Autism Therapy: schedule

definition of schedule: A schedule can be a document or timeline that lists or shows what steps are next in a child’s day – “Look at your picture schedule to see what to do after breakfast.” Or a schedule can mean setting up a time for a child to be somewhere – “May I schedule a playdate?” Joint schedules involve interaction among several children. Schedules may be written, visual, or a combination of both.

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Journal of Autism and Developmental Disorders, by Golnik, AE, and Ireland M., published in 2009, summarized Jan 8, 2010

Some physicians may recommend complementary alternative medicine (CAM) therapies for children with autism.

A survey was offered to 3,100 pediatricians and family medicine practitioners, and about 1 out of 5 responded to the survey (539 physicians). The survey showed that 49% of the doctors encouraged multi-vitamin therapy for children with autism. And 19 to 25% of them encouraged essential fatty acids (EFAs), melatonin, and probiotics as therapy for autism. Physicians discouraged parents from using some therapies. Therapies that were discouraged include chelation (61%), anti-infection treatments (57%), and secretin (43%). Many of the doctors (76%) also urged immunizations according to the recommended schedule. The authors said that doctors may want to ask families about therapies that families might be using, even if the parents do not bring up the topic.


Research in Autism Spectrum Disorders, by Kroeger, KA, and Sorensen_Burnworth R., published in 2009, summarized Jul 31, 2009

Several methods of behavioral therapy may be useful for toilet training children with autism and mental retardation.

This article talked about nine different applied behavior analysis (ABA) methods for toilet training. The most common method was called graduated guidance. This method uses prompts to teach each step of behaviors needed to go to the bathroom independently. Prompts include word and hand gestures. Reward for successes and taking away rewards for mistakes may be a helpful system for toilet training. Other methods include setting schedules for sitting on the toilet, following the child's own personal schedule for when they usually need to go, and giving plenty of liquids so they need to go often. Another approach is to ask the person to make up for mistakes when they happen, like cleaning up accidents. Also, showing children videos about the process of going to the bathroom can help them understand what it is they will be doing.


Journal of Applied Behavior Analysis, by Betz, A., Higbee TS, and Reagon KA, published in 2008, summarized Jun 1, 2009

Children with autism may be more involved in behavior therapy activities and complete more of them if they are paired with another child.

Three pairs of children with autism (4-5 years old) used joint activity schedules during applied behavior analysis (ABA) therapy. The joint schedules seemed to help the children be more involved in the activity. This included taking turns, playing games, and setting up and cleaning up games. When the joint schedules were changed to individual schedules for one pair of children, their involvement dropped. As soon as they switched back to a joint schedule, they became involved again. Therefore, joint schedules may be a useful autism therapy tool and may also increase interactions between children during treatment.


The Nurse Practitioner, by Weber, K., published in 2008, summarized Nov 3, 2008

Nurse practitioners can be an important part of the treatment team of a person with Asperger syndrome and can help to guide the intervention plan.

This review article describes Asperger's syndrome, drug therapies, and intervention options. The author suggests that people with Asperger's syndrome do best when they keep to a schedule. It helps them if changes are made slowly. The author suggests working with the strengths of the person with Asperger's syndrome and using these strengths to find a job that is a good fit. When speaking to a person with Asperger syndrome, it is important to speak clearly and say what you mean.


Easter Seals of Central Pennsylvania recently opened Silvi Sensory Integration Center, to provide support for people with sensory processing disorders, including autism. The only sense it does not stimulate is smell. Annie Smith, the director of therapy services, delights in showing visitors around. She points out lights, music, bubbles, and vibrations while explaining that each child will have an individualized program. Smith explained, “With a physician’s referral, any family interested in the center can schedule an evaluation.” Joe Fialko, owner of Soundbeam USA, has developed sensory centers for over 15 years and considers the Silvi Center one of the highlights – a transformed former garage.


