A problem-solving approach that is combined with applied behavior analysis (ABA) may be helpful for children with autism who have tantrums and aggression.
This article reviews research-based treatments for tantrums, and describes the strengths and problems of each intervention approach. The most common treatment approach for problem behavior is ABA therapy that is skill building in nature. It appears that the use of functional assessment makes it more likely that the ABA therapy will work. Many of the treatment studies also taught the child how to communicate. The author notes that brain (antipsychotic) drugs are being used more and more often for younger and younger children.
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Responding to neurofeedback
Nov 12, 2010 by AnonymousWe have used neurofeedback (NFB) for our Asperger son. I don't know how well it works for autistic people. For Asperger syndrome, it can work very well, but it's a long process.
We started the therapy when my son was 9 years old, having extreme difficulties at school because he couldn't cope with anything. His anxiety was so high even the NFB doctor thought it was remarkable. The initial assessment showed that my son had high delta-theta waves (associated with ADD-like attention span), low sensorimotor rhythm (SMR) waves (associated with sensory issues,fidgeting, tics, agitation, and anxiety), and high high-beta waves (associated with intense anxiety). This profile is pretty much exactly what all Asperger kids look like.
We liked the NFB approach because unlike virtually all other ASD treatments we tried or looked at, this was the first one that looked inside our son's brain to see what was going on. The assessment wasn't based on theory, observation, or cookie-cutter practice, but on the actual output from the kid's head.
The NFB treatment involved playing computer games via electrodes stuck to the scalp and ears. It sounds more fun than it is, because the games are very slow. We had to bribe my son to do the therapy. We are very tech-savvy, so we trained at the centre so that we could do the sessions at home (we live hours away from the clinic).We did the sessions every day so that we could see the results faster. We kept a log sheet of observations, hours of therapy, and game points, and included any observations from his teachers.
After 30 hours of treatment, he suddenly figured out how to control his high-beta waves. Where he used to get scores of 10, he could now get scores of 200, then 400, then 1000. He had no idea how he was controlling the levels, but he was doing it. Within a few days, we noticed that his anxiety was GONE. I mean GONE. Suddenly nothing bothered him anymore. He wasn't afraid of the dark, or of barking dogs, or of rain, or of traffic. He stopped fretting about death and getting older and started simply living.
We continued the therapy for another 30 hours and got his SMRs up. That's when he started eating a bunch of new foods and playing outside. He'd even ask to try out something new. However, the SMR's are the hardest wave to fix, because they're deep in the brain, and he didn't maintain the high SMR's for long.
The one we had the least success with was the delta-theta, which ironically is usually the easiest to treat. Oh well. So he's still a space cadet!
We wrapped up the therapy at 100 hours, very pleased with the results.
My son is now 14 and doing well. We've noticed in the ensuing years since doing his NFB that it's worthwhile to do tune-ups three to four times a year. Video games, sedentary activities, and long car drives all seem to push his brainwaves back into the old patterns. We can tell when this occurs because suddenly he can't cope with anything, he's screaming a lot, and the teachers are phoning us to ask what's going on. All we need to do is a week of NFB, a half-hour per day, and the problems disappear. We've now trained our son to do his own sessions, so it's very easy for us.
If you want to learn more about NFB, you need to do some reading first. The best book on the subject is one that's probably in your public library: A Symphony in the Brain. It explains how the brain works. There is a chapter on NFB near the end. Besides that, there are many books available discussing the applications for NFB treatment. It works so well for anxiety disorders, depression, and post-traumatic stress disorder (which are all disorders in which the brainwaves get into bad patterns and get stuck there) that its popularity is growing. NFB is expensive. There are some people trying to develop simpler, more user-friendly technology, but the practitioners are used to the old systems. We have to wait for a younger generation of NFB doctors to move into the field to take it in new directions.
Responding to relationship development intervention (RDI)
Jun 15, 2010 by AnonymousRDI or Relationship Development INtervention is a useful approach to enabling the teacher and parent. It is structured and developed with a series of behavioral objectives which help the parent and teacher get onto the "same page" in any theraputic setting.
RDI provides a well written structured "pre assessment" and pages of activities to direct the teacher/parent on "things to do" as they work through the assessment. The model is based on excellent research in teacher education and has impact because it is a "can't miss "approach.
Marvin M. Kowalewski, Ph.D, Director Counseling Solutions Port Charlotte, Florida
A magical vacation...
Aug 20, 2009 by AnonymousOkay. Here goes.
We had a wonderful vacation. I can only say that now, a few days later, after I’ve been given time to ponder and reflect. I wrote a blog on the airplane home, but after reading it now a few days later, I think it was a little harsh so I’m doing a re-write. I liken it to childbirth. After the baby is out and you’re thrilled to be a parent, you don’t really remember the agony of it all. You even start thinking about when you’ll have another one.
To be honest, most of the trip was exhausting to us. We learned a lot, which is a good thing. We’ll do things a bit differently next time, whenever that turns out to be. We think the kids had a great time; at least they’re saying that they did now. They were not very well-behaved for a large portion of the vacation. In fact, Donald Duck himself had to break up a fight between Thomas and Hayley at Chef Mickey’s at the Contemporary Resort. We were suitably mortified, I can assure you. We were, needless to say, disappointed in the kids and their behavior. We had hoped that they would be magically wonderful, since every Disney employee we ran into wished us a “magical” day. Even when I called the front desk for extra towels, I was wished a “magical” evening. I should have asked for “magical” towels.
