29 May 2018

BY: admin

ABACAS Team

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Helping Your Child Learn New Skills (Part 2)

So you know what behaviour you need to teach…but where do you start?

Following on from our task analysis post last week, you may now be at the point where you have worked out the steps of the routine behaviour that you need to teach your child. The question now is to work out which skill to teach first. The answer isn’t as obvious as you may think!

What is Chaining?

Chaining is the technique used in Applied Behaviour Analysis interventions to systematically teach a sequence of skills. Behaviour chains are a series of related behaviours, each of which leads to the next step. For example in brushing teeth, the first step may be to take the lid off the toothpaste, then squeeze a little of it onto the brush, replacing the lid, then bringing the brush to the mouth and so on. Each step along the way cues the next step in the sequence.  We are working towards being able to reinforce the last step (e.g. teeth brushed).

There are actually four types of chaining procedures to choose from:

(a)Backward Chaining;

(b) Backward Chaining with Leaps Ahead;

(c) Forward Chaining; and

(d) Total Task Chaining.

Confused? Don’t worry – we are going to break each of these down so you can work out which will be the best procedure to use for the behaviour you are trying to teach your child.

Backward Chaining

You don’t always have to start at the beginning. Sometimes we can teach a routine by starting with the last step. In backward chaining:

  • The steps are taught in reverse order. In another word, first skill to be taught is the last skill on the chain.
  • The facilitator supports (prompts) the learner through the first several steps and the learner independently finishes the last step to finish the task.
  • Once the last step is mastered, the step before the last step is then being taught.
  • This technique is often used for tasks with a motivating end (e.g. baking cookies) or to allow escape (e.g. finish brushing teeth, putting the tooth brush away)

Let’s swap from brushing teeth to cooking a batch of cookies. Most children like cookies so this task may be more motivating. There is also an obvious reinforcer – getting to eat cookies once they are cooked!

The sequence for eating cookies may look like this for a child:

(1) Mix dry ingredients with wet ingredients

(2) Stir to mix

(3) Shape into small balls

(4) Place on tray

(5) Push down on the dough on the tray

(6) Bake (note – the parent might choose to do this step for a young child)

Using a backward chaining procedure you would prompt them through steps 1-5. This might look like verbal instruction or physically showing a child how to mix ingredients. When it came to step 6 (and if this was appropriate for their age) the child would be expected to do this step by themselves, with praise at the end from their parent. Once this step is mastered, then the next step is the pushing down on the dough and so on.Reinforcement (praise) is linked to either the end of the sequence once it’s mastered or to the individual step being taught.

The key to using a chaining technique is to be very clear about the behaviour you are trying to teach.

In next week’s post, we are going to look at Backward Chaining with Leaps Ahead.

Needing help?

As always you are very welcome to contact Jenny Lin, Program Manager for assistance on any aspect of your child’s behaviour. Jenny can be contacted through the office on 9274 7062.

28 May 2018

BY: admin

Psychology Team

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How to Help your Child with Grief and Loss

Feelings of grief and loss can be triggered for children by changes such as the death of a loved one, the loss of an important person from their life, parental separation, and moving to a new school or home.

As a parent you will want to protect your child from distress but grief and loss is often a very natural reaction to something very sad that has happened in a child’s life.  It doesn’t mean that the child is not coping. Rather it may mean that the child is just very naturally expressing their emotions.

How do children express grief or loss?

Depending on the age of the child, children may express their grief differently to adults. And as with all children, you may notice differences in the way that individual children respond.

Children sometimes do not understand what a loss means. Particularly for young children who experience the death of a loved one they may not comprehend the implications of death. This may mean they act as if nothing has happened. It’s important to plan how you will explain a death or change to your child in a way they will understand.

Some children will respond to feelings of grief or loss by acting angry, oppositional and defiant. This is usually because they do not know how to process their feelings, and feel out of control. This is particularly true for teenagers who may begin to push boundaries in response to feelings of grief and loss. It is important to respond to underlying feelings, be supportive and understanding, and find ways for children to express feelings in safe ways.

