Behavioural Interventionist and Visual Supports for Children with Aserger's Disorder

I visited another school a few weeks ago and asked the parent of the child I was observing if I could go over my observations in the blog, "YES! Share so that other people realize this!"

So, parents are always arguing for classroom aide, a paraprofessional, to work with their child. And they often want that assistant there ALL the time. But there is a problem with this, actually a few. See if you can tell what the problem will be from the old cartoon I often show parents to explain the issue.

Heres number 1: Your child should be getting his or her cues from a couple of places in the classroom environment. Often teacher aides become the only place they look. Where should the social cue come from? First, the classroom teacher. And second, other students. When I do my observations in a school I pay close attention to the number of cues a child picks up, and usually the number from the teacher, other students or the white board or classroom schedule is near zero. Almost all of the social cues, what to do when, are obtained from the teacher aide.

This is why as a behavioural consultant I push the use of visual prompts and cues over verbal prompts and cues. Verbal prompts end up being requested, they end up being waited for, and students end up reliant on verbal prompts.  "Use visual prompts - point, and stop talking so much," is my usual advice. Yes, I know we want students with ASD and Aspegers to talk more and give eye contact, but you need to be careful. The eye contact becomes a prompt for the teacher aide to tell the student what to do.  Look at the cartoon. Got it?

Here is an example: The bell rings for recess (environmental cue ...a big one!), the teacher says, "Let's get our desks cleaned up and line up..." (another Massive prompt here, but regretfully not from where the student is use to looking. He or she usually looks to his classroom aide for prompts!) At this point the other students all start to put their coats on for recess. (a GIANT social cue). But what is this a prompt to do? The student sees the other students getting their coats on and turns ......to his aide!!!!!! At that point she says, "Now lets get your coat on."

READ THE CARTOON. See what happened?

This is why its necessary to occasionally have your behavioural interventionist go to the school and observe what's going on. In most professions observation and feedback is a critical part of quality control, but who is doing that for the teacher aide? The teacher? I don't think most teachers have the behavioural expertise to take on that task.

So, that's that. All of this could have been avoided by using the classroom aide (the schools behavioural interventionist) use visual supports to guide the student, not to getting things done, but to learning how and where to find social prompts as to what is going on and what I should be doing. The aim of a support person is to teach skills that lead to independence, not get todays math done or your child's coat put on. Independence comes through learning to use environmental and social prompts to navigate the world.

Besides that, the cartoon is funny. Just so typical, right?

For information of behavioural interventions services, autism diagnosis and treatment that Dr. Roche provides please visit his website at www.relatedminds.com

Adult Autism | Aspeger's Disorder in Burnaby | Vancouver

Dr. Jim Roche provides diagnostic testing, assessments and treatment for adults with ASD|High Functioning Autism|Aspeger's Disorder.  He has been working with adults with Aspeger's and related cognitive disorders for over 20 years.

Dr. Roche has worked as a clinical psychologist in private practice, a psychologist for local school districts, a provincial consultant on autism and related disorders and in community based rehabilitation programs. For more information visit his website at www.relatedminds.com

Behavioural Consultants and Asperger's Disorder

I am often asked what a behavioural consultant can do, what services we provide, for children, adolescents and adults with Asperger's Disorder, high functioning autism and NVLD (Non-Verbal Learning Disorders)?

First and foremost, I provide psychoeducation - I help parents, children, teens and adults understand the nature of their disorder.  Most individuals come to me because they want a behavioural consultant for Asperger's. That sometimes includes diagnostic testing, sometimes additional psychoeducational testing to help develop a school IEP 9Individual Education Plan) or with adult a workplace intervention plan.

some individuals see me, and have another behaviour interventionist in the home who is attuned to ABA techniques. Regretfully, while every parent of a child with Asperger's Disorder or autism spectrum disorder needs to know about ABA they also need to understand the neurocognitive details of the disorder to get why someone does what they do. This often includes working with older children and teens on materials such as Michelle Winners "Social Behavior Mapping" or using programs such as the "Social Detective" series or "SuperFlex" to understand themselves and start to make changes. It's hard to imagine working towards a goal without understanding what road your on! Psychoeducation helps with this. Often we meet every other week to go over how skills and tools we learned about in the office are working at home, school or the workplace.

I also consult with individuals about more basic behavioural problems, especially with small children who develop co-morbid disorders and need supportive interventions. This may include working on issues of anxiety, emotional regulation, anger management and social interactions.

