Any Behavioral Techniques That Work Well For Children With Autism And Adhd?
I am wondering what works for others as far as behavior strategies, systems, plans etc. My son is six years old with several diagnoses including adhd, bipolar, and high functioning autism. His behavior is a major issue. We have tried time outs, reward systems where he got stickers and then a reward at the end of the week or day, 123 magic, and more with no success. Any ideas?
You really need to do Applied Behavior Analysis because many of the problems that kids with those diagnoses have is difficulty with communication.
With ABA you will be teaching him to ask for what he wants and to accept “not now.”
Reward systems do not work if there is a problem with one of the following, Immediacy, Satiation and Desirability. I suspect your problem with reinforcement may have to do with immediacy and desirability. 6 year olds cannot wait all day to be reinforced, even if you are using stickers as token economy. He may not be able to see that getting X amount of stickers = something at the end of the day.
I would use primary reinforcers (The actual reinforcer) at first, which for children with autism is not easy. Sit down with your child and find out what he finds reinforcing and make a visual reinforcement menu.
Reinforce every ten minutes with something minor, like playing with bubbles for two minutes or a couple of goldfish and then increase the frequency to fifteen minutes and a slightly bigger reinforcer. Continues to lengthen the time and vary the reinforcer. Being reinforced once an hour may be too long for him. Any time he backslides, you have either lengthened the time too quickly or satiated him with the reinforcer
The other key is teaching your child the behavior that you want to have to replace the problem behavior. Say he tantrums when you tell him “No.” At a time when you are both relaxed and not mad, tell him that you and he are going to play a behavior game. Tell him that you want to show him a new way of responding when you tell him “No.”
Making sure you have his reinforcer at hand, role model for him how you would like him to act when he can’t have what he wants. Now you play him. Have him tell you “No,” and show the good behavior. Have him reinforce you and then switch roles. Switch again and this time you tantrum. Ask him if you should get a reward for the tantrum. Then role model and have him reinforce your good behavior. Take turns and have fun! Do this every day until you start seeing the behavior in context when you tell him “No.”
The thing that most people do is fail to teach the replacement behavior. They are very good at telling the kid what he is doing wrong, but they really don’t reinforce him when he does things right. When you are trying to think of a replacement behavior to teach, think, “What would I want him to do instead?” Then teach that behavior.
These techniques are part of ABA. If you go to Dr. Mac’s Amazing Behavior Analysis Page, you can read more about it.
We teach kids to go on the potty, we teach them to read, but we punish behavior. Does that make sense?
My son is 8, he’s got several dx’s that are similar to your sons including PDD.NOS, ADD.NOS and others but he’s probably bipolar.
Last year he had a point card where he was able to get a puzzle piece every 8 minutes when he stayed on task and after 4 of them (32 minutes) he could cash in for 10 minutes of preferred activity time.
I found when my son was having difficulties the shorter interval helped reinforce good behaviors well.
His pointcard was discontinued because he was doing ok, last year though his kindergarten teachers said he would have difficulty with first grade. He repeated kindergarten and his behaviors and speech/social delays were why, he is doing well now.
my class is 3 and 4 year olds but one of our kids is 5 and two of our kids are on the token system where they earn 5 stars then get two minutes with a choice or a reward to play with for two minutes and one of those is in food therapy where the child takes 5 bites and then gets a special toy to play with for 2 minutes.
not sure if this is something you would want to try but maybe start with 6 stars when he does things like sitting nicely in his chair at school for 20 minutes for one star and so on. when he gets his stars maybe he gets to play with something he likes for 5 or 10 minutes.
you said you had used a reward system similar to this before and it didn’t work but maybe he needs some shorter goals to start working towards at first before extending it to the end of the day.
you can also search behavior management on the internet and get some decent hits.
this is my first year using the token system with two of our severe non-compliant kids but it seems to be working well so far. the thing to remember is to encourage him on the positive side he is at the age where he knows he is different from his peers and it causes some self esteem issues as well which leads to behavior sometimes. but good luck!
small segment rewards – and rewards are either positive or neutral – praise and support the behavior you want – and ignore the behavior you do want.
Don’t talk anything to death – use short one word answers and be sure you have taught him what he is supposed to do directly – not just yell or tell him what he should not do.
Pick one system and work it for several weeks – don’t try one day of this and one of that – consistancy is what you need.
My son is on an herbal regimen of Colloidal Minerals, Digestive Bitters Tonic, GABA Plus, and Serotonin. When he runs outs, he gets very hard to handle. Is your son on meds? If he is, maybe he’s on the wrong kind for him. Or you can try the herbs. Not necessarily the herbs my son takes as all children and their autism is different. I took him to an Iridologist/Herb Specialist.
besides focusing onthe behavior itself–look at what triggers the behavior–and see if you cna modify that….by giving more breaks, etc…
Here are some ideas that I have seen a lot of success with:
1) Social Stories: A social story is a story that you read to the child to prepare them to handle a specific activity that they struggle with (ie: following directions, solving conflict, getting in line, etc). There are books you can buy with “ready-made” social stories to use with kids. I often create my own, personalized stories for kids that uses their name and addresses their specific behaviors.
