The Ethics of It:

As Applied Behavior Analysis (ABA) professionals, and as a commitment to the clients we serve, we are required to follow the ethical code for behavior analysts. In the section of the Ethics Code for Behavior Analysts referred to as “Responsibility in Practice” behavior analyst are required to collaborate with colleagues as outlined in Section 2.10:

“Behavior analysts collaborate with colleagues from their own and other professions in the best interest of clients and stakeholders. Behavior analysts address conflicts by compromising when possible and always prioritizing the best interest of the client. Behavior analysts document all actions taken in these circumstances and their eventual outcomes.”

Behavior analysts are required to obtain informed consent to arrange appropriate consultation with referrals, and operate in accordance with all requirements including, but not limited to regulations, laws, and funder policies (Section 3.06: Consulting with Other Providers). 

Collaboration with colleagues is an integral and necessary part of clinical practice, and time should be allotted for effective collaboration. One method to establish effective collaboration is by creating opportunities to collaborate from the outset–this can be achieved by including colleagues in the initial assessment process.

Initial Assessment:

When conducting an initial assessment with a new client, the initial assessment is typically comprehensive, and includes direct observations of the client in their natural environment; preference assessments; the utilization of formal assessment protocols; parent interviews; and data collection pertaining to possible behaviors targeted to be decreased. In designing their initial assessment process, behavior analysts should seek to collaborate with school personnel to understand some of the strengths and interests of the learner. For example, a paraprofessional may have insight into items that can be incorporated into a preference assessment for a learner. In including other professionals in the initial assessment process, one can not only gain valuable information about the client, one can also build a professional relationship from the outset, and potentially create a foundation to be able to address (possible) future disagreements in a cordial manner. 

Open Lines:

Effective, thoughtful and empathetic communication is essential to building meaningful collaborative relationships. Indeed, communication should be initiated when challenging behaviors arise and when clients are performing well. Collaboration shouldn’t only occur in times of difficulty–it should occur when progress is directly observed, and planned long or short-term objectives are met. In this sense, maintaining open lines of communication means collaboration can be enduring, authentic and positive. In my own experience of managing more complex cases, proactively securing consent to connect with school-based behavior analysts has helped to facilitate the functional behavioral assessment process, increase the effectiveness of data collection procedures, and ensure continuity of skill acquisition goals. 

Managing Disagreements:

How one communicates in disagreements is equally as important as what one communicates during disagreements. Disagreements should be approached from the perspective of mutual respect and intention to understand. We can demonstrate mutual respect by actively listening through nonverbal and verbal communication—leaning towards the speaker, nodding our head, and even taking notes are outward behavioral signs that one is engaged with the speaker. We can practice active listening even in moments when we may disagree.  In addition, mutual respect involves recognizing that one is working within their discipline, and attempting to tackle problems from the perspective of their discipline, and this commitment to helping the learner should be respected even if there is disagreement. I have practiced active listening in virtual meetings with related service providers whose nonverbal communication has indicated their disagreement with my approach. In allowing other providers space and time to articulate their point, even when there is visible disagreement, I’ve created effective opportunities for collaboration.

On-Site Visits:

With the onset of the pandemic, many collaborative opportunities have moved to a virtual mode; however, one should consider scheduling onsite visits and in-person meetings. Such meetings not only provide an authentic context for communication, they simultaneously offer opportunities to observe the learner in a different environment to program for the generalization of skills. For example, the behavior analyst who works with a learner who also attends a Saturday program at a sensory gym under the supervision of an occupational therapist, may not only gain insight into the learner’s behavior in a different context, they may also have the chance to display mutual respect, and active listening during a pre-scheduled meeting with the occupational therapist. 

Mode & Flexibility:

Importantly, in-person meetings may not always be the preferred or available mode of collaboration. Time constraints and commute times may make regular in-person meetings difficult to schedule. One must decide on a mode or multiple modes of collaboration that are effective. Some providers may prefer to meet via a video call or in person. It’s important to establish modes of collaboration and times of day that work in order to schedule meetings for all parties involved. With the intention of resolving and/or preventing disagreements, behavior analysts can see advantages in flexible scheduling with collaborators. I’ve seen the benefits of exhibiting flexible scheduling particularly in collaborating with school-based staff whose schedules might be busy with larger caseloads, and faculty meetings–in scheduling meetings that are convenient for collaborators, I’ve been able to build connections, and open lines of communication, which would otherwise have not occurred. 