Multnomah County Library has started a Sensory Storytime at several of its branches for kids on the autism spectrum. Librarian Peter Ford says he tries to channel a calm "Mr. Rogers" when he does storytime with the children. He reads more slowly, points at the illustrations, and asks questions. The county has been using this form of storytime for about six years when two librarians realized there were kids on the spectrum not being served by library activities. They coordinated with Therapy Solutions for Kids to create a sensory rich experience incorporating speech and occupational therapy methods. The story sessions are completed using Boardmaker, which is a form of a visual schedule so that children know what's coming next in the session. For example, icons let the children know when it is time to start, play a game based on the story, and say goodbye.

Read original article: Multnomah County Library's Sensory Storytime is Low-key for Children with Autism Symptoms


In this article, a Florida mom discusses her son's stimming and offers some suggestions to manage the behavior. First of all, the mom observes that all of us have behaviors that we repeat over and over again in stressful situations that may be likened to stimming. For example, she asks, ""What sends you into orbit? I know I have my list. As a hard working mother who juggles to balance work, home and my son’s intense therapy schedule, I have little patience for a certain group of moms." She explains the specific situations that seem to set her child off, and then talks about how she handles them. Her suggestions include having a plan when entering new situations, educate others around her son to let them know what is happening, talk about it with your child if possible, and finally realize your own calming behaviors.

Read original article: Autism Awareness: To Stim or Not to Stim, Is it an Option?


This article by special education teacher, Pamela Gross Downing, offers some tips on transitioning back to school after summer vacation for kids with autism. Many children with autism become accustomed to their summer routine and parents are encouraged to prepare children in advance. One suggestion is to begin waking the child a little earlier each morning. Another tip is to drive by the school, show your child his or her new classroom, and if possible meet with the teacher. A picture schedule of each day’s activities can be placed where the child can see it. He or she is able to get used to the order in which things will happen – get up, eat breakfast, get dressed, drive to school, etc. Parents can get out school supplies and let the child become familiar with them. Downing reminds parents that as much as they prepare, there may still be struggles in the beginning.

Read original article: Transition to School Important for Children with Autism



Please comment on this autism topic.

Responding to neurofeedback

Feb 2, 2011 by Monkey's Mom

    We have been using neuro feedback for our 9 year old daughter for about 5 months at this point.  We also use chiropractic re-adjustments twice weekly to alleviate the pain and pressure on her spine as well as allowing the nerves to communicate properly.  She now after almost four years is able to recognize pain and say it is pain instead of acting out.  She has a combination of problems, along with ASD, she was severley abused and neglected prior to being placed with us as a foster child.  She has probably had some in utero chemical exposure, although that was denied prior to adoption and she was born to teenage parents with a familial history of mental illness.  She has been out of that environment for almost four years now and is adjusting very well. 


     The good news is I was able to take her to an unfamiliar major urban area, we live in the country, for a two day group tour.  She was able to manage the subway, museums, city noise, a large hotel, the holidays and a very busy schedule for the entire two days without any tantrums, outbursts or behavioral issues for the entire two days and on the train ride to and from.  She has also not been in the "quiet room" this year at school either. 


     We at this point are attempting to decrease some of her meds.  It has been a little hit and miss trying to get the correct frequency and locations when we are trying to correct or address specific behaviors.  When the doctor places the electrode on an area that he knows on other children will treat obsessive behaviors, it activate her frontal lobe and she becomes alomst manic prior to and after her meds wear off. 


It takes really knowing your child and a good relationship with the provider as well as working very closely with her school contacts and teachers.  Communication is key if this is going to work at all.  If we don't communicate she doesn't get the treatment she needs and it may take several weeks to get back where she was before something was changed.


     So as a parent I feel it is truly worth everything it takes to get this accomplished.  Just be prepared for things to happen you didn't expect, either good or bad and find a provider that is willing to re-adjust a treatment when something goes wrong.  Be patient as you may initially see results for only a few days at a time.  Then understand that not every child is "wired" the same and until their is a good relationship between client and provider and an understanding of what does and doesn't work it will, be experimental for a little while.        


As a special education teacher visuals were high on the priority list with me and our educational assistants for communication, adapting behavior and scheduling. What a difference visuals can make in someones life and for everyone supporting them. I too used happy & not so happy faces :) , :I and :(


This also became a great method for one young man with autism to self evaluate his own work. He rated himself on every activity/project he did and he was so honest in his evaluations! This visual notation on his work schedule would then remind him of how well he had done or that he needed more effort the next time. When using a visual schedule created with a series of cards (velcro) we had an assortment of "faces cards" Later when he had a written work schedule there was a self evaluation column where he drew the appropriate face. We also evaluated his work with the same visual notation, noting when our evaluations were the same as his, which was most frequent!