I have kids read the story BEFORE they encounter situations they typically struggle with or I have them read it at the start of each day to remind them how to handle the situations before they occur. When you illustrate the books, it is great if you can take actual pictures of your child doing “the right thing.” He is more likely to relate and replicate the behavior if he can seem himself doing it… plus, he will probably think this is fun. Here are some sites with examples and further explanation:http://www.polyxo.com/socialstories/http://www.ehow.com/how_4479088_write-so…http://portal.creativetherapystore.com/p…
2) Behaviors Plan: It sounds like you are doing this. Just thought I would share some tricks of the trade that I have learned along the way in implementing behavior plans (many of my plans failed until I learned these things):
**Choose 1 and only 1, very specific goal. For example, Johnny will follow directions or Johnny will wait his turn to speak and not interrupt. Once Johnny is successful and seems to be meeting his goal regularly, you can slowly begin adding additional goals. You must reward Johnny if he achieves his goal… even if he does something else during the day you don’t like. It is unfair to withhold the reward if he achieved the goal, even if he made another bad choice. This will confuse him and decrease the success of the plan.
** Once you choose a goal, very clearly define and describe to your son what the goal means. Do not assume he knows, because he probably doesn’t. For example: Following directions means: when I arrive at school I put away my book bag and get out my morning work, I listen to the teacher or my parents when they are explaining directions and do what they say, if I don’t understand the directions I raise my hand and ask for help… think about your sons specific behaviors, so you can very specifically instruct him as to how to achieve the goal…. kids with autism don’t disregard rules because they want to be bad and don’t care… they do it because they don’t “get it.” It is important to clearly describe to your son what you want him to do… what does it look like to follow directions (what would you see him doing if you walked in his classroom and saw him following directions?)
**Give frequent rewards and feedback. A sticker may not be enough. When I have children with severe behavioral problems, I give them special watches that I have set to vibrate every 30 minutes throughout the school day. When their watch vibrates, they raise their hand and ask their teacher if they achieved their goal during the 30 minute time frame. If the teacher has time, it is helpful if he/she can tell the child, specifically, why they did or did achieve the goal.
If they achieve the goal, they can put a sticker on their chart. If they earn 4/5 stickers by lunch (varies by child…. if they can never seem to accomplish 4/5, then the goal should be 3/5 or even 2/5… goal must be challenging, but realistic), ie: time on the computer, bouncy ball, play a game (your child should be involved in choosing the reward so that it is motivating for him….. this is very important. If the reward isn’t motivating, he won’t try to earn it.
After lunch, we start again… if the child can earn 4/5 stickers by the end of the day, he gets another reward.
**As the child is successful with their plan we can make it more challenging by: increasing how many stickers they must earn, lengthening the time frame for feedback (ie: from 30 to 45 minutes), or adding additional goals to the plan.
**When trying to decide what goal to focus on first…. choose the behavior that is either most annoying or destructive to you or his classroom teacher.
**State his goal in positive, not negative terms…. this teaches the child what he SHOULD DO rather than what he should not do and it is more encouraging. For example, instead of saying, “Johnny will not use unkind words or hit others” say “Johnny will use kind words and keep his hands to himself. Then, you go on to describe that for him… give examples of what kind words are, explain that keeping hands to self means you don’t touch others without their permission, etc.
**Give as much encouragement as you possibly can. When he achieves his goal, say thing like “wow, you did a great job. You must of have really followed directions today. How did you do it? You should feel proud inside for being such a good direction follower. I know I feel great when I follow directions. How do you feel?” This will help him take the “extrisic” (rewards) to the “instrnsic” (feeling good inside for doing the right thing).
When he messes up, talk about it, ask him how he would like to try and change his behavior tomorrow and remind him that everybody messes up and tomorrow is a new day. If he gets too discouraged, he will give up. He needs to know he is not bad and that the adults in his life believe in him. Most likely, he isn’t happy with his behavior either (even if he pretends not to care).
** Drill him on the goal, especially in the beginning. Make sure he gets that earning the rewards isn’t just about earning stickers, it is about achieving his goal. Make sure he really gets what he needs to do to achieve his goal. Typically at first, kids are more focused on the reward and, as adults, we have to make sure we take the time to instruct and even drill them on how they will accomplish their goal.
Here is a website where you can find the watches if you are interested:http://www.amazon.com/gp/product/B00013K…
3) Here is a link for a great website with many tools/books parents and teachers can use to teach social skills to children the ADHD and Aspergers: http://www.asperger.net/index_social_ski…
*** Also, just thought I would throw out there for consideration…. there are emotional symptoms of high functioning autism that could very much mirror bi-polar disorder. It is incredibly rare that children, especially so young are diagnosed with Bi-polar. Personally, I would argue that doctors/psychologist cannot, ethically and appropriately, make that diagnosis at such a young age. Of course I don’t know your child, but I wonder if the autism is actually responsible for some of the behaviors that appear to be bi-polar disorder.
Best wishes to you. It is so wonderful that you are advocating for your son and trying to find ways to help him be more successful. Early intervention makes a big difference. If you haven’t already, I would also suggest asking your child’s school for help. If the ADHD, autism, or mental health diagnosis are severe enough, he could qualify for special education services. If you have a school counselor, they can help you any time.