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Choice Boards and “Wait” support for students with autism in the classroom

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Choice boards and ‘Wait’ support in the classroom benefit autistic students based on their individual needs. Different Choice boards are necessary depending on the student’s motor and communication skills. These boards can display objects, pictures, icons, or words for various activities or reinforcers. It is important for the pictures to accurately represent the actual objects for the student to make the connection. Choice boards can be easily made using materials like poster paper, card stock, whiteboards, or any writable surface.

We will discuss two techniques for supporting students with autism in the classroom:

  1. Choice Boards
  2. Wait Supports

Choice boards are commonly used alongside a student’s schedule to allow them to choose activities at designated times. These boards are usually placed near areas for free or break time, encouraging independent selection of activities. Implementing choice boards can create structure and routine for students with autism, helping to reduce anxiety.

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Choice boards for autism in the classroom

What are Choice boards for autism?

A Choice board is a type of visual environmental support that can benefit students, especially students with ASD. Choices should be incorporated into as many activities as possible, as choice boards provide students with decision-making opportunities and a sense of responsibility for their behavior and work. A Choice board may or may not have written words describing the image.

How are Choice boards used?

When introducing a Choice board to a student with autism, make sure to show the board, read the choices aloud, and point to the choice you are reading. You need to wait for the student to select a choice by either pointing, removing the choice, handing it to you, or verbally choosing.

When to use a Choice board in the classroom

  • Reinforcers
  • Rewards
  • Activiities or Actions
  • Materials or Supplies

What are the benefits of using Choice boards within the classroom?

Choice boards are used to encourage communication, provide a visual reminder of what activities are available, and encourage independent decision-making throughout the day within the school setting. Offering a choice before an activity/task begins may increase the likelihood of participation and decrease the possibility of a student with autism engaging in challenging behaviors.

Choice boards are most effective when the choices are appropriate and make sense at the moment. If a choice cannot be honored in that scenario, then it should be removed from the choice board. Failing to do so only frustrates the student when the choice cannot happen and decreases the likelihood of them wanting to use the choice board.

Additionally, similar to their average peers, if there are too many choices, students can become overwhelmed and either take too long or avoid making a choice. The opposite is also true, only having two choices in every instance for a choice can decrease the effectiveness of a choice board. Those making the choice boards should continually evaluate if there are too many or too few choice boards.

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Wait Support for students with autism in the classroom

Why are ‘Wait’ supports important for children with autism?

Similar to Choice boards, ‘Wait’ support is another visual strategy or tool that can be incorporated throughout the school day. As we know, waiting is a difficult skill for many children, with or without disabilities. However, for students with autism, in particular, waiting typically presents problems because time is an abstract concept, they are not aware of the social rules of waiting, or they do not comprehend the reason for waiting.

We also know that if a student waits too long or is not engaged in some type of activity, even if it is a simple activity such as putting a backpack away or clearing a desk, then unwanted behaviors will likely occur. Therefore, students with ASD will typically require specific instructions to develop appropriate waiting behaviors.

Guidelines to determine the type of ‘Wait’ support

When developing ‘Wait’ supports, you need to determine if the student has the prerequisite skills that are necessary to engage in waiting behaviors. Students have to wait on many occasions throughout the day.

Examples of wait times at school

  • Wait to access a preferred activity or object
  • Wait for the bus in the morning and afternoon
  • Stand in line to leave the classroom
  • Wait for lunch to be served
  • Wait for everyone to be quiet for circle time

Wait support tools

  • Visual timers
  • Countdown strips
  • Distractors

First, role-play and practice waiting using different instructions and in different settings when you want to identify this skill.

Keep in mind that when you are practicing ‘learning to wait’ with your students, make sure it is authentic and in an actual setting where you would expect the student to use this skill.

Again, be sure to teach waiting skills across various settings to increase the likelihood of generalization. Even using a peer model or a peer buddy during waiting times can offer support for desired behaviors.

Additionally, specific ‘physical supports’ such as chairs near the waiting area, setting a timer, or holding a picture representing “wait,” can also help a student learn this concept.

5 Tips for Using Wait Times:

  • Give Reminders. For example, if the wait time is three minutes, at one minute, point to the time and say you have one minute left.
  • Practice. Build up the amount of time spent waiting through practice just like any skill; waiting takes practice over and over again.
  • Repetition. Incorporate wait times into the schedule so students can get used to it becoming part of the daily routine.
  • Provide Visuals. Incorporate colors as an additional time visual. Red could mean wait. Yellow could mean almost 1 minute left. Green means the waiting is up, and it’s time for an activity or reward after waiting.
  • Flip Cards. Use flip cards as a means for waiting, such as starting from 10 and counting down to 0, as it incorporates two skills at once.

As you know, for any kind of learning to take place, it is essential for students to have an active involvement with their teachers, peers, and the curriculum. Given that students with autism tend to be passive learners, it is necessary to plan activities that require students to become active participants. This can occur by creating opportunities for students to respond. Research supports a functional relationship between academic performance and how often a student can respond. Therefore, the more students participate in an activity, the more off-task and disruptive behaviors will decrease.

Let LeafWing Center help establish some basic Choice boards and ‘Wait’ support techniques for your child that simulate the classroom setting. This will aid and decrease anxiety when the student is ready to make the transition to the classroom. Make sure to share the methods with the child’s teacher to help reinforce the foundation that has been established by the ABA therapist for children with autism.

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Related Glossary Terms

Other Related Articles:

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

ABA-based therapy can be used in a multitude of areas. Currently, these interventions are used primarily with individuals living with ASD; however, their applications can be used with individuals living with pervasive developmental disorders as well as other disorders. For ASD, it can be used in effectively teaching specific skills that may not be in a child’s repertoire of skills to help him/her function better in their environment whether that be at home, school, or out in the community.  In conjunction with skill acquisition programs, ABA-based interventions can also be used in addressing behavioral excesses (e.g., tantrum behaviors, aggressive behaviors, self-injurious behaviors). Lastly, it can also be utilized in parent/caregiver training.

