Holidays tend to be a challenging time for children with Autism Spectrum Disorder and Valentine’s Day is no exception. Thinking back as a child, Valentine’s Day was a wondrous day filled with pink, purple, and red decorative cards passed around to each friend in the classroom, bite-sized pieces of candy, and that special feeling when someone asked to be their valentine. While this day holds a special place in most people’s childhood memories, it cannot be said for many children on the spectrum.

So the question lies…how can we make Valentine’s Day an inclusive event for all?

Imagine this, your child wakes up, gets ready for the day, arrives at school, then when he walks into the classroom…BOOM! Banners. Frills. Hearts. Glitter. Talk about sensory overload! Your child is standing there stunned from all the environmental stimulation. This is NOT his classroom. This is NOT normal routine.

Tip #1: Plan with the school in advance.

Check-in with your child’s school to see what decorations they may use and what activities are planned for the students. If your child has auditory sensitivities, perhaps invest in a pair of noise-cancelling headphones. If your child tends to grab objects that have different textures or visual appearances like glitter, gloss, shine, or fuzz, caution staff to have extras with the preferred texture on-hand to redirect your child from pulling decorations off the walls. Collaborate with your child’s teacher on any activities that may be challenging and provide suggestions for alternative activities that are part of your child’s normal routine that can help your child deescalate. In addition, discuss any objects or activities that should be added into your child’s communication device that is relevant to the day. Request visual schedules to help your child anticipate what activities are next and support smooth transitions.

Tip #2: Desensitize

Bring some Valentine’s Day related decorations into your home to have your child become familiar with seeing these objects. Incorporate your child’s specific interests with Valentine’s Day related activities such as beading a bracelet with hearts, coloring Elsa from Frozen on a Valentine’s Day card, or baking rose-shaped cookies together. The more your child pairs the colors and shapes associated with Valentine’s Day to their personal interests, the better!

Tip #3: Role-play and practice at home.

Social stories are always a good place to start to introduce new concepts to your child’s world. Social stories are short descriptions of particular situations or activities. They are used to help teach your child the expectation of what is to come, as well as the expectation of how he should behave when placed in these situations. The pictures allow your child to really understand his role by observing the models in the social stories. Social stories can be presented as a book or videos. After reviewing some social stories, practice handing out cards and candy to family, friends, and neighbors through role-play. Giving up highly reinforcing items like candy is often difficult and can lead to challenging behaviors. One suggestion is to start with a candy exchange. Reinforce your child handing over hand, by then providing them with a different piece that they can eat. Practice with various people and hopefully your child will have a more enjoyable Valentine’s Day that they will remember for the next year!

Here are some Valentine’s Day videos and resources to share with your special one:

·        A Little Spot of Love on Valentine’s Day by Diane Alber https://www.youtube.com/watch?v=oNbOWfunrKs

·        Valentine’s Day Social Skills Story for Preschool by ABA in School https://www.youtube.com/watch?v=y9FhTaZwkSQ

·        Positively Autism Valentine’s Day Social Story

http://www.positivelyautism.com/downloads/SocialStoryValentinesDay.pdf

·        Pete the Cat’s Groovy Side to Love Read Out-Loud

https://www.youtube.com/watch?v=1TIzdI8E42k

·        Pete the Cat Valentine’s Day is Cool Read Out-Loud

https://www.youtube.com/watch?v=ntXvVxOlg04

·        Spread Love with Llama Read-Outloud

https://www.youtube.com/watch?v=1pDhFgmOtkI

·        Curious George Valentine’s Day

https://www.youtube.com/watch?v=b7L5ehQep3A

·        Valentine’s Day History for Kids!

https://www.youtube.com/watch?v=_zJ6i1DJcj0

·        5 Little Hearts- The Kiboomers Preschool Songs and Nursery Rhymes for Valentine’s Day

https://www.youtube.com/watch?v=n5noNWgcAAE

·        I’m a Little Valentine- The Kiboomers Preschool Songs and Nursery Rhymes

https://www.youtube.com/watch?v=tMDaj-CM_5Q

Written by Chelsey Kim, BCBA, LABA, Clinical Supervisor, with ABA Helps, LLC

While Thanksgiving is a time to reflect on all the reasons to be grateful during this holiday season, it can also be very stressful for families with loved ones on the autism spectrum. One of the most commonly reported frustrations is that their child is a “picky eater”. Let’s talk about that!

WHAT IS FOOD SELECTIVITY?

Food selectivity encompasses a range of behaviors often associated with being a “picky eater” such as refusing to eat certain foods, having a very limited number of foods a child is willing to eat, or eating large amounts of a single food. The effects of food selectivity can range anywhere from a mild annoyance like having to prepare separate meals for your child to malnutrition and low body weight that may require a feeding tube.

WHY IS IT COMMON IN THE ASD COMMUNITY?

A study conducted by Bryant-Waugh et al., (2010) showed that approximately a quarter of all children have eating problems during their first couple years, however the rate of eating problems in children with developmental disabilities can be as high as 80%. Eating patterns for those on the autism spectrum tend to be governed by sensory features including texture, color, taste, shape, temperature, or combinations of multiple features. Williams et al. (2000) found that 69% found aversion to texture, 58% found aversion to appearance, 45% found aversion to taste, 36% found aversion to smell, and 22% found aversion to temperature. From a behavioral standpoint, many individuals with autism have restricted interests that shape their behaviors. From an outsider’s perspective who may not be aware of your child’s diagnosis, your child may appear to be difficult, inflexible, or stubborn, however this characteristic is one of the hallmark symptoms of autism spectrum disorders.