Spring Break #2

May 1, 2009 by Anonymous

Spring Break #2 is here!  Unfortunately, Thomas' school is one of those that has been closed due to a "probable case" of this swine flu.  Perhaps I'm a slacker mom, perhaps I'm being far too blaise, but I think that this whole thing is a lot of hooey that conveniently coincides with the network ratings time, generally referred to as "May Sweeps."

 

As a result of all of this Swine Flu stuff, Thomas' school is closed until May 11 - a terrific thing indeed for an autistic child who has a difficult time adjusting to schedule changes - and especially unscheduled schedule changes.  We're going to try to do a lot of reading next week and some math in the new Everyday Mathematics book Mrs. H. sent home last week.

As for Hayley, she's lucky she was even let into Preschool this morning, being the sister of a boy who attends an infected school.  They had to have the director of the preschool call their insurance agent to see if she could attend.  Luckily, they gave her the all-clear, but I feel like we're about to be quarantined with a big blood-red cross painted on our front door.  However, instead of lamb's blood, they'll have to use the small can of Ralph Lauren "Hunting Coat Red" we have in the garage.  A modern spin on a medieval plague classic.

Again, I think it's a load of hooey.

Last Wednesday, Jonathan took the kids to see Thomas' Sea Life exhibit at school.  The kids mostly played in the classroom centers, but Jonathan (I was working) got a chance to talk to Mrs. H. who again expressed her desire to "take Thomas home," because she is so attached to him.  She has no idea what she's talking about since Jonathan and I have positively decided that Thomas is a different kid at school - a more focused and less energetic kid.  She also said that Thomas is reading at level C, which means absolutely nothing to the lay-person, but she explained to me on Thursday that it's a first-grade level.  We think that's great, but why won't Thomas read at home for us?!  It's like an exercise in futility trying to get him to sound out words.  He'll make the letter sounds but then he won't put them together to make a whole word.  Mrs. H. says that it's okay; he'll get it and she's just thrilled with his ability to read so far.  That should be good enough for us, but I keep trying to find opportunities for him to read.  I've tried saying, "You have to learn to read before we go to Walt Disney World 'cause we'll need your help reading the signs!"  I don't think he buys it.  Honestly, I don't either.

Thomas will be attending Hayley's dance recital with us this year and he will hopefully be well-behaved.  My parents are going, Jonathan's mom is going and the three of us, so Hayley will have quite a little audience watching her dance to "I Feel Pretty."  She does a lot better than she did last year.  I was talking to one of the other moms from Hayley's dance class who's daughter was in Hayley's class last year too and we both agreed that we and our husbands laughed ourselves silly watching the little girls' recital - they were just so interested in the people and the lights and the costumes that any interest in dancing was not a priority at all.  It was adorable.  

Thomas has expressed an interest in participating in a dance class next year.  Jonathan and I are both fine with it, but we wonder if that will open Thomas up to a bunch of teasing.  Of course, it will roll right off of Thomas' back as he is nearly immune to that kind of thing, if he has even experienced it yet.  Maybe we'll sign him up and perhaps notify the staff of the special circumstances, adding a stipulation that if Thomas can't do it or is too disruptive, he can get out of the class and we can get at least most of our money back.  I have to admit that I think it's kind of cool that he would even want to do a dance class.  Another Billy Elliot, maybe?  Mommy can dream.


Scheduling conflict

Mar 31, 2009 by Anonymous

Our uneventful Spring Break is over and the kids started back to school yesterday.  I’ve always wondered why schools in our area have such an early Spring Break…the weather is almost never decent and this past week was no exception.  If it wasn’t cold, it was rainy.  Thursday was probably the nicest day of the bunch so we went to the zoo.  It was a little cool but the sun was shining and oddly, the zoo wasn’t packed with other Spring Breakers.  I guess most people go out of town, but we’re saving that for the stifling heat and humidity of August in Florida.  You never know…it could be an unseasonably cool eighty-five degrees in Orlando in August.  That’s what we’re hoping for.