In skill acquisition programs, a child’s repertoire of skills is assessed in the beginning phase of the services in key adaptive areas such as communication/language, self-help, social skills, and motor skills as well.  Once skills to be taught are identified, a goal for each skill is developed and then addressed/taught by using ABA-based techniques to teach those important skills. Ultimately, an ABA-based therapy will facilitate a degree of maintenance (i.e., the child can still perform the learned behaviors in the absence of training/intervention over time) and generalization (i.e., the learned behaviors are observed to occur in situations different from the instructional setting).  These two concepts are very important in any ABA-based intervention.

In behavior management, the challenging behaviors are assessed for their function in the beginning phase of the services. In this phase, the “why does this behavior happen in the first place?” is determined. Once known, an ABA-based therapy will be developed to not just decrease the occurrence of the behavior being addressed, but also teach the child a functionally-equivalent behavior that is socially-appropriate.  For example, if a child resorts to tantrum behaviors when she is told she cannot have a specific item, she may be taught to accept an alternative or find an alternative for herself. Of course, we can only do this up to a certain point—the offering of alternatives.  There comes a point when a ‘no’ means ‘no’ so the tantrum behavior will be left to run its course (i.e., to continue until it ceases).  This is never easy and will take some time for parents/caregivers to get used to, but research has shown that over time and consistent application of an ABA-based behavior management program, the challenging behavior will get better.

In parent training, individuals that provide care for a child may receive customized “curriculum” that best fit their situation.  A typical area covered in parent training is teaching responsible adults pertinent ABA-based concepts to help adults understand the rationale behind interventions that are being used in their child’s ABA-based services.  Another area covered in parent training is teaching adults specific skill acquisition programs and/or behavior management programs that they will implement during family time.  Other areas covered in parent training may be data collection, how to facilitate maintenance, how to facilitate generalization of learned skills to name a few.

There is no “one format” that will fit all children and their families’ needs. The ABA professionals you’re currently working with, with your participation,  will develop an ABA-based treatment package that will best fit your child’s and your family’s needs. For more information regarding this topic, we encourage you to speak with your BCBA or reach out to us at info@leafwingcenter.org.

Who Can Benefit From ABA Therapy?

There is a common misconception that the principles of ABA are specific to Autism. This is not the case. The principles and methods of ABA are scientifically backed and can be applied to any individual. With that said, the U.S. Surgeon General and the American Psychological Association consider ABA to be an evidence based practice. Forty years of extensive literature have documented ABA therapy as an effective and successful practice to reduce problem behavior and increase skills for individuals with intellectual disabilities and Autism Spectrum Disorders (ASD). Children, teenagers, and adults with ASD can benefit from ABA therapy. Especially when started early, ABA therapy can benefit individuals by targeting challenging behaviors, attention skills, play skills, communication, motor, social, and other skills. Individuals with other developmental challenges such as ADHD or intellectual disability can benefit from ABA therapy as well. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

Additionally, parents and caregivers of individuals living with ASD can also benefit from the principles of ABA. Depending on the needs of your loved one, the use of specified ABA techniques in addition to 1:1 services, may help produce more desirable treatment outcomes. The term “caregiver training” is common in ABA services and refers to the individualized instruction that a BCBA or ABA Supervisor provides to parents and caregivers. This typically involves a combination of individualized ABA techniques and methods parents and caregivers can use outside of 1:1 sessions to facilitate ongoing progress in specified areas.

ABA therapy can help people living with ASD, intellectual disability, and other developmental challenges achieve their goals and live higher quality lives.

What does ABA Therapy look like?

Agencies that provide ABA-based services in the home-setting are more likely to implement ABA services similarly than doing the same exact protocols or procedures. Regardless, an ABA agency under the guidance of a Board-Certified Behavior Analyst follows the same research-based theories to guide treatment that all other acceptable ABA agencies use.

ABA-based services start with a functional behavior assessment (FBA). In a nutshell, a FBA assesses why the behaviors may be happening in the first place. From there, the FBA will also determine the best way to address the difficulties using tactics that have been proven effective over time with a focus on behavioral replacement versus simple elimination of a problem behavior. The FBA will also have recommendations for other relevant skills/behaviors to be taught and parent skills that can be taught in a parent training format to name a few. From there, the intensity of the ABA-based services is determined, again, based on the clinical needs of your child. The completed FBA is then submitted to the funding source for approval.

One-on-one sessions between a behavior technician and your child will start once services are approved. The duration per session and the frequency of these sessions per week/month will all depend on how many hours your child’s ABA services have been approved for—usually, this will be the number recommended in the FBA. The sessions are used to teach identified skills/behaviors via effective teaching procedures. Another aspect of ABA-based services in the home-setting is parent training. Parent training can take many forms depending on what goals have been established during the FBA process. The number of hours dedicated for parent training is also variable and solely depends on the clinical need for it. If a 1:1 session is between a behavior technician and your child, a parent training session or appointment is between you and the case supervisor and with and without your child present, depending on the parent goal(s) identified. Parent training service’s goal is for you to be able to have ample skills/knowledge in order for you to become more effective in addressing behavioral difficulties as they occur outside of scheduled ABA sessions. Depending on the goals established, you may be required to participate in your child’s 1:1 sessions. These participations are a good way for you to practice what you have learned from the case supervisor while at the same time, having the behavior technician available to you to give you feedback as you practice on those new skills.

As mentioned in the beginning, no two ABA agencies will do the same exact thing when it comes to providing ABA services; however, good agencies will always base their practice on the same empirically-proven procedures.

How do I start ABA Therapy?

In most cases, the first item required to start ABA therapy is the individual’s autism spectrum disorder (ASD) diagnosis report. This is typically conducted by a doctor such as a psychiatrist, psychologist, or a developmental pediatrician. Most ABA therapy agencies and insurance companies will ask for a copy of this diagnosis report during the intake process as it is required to request an ABA assessment authorization from the individual’s medical insurance provider.

