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Advice on behavorial issues? Help!

Moderators: MrCoffee, Necroramo, spectrummum

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LadyAlicia

Tue Jan 03 2006, 05:32PM

Registered Member #38
Joined Tue Jan 03 2006, 09:49AM
Location: PA
posts 13

I'm new to the group and I see that I'm not the only one dealing with behavorial issues here, but I'm hoping by talking with everyone, I could possibly help my son who's 5 and was diagnosed last year with PDD-NOS. He's always had a hard time with transitions, but his first TSS that worked with him helped a lot with that. Then she moved on and none of the other TSS's we've had have been able to help. When we take him to OT and speech he has these horrible meltdowns. Two weeks ago he threw a chair and put a hole in the wall. I've become very frustrated that they don't know how to deal with him. She told me that it's not in her job description to deal with behaviorial issues; that's the TSS's job. The TSS goes with us and she doesn't know how to deal with it either. Ugh. It's soooo frustrating because I feel like we've gotten nowhere in the last six months! 1-2-3 Magic worked well in the beginning, but not since. Time outs don't work either. We've even tried rewarding him with going to play at Burger King after OT and speech if he does good, and that hasn't really worked. I've since pulled him out of the OT place and am placing him somewhere else due to what the OT did, which was called the doctor that day to tell them they might have to discharge him. I didn't appreciate that being that I am his mother and pretty much let her know that. I felt that she should have discussed that with me FIRST, then call the doctor and whoever else her policy required. I'm the mother, I'm the one paying, so you discuss it with me first. If for no other reason, then out of respect! Nonetheless, has anyone tried anything else to help with transitioning or "meltdowns"?? Thanks so much!

momtocam

Tue Jan 03 2006, 11:06PM

Registered Member #35
Joined: Sat Dec 31 2005, 10:56PM
Location: Phoenix, AZ
posts 9

Sorry, but what is TSS?

MrCoffee

Wed Jan 04 2006, 12:25AM

posts 157

That's an interesting question. Can you tell us what the TSS abbreviation stands for, LadyAlicia? I know you've mentioned so far that they're therapists that the state pays for, and much like an ILS (Independant Living Skills) worker in Minnesota, from what I understand so far.

MrCoffee

[ Edited Tue Jan 03 2006, 10:26PM ]

LadyAlicia

Wed Jan 04 2006, 10:23AM

Registered Member #38
Joined: Tue Jan 03 2006, 09:49AM
Location: PA
posts 13

The TSS stands for Therapeutic Staff Support. There's also a BSC which stands for Behavorial Specialists Consultants. From what I understand, there are only certain states that pay for this service and PA is one of them. They come into the home and work with you and your child on how to deal with behavorial issues and various tasks. My therapist works on his letters, putting together puzzles, teaching him numbers, works on getting him to respond to her when he's asked a question. Just various things to help improve his verbal skills, motor skills, etc. Since we had trouble transitioning places, she would go with us to stores, the doctors, and so on, to work on that. It's baically just more support and help in dealing with the issues you child might have. We were getting 20 hours a week during the summer, but now that school has started we reduced it to 12. Sometimes it can be intrusive with them coming into your home, but I'm not doing this for me; I'm doing it for Cory. There are days where I want to quit with it, but I just tell myself it's to help him, so..... Sorry I didn't explain that. I guess I just assumed that someone on here probably had already discussed that somewhere along the line with as many people belonging to the group. That might be something to add for information to the site because people may not know their state has this service when they can get it. If they choose not to pursue it, so be it, but it's always good to know your options!

Hope I cleared it up for both of you.

StacyMichelle

Wed Jan 04 2006, 04:20PM

Autism Consultant & Advocate

Registered Member #8
Joined: Fri Dec 16 2005, 04:17PM
Location: Lake Geneva, WI
posts 28

Hello LadyAlicia. I've been working with autistic children for just over 9 years now, and 5 of those years I was what you call a TSS. We call it Line Therapist in Wisconsin.

