Source: Smarter Parenting
Understand the diagnosis, know what to do next and access resources
Many parents have questions about the Autism diagnosis and what it means. The following are guidelines to help parents know how the diagnosis is reached and what it means:
• A team of professionals, with the Pediatrician leading the team, is required to reach an Autism diagnosis. The team approach is unique to Autism. The team may include school psychologists, counselors, parents, teachers, speech pathologists, occupational therapists, etc. Parents working with the Pediatrician will know how to evaluate needs and create the team.
• Autism exists on a spectrum so children with this diagnosis will not behave or demonstrate the exact same behaviors.
• There is ongoing research and the terminology is constantly changing. Terms like “Aspergers” and “PDD NOS” are outdated terms that have been replaced in the newer editions of the diagnostic manuals used by professionals. Be aware and understand that changes may continue to occur while parenting a child with autism.
• Research has shown that vaccinations do not cause Autism. Currently there are no known causes of Autism.
Autism Spectrum Disorder (ASD) diagnostic criteria
This is the criteria for Autism Spectrum Disorder from the DSM-5 (Diagnostical and Statistical Manual of Mental Disorders, Fifth Edition). Psychologists, Psychiatrists and other Mental Health professionals will use these guidelines to determine diagnosis.
Parents: Though not specifically stated, the Autism diagnosis should include your child’s physician to rule out physical and developmental disorders that may be the actual cause of behavior issues.
1. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive, see text).
2. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text).
3. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities or may be masked by learned strategies in later life).
4. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
5. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make co-morbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.
Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder. Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet the criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder.
Diagnosis is confirmed. Now what?
Once the Autism diagnosis is confirmed, autism parenting begins with learning strategies and treatments. The recommendations for treatment will vary depending on your child, age, specific manifestations and behaviors, however, it is recommended that parents seek out a physician well versed in treating Autism and who operates under the Medical Home Model. Parents will always be an important part of treatment. The important things to remember is to remain calm. Becoming too emotional will cloud your reactions and may be more difficult to teach your child. Seek out the help of professionals who can assist in parenting a child with an autism spectrum disorder.
Autism parenting should begin with researching various techniques based on your child’s needs. Make a list of how Autism is manifested in your child. You can begin by researching specific approaches to dealing with that type of behavior. The skills on Smarter Parenting are also helpful. In any interaction with your child you will use Preventive Teaching and Corrective Teaching. You can see how to apply these skills in the Behavior Skills tab on this page.
Diagnosing early provides more time for parents and professionals to customize treatment for the child and for the treatment to be a normal part of the child’s life. Trying to make corrections later are more challenging when parenting a child with an autism spectrum disorder. Children with Autism often struggle with change. Early intervention can come in many different methods. Treatment is most effective under a team approach with a physician using the Medical Home Model
The Medical Home Model is an approach where a medical physician is in charge of the overall treatment which includes a team of other professionals and the parents. The team may consist of a mental health therapist, occupational therapists, nutritionist or whatever may be necessary for the child. The physician will know what is needed for treatment. The physician is the primary point of contact and oversees the progress of treatment. Professionals agree that intervening early is best.
Diagnosing early provides more time for parents and professionals to customize treatment for the child and for the treatment to be a normal part of the child’s life. Trying to make corrections later are more challenging. Children with Autism often struggle with change. Early intervention can come in many different methods.
Some parents report improvement in their child’s behavior because of a change in diet. Every child is different and parents should consult their physician when making changes to diets to address Autism.
Medicine can also be used to treat symptoms of behaviors but they do not treat Autism directly. Parents should always ask what the short-term and long-term side effects of medications may be for their child. They should also ask physicians about the medicine and it’s history. Some questions parents can as are: What, exactly, will this medication address? It is a new drug or has it been around for a long time? How long was it initially tested and what were the results of those studies?
