Children with special needs thrive on structure, routine and predictability, something that unfortunately through this time runs on very low supply at a common household. Every child has the right to be sad or anxious during these times but it’s extremely hard for a child with special needs to express their frustrations,  fears and anxieties and communicate about their feelings , so here are some tips that you can follow as a parent in order to comfort them and ensure to them that this shall pass.

Keep a consistent schedule
It is OK to have a late Friday Pizza and movie night with your child, but if this becomes a habit everyday now that schools are out, it will eventually create more issues and behaviors. Try to maintain a daily schedule with bed time, nap time and waking up time similar to the typical school days. Eventually schools will re-open and you don’t want to go through the process of having to do bed time training again. 

Maintain their school schedule at home
If your child cannot participate in their remote school program that their teachers have set up, it’s wise to communicate with their teachers and receive training for you or any other care taker on how to implement the same learning schedule and activities at home. Of course, if you have other kids at home that need your attention it can be challenging, but even if you can maintain fifty percent of that schedule will make such a difference in the progress of your child. Set up a similar token system, with rewards and breaks and snack time similar to the school setting. If your child has a number of ADL programs, such as learning how to wash their hands, or getting dressed, or toilet training please follow it. We all have days that we want to stay with our pajamas on all day, but it is essential for parents of special education kids to maintain those daily routines and keep assisting their kids with their daily routines even if they are not going anywhere. It takes their special education and their behavior analyst weeks and months to teach them how to put on their shirts or their pants, and this is something that cannot be taken for granted or let it regress. 

Mindfulness and Self Care
There is evidence and statistics that show an increase in the numbers of heart attacks, depression, addiction and domestic violence during the pandemic. Also eating unhealthily and gaining weight are very common now, because most of us are secluded in the house, bored and let’s face it food and baking makes everything better some times. Most of us know how to deal with the daily stress of life and have some coping skills that have help us throughout the years. But this pandemic it’s something new and unheard to all us, and it’s just hard to deal with the unpredictable.  For that reason, it is important to be able to practice mindfulness and Self Care. There are many different types of self-care, such as: Emotional self-care, physical self- care, mental self- care, social self- care and financial self-care. Keeping a journal or just a notebook, and writing down every day which type of self-care you would like to practice it’s a great idea. You can start your week by stating that Monday, you would like to work on your physical self-care, and write down how will you do it, such as I will exercise for half hour and eat a nutritious and healthy meal etc. You can practice more than one self-care type everyday of course, but writing it down makes it more visible and tangible and you can even reward yourself for following through with your goals of self-care. 

Mindfulness it’s also very similar to self-care, and it has been a new trend at jobs settings, schools and sports teams. It decreases stress, improves academics, helps with better emotional and self-control, improves clarity and sleep and in general it helps with general health and the wellbeing of an individual. Any activity that provides a healthy way to de-stress and calm oneself, such as yoga, Reiki Zen -Picture coloring, deep breathing exercising, positive affirmation writing and meditation count as a productive mindfulness activity. It’s something you can do at home with your family and can increase focus, positivity and strengthen emotional control. You can practice most of the mindfulness activity at home, either alone or with your family or with friends, schoolmates  colleagues and extended family members as a group practice via Skype or zoom.

For those who support children and adolescents with ADHD, Anxiety, and Disruptive Behavior, the value of evidence-based information on symptoms and treatments is crucial.

Joshua Rosenthal, PsyD, designed his upcoming, free Behavioral Skills Training Webinar Series for these parents, clinicians, and school professionals. He will cover key strategies and treatments on these topics to help improve behavior and communication in and out of the home. (Note: CEUs are not available at this time.)

