problems. This can take anywhere from 1 hour to 20 hours depending on the child and the situation. In Tyler’s case, the assessment took quite a while. But, it’s the clear evaluation of where the child is at today that allows us to come up with clear, effective treatment goals.
For Tyler, we used the assessment and treatment goals to create a behavior plan and a skill acquisition plan. We matched him with therapists that we felt would be well suited to the goals and requirements of these plans and trained them to carry out the plans’ objectives. This is what we do for every child we work with, creating completely customized plans and treatment goals for each child.
Therapy takes place 2-4 hours at a time, multiple days per week. In Tyler’s case, we focused immediately on skill building through repetition. It was important to start working on building progress in his ability to communicate and be around others in a way that wasn’t harmful to himself or those around him.
As we worked with him, we also worked with his mother, training her in every method we were using with Tyler. ABA therapy is not something that can be done effectively for just a few hours a week. It’s crucial that the families get involved so that therapy happens around the clock 24/7. The children need the consistency. They need to understand, for example, that they won’t receive a glass of milk at any time if they don’t request it, either by holding up a picture of milk or by asking for it.
Cornerstones: Was teaching Tyler how to request things he wanted a pivotal part of his treatment plan?
Ginny: Absolutely. With Tyler, we started with pictures. He was given a stack of pictures containing items he might want or need. We, the therapist and his mother, worked with him until he was using the pictures to consistently communicate what he wanted. Just this simple thing of being able to tell someone that he was hungry or thirsty, or that he wanted to throw a ball around, made a huge difference in how much he was acting out.
Once he was competent in the skill of requesting through pictures, we started working with him on vocal requests. Within a few months, Tyler was verbally communicating things that he wanted and didn’t want instead of acting out.
Cornerstones: What were some of the other skills your team worked on with Tyler that made a big difference in curbing his negative behavior?
Ginny: Independent dressing and eating with utensils were two skills that made a big difference for Tyler. In ABA therapy, a lot of skills are taught through demonstration – an adult demonstrating and asking the child to mimic the actions. This was effective with Tyler and he soon began to dress himself in the morning and use utensils to eat.
One of the key aspects of ABA therapy is to understand why a child is having behavior problems. If we understand the why – what the child wants – then we can begin to replace the problem behavior with functional skills. When the child is getting their needs met, there’s no longer a need for the problem behavioral. Their needs are being met in a more functional way.
I want to stress the importance of consistency when it comes to building these types of life skills, and why we work so much with families, not just the children. The therapist is only there for a few hours at a time. With Tyler, even if his therapist made great strides getting him to eat with utensils during a session, all the work would be undone if his mother didn’t carry it through to the other meals of the day. Her involvement was really crucial to his progress.
For every client, the family’s involvement is so important that it’s one of the things we consider when creating treatment plans. We look at who’s in the home, the parents’ work schedules, stress levels, and all different aspects of the family dynamic. This helps us create a treatment plan with realistic objectives and goals. We are there to support the whole family and don’t want to set them up for failure by creating a treatment plan that the family is not able to carry out successfully.
Tyler had a very committed team from the start, including a committed family. It’s taken a while, but he’s made remarkable progress over the last year.
Cornerstones: Tell me more about where Tyler’s at today, after about a year of ABA therapy.
Ginny: He’s like a whole different kid! Throughout the past year, as Tyler learned alternative ways – more effective ways! – to get his needs met, we began to see a gradual reduction in problem behaviors. As his behavior improved inside the home, we did more and more work with him out in the community, particularly with safety skills. As I mentioned earlier, Tyler had a habit of running away from his caretakers when they were out in public. This was a huge safety concern and we worked diligently with him to stop that behavior. It’s much easier to take Tyler places now, which is good for him and his family.
Of course, as his mother mentioned in her note to us, Tyler’s participation in the Special Olympics is huge! A year ago, he would have never been able to achieve participation, let alone earn a medal! His acquisition of skills like waiting and responding to other people’s ques are crucial to his success with the Special Olympics. For example, throwing a softball requires knowing how to patiently wait your turn, understanding when it’s your turn, knowing how to listen to directions about where to stand and the direction to throw the ball, and allowing other children to have their turn while you go back to waiting. When you think about it, there are a lot of different skills involved in what might seem like a simple task!
Tyler also has a younger brother with whom he is now able to interact on a much healthier level. This required us working with Tyler on the unpredictable nature of other children, teaching him skills for how to deal that aspect of behavior.
We are so proud of Tyler and grateful for the involvement and encouragement from his mother. Seeing a child make this kind of progress is why we, at Cornerstones, do what we do every day.
Are you the parent or caretaker of a child with autism? Find out more about ABA Therapy and the work we do at Cornerstones.
Are you looking for ABA services for your child in the comfort of your home? Are you looking for less stress in your life? Cornerstones Autism Services can help.