                The transition back to school went okay for Thomas yesterday but his teacher wanted to speak with me about some trouble he had today.  The teacher lets the kids pick jobs every Monday such as line leader, book helper, weather helper and so on.  One of the jobs is “schedule helper” and though Thomas always vies for this job in particular, it is one of the more popular ones and he seldom gets it.  The schedule helper tends to the picture schedule up on the wall of the classroom.  When the kids have completed one of the schedule items, the helper flips that item over to indicate that it’s all done.  Thomas has been using a schedule like this since he was three and started developmental preschool.  The problem is that he is somewhat obsessed with it. If the schedule helper is less-than-diligent about flipping completed items over, Thomas goes to the schedule to do it himself.  I’m a little disappointed because I thought that the goal was to get Thomas away from a picture schedule altogether, but the teacher says that a lot of the other kids in class benefit from it as well.

                Today, the schedule was messed up somehow.  “Exercise” was before “Calendar” or something and Thomas wanted to change it.  Mrs. H. told him that she knew the schedule was wrong but that it wasn’t his job to change it.  He kept trying to tell her that it was wrong and I guess (sigh and extreme embarrassment…) he yelled at her that she wasn’t listening to him.  She was stern with him and told him to sit down.  She also warned him that if he touched the schedule again, he would be moving his card to yellow.  This whole green-yellow-red thing is an amazing motivator for Thomas.  Once she warned him about the card, he sat down and started crying.  He did recover and was able to go on with his day (which is great) but I feel bad that he had a rough time.  After school, I explained that I wasn’t angry with him and tried to tell him that everyone has bad days sometime.  Thomas argued about this with me and told me that I should be mad at him and that I should make a mad face!  I told him that I had a bad day at work on Sunday (and that my general manager would probably holler at me today as a result of it) and that it would be okay and maybe the next day would be better…that if every day was great and exactly the same, life would be boring.  Remarkably, this line of reasoning made more of an impression on Thomas than anything else I said.  He’s recovered from school nicely and is eating noodles dipped in pizza sauce now, so all appears to be well.  Another factor that might have had something to do with his trouble today was that Hayley said she wasn’t feeling well this morning so we didn’t go in to help like we normally do on Tuesdays.  Ah, well.  I shouldn’t let his trouble get me down either.  I should listen to my own advice.

                Don’t worry about my bad day at work, either.  One mistake I made was relying too heavily on the technology the restaurant uses (and which normally works perfectly) and the other mistake was that I didn’t card a gentleman who appeared to be every bit of thirty-five years-old but was really twenty-two.  Okay…lesson learned.  I’m carding anyone who appears to possibly be under fifty and that should take care of that.  They might write me up or something.  I think I’ll live to fight another day.  The other assistant manager definitely didn’t think I’d be fired, but can you imagine?  I’ve never been fired from a job (or even officially reprimanded) in my life and to have to deal with this while waiting tables…honestly.  The upside is, of course that I’ve gotten a good start on our Disney nest-egg and every time I have to go into the restaurant kitchen to make yet another “fresher” pot of decaf for the persnickety old ladies at table such-and-such, or fetch a whole plate of lemons for the people in the corner booth who are apparently intent on making their own lemonade out of the free water, lemons and Splenda packets we keep on the tables, I just think of my kids and my husband at Disney World, smiling from mouse-ear to mouse-ear.

                I wonder what “happy place” I’ll find after Disney is over to keep me going with this restaurant gig.  The kids are fine with me working but I think that the adjustment is getting to Jonathan a bit.  He’s exhausted most nights when I get home and I picked up a shift for tomorrow night – normally a night off – and I’ll be staying past closing so everyone will be in bed when I get home.  I can tell that it’s rough for him to come home and play tag-team with me.  One day Jonathan was late getting home from work and I stood in the doorway, waiting to see his truck come around the bend.  When I spotted him, I got into my car and we blew kisses to one another as he pulled in and I pulled out of the driveway.

                Like two Chevy Silverados, passing in the night.



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