Evidence-based Treatment of ADHD, Disruptive Behavior/ODD, and Anxiety in Children & Adolescents

• Tuesday, January 18th: ADHD: Strategies for Success At Home and In the Classroom
• Wednesday, January 19th: Disruptive Behaviors & ODD: Methods to Improve Conduct and Communication
• Thursday, January 20th: Anxiety: Evidence-based Treatment in Children and Adolescents

Time: 12-1 pm EST (You may register for 1-3 of the webinars)

Speaker: Joshua Rosenthal, PsyD.

These 60-minute FREE webinars will cover the following topics:

• Key signs and symptoms of childhood ADHD, Disruptive Behavior/ODD & Anxiety
• Skills to improve behavior, compliance and communication at home
• Tactics to collaborate with teachers and clinicians to improve behavior outside the home
• Strategies to boost child self-esteem and peer relationships
• Tactics to respond to difficult situations for children

>> RSVP here today to reserve your Zoom seat(s) << 

We are working to support our community of parents, clinicians, school staff, trainees and students with free access to our latest knowledge and treatments in Childhood and Adolescent Psychology. Contact us to be added to our mailing list for future Webinar and Group information.

We hope you can join us!

**We are also accepting registrations for our Educational Behavioral Skills Training Webinars and Clinical Parent Training Groups.

Written by Elena Dezoraiev, MSEd, BCBA-LP

Under the diagnostic criteria of Restricted and repetitive Patterns of Behavior of Autism Spectrum Disorder (ASD), a subcategory of insistence of sameness, inflexible adherence to routines exists. A subcategory describing how an individual with ASD can become extremely distressed over various changes in his or her routines. When working with individuals with ASD, one of the main skills addressed as providers or, a concern expressed by a caregiver is how to prepare better and, or, teach skills such as waiting, the passage of time, understanding when and why an activity/event occurs or not, and excepting routine changes with “typical” behaviors. Changes such as we are currently experiencing in our lives from the COVID-19 (Cornonavirus). It can become challenging for an individual with ASD or a caregiver to handle sudden changes such as school closures and changes in providers, services, or even just remaining at home for days and weeks at a time.  However, there are various resources and strategies that can be implemented and taught to individuals with ASD to help them cope with the sudden changes of routine as well as engage in less maladaptive behaviors. 

Social Stories
Social stories are a great tool to explain or describe a particular situation, event, or activity tailored explicitly to the reader’s needs and repertoire of skills. The story can include pictures and words, sentences or simple phrases, comic strips, favorite characters, or even actual pictures of the readers engaging in any behavior. A social story can be used to describe the current situation and the reasons why someone has to stay at home, and it can explain and answer relevant questions and doubts that the individual may be facing. As well as describe and or list routines and day-to-day activities. Social stories are also an excellent tool for behavior strategies; it can help teach feeling and emotions of others as well as those of the learner. For example: “I feel mad because I can’t go outside/playground/school. I want to cry and scream. When I feel mad, I can tell my mom or dad, I can ask for a break or something to do.” When social stories are created, they need to be presented and rehearsed often to help clarify and solidify the information presented through the story. 

Visuals Support
When presented with information visually as well as verbally, following a routine and working through various changes can become less confusing and more fluent. Visual supports are concrete cues that provide individuals with information about their routine, activities/tasks, and events. Visual support can be in the form of calendars, schedules (hour-to-hour, daily, weekly, monthly), checklists, reinforcement menus, written rules and expectations, first-then, and more. 

The concept of time can sometimes elude individuals with disabilities and, visual schedules can help them to anticipate tasks and activities; it can reduce verbal prompting provided by a caregiver and increase independence by the learner. 

A general daily schedule can be created for a learner with actual events such as morning/evening routines, mealtimes, and interchangeable activities such as chores, academic tasks, leisure activities. Within that schedule, smaller step-by-step (Task Analysis) visuals can be presented for necessary activities (e.g., a step-by-step visual in the bathroom how to brush your teeth). When engaging in a highly reinforcing activity, or less reinforcing, a timer and a first-then visual can be implemented to solidify the understanding of when the activity is ending and what comes next. When creating visual support, the following must be kept in mind: the learning and understanding abilities of the individual. The setting event, or environment that the visuals will pertain too, how much support will the learner require to refer and follow the visual, as well as reinforcing the individual for using their visual support. 

