Autism Therapy: hitting

definition of hitting: A child my hit another child or he may hit himself. If he hits himself, it is described as a self-injurious behavior. Hitting is a self-injurious behavior that children with autism might exhibit.

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Child Adolesc Psychiatric Clin N Am, by Minshawi, NF, published in 2008, summarized Jan 28, 2009

Applied behavior analysis (ABA therapy) may be helpful in stopping self-injurious behavior in people with autism.

Self-injurious behavior can be one of the hardest symptoms of autism. Self-injurious behavior is most often self-hitting or banging of the head and face and self-biting. People with low IQ are more likely to have self-injurious behavior. Some people believe that self-injurious behaviors are shaped, strengthened, and maintained because the person with autism gets desired feedback from the behavior. This article reviews self-injurious behavior in autism and describes treatments.


J. Neural Transm, by Canitano, R., published in 2006, summarized Oct 24, 2006

Risperidone is able to decrease self-injurious behavior in children with autism.

Self-injurious behavior is a special type of repetitive behavior that can be found in children with autism. In this study, self-injurious behavior included head-hitting and hand-biting. Most of the children showed anxiety, anger, and frustration, all of which were associated with self-injurious behavior. Risperdone is traditionally used to treat epilepsy, although recently it has been prescribed to children with autism. This study of the effects of risperdone on children with autism included only eleven children and was open-label, meaning that the children, parents, and researchers all knew that they were receiving the medication.


Journal of Autism and Developmental Disorders, by Horner, RH, Carr EG, Strain PS, Todd AW, and Reed HK, published in 2002, summarized Oct 21, 2006

This article describes in detail how the applied behavior analysis (ABA) approach can be used to decrease problem behaviors in young children with autism.

The authors focus on using the ABA approach to reduce inappropriate behaviors, for example, hitting, tantrums, finger-chewing, self-injury, and aggression. The ABA approach has been shown to reduce these behaviors by about 90% or more, regardless of the type of autism diagnosed. In addition, the reduction in problem behaviors is larger when familiar people (for example, teachers and parents) are responsible for ABA treatment versus when hospital staff or specialists are involved. Further, the ABA approach works best when the practitioner observes the child carefully enough to know what a good reinforcer would be for that specific child. For example, one child may respond to praise, but another may want access to a mechanical car. Finally, the authors conclude that future research should focus on, among other things, the effectiveness of ABA treatments in different settings (home, community, school, clinic).


Helen Andreae, a recent graduate of Victoria University in New Zealand, designed “Auti” to teach positive play behaviors to children with autism. “Auti” is a prototype toy that responds to positive interaction, but shuts down in response to screaming or hitting. So far only children of friends and family have played with “Auti”, but they love his soft possum fur. Andreae explains that the sensors in "Auti" can be adjusted for individual children, and that once “Auti” moves out of the prototype stage, she’d like to broaden its range of teaching capabilities.

Read original article: New Toy Helps Kids with Autism


Stuti Chandhok, a classically trained musician in India, is one of the first certified musical therapy providers in that country. She has been working with children with autism and other special needs for over 10 years. The children she works with have increased communication, creativity, and confidence. Dr P.K. Partheeban, Director of the Swabhimaan Trust in Chennai, has found that “Rhythmic music which is in conjunction with the heartbeat can be really soothing and rejuvenating. Good rhythmic music, whether it's drums, guitar, flute or veena, can stimulate the mind, depending on how the music is presented to the children.”

Read original article: Hitting the Right Note



Please comment on this autism topic.

The long and winding road

Jul 4, 2009 by Anonymous

Conor is the name of my beautiful green-eyed boy who last year was formally diagnosed with autism spectrum disorder. We had been told by a teacher at his daycare that she felt he needed to be evaluated. We took him to our local school district and they agreed that he had "developmental delays." It wasn't until January of last year that his speech therapist actually uttered the word "autism" in assocation with Conor and that was the most devastating word we had probably evere heard. However, whatever we started to read about autism didn't seem to fit him completely. Conor is a very affectionate, articulate and happy little boy. There didn't seem to be any books out there to describe him in the context of having autism. That seems to be changing but it's still quite lacking. I guess I'll have to write my own book!