Children can sometimes feel despair in response to grief or loss; this may include sadness, crying, hopelessness, anxiousness, being clingy, and being fearful of separating from loved ones. It is important to provide lots of love and reassurance, and model that you can be sad but still live your life.

Some children may feel guilt, blame or responsibility for events surrounding grief or loss. Letting children talk about their worries openly will allow adults to challenge ideas, give more realistic explanations, and remove burden from children.

Tips for responding to children’s grief:

  • Gradually children will accept the reality of loss, try to encourage them to also find some hope for the future.
  • Let children be involved in rituals around loss such as choosing and decorating their new room, making photo collages of their memory of a loved one.
  • Allow children to continue talking about loss and their feelings around that. Give permission for children to express whatever emotions they may have, even if they differ to your own.
  • Consistency can help children adjust to changes; having familiar people, places, and things around them can provide a sense of security in a difficult time.
  • Model the expression of your own emotions regarding the loss in healthy and appropriate ways.

Our psychology team at the Child Wellbeing Centre are also there to help you if you are still worried about how your child is coping.

Please call 9274 7062 for further information.

22 May 2018

BY: admin

ABACAS Team

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Helping Your Child Learn New Skills

For some children on the autism spectrum (and other children with developmental needs), learning daily behaviours and routines can be challenging. Brushing teeth, getting dressed, putting shoes on or preparing snacks are all examples of daily independent living skills where children may need extra help.

Some children need help breaking down the parts of the task into smaller chunks and learning step by step. Knowing the steps involved in the task are important. You need to be able to identify the skills your child needs to be able to teach them.

What is Task Analysis?

Task analysis is breaking down a complex task into a sequence of smaller steps with specific instructions and the expected responses.

Let’s take the example of brushing teeth. For many of us this behaviour is so automatic now that we don’t even think about what we’re doing. Imagine though trying to teach this behaviour to someone who has never done this or done this by themselves before. To help you work out how to explain brushing your teeth, you might break it down into the following steps:

Go to the bathroom, then find the sink

Find toothbrush and tooth paste

Squeeze tooth paste onto tooth brush

Brush*

Rinse mouth

Put toothbrush away

Dry hand

*Note teaching children the actual art of brushing teeth, might be a whole separate lesson, with its own sequence of steps to follow.

Performing an action yourself (e.g. brushing your own teeth) or watching someone else do it will help you identify the steps in the behaviour. Try and note as much detail as you can as this can help you later to work out where to start.

So I have my steps identified, what next?

Now to the fun part. After a task analysis is developed the next step is to teach the steps or skills that make up the sequence. In ABA speak we talk about “chaining procedures”. This is the process where the sequence of skills/steps are taught one after the other…building up until the whole behaviour can be performed independently by the child.

Don’t worry! In the next ABACAS Tuesday the team will be talking about how to use chaining techniques at home.  However you don’t have to wait. If you have a particular behaviour that you’d like to teach your child,  why not grab a pen and pencil and see if you can’t start breaking the behaviour down into steps.

Want more help?

Jenny Lin, Program Manager and the team are available for consultation. All you need to do is to call reception on 9274 7062 for further information.

16 May 2018

BY: admin

Psychology Team

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6 Tips for Managing Parenting Stress

Parenting can be stressful and all parents will feel stress at some point of their parenting journey. Stress can start in pregnancy as the body experiences change. Then in the process of caring for babies, stress can be triggered by lack of sleep, competing demands and changes in routines.

Later as children get older, stress can come with the many demands of parenting….a bit like trying to juggle many balls in the air at the same time.

How do you know you are experiencing stress?

The most common signs of stress include physical symptoms of tiredness, low energy, aches and pains. We can find ourselves more susceptible to the colds, flus and bugs going around. Mentally we can have difficulty concentrating, remembering and being organised. Emotionally we can feel sad and depressed or find ourselves quicker to anger than usual.