WHERE DO I BEGIN?

The first step is to ensure that your child doesn’t have an underlying medical condition that contributes to food selectivity. Make sure to schedule a visit with your Pediatrician to discuss your concerns. Your Pediatrician may refer you to a Pediatric Gastroenterologist or a Nutritionist for further testing. Bring a detailed feeding history to your visit including the first experiences with feeding (bottle vs. breast feeding), how your child transitioned to baby food, and any notable digestive issues or food allergies. Other behaviors to observe and note before your visit are the settings in which your child eats. Does your child eat on a regular schedule or does he graze throughout the day? Does your child sit at the table for all his meals or in the living room in front of the TV or ipad? Does your child have preferences to specific brands? Is there a pattern in texture, color, taste, shape, or temperature of foods your child will or will not eat? How is the food presented? How long does it take for your child to finish eating? What does your child’s refusal behavior look like? All this information will help determine whether the selectivity is medical or behavioral. Depending on the outcome, your child’s specialists may recommend ABA with or without the addition of feeding therapy.

SO IT’S BEHAVIORAL…

Let’s get started! Your ABA team will assess the behavior by conducting observations and take data on the food selectivity. Additional assessments to determine the function behind the behavior may occur. An individualized treatment plan will be introduced which may include increasing motivation to eat by sticking to a regular schedule and disallowing snacking or grazing, limiting access to liquids to increase hunger, using visuals and models, and creating contingencies for reinforcement for taking bites of new foods. Convincing your child to eat new foods can be challenging. Start small and provide lots of praise for simple interactions like touching, licking, and smelling. Every opportunity is a chance to change behavior.

Contact ABA Helps, LLC to make strides toward a better future. We are here to help you hand in hand!

Written by Chelsey Kim, BCBA, LABA, Clinical Supervisor, with ABA Helps, LLC.

Resources

Bryant-Waugh, R., Markham, L., Kreipe, R. E., & Walsh, B. T. (2010). Feeding and eating disorders in childhood. The International journal of eating disorders, 43(2), 98–111. https://doi.org/10.1002/eat.20795

Williams, P. G., Dalrymple, N., & Neal, J. (2000). Eating habits of children with autism. Pediatric nursing, 26(3), 259–264.

One of the most challenging situations for parents with children on the spectrum is the dreaded visit to the dentist. Stories from parents often sound like a Halloween tale of terror: biting and screaming with parents having to hold down their children all whilst water spraying down on everyone. Time and time again, parents have described dental visits as a nightmare.

Some studies have indicated that dental disease is more prevalent in children with autism due to a lack of self-help skills or sensory issues associated the feel and taste of teeth-brushing. This can often lead to behavioral problems like those described above and more. Here are some tips to improve your child’s dental health and hopefully avoid frequent trips to the dentist.

TRY DIFFERENT METHODS

A quick search on Amazon will generate different types of toothbrushes that may be more suited to your child’s needs. A three-sided toothbrush? U-shaped toothbrush? Electric singing toothbrush? Extra-soft bristled toothbrush? Teeth-brushing doesn’t have to be a “one-size fits all” scenario!

PRACTICE

Invest a few bucks into purchasing a dental mirror and role-play "going to the dentist". Have your child practice laying back with their mouth open while you use the dental mirror to inspect their mouths. Start off slowly and gradually increase the amount of time you are inspecting their mouth. You can also practice using a hand gesture so that your child can indicate they need a break while someone may be working in their mouth.

USE VISUALS

Children often learn best with visuals and modeling. Practice oral hygiene routines with a visual present that shows each section of the teeth that needs to be brushed. If your child isn’t brushing long enough, try having them brush along to a song or with a timer so they know exactly when to stop. You can also try showing videos of other children brushing their teeth and have your child follow along.

REINFORCEMENT

Make sure to reward your child for practicing good oral hygiene. Use statements like “First brush your teeth, then we can go to the park”. Honor your child’s request to take a break if they ask appropriately as to avoid making this task aversive. Associate teeth-brushing as a positive experience by providing plenty of reinforcement, but maybe not sweet treats.

For those times when visits to the dentist are unavoidable, call ahead to discuss your child’s specific needs. This may include listening to music, noise-cancelling headphones, sunglasses, watching a video, a weighted blanket or vest, or visuals.

Below are some dentists specialized in working with the special-needs population in Massachusetts!

·        Bubble Dentistry (Newton)

·        Triangle Family Dental (Amherst)

·        Tufts Dental Facilities (Multiple Locations)

·        The Pediatric Dental Group (Franklin and Milford)

·        Dentistry for Children (Weymouth)

·        Simply Pediatric Dentistry (Randolph)

·        The Medford Center for Orthodontics and Pediatric Dentistry (Medford)

·        Smiles Pediatric Dentistry (Quincy)

·        Chestnut Dental (Bedford, Needham, and Franklin)

·        Andover Pediatric Dentistry (Andover)

·        Dr. Kallen Hull (Reading)

·        Dr. Teddi Olszewski (Northhampton)

Written by Chelsey Kim, BCBA, LABA, Clinical Supervisor, with ABA Helps, LLC.