Choices
As providers and caregivers of individuals with disabilities, we may sometimes forget that even someone with a disability, regardless of his or her functioning or learning skills, can make their own choices if provided appropriately to them. Research has shown that choice-making opportunities are very effective in not only reducing problem behavior but also increasing motivation and task engagement. Choices can be given for practically any activity or task; academic tasks, leisure time, completing chores, meals, and even something as simple as morning routine of brushing your teeth first or getting dressed, and the same for the night routine. If possible, provide a choice of 2 and more per activity, task, or item. Choices should be present to the individual in a manner that best understood by them. Choices can be presented via pictures, written words, or just by verbally asking. Once a choice is made it must be honored by the caregiver. If a specific choice is not available at a particular day or time, either remove it from the presented choices or ask the individual to pick an alternative. 

Resources:

https://pdfs.semanticscholar.org/a704/363f032bd4f0c61fe1c44a7774546f7f1275.pdf

https://www.autismspeaks.org/templates-personalized-teaching-stories

 

New Year, new you? People have been making – and breaking – New Year’s resolutions since the birth of Father Time. So what does it take to make goals you can actually accomplish?

Strategies to choosing the resolutions you can conquer
Over half of people’s New Year’s targets involve finances, weight loss, or fitness, according to a 2021 survey by Statista. Planning what you hope to change thoughtfully, however, may increase your chances for success.

1. Choose smaller goals: “If you set lofty goals that differ tremendously from what you are currently doing, it will be more difficult to achieve them,” says Niloo Dardashti, PsyD., Vice President and Director of Adult and Couples Services at Manhattan Psychology Group, PC. “The brain is wired to observe behaviors and negatively or positively reinforce them. In other words, if you follow through with a goal, it reinforces the belief that you can do it and vice versa.” Instead of resolving to lose 50 pounds, for example, try to limit desserts to 2 times per week, or walk an additional 4,000 steps per day.
2. Opt for intangible goals with broader impact: “Identify a goal that you can apply to multiple areas of your life instead of pigeon-holing yourself into one specific action,” says Karen Surowiec, PsyD., Child, Adolescent and Adult Psychologist at Manhattan Psychology Group, PC. “A concept or an outlook that extends throughout your lifestyle can feel easier to latch onto and make a large impact.” Consider less concrete goals when you identify beneficial personal changes, such as listening to your intuition more consistently, or turning off self-doubting thoughts.
3. Rethink your resolutions mindset: “You don’t have to call them resolutions, or even goals,” says Dr. Surowiec. “Rewording them as ‘new behaviors’ or ‘changes’ can help you achieve success.” Converting your resolutions into changes provides similar intentions, but takes away the traditional pressures associated with New Year’s resolutions.

Tactics to prevent resolutions failure
Falling off the horse, slipping up, or just plain giving up… no matter what you call it, the dreaded disappointment of failure when you break your resolution is hard. An estimated 68% of people abandon their New Year’s resolutions within 2 months, and the majority blame lack of willpower as their primary reason for failure, according to a 2020 study by OnePoll. With the right outlook and support, however, you increase your chances of sticking with your plans.