I hope that I can help you. I give the children that I work with 10, 5, and 1 minute warnings for transitions. If you haven't tried this, I find it very effective.

I also use red and green choice cards. You can find the program at www.redandgreenchoices.com. It's a nice program because you do not go around telling your child "no" or that they are wrong all day long. Instead you are explaining their choices: a green choice (good) has green consequences (good stuff, treats) and a red choice (not-so-good) has red consequences (not getting the good stuff).

You could use this for Cory by making a Green Choice card that has corresponding pictures above these words wich are set up like an equation:

calm OT = Burger King

Then you can make one for the red choice on the back of that card:

yelling OT = No Burger King Today

You can substitute any behavior, transition, and reward for different situations. I could make you one one if you would like, if you need a better visual.

I hope that this helped. Please email me if you have further questions, and especially if you have already tried these things. I'm always willing to help.

Talk to you soon!

LadyAlicia

Wed Jan 04 2006, 08:02PM

Registered Member #38
Joined: Tue Jan 03 2006, 09:49AM
Location: PA
posts 13

Thanks so much, StacyMichelle! That is a wonderful suggestion. I am willing to try anything anyone has to offer! We have tried to "forewarn" him before we transition like you said, but no luck.

Trial and error like everything I suppose. Today I tried to tell him about going to the doctors early, then a little later, a little later, etc. When he said, "I no go to doctor," I said, "Use your words and tell Mommy why." But he just repeats over and over the same thing. I had a nice chat with the doctor today since I took my father-in-law to help control him so I could do so, and he said it's not because he doesn't like him (the doc), it's obviously too stimulating for him and too many unfamiliar faces, etc., and he's just not comfortable there and that's why he has these horrible meltdowns there. He literally screamed the whole time, banged his head on the walls, kicked and punched me while trying to contain him in the "litlle" waiting room, kicked his pap...Ugh! Everyone there is wonderful, though, and understands, but it's very depressing. I offered to take him for french fries if he was good, to the store for a treat...I was pulling all sorts of things out of thin air and nothing worked. Once he had it in his head he didn't want to be there, he didn't care what I had to offer! But this info you gave me about the red and green choice cards is wonderful. I wish I had a TSS that's been dealing with Autistic children for as long as you. All the ones I get are right out of college. A little frustrating because I actually know how to deal with his behaviors more than they do half the time. My husband looks at me and says "Is this for real?" LOL The one time he was under a table and wouldn't come out and the BSC and TSS looked at each other and the one said, "What should we do?" And the other said, "I don't know." So I offered him to come out and we would have a snack together and he came out. That's when my husband just rolled his eyes and walked away. They've done well with teaching him things, but as far as behavorial issues, they don't even have ideas. It gets so frsutrating as a parent.

I realzie all children are different, but at least have some ideas and TRY something. That's why I thought I'd get on here and chat with others and see what they do that works! Thank you so very much for responding!! I can't tell you how much this means to me. I will go to that website now.
Alicia

StacyMichelle

Thu Jan 05 2006, 11:00AM

Autism Consultant & Advocate

Registered Member #8
Joined: Fri Dec 16 2005, 04:17PM
Location: Lake Geneva, WI
posts 28

Hooray! I'm glad that something I had to offer is new to you. You are right, it is all very trial and error because each child is very different.

Another thing to think about is that Cory most certainly needs to learn some calming strategies. You and your husband will have to do it for him now, but as he gets older he will be able to monitor himself even better. The way I approach working with any autistic child is to teach them the skills they will need to function in this world WITHOUT ME. That is always my goal, and that is why I think calming strategies are so important.

Here is where you can start. I will send you a 1 to 5 scale that I made on the computer. I print them up on 3 by 5 notecards, and then I usually laminate them so they don't get torn up. The scale is like a thermometer, cool on the bottom and hot on the top.