The second item required to start ABA therapy is a funding source. In the United States, and in cases where Medi-Cal or Medicare insurances are involved, there is a legal requirement for ABA services to be covered when there is a medical necessity (ASD diagnosis). Medi-Cal and Medicare cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary, however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of the coverage and to ensure that ABA is in fact, a covered benefit. Additionally, some families opt to pay for ABA services out-of-pocket.

The next step to starting ABA therapy is to contact an ABA provider whom you are interested in working with. Depending on your geographic location, ABA agencies exist in many cities across the United States. Your insurance carrier, local support groups, and even a thorough online search can help you find reputable and properly credentialed ABA agencies near you. Our organization, LeafWing Center, is based in southern California and is recognized for aiding people with ASD achieve their goals with the research based on applied behavior analysis.

Once you have identified the ABA provider with whom you wish to work, they should help you facilitate the next steps. These will include facilitating paperwork and authorizations with your funding source. Once the assessment process begins, a BCBA (Board Certified Behavior Analyst) or qualified Program Supervisor should get in contact with you to arrange times in which interviews with parents/caregivers and observations of your loved one can be conducted. This will help in the process of gathering important clinical information so that with your collaboration, the most effective treatment plans and goals can be established for your loved one. This process is referred to as the Functional Behavior Assessment (FBA) and is elaborated on in different blog posts on our website. With regard as to what can be expected once ABA therapy begins, please read our blog post titled: When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

Speech Therapy

Nonverbal Autism

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The term nonverbal autism is used to describe individuals on the autism spectrum who have limited or no verbal communication skills. However, it does not necessarily indicate intellectual disability.

Nonverbal autistic children should not be automatically considered intellectually impaired simply because they lack speech. This assumption can lead to under-stimulation, which in turn can cause anger, frustration, and/or depression in the child or adolescent.

Let’s dive in!

Let Leafwing professionals educate you and your child to develop the language skills that will help guide your child to reach their full potential.

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Nonverbal Autism

What are the early signs of autism?

Based on research conducted in 2007, it was found that approximately 30-38 percent of parents of autistic children observed symptoms before their child’s first birthday. This number is unexpectedly high, considering that autism is often perceived as an issue that may not become apparent until later in childhood. In the majority of those cases, approximately 80 percent noticed signs by the time their child reached 24 months.

Early signs of autism include:

  • not responding to their name by 12 months old
  • not babbling or laughing along with their parents by 12 months old
  • not pointing to objects of interest by 14 months old
  • not playing pretend by 18 months old
  • avoiding eye contact or preferring to be alone
  • not meeting developmental milestones for speech and language
  • repeating words or phrases over and over
  • being upset by minor changes to their schedule
  • flapping their hands or rocking their body for comfort
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When to see a professional

Don’t let your child fall behind! If you notice they’re not hitting their language milestones, it’s time to seek professional help.

If your child is not babbling or talking, it may be necessary to consult a therapist or speech-language pathologist to determine if nonverbal autism is a possibility. Let LeafWing investigate and assist your child in developing their communication skills.

Language development and speech in older children can be evaluated using a standardized vocabulary checklist, such as the Language Development Survey (LDS). This assessment tool can assist in identifying language delays in children between the ages of 18-35 months by analyzing their vocabulary usage and word combinations.

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Nonverbal Autism

How is nonverbal autism diagnosed?

First, the parent should obtain a definite diagnosis from a medical professional who will conduct a series of tests, which include

  • physical examination
  • MRI and CT scans
  • blood tests
  • and hearing tests.

These assessments enable the professionals to eliminate any other developmental or physical disabilities hindering the child’s speech.

When it comes to diagnosing nonverbal autism in children, it can be a difficult task. This is because there are no clear distinctions between different types of communication difficulties, and it can be hard to differentiate between language delays and autism-related communication problems. The lack of verbal output for children with nonverbal autism typically makes the challenges associated with diagnosis even more difficult.

Unlocking the puzzle of nonverbal autism in children can feel like navigating a maze of communication challenges, where clear distinctions are scarce, and diagnoses are elusive.

Once the parent has a diagnosis, a therapist will use some standardized assessment tools that assess young children with significant language and speech delays, such as:

  • Gilliam Autism Rating Scale (GARS3) – is a comprehensive assessment tool that assesses communication, socialization, sensory functioning, play, self-help skills, and behavior in autism spectrum disorder patients.
  • Autism Diagnostic Observation Schedule (ADOS-2) – assesses an individual’s behavior, communication, and social interaction skills.

The assessment tools help to identify deficits or unusual patterns that may indicate the presence of autism spectrum disorder.

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Nonverbal Autism

How do you work with a child who is nonverbal?

The first step in working with a nonverbal autistic child is to establish trust and rapport. This can often be done by taking time to get to know them, showing interest in their interests and hobbies, and acting as a supportive companion. It is essential to use clear body language and gestures when communicating, as well as verbal communication if appropriate. Additionally, it may be helpful to use visual tools such as

  • picture cards
  • calendars
  • simple visual schedules

to help children with autism better communicate what they need or want.

Nonverbal Autism: Visual Behavior Supports

Visual supports, such as pictures or other visual representations, can assist children in communication by facilitating the expression of emotions and frustrations. They also aid in comprehending social norms, such as initiating conversations and potentially reducing aggressive behavior.

Visual supports are like a superhero cape for children, guiding them on the path of good behavior and reminding them of the consequences that await if they stray. These magical tools not only help little ones remember the rules but also foster communication and build excellent relationships along the way!