I try, as much as possible, to use materials similar to those used by many school districts when working with students with Asperger's Disorder.

And frankly, every other week an adult takes home one or more of my children's books, posters or other materials because these really simple and clear programs clarify issues for them that adult autism and Asperger's materials just don't.

As a registered marriage and family therapist (RMFT), in addition to being a registered psychologist, teacher of special education and school psychologist, I also spend a good deal of time working with families on "family systems" issues. These can range from direct couple counselling for the adult with Aspeger's, to parent education and family dynamics. The range of services is wide, and depends upon your needs.

For more information on working with me as a "behavioural consultant," (I am an approved ACT Behavioural Consultant and work with provincial funding when it is available) or for information on testing, assessment, educational or workplace issues, please visit my web page at https://www.relatedminds.com/adult-autism-and-aspergers-disorder/ for adults or https://www.relatedminds.com/autism/ for children and teens.

Therapy for children and teens with autism | Burnaby | Vancouver

Dr. Jim Roche provides individual and family therapy as well as parent education to individuals with Asperger's disorder and autism in Vancouver and Burnaby. He is a registered psychologist and approved behaviour interventionist with ACT (Autism Community Training). Additionally he provides diagnostic assessment and testing for individuals suspected of autism which can lead to government funding. Information on his autism/Asperger's practice can be found here:
http://therapists.psychologytoday.com/rms/70682
http://www.relatedminds.com/autism/
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A recent article in the New York Times addresses children with autism, "Inside the Mind of a Child with Autism." Here is the link: http://nyti.ms/1kk8Zcq  This is a great article about something so simple you might wonder why it needs to be discussed, but it does. How to work --- actually, how to PLAY---with your child who has autism (or Asperger's).  It talks about something really basic we all do: The more time a child spends giving eye contact - and some social reciprocity - the more time the child gets to play with those special little things they like to play with. Using the child's "affinities" to reinforce social reciprocity. An example they give is, "If a child is fascinated by Thomas the Tank Engine, use those characters to prompt and reinforce social development." This is what I actually do with children in their homes, in the office and at schools. Often being down on the floor playing side by side and demonstrating how to encourage this social reciprocity.  Many people do this, and when I model it I often use "self talk" to teach parents not just how to do this, but what they are doing and why it helps. Understanding why something makes things better lets you do that thing better than before.

There is a new book about this by Ron Suskind, a former wall street reporter called, "Life, Animated" in which he describes going through this process with his autistic son.

Finally Sally Rogers, a professor of psychiatry at the Mind Institute at the University of Davis in California (they have a great series of podcasts by the way) is looking at this teaching process and gathering some real data on it's effectiveness. The whole aim is to find out how best to do this "joint play" that is so critical to a child with autism spectrum disorder or Asperger's in order to develop social interaction skills. Another place you can read about this is Dr. Stanley Greenspan's "Floortime," which is, for the most part, exactly what it seems. Time on the floor interacting through joint play.

Using play that is an "affinity" to the child a lot can be done, and while I am always stressing the need for basic research on the causes of autism, it's a pleasure to read about some in depth research on the day to day therapeutic interventions we use when working with children with autism spectrum disorder.

Take a look at the article, and at the New York Time's website on mental health issues.

Adult Treatment for Autism and Asperger's

In my practice in Burnaby I am often asked to suggest books and reading about Aspeger's and couples..dating..and working. Here is the best book I recommend: The Journal of Best Practices by David Finch.

David's book is an easy read, funny and informative. He gives many examples of how the person with Asperger's needs to deal with the world around them to "be a better husband" as he says. The book is based upon his essay "Somewhere Inside, the Path to Empathy," which appeared in the New York Times.

You can find this book through my website at www.relatedminds.com

There you will also find information on testing and diagnostic services for teens and adults who suspect they have Asperger's or High Functioning Autism. A full assessment for Aspeger's with an adult costs approximately $1,200.00 and is not always recommended. Sometimes it might be better to simply spend our time looking at current problems, understanding how they develop and working on step by step solutions. Often, amazingly enough, the solutions for problems that a couple with one member having Aspeger's might experience might be very similar to what we do with children or teens. The skills are all pretty similar.

For more information on the diagnosis of Aspegers or autism spectrum disorder in children, teens or adults, please visit my web page or contact me to make an appointment.

Dr. Jim Roche
Offices located in Burnaby, BC
Serving Burnaby, Vancouver, New Westminster, Coquitlam and Maple Ridge.