1. Celebrate small milestones, not just a big achievement: “It is OK to start with a big goal – for example, to get fit,” says Dr. Surowiec, “but drill down into that: ‘What is it about this goal that is going to help me or make my life better?’ Once you identify what you hope to achieve, say feeling healthier, you can determine smaller, more attainable resolutions under that larger goal.” Rejoicing in one or more stepping stones towards a broader resolution will feel easier to accomplish and keep you motivated.
2. Identify your support system: “As you work towards a goal, consider who can support you in your journey,” says Dr. Dardashti. “Additionally, rethink damaging relationships with certain friends or family members that negatively affect your progress towards positive changes.” Negative peer pressure can sideline goals to quit or reduce drinking, for example.
3. Seek therapy to help accomplish your goals: ”When it comes to past failures, your therapist is not there to scold you, but to give you compassionate support, understanding, and tools that can fit into your lifestyle to help you reach your goals,” says Dr. Surowiec. “Therapy can give you specific and customized strategies to find what works for you because it’s not one size fits all. It is finding out what your risk and comfort tolerances are and developing skills that are best for you.”
4. Seek therapy to improve your relationships and mental health: “Our levels of internal conflict have risen in many ways due to Covid, especially with regard to career and relationship choices,” says Dr. Dardashti. “Therapy can help you work through these conflicts and figure out next steps.”

Example Resolution, from Start to Finish:

1. Identify your goal: To lose 15 pounds.
2. Break down your goal into smaller goals: Instead of just planning to lose 15 pounds, identify small actions that progress towards that larger goal. For example, create a grocery list in advance to plan healthier meals more easily, or up your water intake to at least 2 liters per day.
3. Consider why you want to lose weight: To get healthier? To feel more confident? Write down your desired outcomes as a result of losing the weight. If you have a clear purpose, it will boost your motivation and make the work more meaningful.
4. Break destructive habits hindering progress: Changing behaviors that have sidelined your weight loss in the past will be challenging to stop. But there are strategies to cease late-night snacking, for example. Stock your fridge with healthier foods and replace the time you would have spent snacking with new habits, such as reading, learning a new skill, or doing a yoga video.
5. Reframe negative thoughts: You can acknowledge your negative thoughts, but you can find ways to turn them into positive thoughts instead of allowing them to disrupt your work towards your goal. Take deep breaths and chant or journal self-loving thoughts as you would tell someone you care about. For example, ‘I am valuable, I am worthy of a healthy mind and body, and I am loved regardless of my size.”
6. Create a team to help you: A support system can keep you accountable and offer you respect and care. Identify some trusted friends and family members, and share your weight loss goal with them. They can cheer you on and back your goal planning; for example, they may suggest healthier restaurant options or light physical activity during your time together.
7. Stick with it: Changing your behaviors can feel difficult, but your therapist can provide a trusted space to talk about your goals. You can talk to your therapist about why you turn to food for comfort, or why you feel shame towards your body, for example. Therapy can help you transform these actions and feelings into healthier, positive patterns with long-term impacts.

Manhattan Psychology Group can offer immediate and ongoing support to help you, your spouse or your children set new goals, break destructive habits, and improve mental health and relationships with others. From individual therapy sessions to virtual parent training groups and webinars, we provide tools and strategies to help you feel happier, healthier, and more confident. New year, new better you.

For more information or to schedule a free consultation, contact us today!

At Manhattan Psychology Group, we love working with kids.  And we think we’re pretty good at it!  But to do right by them and be effective in a treatment program, we usually find we need to work with their parents as our partners.  Parents are essential for maintaining the consistency and continuity that is necessary for applied behavior analysis to be successful.  But it only works if parents are committed, engaged, informed, and trained.  Parent training and participation is thus a key priority of an applied behavior analysis services program at Manhattan Psychology Group.  Keep reading to see why.

With ABA, Consistency is Key
In the Applied Behavioral Analysis practice at Manhattan Psychology Group, our Board-Certified therapists specialize in working directly with children of all ages and difficulties.  And we do so in their full range of natural settings—home, school, camp, and the ice cream shops and subway stops in between.  This clinical work is the core of what we were all trained to do, and it is the active heart of our therapeutic approach.