What can you do about stress?

Some simple steps to start you managing stress includes:

Identify your triggers. Knowing is half the battle. Identify your triggers for stress. Things like relationship issues, work and and coping with illness can add to the stress of being a parent. Some of these triggers can be predicted – and when this is the case – you can aim to support yourself during these periods.

Notice your symptoms of stress. Knowing your symptoms of stress helps you to identify them early on. Irritability, interrupted sleep, headaches and changes in appetite may signal that you are becoming more stressed. The following strategies should help to reduce your symptoms.

Lifestyle. Eating regular meals, attending to your sleep routines and exercising regularly are important lifestyle factors that improve mood and decrease stress. Make time for yourself in your busy routine to engage in these activities.

Socialising with other adults. Find some time to meet up with friends or family members. Compassionate friends can make all the difference.

Relaxation. Developing a relaxation routine or even brief techniques to calm yourself may reduce your stress. Deep breathing, muscle relaxation and guided meditation are some examples. Mindfulness and grounding can be used to stay connected to the present.

Address unhelpful thoughts. How we think affects how we feel. If you have having negative thoughts you may like to speak to a friend or a counsellor. It is possible to train your brain to dispute negative thoughts and find balanced alternatives.

Of course if you are feeling stress it may not be anything to do with the children. Other things cause us stress too – relationship difficulties, financial strains, having to care for others in the family. The list goes on!

Always feel free to talk to you consultant in the Centre. If we are not the right people to help, we can help you find other professionals who may be able to help.

Please contact Tracey on reception for further information about our services on 9274 7062.

14 May 2018

BY: admin

Occupational Therapist Team / Psychology Team

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11 Tips for Helping Fussy Eaters

Children’s eating (or not eating) can cause parents lots of worry and stress. Good nutrition in childhood is important for so many reasons. It supports children growth, overall health and learning. Yet some children are very fussy about what they eat. This may look like only choosing some foods, refusing to try new foods and skipping some food groups all together! I can’t even begin to tell you how many times I’ve come across children and the only thing they will eat reliably is chicken nuggets.

Why are children so fussy?

Children become fussy eaters for a range of reasons. Sometimes it’s due to habits, strong wills and/or sensory difficulties. On this last point, some food textures and tastes can cause distress. While most children grow out of their fussy ways, some will need some help along the way.

What can you do to improve eating?

The following are eleven tips to help improve your child’s eating:

  1. Model good eating: Children learn so much about the world from their caregivers and modelling eating the type of food you would like them to eat is an excellent start. It is also great if they are surrounded by other children eating different food types.
  2. Make eating fun: Why not create a fruit face or cut vegetables into cool shapes? By making eating healthy food fun, children are going to be more motivated to try some. There are lots of great websites that you can try for recipes for children. For example: https://www.parents.com/recipes/familyrecipes/
  3. Have realistic expectations: Don’t expect your child to finish the plate or try new food everyday. Set small but achievable goals such as trying 1 bite of everything on the plate. Also keep meals friendly. It is better to put a small bit of new food alongside a larger amount of food that your child likes.
  4. Make mealtimes happy & social: Try and make mealtimes an important time for the family to sit down together. Avoid distractions such as having the TV on. Try not to worry about anything that goes wrong during dinner (such as spilled drinks or food). Meal times as positive as possible.
  5. Praise your child for trying: Its very important to praise and give attention to your child when they try new foods. For some children, a reward chart may be appropriate. However, do not make the reward a different food. This will teach your child that one food is more desirable than another.
  6. Do not give attention when your child is refusing: It is similarly important not to give too much attention to your child when they are refusing to eat. This can act as a motivator for children to refuse more. Try and ignore the behaviour as best as you can.
  7. Do not make special meals for your child: Tying in with the previous tip, by making a special meal for your child you are giving them special attention when refusing. This can encourage them to refuse more as they know they will get food they prefer.
  8. Give your child some say: Refusing food is often a response to wanting greater independence. You can give your child that independence in allowing them to choose their food from a range of healthy options. This way children still feel in control and are more likely to try the healthy option that they choose.
  9. Choosing new foods with a similar texture: If your child has a sensory aversion to a particular type of food due to it’s texture, try and think of some healthy options which have a different texture. This is particularly relevant if your child has ASD or another developmental disability.
  10. Offer the new food repeatedly: Your child will most likely have to see the food quite a few times before they will try it. You can also set smaller goals such as touch, smell or lick the food before trying it.
  11. Involve your child in cooking: You can also involve children in the preparation of a meal (e.g. chopping vegetables) which increases their engagement as well as giving them a chance to feel the food out before eating it.