5 - Angry
4 - Sad
3 - Excited
2 - Happy
1 - Calm

I put little faces with them, as well as color coding. I explain the card to my children, and then tell them that the goal is to be at a 1 or a 2, because that is where our bodies and minds feel the best.

I keep the card with me, and throughout the day I ask the child where he/she is on the scale. Once the kids get the hang of it, they are brilliantly honest. When you see Cory running around the house, you might ask him where he thinks he is on the scale (a 3) and suggest that he gets back to a 1 or a 2 (which I'll tell you how to do in a moment). You can also use sign language/body language to tell your child that they need to "calm down" by taking both of your hands, palms down, and pushing downwards from chest-high as if you were pushing down a gigantic volume control. It's a good physical visual cue to your child, and you often don't even need to say anything.

When he begins getting worked up (a 4), ask him where he thinks he is. You can encourage him to get back to a 1 or a 2 by saying "The Red Choice is to stay at a 4 or get up to a 5. The Green Choice is to get down to a 1 or 2, and I will help you."

(You can reinforce ANY green choices he makes by putting marbles in a small container, and when it's full he may get a special treat. Make sure it's a SMALL container, it swhould only take about 5 marbles to earn the first reward. We have to sell him on this idea!! And at first, always present what the Red and Green choice is first, then let him chose.)

Now, how to calm. Well, it varies from child to child, but the children I work with right now really like this strategy.

1. Take 3 deep breaths.
2. Stretch your arms and legs.
3. Count backwards from current level to a 1.

You can develope your own strategy with Cory. Does he like getting squeezes? What does he do to self-soothe? You can try a few things before you make it your strategy, and then encourage him to use it when he needs to get back to a 1 or 2.

I hope that made sense! Let me know if I can help in any other way.

Stacy Michelle

LadyAlicia

Thu Jan 05 2006, 03:08PM

Registered Member #38
Joined: Tue Jan 03 2006, 09:49AM
Location: PA
posts 13

We did do a sticker chart with him for when he did what he was asked to do. When he filled that up, he got a small prize. Then it stopped working. Now he's gotten to the point where he doesn't want a small prize; he wants something bigger and better. It seems that things we try start to work out great, then they end up not working.

But I'm going to try this for the behaviors and see where it takes us. I appreciate you taking the time to do ths for me.

It's always worth a shot!!

LadyAlicia

Thu Jan 05 2006, 03:08PM

Registered Member #38
Joined: Tue Jan 03 2006, 09:49AM
Location: PA
posts 13

But I'm going to try this for the behaviors and see where it takes us. I appreciate you taking the time to do ths for me.

It's always worth a shot!!

jsmith567

Sat Jan 07 2006, 12:03PM

Registered Member #20
Joined: Tue Dec 20 2005, 09:00PM
posts 6

One thing that seemed to help Jake, so far atleast, has been social stories books. I just make my own with clipart or stick figure drawings, and personalize it for my son. For the OT issue, you'd write what (ideally) happens step by step and how a good OT sessions would look, including options for alternative behaviors when he's angry (like squeezing a soft ball, or jumping or something). These really seemed to help Jake with his hitting. HTH.

Jen

LadyAlicia

Sat Jan 07 2006, 01:33PM

Registered Member #38
Joined: Tue Jan 03 2006, 09:49AM
Location: PA
posts 13

Thanks, Jen. I'll have to try that. When I tell him beforehand we're going to be going to OT, he starts yelling "No, No, No!" At that point I can't even try and explain to him what will transpire there. He just keeps yelling "No, No, No!" I know he hears me telling him "they won't hurt you, you'll have some fun playing with the toys," but once he has it in his head he doesn't want to go somewhere, forget it. BUT I am trying a new OT and speech place, so I'm hoping they'll be more experienced and things will improve, and perhaps I can tell them what your suggestion is and they'll have a way that it will work. That is, if the way you told me doesn't work first.

Thanks so much for your suggestion!! Everyone is being so helpful and it's so appreciated.
Alicia

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