Nevertheless, as it turns out, loving a child with autism is not the worst thing in the world. We have been enormously blessed with the school Conor attends, where he has been for two years now. He is attending summer school now to keep up the work and not have it disrupted. He only has two more weeks left at this school and then will move to his new elementary school for kindergarten. We are trying to prepare him as best we can. We have set up meetings with his new teacher and drive by the school whenever we have an opportunity. His new school has the same cross-categorical program that his current school has so while he'll have a whole new teacher, school and routine to adjust to, he'll at least have the same program. In the morning, he'll have one-on-one work for his IEP and then in the afternoon, he'll attend regular kindergarten witih his peer group and have an assistant who will shadow him and another cross-cat student. I am excited to have him start this new school with all the possibilities it will provide. He'll be in a class with children his own age, whereas now, he's in with some kids who are a little younger than he is, whom he often imitates (i.e., screaming, hitting himself, making baby noises, etc.). His teachers are confident that he'll outgrow this tendency to imitate, which will come with maturity. We can ask him, "Hey, who are you imitating now?" and he'll respond, "Justin, Payton, Jacob, etc." So he knows he's doing it and knows it's not an entirely desirable behavior. His teachers have commented that this is upsetting to the child he's imitating so we work diligently to overcome that behavior.

 Conor has come a remarkably long way and his teachers agree. There are many things he can now do that he wasn't able to do before. Academically, he's right on track, but socially, not so much. He has a hard time making friends. We hope that he will develop better skills in kindergarten to make connections with friends and learn the appropriate ways to interact with friends. Sharing is a big hurdle!

Conor has an 18-month old sister and that has been an interesting journey. When we first brought her home from the hospital, he didn't want us to get her out of the car! He has had to learn what is appropriate behavior with her and how to be gentle. It's very disconcerting when he laughs inappropriately when she cries in distress. However, if I cry, he shows immense concern and empathy. It's pretty remarkable to witness. I think as he and his baby sister get closer and closer as they grow up together, his connection to her will be more compassionate.

Conor has been a study subject to research the low-dose effects of Risperdal in ASD children. Having him participate in this study was a very arduous and painful decision. His participation ends next month and we're not entirely sure how much it has helped him or affected his behavior positively. In fact, there seems to be an emphasis on some undesirable behaviors and we're not sure if it's environmental or biological. Who knows? All of this is such a crap shoot... everyone just wants a definitive explanation about how to heal/treat/cure autism. Lord knows I sure do! But as I have said, this I can handle. It's certainly a challenge but it's not insurmountable. My child is healthy and happy... we can work together to get him where he needs to be.


Glass half empty or half full?...

Jun 21, 2009 by Anonymous

There are times in your life when uncertainty can make you doubt yourself. Times when it is hard to tell whether your glass is half empty or half full.  Perhaps you ran into someone, an old classmate, whose career path has taken them places you only dream about.  Perhaps you ran into an old friend who shared with you some accomplishment their child has achieved, or some possession that you cannot possibly realistically hope to own.   There are many times in our lives when someone else’s good fortune will make us question ourselves.   I guess that in itself is just human nature and I am human…ok, wait…didn’t I promise to get off this soapbox last week?   Yes, we know I am human.  Yes, we have already covered the I felt guilt and then vowed to make a difference declaration.  And yes, yes..yes we already touched on the I am fortunate to have a child as beautiful, healthy and special as Joshua even though it involves a lot of work, time and energy.  Gotcha.  So since I don’t have a lot of time to expound on my virtues as a tireless dedicated ASD mom and I am sure you’re bored by now let’s just get to it.  Straight, no chaser.    