Types of Visual Behavior

  • First-Then Boards: breaks tasks down into smaller, easy-to-understand segments. It is a visual display of something that your child prefers and will receive or can participate in after they complete a task that they do not prefer.
  • Contingency Maps: shows a child what will happen if they engage in a particular behavior. However, unlike a first-then-board, a contingency map depicts both sides of the coin – what will happen if the child does what is expected of them and what happens if they do not.
  • Visual Daily Schedules: the expectation of the events in their day. Visual schedules help mitigate anxiety and lend a sense of predictability. You can create a visual daily schedule with photographs, drawings, or written lists, beginning with the first thing your child should do in the morning and ending with the last thing they should do at night.

Guidelines for Communication with Nonverbal Autistic Children

No matter where your child falls on the autism spectrum, they can communicate in some manner. Even if they are nonverbal, there are a variety of strategies that can be used to help them express themselves and build meaningful relationships with you and others.

  • Encourage play and social interaction. All children learn through play, and that includes learning the language. Interactive play provides a delightful chance for you and your child to communicate. Play games that your child enjoys. Incorporate playful activities that promote social interaction. For example, singing, reciting nursery rhymes, and gentle roughhousing. During your interactions, crouch down close to your child so your voice and face are closer, increasing the chance of them looking at you.
  • Imitate each other. Copying your child’s sounds and play behaviors will encourage more vocalizing and interaction. It also encourages your child to copy you and take turns. Make sure you imitate how your child is playing – so long as it’s a positive behavior. For example, when your child rolls a car across the floor, then you, too, roll a car across the floor. If they crash the car, you crash your car, too. Be sure not to imitate inappropriate behavior like throwing the car!
  • Focus on nonverbal communication. Gestures and eye contact can build a foundation for language. Encourage your child by modeling and responding to these behaviors. Exaggerate your gestures. Use both your body and your voice when communicating – for example, by extending your hand to point when you say “look” and nodding your head when you say “yes.” Use gestures that are easy for your child to copy. Examples include clapping, opening hands, reaching out arms, etc. Respond to your child’s gestures: When they look at or point to a toy, hand it to them or take the cue for you to play with it—similarly, point to a toy you want before picking it up.
  • Give time for your child to talk. It’s natural for us to want to fill in the missing words when a child doesn’t quickly respond. It is vital to give your child lots of opportunities to communicate, even if they are not talking. When you ask a question or see that your child wants something, pause for several seconds while looking at them enthusiastically. Watch for any sound or body movement and respond promptly. The promptness of your response helps your child feel the power of communication.
  • Simplify your language. Be literal and obvious in your choice of language. Say precisely what you mean. Speak in short phrases, such as “roll ball” or “throw ball.” You can increase the number of words in a phrase once your child’s vocabulary increases.
  • Follow your child’s interests. Rather than interrupting your child’s focus, follow along with words. Use simple words about what your child is doing. By talking about what engages your child, you’ll help them learn the associated vocabulary.
  • Consider assistive devices and visual supports. Assistive technologies and visual supports can do more than replace speech. They can foster its development. Examples include devices and apps with pictures your child touches to produce words. On a simpler level, visual supports can consist of images and groups of pictures that your child can use to indicate requests and thoughts.

It is important to remember that clear and concise instructions are more effective for children. The level of language used should be appropriate for the child’s current language abilities. As the child progresses and succeeds, instructions can become more complex and include more language.

Respect your child’s current communication level. Though your child may be nonverbal, their thoughts and emotions are just as valid as those of a verbal person. It is essential to learn how to listen to the communication attempts that your child makes, such as gestures, facial expressions, vocalizations, or body language. Respect what your child can do rather than focusing on what they cannot yet do.

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Nonverbal Autism

How ABA therapy can help with nonverbal autism

ABA therapy is effective in identifying and targeting skill development goals. It typically addresses skill deficits across various domains, which vary depending on the individual needs of the learner.

Behavior analysts must only use ABA-based treatment programs that are proven effective for specific difficulties. This is known as evidence-based practice. Treatment programs can be tailored to each person, but they all share a solid foundation of methods proven effective through repeated implementation in real-life situations.

Let Leafwing be your partner in unlocking your child’s full potential. We pride ourselves on creating a solid bond between your child and our therapy team, especially at the start of the ABA therapy program. Our staff is dedicated to building a positive relationship with your child, not just at the beginning but throughout the entire program. In the first few weeks, we focus on play and conversation to make your child feel at ease and enjoy their time with our Behavior technician. This ensures positive experiences and maximizes learning rates for extraordinary results.

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Glossary Terms

Other Related Articles

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

ABA-based therapy can be used in a multitude of areas. Currently, these interventions are used primarily with individuals living with ASD; however, their applications can be used with individuals living with pervasive developmental disorders as well as other disorders. For ASD, it can be used in effectively teaching specific skills that may not be in a child’s repertoire of skills to help him/her function better in their environment whether that be at home, school, or out in the community.  In conjunction with skill acquisition programs, ABA-based interventions can also be used in addressing behavioral excesses (e.g., tantrum behaviors, aggressive behaviors, self-injurious behaviors). Lastly, it can also be utilized in parent/caregiver training.

In skill acquisition programs, a child’s repertoire of skills is assessed in the beginning phase of the services in key adaptive areas such as communication/language, self-help, social skills, and motor skills as well.  Once skills to be taught are identified, a goal for each skill is developed and then addressed/taught by using ABA-based techniques to teach those important skills. Ultimately, an ABA-based therapy will facilitate a degree of maintenance (i.e., the child can still perform the learned behaviors in the absence of training/intervention over time) and generalization (i.e., the learned behaviors are observed to occur in situations different from the instructional setting).  These two concepts are very important in any ABA-based intervention.