Word Choice:

When communicating, behavior analysts should refrain from the utilization of behavior analytic terminology, which could serve as a barrier to effective collaboration. Such terminology may be confusing to a professional who is unfamiliar with the science of ABA. Not everyone is familiar with how to label different components of verbal behavior. Further, it is within our scope of practice to communicate in a way that helps the listener understand, and therefore able to implement our recommendations. 

In summary, it is necessary to collaborate with providers, teachers, and healthcare professionals who may not be familiar with ABA–we must obtain informed consent prior to doing so. While we have a commitment to practicing ABA rooted in evidenced-based techniques, we should also adopt methods to facilitate ongoing collaboration and resolution of disagreements while centering the individual needs of the client. 

 

 

References:

Behavior Analyst Certification Board (2020) Ethics Code for Behavior Analysts https://www.bacb.com/wp-content/uploads/2022/01/Ethics-Code-for-Behavior-Analysts-230119-a.pdf

When we consider supporting autistic individuals in finding jobs, first “why” questions emerge from a psychological perspective. Why do autistic people experience the highest rates of unemployment for all disabled groups? And why do autistic individuals struggle to find employment?

I want to review <strong>How</strong> can we support autistic individuals to find jobs and <strong>What</strong> action steps can we take to provide that support. I feel inspired to support autistic individuals who are in pursuit of employment, and I hope you will be, as well.

A simple way to conceptualize how to support autistic individuals to find jobs involves (a) to provide job coaching (see Tips for a Mind-Centered Pathway) and (b) to take a person-centered approach (see Tips for a Heart-Centered Pathway). We invite you to and recommend engaging in both of these pathways simultaneously!

What is the objective of Applied Behavior Analysis (ABA) when treating neurodiverse individuals? At Manhattan Psychology Group (MPG), providers in the field of psychology, behavior analysis, and education share a vision that the purpose of therapy is to equip our learners with the tools they need to navigate life’s challenges and to achieve personal growth. Treatment should be individualized and designed to incorporate the specific desires of the individual receiving therapy, making space for each individual to gain access to joys of life that may be unique to them. We should celebrate everyone’s differences, and create a therapeutic environment where individuals and their families feel safe and supported.

Typically when therapists suggest parent training, this feedback is sometimes not received well by parents or caregivers – especially if the initial request was individual treatment for their child. So, why is parent training recommended for families who are dealing with their child’s disruptive behaviors at home? And what does parent training really mean?

Navigating the Connection between Anxiety and Autism Spectrum Disorder

Anxiety and Autism Spectrum Disorder (ASD) are two prominent issues that have seen an alarming increase in prevalence over the last few years. Anxiety ranks among the most prevalent mental health disorders in the United States. According to the National Institute of Mental Health, approximately 325 of adolescents have encountered an anxiety disorder, and around 19% of adults have experienced one in the past year. Rates tend to be higher in females than males.

Moreover, an estimated 31.1% of adults will face an anxiety disorder at some point in their lives. In parallel, the Centers for Disease Control reports a surge in Autism Spectrum Disorder (ASD) rates over the past two decades. In 2002, Autism was thought to affect 1 in 150 children, but by 2018 that number had jumped to 1 in 44 children fitting the criteria for an ASD diagnosis.

So, when and how do these two disorders intersect, and what should parents expect in cases of comorbidity? To better grasp this connection, we must first understand the nature of each condition.

What is Anxiety?

Anxiety, as defined by the Diagnostic and Statistical Manual (DSM-5), entails “excessive worry and apprehensive expectations, occurring more days than not for at least 6 months, about a number of events or activities, such as work or school performance. “While occasional anxiety is normal, an anxiety disorder diagnosis is made when anxious thoughts impede daily activities like school work and relationships.