Last week was a crappy week.   Maybe it had something to do with the nonstop rain, my over zealous self-medicating with the demon caffeine or maybe it was because I had looked at my once bouncy cheeked little boy and saw a young man standing nearly eye to eye with me and felt the beginnings of a panic attack coming on.   Realization was not only hitting home, it was kicking my ass.   Not only was my son facing the oncoming challenges of puberty, making friends, girls… (Ok, putting paper bag over mouth and nose and breathing deeply and slowly) but now my shield was gone as well.   The reason why I could not go out with friends, join a specific social outing or go back to school to complete my degree.    This realization came with the speed and impact of a skillfully placed combination of a prize fight.   One minute I was feeling down about my life, next I was talking to another parent on Facebook (do not sit there and act as if I am the only Facebook addict out there)  whom I had not seen since our sons were in kindergarten together.    While I will not talk about her son’s condition here, needless to say after inquiring about him I felt like I had no right to complain though she admonished my saying so and said in her own kind hearted and generous way that as parents we have the right to complain and should not feel bad about it, nor should I pity her.   I get tired of the things I struggle with; school, insurance issues, his difficulty with making friends.  And then I am faced with the sobering fact that while I may have had to fight for services in school and through my insurance company there are those who cannot get an IEP, or who have no insurance or availability of services.  

So, in short you may ask have I been humbled this week…maybe not the best word.  Just a week when I saw my glass as half full as opposed to half empty and for once appreciated the glass more than the contents.


My son, Elrynn, who is first grade, has a classmate who is mildly autistic.  The little boy in question seems attracted by Elrynn's sensitive nature but is struggling to let him know that he would like to be friends.  Essentially, Elrynn is experiencing daily this little boy hitting and pushing him in order to gain his attention.  Elrynn now does not wish to go to school because he is quite (understandably) upset by this.  Both I and the teacher have spoken to  Elrynn about this little boys needs and Elrynn has tried to include him in active play, but when invited to join, he doesn't know how to, becomes frustrated and then hits out further.  Both the classroom teacher and I are concerned that both boys learn from this experience but are unsure how to go about helping them.  

 

Any suggestions?

 

FMB


A wild ride

Jun 17, 2008 by Anonymous

            It just goes by so fast.  All of the planning and preparation to get away for one measly week (not enough time!) and the vacation is over in a flash.  We’ve gotten back to normal; the laundry is all done and the bags are all unpacked and put away.  We had a really great time, the kids especially!  Thomas tried new things this year that we couldn’t get him to do last year and he wore his blue Speedo goggles faithfully all week.

            Thomas still has a problem with swimming in the lake.  We tried to get him in a few times but the closest we got was when my Aunt Suzy convinced him to splash on the shore.  That was better than nothing!  The rest of the time, he sat on the pier and watched everyone in the water.  My Uncle Jeff and Aunt Paula brought a huge eight-person round floating lounger for people to sit in, and we tried to get Thomas into that too, but he wasn’t going for it.  Thomas and Hayley mostly swam in the pools and played with other kids’ toys.  We did notice as the week wore on that Thomas was having a generally difficult time adjusting.  Going on vacation right after school ends for the summer requires a lot of adaptation on Thomas’ part and we could see that he was really struggling.  I find it so interesting that Thomas was clearly having fun and enjoying himself, yet he was struggling inside at the same time.  It’s hard to describe that to someone unless they see it firsthand.  Thomas was particularly difficult in the evenings while we were trying to get dinner on the table or getting ready for bed.  He did a lot of “wrestling” with Hayley (whether she was willing or not).  He definitely needs more sensory input at these times of change.  Thomas also had difficulty with what experts and teachers call “compliance.”  To you and me, that means listening and doing what the hell Jonathan and I say.  We had some upsetting times when we had to remove Thomas from group situations because he was being too rough.  The last night, we all had a big potluck and ate each other’s leftovers before heading home on Saturday.  Thomas was actually hitting us; punching right in the stomach.  I realized that he was acting out the boxing game on the Wii because after he punched, he would fall on the ground and start counting to ten.  Funny, but unacceptable.  I warned him once that if he did it again, we’d leave, so we did.  He was really upset and he knew what he did wrong because he kept telling us that he was sorry and that he wouldn’t hit again but we had to put our foot down, especially in front of all those people!  It’s interesting how much more motivated a parent is to be firm when there’s an audience, isn’t it?