In behavior management, the challenging behaviors are assessed for their function in the beginning phase of the services. In this phase, the “why does this behavior happen in the first place?” is determined. Once known, an ABA-based therapy will be developed to not just decrease the occurrence of the behavior being addressed, but also teach the child a functionally-equivalent behavior that is socially-appropriate.  For example, if a child resorts to tantrum behaviors when she is told she cannot have a specific item, she may be taught to accept an alternative or find an alternative for herself. Of course, we can only do this up to a certain point—the offering of alternatives.  There comes a point when a ‘no’ means ‘no’ so the tantrum behavior will be left to run its course (i.e., to continue until it ceases).  This is never easy and will take some time for parents/caregivers to get used to, but research has shown that over time and consistent application of an ABA-based behavior management program, the challenging behavior will get better.

In parent training, individuals that provide care for a child may receive customized “curriculum” that best fit their situation.  A typical area covered in parent training is teaching responsible adults pertinent ABA-based concepts to help adults understand the rationale behind interventions that are being used in their child’s ABA-based services.  Another area covered in parent training is teaching adults specific skill acquisition programs and/or behavior management programs that they will implement during family time.  Other areas covered in parent training may be data collection, how to facilitate maintenance, how to facilitate generalization of learned skills to name a few.

There is no “one format” that will fit all children and their families’ needs. The ABA professionals you’re currently working with, with your participation,  will develop an ABA-based treatment package that will best fit your child’s and your family’s needs. For more information regarding this topic, we encourage you to speak with your BCBA or reach out to us at info@leafwingcenter.org.

Who Can Benefit From ABA Therapy?

There is a common misconception that the principles of ABA are specific to Autism. This is not the case. The principles and methods of ABA are scientifically backed and can be applied to any individual. With that said, the U.S. Surgeon General and the American Psychological Association consider ABA to be an evidence based practice. Forty years of extensive literature have documented ABA therapy as an effective and successful practice to reduce problem behavior and increase skills for individuals with intellectual disabilities and Autism Spectrum Disorders (ASD). Children, teenagers, and adults with ASD can benefit from ABA therapy. Especially when started early, ABA therapy can benefit individuals by targeting challenging behaviors, attention skills, play skills, communication, motor, social, and other skills. Individuals with other developmental challenges such as ADHD or intellectual disability can benefit from ABA therapy as well. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

Additionally, parents and caregivers of individuals living with ASD can also benefit from the principles of ABA. Depending on the needs of your loved one, the use of specified ABA techniques in addition to 1:1 services, may help produce more desirable treatment outcomes. The term “caregiver training” is common in ABA services and refers to the individualized instruction that a BCBA or ABA Supervisor provides to parents and caregivers. This typically involves a combination of individualized ABA techniques and methods parents and caregivers can use outside of 1:1 sessions to facilitate ongoing progress in specified areas.

ABA therapy can help people living with ASD, intellectual disability, and other developmental challenges achieve their goals and live higher quality lives.

What does ABA Therapy look like?

Agencies that provide ABA-based services in the home-setting are more likely to implement ABA services similarly than doing the same exact protocols or procedures. Regardless, an ABA agency under the guidance of a Board-Certified Behavior Analyst follows the same research-based theories to guide treatment that all other acceptable ABA agencies use.

ABA-based services start with a functional behavior assessment (FBA). In a nutshell, a FBA assesses why the behaviors may be happening in the first place. From there, the FBA will also determine the best way to address the difficulties using tactics that have been proven effective over time with a focus on behavioral replacement versus simple elimination of a problem behavior. The FBA will also have recommendations for other relevant skills/behaviors to be taught and parent skills that can be taught in a parent training format to name a few. From there, the intensity of the ABA-based services is determined, again, based on the clinical needs of your child. The completed FBA is then submitted to the funding source for approval.

One-on-one sessions between a behavior technician and your child will start once services are approved. The duration per session and the frequency of these sessions per week/month will all depend on how many hours your child’s ABA services have been approved for—usually, this will be the number recommended in the FBA. The sessions are used to teach identified skills/behaviors via effective teaching procedures. Another aspect of ABA-based services in the home-setting is parent training. Parent training can take many forms depending on what goals have been established during the FBA process. The number of hours dedicated for parent training is also variable and solely depends on the clinical need for it. If a 1:1 session is between a behavior technician and your child, a parent training session or appointment is between you and the case supervisor and with and without your child present, depending on the parent goal(s) identified. Parent training service’s goal is for you to be able to have ample skills/knowledge in order for you to become more effective in addressing behavioral difficulties as they occur outside of scheduled ABA sessions. Depending on the goals established, you may be required to participate in your child’s 1:1 sessions. These participations are a good way for you to practice what you have learned from the case supervisor while at the same time, having the behavior technician available to you to give you feedback as you practice on those new skills.

As mentioned in the beginning, no two ABA agencies will do the same exact thing when it comes to providing ABA services; however, good agencies will always base their practice on the same empirically-proven procedures.

How do I start ABA Therapy?

In most cases, the first item required to start ABA therapy is the individual’s autism spectrum disorder (ASD) diagnosis report. This is typically conducted by a doctor such as a psychiatrist, psychologist, or a developmental pediatrician. Most ABA therapy agencies and insurance companies will ask for a copy of this diagnosis report during the intake process as it is required to request an ABA assessment authorization from the individual’s medical insurance provider.

The second item required to start ABA therapy is a funding source. In the United States, and in cases where Medi-Cal or Medicare insurances are involved, there is a legal requirement for ABA services to be covered when there is a medical necessity (ASD diagnosis). Medi-Cal and Medicare cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary, however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of the coverage and to ensure that ABA is in fact, a covered benefit. Additionally, some families opt to pay for ABA services out-of-pocket.

The next step to starting ABA therapy is to contact an ABA provider whom you are interested in working with. Depending on your geographic location, ABA agencies exist in many cities across the United States. Your insurance carrier, local support groups, and even a thorough online search can help you find reputable and properly credentialed ABA agencies near you. Our organization, LeafWing Center, is based in southern California and is recognized for aiding people with ASD achieve their goals with the research based on applied behavior analysis.