Applied behavioral analysis isn’t, though, about changing behavior when a clinician is present.  The goal of therapy is functional:  to create adaptive behaviors that generalize across all settings, so the child is truly set up for success.  This is the main reason why our clinical work takes place in the normal places of a child’s life, rather than in a removed room in some therapists stuffy office.  Another way of saying this is that applied behavior analysis, as a program, requires consistency: children need to learn that the same behavioral rules apply whether they are at home or at school, and practicing behavior across settings helps form habits, making generalization more likely.

Being consistent, however, is hard.  A child with a broad suite of services will often have overlapping needs involving multiple types of clinicians, including Speech Language pathologists and occupational therapists that don’t specialize in applied behavior analysis and have different day to day focuses.  (It is for this reason that, at Manhattan Psychology Group, our ABA therapists organize and lead teams of clinicians that work together and meet regularly—so that all clinicians are on the same page and can support and reinforce each others’ goals and work.)  Moreover, the portion of a week for which an Applied Behavior Analyst is present invariably comprises just a fraction of an overall week.  20 hours per week of Applied Behavior Analyst services is, in relative terms, a fairly intense course of therapy.  But a 7-day week with 24 hours per day has 168 hours; even allowing 8 hours per day of sleeping, a “waking” week has 112 hours.  20 hours of Applied Behavior Analyst Services comprises less than 20% of the overall waking hours in a week.

Consistency means parents
The bottom line of all of this is that applied behavioral analysis requires consistency across settings, people, and times of day to be truly effective.  And when it comes to consistency and follow-through, the most important actors are parents.  Parents are the people most frequently present with their children.  Parents are the one the child is most attached to, and to whom the child’s previous behaviors are thus far adapted to.  Simply put, parent commitment and ability to follow through can make or break the consistency that an Applied Behavior Analysis program requires for the generalization that is the measure of a program’s success.

Not sure why it works?  Let’s first consider Benjamin.  Ben is a 5-year-old child with autism spectrum disorder. He won’t sleep independently and when things don’t go his way, instead of verbalizing his frustration he throws non-preferred items out of the bathroom window. Ben’s parents are exhausted.  Ben quickly learns that a different set of rules apply with his parents than with his ABA therapists.  Ben’s skills don’t generalize.  Ben also begins to backslide in therapy—he takes his ABA therapist less seriously, and if his ABA therapist and his parent are around at the same time, he might regress with programming he had been progressing in knowing that he can get a better response out of his parent.

Now let’s consider Oliver. Oliver is a 4-year-old with autism spectrum disorder and ADHD. He is in therapy principally because he only wants to eat foods that are white and while he is capable of spoken language, he prefers to communicate by barking. Oliver’s parents are deeply involved. They learn the strategies the ABA therapist utilizes and replicate them when his therapist is not there. When Oliver eats a green food with his therapist, he will eat the same food with his parents the next day. Oliver learns that using words is a more effective way to get a snack then barking. Oliver makes progress at a faster rate with his therapist because he knows his old tricks will not be effective.

It’s not easy to be an “Oliver’s mom,” and daily life can make it really tempting to be a “Benjamin’s dad.”  After all, it is simply easier after coming home from work, when you haven’t seen your child all day, to do what feels convenient, comfortable, relaxing, and good.  But the benefits for Oliver, and his parents, are substantial.  They’re playing the long game, and it’s going to pay off.

Parent Training at MPG
Because engaged parents are so important to successful outcomes, parent training is a key part of any comprehensive ABA program at Manhattan Psychology Group.  What parent training looks like can vary a great deal based on the needs of the child, the parents’ availability and interest, and everyone’s personality.  But, in general, our therapists will host at-home sessions with parents in which they teach, model, and role play, and give feedback to parents afterwards.  It’s kind of like the therapist is the parents’ coach.

Sessions aren’t everything, of course.  To be effective partners in an ABA program, parents need to have a complete understanding of the program and its goals.  So, we include parents in our weekly team meetings and, not only that, we take seriously their feedback and listen to what they have to say.  It is common to text and/or email throughout the week, as we work as partners to meet the child’s needs.