Anxiety disorder comes in various forms, from Generalized Anxiety Disorder to Post Traumatic Stress Disorder, Social Anxiety Disorder, and Panic Disorder. More often, anxiety disorders co-occur with other conditions like ADHD, depression, and eating disorders. Individuals with ASD often report higher rates of anxiety, with half of autistic adults meeting the criteria for an anxiety disorder. Steensel et. AI (2011) found that 40% of autistic children experience comorbid anxiety disorders.

What is Autism Spectrum Disorder?:

ASD is a broad diagnosis, as outlined by the DSM-5, encompassing a wide spectrum of children displaying persistent deficits in social communication, social interaction, and repetitive patterns of behavior, interests, or activities.

ASD can present with or without intellectual Impairment and may involve Various Medical, genetic, or environmental factors. The severity of ASD varies from “requiring support” (Level 1) to “Requiring very substantial support” (Level 3).

Understanding what co-morbidity is?

Why do individuals who meet ASD criteria are most likely to also meet criteria for an anxiety disorder? Our world is primarily designed for neurotypical individuals, which can lead to stress and anxiety for those who are neurodivergent. While this question is still being researched clinical observations have revealed several phenomena:

• Individuals with ASD often exhibit inflexibility or rigidities. When they cannot adhere to their need for rigidity, anxiety is a natural response. 
• Many individuals with ASD have distinct sensory experiences, such as heightened sensitivity to sounds. The anticipation of possible sensory discomfort can lead to anxiety. 
• Social situations may not come intuitively to individuals with ASD. They often sense that they are not meeting social expectations without understanding what they should be doing differently, causing anxiety.
• Communication difficulties can also contribute to anxiety. The uncertainty of having one’s needs met or understood is a valid source of anxiety.
• Some individuals with ASD engage in “masking,” consistently suppressing their natural behaviors to gain social acceptance, which creates stress and anxiety. 

Recognizing Anxiety in Neurodivergent Children:

Just like anxiety that is not accompanied by a comorbid diagnosis, the presentation can look a little different for everyone. Anxiety in neurodivergent children can manifest differently than in neurotypical children. While the symptoms may vary, there are common indications, such as elevated heart rate, increased breathing rate, and verbal expressions of fear. However, anxiety is not always obvious.

It can often resemble avoidance or a lack of interest in anxiety-inducing activities. In some cases, anxiety may present as anger or temper tantrums. Children may lack the vocabulary and self-awareness to describe their feelings as anxiety, leading them to mask it through angry outbursts. Seeking to control situations is another common response to anxiety, with children acting out to escape stressful situations.

Anxiety is a normal experience for children with Autism Spectrum Disorder. If you suspect your child could benefit from assistance in recognizing and addressing their anxiety, do not hesitate to reach out to us. We are here to provide the support you and your child need.

Frequently Asked Questions (FAQs)

What is Anxiety, and how prevalent is it?

Anxiety is characterized by excessive worry and apprehension about various events or activities that impede daily life. It’s a prevalent mental health disorder, affecting approximately 19% of adults in the past year and about 31.1% of adults in their lifetime, according to the National Institute of Mental Health. 

What is Autism Spectrum Disorder (ASD), and how has its prevalence changed over the years?

ASD is a broad diagnosis encompassing deficits in social communication and repetitive behavior. Its prevalence has increased significantly, with rates jumping from 1 in 150 children in 2002 to 1 in 44 in 2018.

Can anxiety in individuals with Autism Spectrum Disorder be managed effectively?

Yes, Anxiety in individuals with ASD can be managed effectively with appropriate interventions and support. A personalized approach, including therapy and coping strategies, can help individuals better manage their anxiety. 

Is it possible for individuals with ASD to overcome their anxiety challenges over time?

While anxiety challenges may persist, individuals with ASD can learn to better manage their anxiety and develop effective coping mechanisms. Early intervention and consistent support play a significant role in helping individuals thrive.