Once you have identified the ABA provider with whom you wish to work, they should help you facilitate the next steps. These will include facilitating paperwork and authorizations with your funding source. Once the assessment process begins, a BCBA (Board Certified Behavior Analyst) or qualified Program Supervisor should get in contact with you to arrange times in which interviews with parents/caregivers and observations of your loved one can be conducted. This will help in the process of gathering important clinical information so that with your collaboration, the most effective treatment plans and goals can be established for your loved one. This process is referred to as the Functional Behavior Assessment (FBA) and is elaborated on in different blog posts on our website. With regard as to what can be expected once ABA therapy begins, please read our blog post titled: When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

What to do before and after telling your child with autism “No”

What to do before and after telling your child with autism ‘No’

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What should happen before and after telling a child with autism ‘no’? Telling a child ‘no’ can be a difficult task for any parent or caregiver. The child may still be in the process of learning the concept of ‘no’. It’s possible that it hasn’t been enforced consistently in the past, resulting in a lack of understanding on the child’s part. Additionally, the child may believe that ‘No’ means they will never have access to the object or activity again, rather than realizing that it simply means they can’t have access at that particular moment. Children don’t always have a full understanding about why they are being denied what they want even if it is a harm to their safety. This can also seem like a monumental task for a parent of a child with autism. Children with autism can have a hard time processing big emotions and being told ‘no’ can produce multiple emotions of anger, sadness, and frustration.

Furthermore, during a typical school day, some objects or activities may not be available to the child, such as restricted computer use or not having access to a preferred toy while working. This can lead to challenges for the child in accepting the situation and potentially exhibiting negative behaviors.

Both parents and teachers face the obstacles of teaching a child how to cope when hearing the word ‘no’. So, what should you do before and after telling your child with autism ‘No’:

Before:

After:

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What to do before and after telling your child with autism “No”

Think of an alternate saying before you tell a child with autism no

Before saying ‘no’ to your child, it’s important to avoid using that exact word. Simply saying ‘no’ can lead to negative behaviors. Instead, find a different way to explain why the answer is no.

For instance, if your child wants something at the grocery store:

Instead of saying: “No, you cannot have that!”
Say: “That’s not on our list today”.

This helps your child understand that the no is not a punishment and may happen at another point. You may even want to explain your reasoning through a social story to help the child understand why they cannot have access to a desired object or activity at a specific time. It’s especially helpful for children with autism. Remember to positively reinforce when the child stays calm and accepts ‘No.’

Consider the various meanings that can be conveyed by the word ‘No’:

  • You can’t have that right now.
  • You are not allowed to do that.
  • We are not going there today.
  • Danger.
  • Stop.
  • Don’t touch that.
  • Maybe.
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What to do before and after telling your child with autism “No”

Give a Visual before telling a child with autism no

Children with autism do very well with visuals in all aspects of their lives, being told no is no exception to this. Visuals can be used in a first/then method. This works when you want to say no for right now. So maybe they want to play a game or do something fun but they need to finish homework. You’re not saying no to something fun forever but you need them to finish a task that is important beforehand. This is similar to what their typical peers’ parents go through as well. So, using a first/then chart is helpful to show a child with autism that they can have what they want after they have completed the assigned task.

Another way a visual could be used is through a Social Story. Social stories are a great way to teach a no that might put a child in danger such as not touching a hot stove or not running across the street while there is traffic. A social story could be used to show pushing the button to cross and then waiting for the light to tell them to cross. This shows a child that one action will always be a no (running across the street when it is not safe) and give them an alternate action to take to avoid the no (waiting for the walk symbol).

Allow time for a child with autism to process after telling them no

As with any child being told ‘no’ or ‘not right now’ can create a difficult emotion that they have to process through. It’s a fact of life that we cannot always have or do what we want when we want. However, it takes time to learn the skill of getting a no and moving on without causing a major undesirable behavior. Allowing time for children to process being angry and upset will teach them to deal with the emotion easier the next time. Just like any skill it can take time to practice, it will get easier the more the child understands a no and knows what they can do after.

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Giving alternates after telling a child with autism no

A good way to help a child process being told no is to give them an alternative. For example, say a child wants a snack of chips, but it is close to dinner. Instead of saying no and being final, you could say chips aren’t an option right now, but you can have grapes or carrot sticks. This gives a child a choice of an alternate option to something they want while you’re still saying no to their original request. Giving an alternate option is a great way to help a child process through the ‘no’ quicker because now they have a choice to make and it seems to them that they are still getting something that they like.

Points to consider when telling a child with autism to accept the words ‘No’ or ‘Stop’

They have a:

  • strong drive toward favorite objects/activities
  • limited understanding of the concept of ‘No.’
  • difficulty in following verbal instructions
  • lack of understanding of why access is denied

Remember, telling a child with autism ‘no’ can seem like an obstacle to a task. However, knowing what to do before and after can make the process easier on everyone involved and the child learns that sometimes a no happens and it’s nothing to be overly upset about as there could be alternate options for their request or their request could be fulfilled at a different time. It is important to provide positive feedback when a child remains calm and accepts the response of ‘No.’

The Leafwing Center offers services to teach children the skill of accepting the word no, which can be reinforced at home. ABA therapists will create personalized plans based on the child’s ability level and are trained to address the behavior that comes with teaching the skill of accepting the word no.

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How to teach your child with autism to wait

How to teach your child with autism to wait

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Parents often ask how to teach their child with autism to wait, as waiting is a part of everyday life. Waiting in lines, for food, or at stop lights is natural. However, waiting can be difficult for the average child, who may feel like waiting equals not getting what they want. For a child with autism, waiting can be even more challenging as they may struggle with understanding what it means to wait and how long it may take. However, there are a few ways to teach a child with autism how to wait, these are:

  • Practicing Waiting
  • Visuals
  • Social Stories
  • Distinguish between waiting and unavailable

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How to teach your child with autism to wait

How do you practice the skill of waiting?