            Thomas did ride the waverunner with Jonathan a couple times.  On Sunday in particular, everyone wanted to ride with Jonathan and he was exhausted by mid-afternoon.  Thomas dictated whether to go right or left and how fast he wanted to go.  He mostly likes to go slow, but he enjoyed it very much.  I told him that Jonathan has been dreaming of riding the waverunner with Thomas since before he was born, but I don’t think he gets it.  Hayley rode a lot as well.  She was very agreeable all week, ready to try any activity that anyone suggested.  She rode a lot with my cousin Suzy, but mainly wanted to see the big balloon outside the boat rental place nearby.  Whoever rode with Hayley got to idle around the pier a lot.

            We went out to eat several times during the week; once for breakfast on the way to Missouri, two nights out during the week and then twice on Saturday on the way home.  Thomas kind of ran hot and cold with that.  Out of the five times we ate out, two of them didn’t go very well with Thomas.  All in all, it was alright.  Three out of five restaurant meals were peaceful.  On Wednesday night, everyone went to our favorite Mexican eatery, then played mini-golf, then rode go-karts and finally we ended up at the frozen custard place.  We all do this every year and it is typically a late evening but we decided to go ahead and try it with the kids.  Dinner went fine, but mini-golf was hard for Thomas.  He kept saying that he didn’t want to play but we sort of dragged him along.  We just kept finishing holes and telling him to come on, come on to the next hole.  By the eighteenth hole (I still can’t believe we made it!), he was actually enjoying himself.

            Onto the go-karts, and this year Thomas was actually ready to try them!  He rode with me in a little two-seater kart and Hayley rode with Jonathan.  Thomas loved it!  I was driving along, mentally patting myself on the back for helping Thomas to finally overcome this aversion to something we all knew he’d love.  He was laughing very deeply in his belly.  I’ve never heard him laugh like that!  He had a great smile on his face and I thought for sure that we’d just have to find a go-kart track near our house.  Unfortunately, Jonathan and I were very short-sighted.  We didn’t think about what would come after the go-kart ride was over.  Thomas did.  After I pulled over at the end of our last lap, I unbuckled our seatbelts and Thomas slid over to my seat and said, “Okay.  My turn!”  Oh, dear.  I took his hand and was able to lead him off the track without much trouble, but he was crying.  He was crying very loudly by the time we got back to Jonathan and Hayley, so we picked him up and tried to soothe him.  It was kind of sweet, somehow.  He loved the ride, but wanted a turn to drive.  Next year, maybe we’ll check out another track that said “Mini-karts for kids” on the billboard.  God help me, can I actually be thinking of letting my son drive his own go-kart?  Honestly, he’d probably be a better go-kart driver than I am.

            Thomas recovered from the go-karting disappointment when we told him that we were going for ice-cream.  When we got to the custard stand, he said, “Hey!  I remember this place!”  I’ll bet.  I think he remembers it because there is a giant ice-cream cone on a pole outside the place.  That’s memorable for an autistic five and a half year-old.  A very visual child, Thomas is.  Both kids fell asleep on our way back to the resort after what we felt was a largely successful evening.

            Now that we’re home again, I can tell that Thomas is trying to re-adjust to being home all day.  He doesn’t ask if he has school anymore.  I wonder if he remembers from last year that there’s weeks and weeks without school after we get home from the vacation house.  The rest of the summer stretches out to what seems like infinity.  Yesterday, we visited the park.  Today, we visited my mom because we had some work done on the car and she met us at the garage.  Tomorrow, there’s an HVAC guy coming to check out our air-conditioning.  Enthralling, I know.  We’ll go swimming, re-up our zoo membership, basically the same stuff as last summer but I’ll try to keep it interesting.  Somehow it always is, and the story of our lives requires no exaggeration.



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