Understanding Your Child’s Needs Beyond Therapy

Identifying signs that your child might benefit from psychological counseling or therapy is crucial. Some of these warning signals include persistent and pervasive sadness or feelings of hopelessness, disproportionate reactive behavior including extreme anger, behavioral challenges at home and school, irrational worries, mood swings, sleep disturbances, and struggles in everyday tasks. Consulting a psychologist helps determine the best treatment. Maintaining open communication with the psychologist to assess progress and align therapeutic goals is vital.

During this time, the psychologist and family may agree that a higher intensity of intervention and support is required, which leads to the question of alternative treatment. When consulting with your support team it is important to be aware of all the treatments available that may assist in managing symptoms and challenging behavior. The following is a list of examples and explanations of intensive treatments that are available beyond individual therapy.

When More Intensive Support Is Needed

Exploring alternative treatments becomes essential when interventions require higher intensity as previously mentioned. Here are some intensive treatments beyond individual therapy:

In-Home Parenting Support

Parent management Training (PMT) encompasses psychoeducation regarding behavior and behavioral functions, as well as targeted work on the development and maintenance of Parenting skills. At times, there is a disconnect between pairing work done in the office and skill implementation at home. When this happens, a more intensive approach to parenting support may be indicated.

This includes the psychologist or behavior analyst coming to your home during challenging moments and providing coaching based on skills learned in the session. Sessions initially occur multiple times per week to establish routines and expectations. For example, if the evening routine (including homework, bath, and bed) is consistently difficult the therapist will come to your home to provide support during these hours. This intervention is designed for parents to feel supported and empowered in the home environment.

Specialized School or School Shadow

At times some children need daily intensive intervention beyond mainstream schools. Depending on the specific need, a psychologist may recommend a more supportive school environment or the introduction of a school shadow. A specialized school might offer increased therapeutic and behavioral support, smaller classes, tailored learning, and social skills groups.

In other cases, a child may need some additional support in their school to meet expectations. During these times, the support team may recommend either a part-time or full-time shadow. A behavioral shadow works under the supervision of a psychologist or behavior analyst and implements the behavior plan that has been developed. This individual has training in behavioral support and communicates daily with the supervising clinician as well as the family. The psychologist will meet regularly with the school as well as parents to track progress and make changes as needed.

Some families also consider the possibility of residential support programs. These schools encompass all areas of psychological and behavioral treatment, while also fostering independent living skills. At times, there is also a focus on vocational skill development. The duration of these supports varies from child to child. If you are considering a specialized school placement for your child, a complete neuropsychological evaluation as well as a meeting with an educational consultant is recommended.

Medication Management

While evidence-based therapies like Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy are effective, medication might complement treatment. Specifically, medication may help support your child in better accessing therapeutic support and increase motivation to engage in sessions. Consultation with a psychiatrist may be recommended if symptoms persist despite therapy. Furthermore, if your child presents with severe symptoms during an intake appointment, the psychologist may immediately recommend consultation with a psychiatrist to jump-start progress. Psychiatrists and psychologists often work in conjunction to best support the psychological well-being of their patients.

ABA or Intensified Behavioral Support

Applied Behavior Analysis (ABA) is an intensive treatment addressing challenging behaviors, not limited to Autism Spectrum Disorder. ABA therapists develop and maintain treatment plans, working across various settings and collaborating with other disciplines. The ABA therapist will work with you as well as any caregivers in developing a treatment plan as well as maintaining integrity and consistency in the intervention. Depending on individual needs, ABA therapists can also provide support during playdates, after-school activities, as well as during summer camp programs. ABA is data-driven, meaning all therapists working with your family will be specifically tracking the frequency, intensity, and duration of all targeted behaviors. As specific treatment goals are met the intensity of the therapy may start to decrease. ABA therapists often work in conjunction with other disciplines as well to ensure consistency across environments. ABA is indicated if behavioral concerns span settings (home, school, etc.) as well as caregivers.
When considering all available options, it is always best to maintain open and consistent communication with your child’s therapist, as well as any other members of the treatment team (school-based professionals, speech therapist, occupational therapist, psychiatrist, etc.) to determine if an alternative treatment is the appropriate next step for your child. All of the supports listed in this article are designed to be complementary, meaning they are indicated alongside individual therapy as well as other therapeutic supports. They are also founded on evidence-based principles, meaning there is significant research to support each treatment. If you are unsure where to start, an initial consultation with a psychologist is a great first step.