One of the first things in teaching your child with autism to wait is to practice waiting. Being able to practice waiting in low-stakes situations can help a child build up the stamina for waiting. Do not let a child’s first experience be out in public or in an unfamiliar place as they will need to process their emotions when it comes to waiting and it can be a stressful situation for everyone. Practice waiting at home so a child with autism can have a safe space to process the frustration or anger that can come with the activity of waiting. When they ask for their favorite treat, ask them to wait for two minutes the first time and explain why we have to wait. Continue to build up the time to practice them waiting and increase their stamina for waiting.

Also, it is important to create a trusting and safe environment for your child with autism as this can help with waiting. Make sure to reward them for their patience and explain the consequences when they do not wait. Give them choices between two activities or items that can help them understand why one has to wait, such as allowing them to choose which toy they get first and the other one after they’ve waited.

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How to teach your child with autism to wait

Wait Visuals for autism

Visual aids can be helpful for children with autism to learn and process new tasks. These aids may include timers or wait symbols to indicate waiting periods. The timer helps the child understand that the wait will end and they will receive what they want. If there are other children present, a wait sign acknowledges the child with autism’s needs and communicates that attention will be given as soon as possible. This reassures the child that they have not been forgotten.

It’s also important to remember that for a child with autism, it might take longer for them to process the instructions of having to wait. So, it’s best to give them enough time and repeated reminders if necessary. The goal is to teach your child the ability to pause and think before responding rather than impulsively reacting.

You can practice this by:

  • role-playing scenarios with them
  • using visual cues
  • rewards

When teaching your child with autism to wait, it’s important to remain consistent, patient, and understanding. It can be helpful to provide visual cues like a timer or picture that shows how long the wait time is going to be.

Use verbal reminders:

  • Count down from 10
  • Repeat instructions in smaller chunks

Additionally, positive reinforcement such as praising your child and offering rewards for successful waiting can help encourage desired behavior. For example, if your child is able to wait a certain amount of time before asking for something, you can reward them with extra playtime or a special treat. It’s also important to stay calm and provide positive reinforcement during times when the waiting process gets difficult. Being consistent, understanding, and reinforcing good behavior teaches your child with autism to wait can be difficult, but the end result is a reward that they desire.

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Wait Social Stories for autism

Social stories are a way to teach children with autism to wait. They use visuals and characters to depict real-life experiences. For instance, waiting in the grocery store can be addressed with a social story. The story can feature a child with the same name as the real-life child waiting in line for check out at a specific grocery store, even including the name of a cashier.

A good social story would include:

  • The who
  • The what
  • The where
  • The why
  • Should be written in a positive manner (what should happen instead of what not to do)
  • Include real-life feelings the child could face in that situation

The story should be written in the first person and should include visuals of the child waiting in line, interacting with the cashier, and getting their food. It can also include a few sentences about how long it took for the checkout process to finish. The social story should end with a positive outcome that reinforces to the child that waiting is an important skill to have and something they can do.

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Distinguish between “wait” and “unavailable”

When teaching your child with autism to wait, it is important to help them distinguish between “wait” and “unavailable.” Waiting can be a difficult concept for someone with autism to understand, but it is essential for their development. To make the distinction clear, explain that waiting means that something will happen soon and that they should remain patient until it does, whereas unavailable means that it won’t happen at all or not for a long time.

Unavailable:

For example, let’s say your child wants cereal for breakfast but you are out of their favorite cereal. You would not want to teach the wait skill here because they are not going to be getting their cereal. Therefore you must show them that unfortunately, they are going to have to pick something else because their cereal is currently not available in the house. You can do this by showing an empty container to show that the cereal is all gone.

Waiting:

Teaching the skill of waiting only works when there is something for the child to receive at the end of the waiting whether tangible or not. This could be the item they wanted to eat or buy or going to the park or leaving the grocery store for home.

Teaching the skill of waiting can be very beneficial to everyone involved. It can prevent meltdowns and undesirable behavior from occurring. Additionally, waiting is a skill that everyone has to learn and put to use in everyday life. Similarly, to their peers, children with autism can struggle at first with the skill of waiting. Therefore, teaching a child with autism to wait through practice, visuals, and social stories can improve their waiting endurance.

The Leafwing Center offers services to teach children the skill of waiting, which can be reinforced at home. Two common difficulties that we encounter when working with families over the years are regarding waiting and when a child is told no.  These two scenarios can be overwhelming as they are often accompanied by the most intense challenging behaviors. ABA therapists will create personalized plans based on the child’s ability level and are trained to address the behavior that comes with teaching the skill of waiting.

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Other Related Article

Frequently asked questions about ABA therapy

What is ABA Therapy used for?

ABA-based therapy can be used in a multitude of areas. Currently, these interventions are used primarily with individuals living with ASD; however, their applications can be used with individuals living with pervasive developmental disorders as well as other disorders. For ASD, it can be used in effectively teaching specific skills that may not be in a child’s repertoire of skills to help him/her function better in their environment whether that be at home, school, or out in the community.  In conjunction with skill acquisition programs, ABA-based interventions can also be used in addressing behavioral excesses (e.g., tantrum behaviors, aggressive behaviors, self-injurious behaviors). Lastly, it can also be utilized in parent/caregiver training.

In skill acquisition programs, a child’s repertoire of skills is assessed in the beginning phase of the services in key adaptive areas such as communication/language, self-help, social skills, and motor skills as well.  Once skills to be taught are identified, a goal for each skill is developed and then addressed/taught by using ABA-based techniques to teach those important skills. Ultimately, an ABA-based therapy will facilitate a degree of maintenance (i.e., the child can still perform the learned behaviors in the absence of training/intervention over time) and generalization (i.e., the learned behaviors are observed to occur in situations different from the instructional setting).  These two concepts are very important in any ABA-based intervention.