A list of the most popular therapy approaches for ASD
Applied Behavioral Analysis (ABA): This approach focuses on the principles of how learning takes place. For example, Effective Rewards is one of those principles. When a behavior is followed by an Effective Reward that behavior will most likely happen again. Smarter Parenting teaches how to use Effective Rewards Effective Praise. Decades of research in behavioral analysis provide many techniques including the lessons and classes from Smarter Parenting. Behavior analysis focuses on the principles that explain how learning takes place. Positive reinforcement is one such principle. When a behavior is followed by some sort of reward, the behavior is more likely to be repeated. Through decades of research, the field of behavior analysis has developed many techniques for increasing useful behaviors and reducing those that may cause harm or interfere with learning. Applied behavior analysis (ABA) is the use of these techniques and principles to bring about meaningful and positive change in behavior.
Verbal Behavior (VB): If your child has a difficult time communicating their needs this is an approach the therapist may to improve communication. Verbal Behavior Therapy uses the theories of B.F. Skinner to teach communication using the principles of Applied Behavioral Analysis. This approach teaches the child to learn language by connecting words with their purposes. This approach focuses on why we use words. It helps children understand that using words have a positive result. If the child is nonverbal the parent can begin by using other means of communication, like pointing to something or drawings. The purpose is to improve communication between parent and child. The steps of Effective Communication support this approach.
Floortime: Using play as a way to communicate, Floortime is exactly as it sounds. It encourages parents to literally get on their children’s levels and get on the floor to play. Parents can combine this approach with other behavioral therapies. By engaging with a child in an activity that they enjoy parents can begin to direct their children from simple tasks to more complex interactions. The approach was developed by child psychiatrist Stanley Greenspan, MD and Serena Weider, PhD. Smarter Parenting encourages parents to use games and activities as a way to teach new behaviors.
TEACCH: This is a curriculum developed by the University of North Carolina – Chapel Hill for people diagnosed with ASD to learn skills. The program was originally created in the 1960’s and has a long history of being empirically tested and evidenced based. In 1972 North Carolina legislated it as a statewide program. They offer a training program for professionals and a set curriculum. Parents can ask their physician about this approach and if there is a trained clinician in this approach.
Son-Rise: This approach is home-based, relationship based play therapy. Parents are trained at the Autism Treatment Center of America, the division of The Option Institute in Sheffield, Massachusetts that teaches The Son-Rise Program. Parents join in the stimming behaviors and focus on engaging in those behaviors rather than eliminating them as a way to help children interact and learn social skills. There are some criticism of this approach however a 2013 peer reviewed journal published an article supporting this approach.
SCERTS: The acronym SCERTS refers to the focus on: SC: Social Communication. ER: Emotional Regulation. TS: Transactional Support. SCERTS is usually applied by a trained professional, usually in a school setting. Parents can ask schools if they have a qualified SCERTS professional in their school.
Most parents will benefit from teaching some basic skills. It is best to begin with two simple skills and add more as the child and parent relationship develop. The two most helpful skills for parents with children of ASD are Preventive Teaching and Correcting Behaviors.
Preventive Teaching and Autism
Children with ASD may have a difficult time dealing with new situations. Using the skill of Preventive Teaching helps prepare your child beforehand and that preparation can lead to less meltdowns and blowups.
Tips for Autism Parenting:
• Be patient.
• Break down tasks to smaller tasks if things are too frustrating for your child.
• More frequent practicing will make the new behavior more and more likely to repeat.
• Be consistent. Keep practicing it until the new behavior is mastered.
• Be patient. I know we said this already but it’s important to be patient and consistent.
Correcting Behaviors and Autism
Children with Autism will need to have their behavior corrected. This skill provides steps for parents to follow when correcting a negative behavior that will help the child improve and maintain a better relationship between child and parent.
Tips for Parenting a child with autism spectrum disorder:
• In describing the behavior you want your child to do in step 5 it will be important to demonstrate it exactly as you want them to behave.
• The most powerful aspect is to practice what you expect. You may want to show them what you expect a few times.
• Be patient.
• Remain calm.
• Be sure they practice it often.
• If your child is nonverbal, you can still use this skill but will focus on demonstration.
• Don’t promise a reward before practicing. Provide one (if you want) AFTER they are able to do the new behavior well.
This is an important skill to use when correcting behavior because it allows your child to know what to do by seeing it and then practicing it themselves. Practicing helps your child internalize the correct behavior.
Use these two skills with children who have Autism and let us know what happened. We would love to hear from you.