Frequently Asked Questions (FAQs)

How Can I Recognize If My Child Needs Psychological Counseling?

Signs such as persistent sadness, extreme anger, behavioral challenges at home/school, irrational worry, mood changes, sleep disturbances, and difficulty with routine tasks can indicate the need for psychological counseling.

How Does In-Home Parenting Support Work?

Parent Management Training (PMT) involves home-based sessions, where therapists coach parents during challenging moments. It aims to implement learned skills in real-time situations, fostering a supportive and empowered home environment.

What are Specialized Schools or School Shadows?

Specialized schools provide increased therapeutic and behavioral support, smaller ratios, differentiated learning, and social skills groups. School shadows, supervised by psychologists, aid children in implementing behavior plans and provide necessary support within mainstream schools.

How Does ABA (Applied Behavior Analysis) Work Beyond Autism Spectrum Disorder (ASD)?

ABA, though commonly associated with ASD< benefits children with various behavioral challenges. It is a data-driven intervention focusing on behavior modification and skill development, implemented at home, school, and community settings.

Are Intensive Treatments Customized for Each Child’s Needs?

Yes, treatments like in-home support, specialized schools, medication, and ABA are tailored to address individual needs. These interventions are designed based on a child’s unique challenges and developmental requirements.

Trigger warning: self harm

Raising awareness and understanding regarding self harm is important. A study in 2020 found that Self Injurious Behavior (often referred to as SIB) is common with individuals diagnosed with Autism, with an estimated prevalence rate of 42% cited in this article.

According to experts, these behaviors can often promote feelings of control and help relieve tension, allowing individuals to express their emotions and escape from an uncomfortable feeling. While this may be the case for individuals with clinical depression, drawing explanations for self injury among autistic populations can be more difficult, as many who engage in this behavior are unable to explain the feelings associated with it.

Autism refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and non-verbal communication. Some common presentations of self injury that autistic individuals may engage in include: hitting themselves with their hands, pulling their own hair, or scratching their own skin. In severe cases, these can occur daily or multiple times throughout every day, which negatively impacts both the child and their family’s quality of life.

Often, a BCBA will work with students and their families on developing a behavior intervention plan to help reduce the presentation of the self injurious behavior. The BCBA’s main objective, at the start, is to identify why the self injury may be occurring. The ‘why’ behind any behavioral issue is referred to as the function, and identifying the function is critical to understanding how to help autistic children get their needs met without engaging in dangerous behavior.

What’s The Function? Self injurious behavior is known to occur for one or more of four possible functions:

Sensory:

Some children with autism may engage in self-injurious behavior to access sensory stimulation. A study conducted in 2018 estimated that approximately 80% to 100% of individuals with autism have sensory processing difficulties. SIB may serve as a self-regulating system of balancing excessive or insufficient extrinsic stimulation (Berkson, 1983).

Example: Scratching self in an effort to self-soothe. Potential replacement behavior may include teaching the student to ask for deep pressure or other physically stimulating items.

Escape

It is possible for self-injurious behavior to occur in order to escape from something aversive. It is a completely normal characteristic for humans to want to run away when they are in danger, or when extremely distressed or uncomfortable. Some autistic children may engage in self-injury to escape from certain events that they have a certain learning history with.

Example: Pinches self whenever the teacher says, “It’s time for math class!” Potential replacement behavior may include teaching the student to request a break, or teaching the student to ask for help.

Attention

Self-injurious behavior can also occur in order to obtain attention from others. These behaviors may evoke a reaction from other people whenever the child desires a social interaction from another person. It can be described as an attempt for a child to gain attention, whether positive or negative.

Example: Banging head on wall to get Dad to run over and say, “What’s wrong?!!” Potential replacement behavior may include teaching the student to request attention or teaching the student to request a hug.