Still need help? Then feel free to call the Centre on 9274 7062 for more information about how we can help. Our occupational therapy and psychology team can parents with fussy eaters.

Written with help from Ruby Simms-Cumbers (Behaviour Therapist).

Naomi Ward

Clinical Director

07 May 2018

BY: admin

Psychology Team

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Helping Children Overcome their Anxiety

A very natural response to anxiety is to try to avoid the thing that makes us feel anxious.  For example, if being near dogs causes makes you feel anxious, then it makes sense to cross the road to avoid the dog sitting patiently at the neighbour’s gate.

Children are no different.

However there is a problem with avoidance. Yes, in the short term, it relieves anxiety. In the example above, the further you move away from the dog, the less anxiety is experienced.  However in the longer term, avoidance actually strengthens anxiety. The child who stays home from school because they are worried about a test, is only going to be anxious (or more anxious) the next time there is a test at school. And if they stay home every time there is a test, their anxiety about tests may even grow.

 What’s the alternative to avoidance?

We need to teach children how to cope with anxiety.

  • Children need to learn positive coping strategies to help manage unpleasant feelings and thoughts.
  • Parents need to model positive coping strategies. Children learn so much through observation of how their parents and peers cope with worry and stress.
  • Children need to have the opportunity to practice their coping strategies a little at a time in a supported way and experience success.
  • Children need praise when they try to beat their worries and recognition for the big steps they are taking.

When you are stuck for ideas…

There are a lot of great resources written with parents in mind that gives lots of great ideas for how to do this. A favourite of mine is “Helping Your Anxious Child” by Rapee, Wignell and Spence.  Your local library should be able to order this one in for you if they don’t have it in stock. Many online book shops sell it too.

And of course there is the Psychology Team at the Centre to help with therapeutic approaches.

Please call Tracey on 9274 7062 for more information about our services.

01 May 2018

BY: admin

ABACAS Team

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How to tell when your ABA program is effective.

It’s not enough to like your therapy team, parents should also have the means to evaluate their effectiveness. In other words, know whether therapy is being effective.  There are 7 dimensions of an Applied Behavioural Analysis (ABA) program that any good intervention should include, these are that they are: Applied, Behavioural, Analytic, Technological, Conceptually Systematic, Effective, and Generality.

Some of the key points from these dimensions are that ABA should always focus on skills that are socially significant for that child. And the best way that we can work out what skills are significant is by working with both the child and the family to set meaningful goals. Programs should teach skills that will help improve day to day life for the child (and family). For some children this might mean focusing on communication, learning to learn skills (e.g. listening and attending), social skills and independence.

ABA is behavioural, and always looks at measurable behaviours. If we can see and describe a behaviour, then we are in a position to be able to teach it. By being able to measure behaviour, we are also in a position to check progress and to identify what is working and what isn’t.

Generality is a key idea in ABA too. This is the concept that skills must be able to continue, with new people and new environments, after formal intervention has ended. There is no point teaching the skill if the child is only able to show it in therapy!

As you can see ABA is focused on working with people, to create practical, independent skills for their futures. Whether this is academics, learning to talk, daily living skills, or social skills it is about what is important for that individual, their family and their local community.

If you’d like to learn more about what principles guide ABA interventions and how they can help you please contact Jenny Lin, Program Manager on 9274 7062.

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