There were two main pieces of advice that we received prior to our vacation that we should not have taken as gospel truth. The first was that autistic children can improve dramatically (magically!) while at Disney World. I really thought that this would happen for Thomas, since he is one of those kids who requires more stimulation than other kids. And Disney World is sensory overload extraordinaire. I’ll just say that Thomas has never acted more autistic in his life. I was quite disappointed. I’m not saying that I thought we’d spend ten days (too long, by the way, but more on that later) in Disney World and come home with a cured boy, but I at least thought that he might be better while on vacation. He was worse. And his badness rubbed off on his sister. Hayley copped an attitude most of the time which I’m sure has nothing to do with the fact that every Disney employee who crossed her path called her “princess.” I was called princess a couple times, but I know I’m not a princess. Trust me, I know. For Hayley, the jury in her brain is still out.
The second thing that we were told to do over and over again by everybody we talked to was to take a break in the middle of the day. Go back to the room, go swimming, take a nap, have a snack, re-charge the old batteries and then go back to the parks in the evening, fresh as daisies. Here’s what happened to us: We got on the bus to go back to the hotel, and during the bus ride the kids fell asleep. We made the trek back to the hotel room where the kids, having rested quite enough on the bus, would be bouncing off the walls just as Jonathan and I wanted to curl up and take a nap. Ha! So we maybe would take them swimming or watch cartoons for a while and then head out again. So this way, the kids were great for the rest of the day but Jonathan and I were completely frazzled and every little thing the kids did wrong set us off. The grown-ups were the cranky ones by day’s end. So some of the best days we had were ones where we went all day long, taking for our “break” a sit-down meal for lunch.
Despite our “go all day long” routine, I managed to pack on twelve pounds! Yes, despite walking around in the hot and humid Florida sun, sometimes toting a child on my back, I managed to gain several pounds over the course of the ten days. I can sum it up in two words: brownie sundaes. We did the basic Disney Dining plan which included one snack, one “quick-service” (fast food) meal and one sit-down table-service meal per person per day. Both the quick-service and the sit-down meal included a dessert for adults. Well, what are you supposed to do but order the dessert and scarf it down? We’d already paid for it! Next time, we think we’ll skip the dining plan, although it was very nice not to have to budget for food which can be a very inexact science. The food was all paid for before we left so that any extra money we brought could be used for incidentals and suchlike. We actually spent very little cash because we didn’t have to pay for food while we were there.
Again, in hindsight, it was a wonderful vacation but not without its ups and downs. We thought the kids would be better than they were. At the end of the trip, we decided that the kids were still a little too young to truly appreciate what they were enjoying. I don’t mean that we expected them to sit us down, look us in the eyes and say, “Mom, Dad, we know just how great an undertaking this has been for you, we understand the cost involved and we truly appreciate everything you’re doing for us. We will always treasure this time with you in our memories.” I don’t think I’ve even said that to my own parents now, who took us all to Disney World when I was in eighth grade. I can say that I have a huge appreciation for them having done it, and I understand what kind of planning and budgeting went into it.
Also, as I hinted at before, ten days was just straight-up too long. Next time, we’ll stay for maybe a week and get better accommodations. The All-Star Movies Resort was fine, but it was clear that it was Disney’s version of the nosebleed section given its proximity to the parks and the clientele. It was rather noisy and we dealt with rude people a lot. Really, at Disney in general, it’s every family for themselves, and those who realize this sooner rather than later will have a better time in general. Jonathan and I, being pushovers, care about other people’s feelings and were shocked at some of the rudeness we witnessed.
So next time – this hypothetical “next time” – we’d stay for shorter in a better hotel, rent a car so that we weren’t constantly at the mercy of the Disney Bus System and ditch the dining plan so that we could eat (less) outside the World and probably spend less. Everything at Disney is so expensive! I read that Disney will ride a money horse until it drops and boy, was that ever true! Plus, if you do the Dining Plan, Disney’s got you – all your money and you’re never leaving the parks until they shuffle you onto the bus to the airport and drop-kick your luggage to its final destination, and they don’t really care where that might happen to be. Our bags did show up, but somewhat smashed.
So that was our trip. If you have any questions, let me know. Now, we gear up for school! Hayley had her kindergarten assessment with Mrs. H. yesterday and she did a swell job! Pre-school really paid off in that respect. After her little interview, we went and visited Thomas’ new classroom and saw his teacher again. After seeing his teacher and class again, Thomas is much more…okay…with going to first grade. Plus, I told him that I’d make him cold pizza to eat for lunch. So that was great! I feel like he’ll be okay now and that he understands he’ll be at school all day and eat lunch with his friends. He’ll get a recess which will really help him out and Mrs. H. said that he will have sensory breaks in her classroom a couple of times per day or as needed. Thomas was pleased to hear that. When we were in his new classroom, he noticed many similarities between his kindergarten room and the first grade room which made him very happy. There was a chart on the wall for the weather, lots of numbers to count the days and the old “green-yellow-red light” cards on the wall to track everyone’s behavior.
As we walked home from school, I asked him again how he felt about it. I said, “So how do you feel about first grade now? Do you think you’ll like it?” He replied, “I think it’ll be great!” I really, REALLY hope he means it! School starts next Wednesday.
I can’t wait, for my own sake. It’s been one hell of a rough summer.
How to obtain a written estimate for SP?
Apr 13, 2008 by AnonymousHello, I am attempting to get some SP,OT,PT written estimates for my 14 yr. old son. I need the estimates for court and I am having a difficult time in getting any agencies in TX. to give a written estimate without doing an assessment first.
I do understand the importance of these assessments, however without the written estimates, the judge will not order his father to pay for the service, therefore we will not be able to pay.
I am in court on a child support case, it turns out that my son's father is a MILLIONARE and now after being a single mom and not having any options or means of providing the extra services that my son so desperately needs....now we are being given a chance to play "catch up" . Please help with some advice.