Tangible

These instances of self-injurious behavior provide access to highly preferred items or activities. Behavior that holds a tangible-access function occurs during times when the child may desire a specific item or activity. This behavior may be reinforced by gaining or earning back something of high value to the child like a game, food item, or a toy.

Example: Pulling own hair, which frightens grandma, to gain access to iPad. Potential replacement behavior may include teaching the student to request the item they would like to access.

Treatment Planning

After identifying the function, the BCBA is then able to develop a method of treatment that directly addresses the self-injurious behavior. Depending on the function and severity of the self-injurious behavior, the BCBA will design a treatment plan that addresses the behavior directly, but also to teach an appropriate replacement behavior. Stay tuned for a future blog post where we will discuss more specifics on the treatment of self-injurious behavior using evidence based practices while adhering to the dimensions of applied behavior analysis (ABA).

It is not uncommon for me to hear about parents concerned that their child is addicted to “screens” (e.g., TV, computers, video games, and portable gaming systems like the “DS”). While a little screen time can serve as a great reward for hard work, a lot of screen time can have negative consequences.  (more…)

Strategies that can be reviewed and individualized during my picky eating consultations can help parents. Picky eating in children can vary significantly, ranging from mild avoidance of certain foods to more challenging behaviors during mealtimes. Understanding the spectrum of food selectivity is crucial.

The following is a brief overview of how food selectivity may present in children, as well as some resources that may present in children, as well as some resources that may be helpful in your search to support your child…

What is Food Selectivity in Children

Children develop selective eating patterns over weeks, months, and years. Multiple factors contribute to this behavior:

• Stemming from genetics, psychological influences, and triggering events like a choking incident.
• Even if a child seems to be more sensitive to taste, texture, or other sensory aspects, most children can broaden their food choices.

Defining Selective Eating

What is selective eating? Things to know: It occurs on a broad continuum!

Selective eating exists along a broad continuum. For parents, it might translate to statements like, “My child refuses new foods” or “My child eats very little!”

• Limited Diet: Children exhibit preferences for specific foods based on placement, closeness, temperature, or form.
• ARFID (Avoidant/Restrictive Food Intake Disorder): Fairly New – Children who are extremely picky eaters may get diagnosed with ARFID by a medical practitioner. ARFID may lead to poor growth and nutrition. Behavioral Intervention strategies may help increase eating behaviors in those diagnosed with ARFID, however, parents/caregivers should consult with a medical practitioner first.

Causes of Selective Eating

How did my child become a selective eater?

Understanding the origins of selective eating involves considering the following:

• Medical issues – this should always be ruled out before seeking behavioral consultation for selective eating.
• Patterns of eating that become increasingly restricted over time – when coming from a behavior analytic perspective, keep in mind what is known about the behavior and the history of reinforcement (positive and negative). If access to specific foods, attention, and routines were provided/removed over time (and functioned as a reinforcer for behaviors), then selective/restrictive eating behaviors were learned and reinforced over time.
• Problems with sleep – evokes irritability and lower threshold for variation and novelty when it comes to eating for some.
• Conditioned taste aversions – association of certain foods with symptoms of being sick or other aversive effects in the environment (e.g., smells, sounds, visuals)

Working on Selective Eating Behaviors

Identifying when selective eating impacts daily life.

• Impacts day-to-day functioning and the ability to participate in family/social routines without additional preparation and/or modifications
• Nutrient intake
• Evoking novel challenging and interfering behaviors

Effective Interventions

What are the most effective interventions for selective eating behaviors?

Effective interventions incorporate various elements:

• Positive Reinforcement: Utilizing reward systems, behavior contracts, and praise.
• Incremental Changes: Gradual steps towards expanding food choices.
• Multidisciplinary Support: Collaboration with professionals like dieticians and therapists.

Proactive Strategies for Success

Deploying proactive strategies is key to addressing selective eating habits.

• Timing and Location: Choosing the right time and place for introducing new foods.
• Visual Supports and Reward Charts: Visual aids and reward systems outlining expectations
• Pairing Preferred Activities: Associating preferred activities like music or TV with meals.

Food-related Strategies

Tailoring food presentation and choices:

• Type and Amount: Offering foods resembling familiar preferences in shape, texture, and color.
• Size Matters: Think about only placing the amount the child is expected to eat on the plate or table.
• Offering Choices: Providing controlled choices with clear boundaries and rewards for compliance.
• Script and Instructions: Plan out what will be said and shown to the child ahead of time.

If the function of the child’s eating behavior is access to tangibles and/or attention in the form of control around choices related to food, proactively build in choice while setting clear boundaries paired with a reward for making a choice – pick choices the family and providers are comfortable with!

• Examples: If rice and pasta are new targeted foods, can say: “Do you want rice or pasta as your side for dinner? When you make a choice and eat it, you can get ice cream for dessert” OR If the target for eating behavior is to increase the amount of food consumed, can present something like: “We are having meatballs with dinner – do you want 1 ½ or 2 with your dinner? When you eat most of the amount you picked out, you can have some dessert when dinner is done”

Navigating a child’s selective eating requires a comprehensive approach involving understanding, tailored interventions, and proactive strategies. By integrating these methods, parents can effectively support their children through the spectrum of food selectivity, fostering healthier eating habits and mealtime behaviors.

Resources for Parents

These books present behavioral interventions to successfully expand children’s diet variety and preferences.

• Broccoli Boot Camp: Basic Training for Parents of Selective Eaters
• Helping Your Child with Extreme Picky Eating: A Step-by-Step Guide for Overcoming Selective Eating, Food Aversion, and Feeding Disorders

Frequently Asked Questions (FAQs)

What Characterizes Selective Eating in Children?

Selective eating manifests across a spectrum: from mild preferences to Avoidant/ Restrictive Food Intake Disorder (ARFID), a more extreme form causing nutritional deficiencies. It encompasses limited diets, food preferences, and potential sensory sensitivities.

When should concerns about Selective Eating be Addressed?

Intervention becomes essential when selective eating impedes daily function, impacts your child’s nutrient intake, or leads to disruptive behaviors. Seeking help is necessary if a child displays extreme pickiness that affects their growth development and overall well-being.

How can parents encourage the exploration of New Foods?

Providing options within the child’s comfort zone, offering clear choices, and linking preferred activities to mealtime can motivate children to expand their food repertoire while creating a positive eating environment. Choosing a similar taste, color or smell is a good starting point.

What contributes to Selective Eating Habits?

Selective eating can arise from various factors, including genetic predispositions, psychological elements, and past experiences such as conditioned taste aversions or medical issues. In addition, challenges in sleep patterns could contribute to heightened food selectivity.

A child’s well being is a critical component of their confidence, success in school, and social and emotional growth. But it can be difficult to get your child to open up about their feelings or challenges so you feel fully aware of their mental health status.

There are approaches to communication and signals to pay attention to regarding your child’s mental health that can help them thrive as they return to school.

1. Talk it out together to ease anxiety

Discuss classes and pieces of school or extra-curriculars outside of the classroom to balance talking about things your child might feel nervous or excited about.

2. Frame your questions thoughtfully

Ask questions about what’s going well, but also about what’s not going well to get the full picture. Ask “What’s challenging?” instead of “Why is it challenging?” to remove any signal of accusation and help your child open up more, because they are less likely to feel defensive.

3. Look for changes in your child’s behavior

Make note of increased irritability, changes in appetite or sleep habits, or a loss of interest in their activities. These could be signs that you’re child is struggling with depression, anxiety, or another mental health challenge.

While temporary behavioral changes can be considered a normal part of adjustment to the back to school routine, if they continue beyond the back to school period or create disruptions in your child’s day to day life, we recommend you seek professional help.

4. Listen and offer support so they know you’re there for them

Communicate clearly that you are available if your child wants to talk, and seek additional resources – from books to journals to a licensed therapist – if you think they need additional help.

Mental healthcare is healthcare. From parents to professionals, additional support for students can make a meaningful difference.

For more information on our Special Group Programs or treatment options for children and teens, contact us.