In behavior management, the challenging behaviors are assessed for their function in the beginning phase of the services. In this phase, the “why does this behavior happen in the first place?” is determined. Once known, an ABA-based therapy will be developed to not just decrease the occurrence of the behavior being addressed, but also teach the child a functionally-equivalent behavior that is socially-appropriate.  For example, if a child resorts to tantrum behaviors when she is told she cannot have a specific item, she may be taught to accept an alternative or find an alternative for herself. Of course, we can only do this up to a certain point—the offering of alternatives.  There comes a point when a ‘no’ means ‘no’ so the tantrum behavior will be left to run its course (i.e., to continue until it ceases).  This is never easy and will take some time for parents/caregivers to get used to, but research has shown that over time and consistent application of an ABA-based behavior management program, the challenging behavior will get better.

In parent training, individuals that provide care for a child may receive customized “curriculum” that best fit their situation.  A typical area covered in parent training is teaching responsible adults pertinent ABA-based concepts to help adults understand the rationale behind interventions that are being used in their child’s ABA-based services.  Another area covered in parent training is teaching adults specific skill acquisition programs and/or behavior management programs that they will implement during family time.  Other areas covered in parent training may be data collection, how to facilitate maintenance, how to facilitate generalization of learned skills to name a few.

There is no “one format” that will fit all children and their families’ needs. The ABA professionals you’re currently working with, with your participation,  will develop an ABA-based treatment package that will best fit your child’s and your family’s needs. For more information regarding this topic, we encourage you to speak with your BCBA or reach out to us at info@leafwingcenter.org.

Who Can Benefit From ABA Therapy?

There is a common misconception that the principles of ABA are specific to Autism. This is not the case. The principles and methods of ABA are scientifically backed and can be applied to any individual. With that said, the U.S. Surgeon General and the American Psychological Association consider ABA to be an evidence based practice. Forty years of extensive literature have documented ABA therapy as an effective and successful practice to reduce problem behavior and increase skills for individuals with intellectual disabilities and Autism Spectrum Disorders (ASD). Children, teenagers, and adults with ASD can benefit from ABA therapy. Especially when started early, ABA therapy can benefit individuals by targeting challenging behaviors, attention skills, play skills, communication, motor, social, and other skills. Individuals with other developmental challenges such as ADHD or intellectual disability can benefit from ABA therapy as well. While early intervention has been demonstrated to lead to more significant treatment outcomes, there is no specific age at which ABA therapy ceases to be helpful.

Additionally, parents and caregivers of individuals living with ASD can also benefit from the principles of ABA. Depending on the needs of your loved one, the use of specified ABA techniques in addition to 1:1 services, may help produce more desirable treatment outcomes. The term “caregiver training” is common in ABA services and refers to the individualized instruction that a BCBA or ABA Supervisor provides to parents and caregivers. This typically involves a combination of individualized ABA techniques and methods parents and caregivers can use outside of 1:1 sessions to facilitate ongoing progress in specified areas.

ABA therapy can help people living with ASD, intellectual disability, and other developmental challenges achieve their goals and live higher quality lives.

What does ABA Therapy look like?

Agencies that provide ABA-based services in the home-setting are more likely to implement ABA services similarly than doing the same exact protocols or procedures. Regardless, an ABA agency under the guidance of a Board-Certified Behavior Analyst follows the same research-based theories to guide treatment that all other acceptable ABA agencies use.

ABA-based services start with a functional behavior assessment (FBA). In a nutshell, a FBA assesses why the behaviors may be happening in the first place. From there, the FBA will also determine the best way to address the difficulties using tactics that have been proven effective over time with a focus on behavioral replacement versus simple elimination of a problem behavior. The FBA will also have recommendations for other relevant skills/behaviors to be taught and parent skills that can be taught in a parent training format to name a few. From there, the intensity of the ABA-based services is determined, again, based on the clinical needs of your child. The completed FBA is then submitted to the funding source for approval.

One-on-one sessions between a behavior technician and your child will start once services are approved. The duration per session and the frequency of these sessions per week/month will all depend on how many hours your child’s ABA services have been approved for—usually, this will be the number recommended in the FBA. The sessions are used to teach identified skills/behaviors via effective teaching procedures. Another aspect of ABA-based services in the home-setting is parent training. Parent training can take many forms depending on what goals have been established during the FBA process. The number of hours dedicated for parent training is also variable and solely depends on the clinical need for it. If a 1:1 session is between a behavior technician and your child, a parent training session or appointment is between you and the case supervisor and with and without your child present, depending on the parent goal(s) identified. Parent training service’s goal is for you to be able to have ample skills/knowledge in order for you to become more effective in addressing behavioral difficulties as they occur outside of scheduled ABA sessions. Depending on the goals established, you may be required to participate in your child’s 1:1 sessions. These participations are a good way for you to practice what you have learned from the case supervisor while at the same time, having the behavior technician available to you to give you feedback as you practice on those new skills.

As mentioned in the beginning, no two ABA agencies will do the same exact thing when it comes to providing ABA services; however, good agencies will always base their practice on the same empirically-proven procedures.

How do I start ABA Therapy?

In most cases, the first item required to start ABA therapy is the individual’s autism spectrum disorder (ASD) diagnosis report. This is typically conducted by a doctor such as a psychiatrist, psychologist, or a developmental pediatrician. Most ABA therapy agencies and insurance companies will ask for a copy of this diagnosis report during the intake process as it is required to request an ABA assessment authorization from the individual’s medical insurance provider.

The second item required to start ABA therapy is a funding source. In the United States, and in cases where Medi-Cal or Medicare insurances are involved, there is a legal requirement for ABA services to be covered when there is a medical necessity (ASD diagnosis). Medi-Cal and Medicare cover all medically necessary behavioral health treatment services for beneficiaries. This typically includes children diagnosed with ASD. Since Applied Behavior Analysis is an evidence based and effective treatment for individuals with ASD, it is considered a covered treatment when medically necessary. In many cases, private insurance will also cover ABA services when medically necessary, however in these cases, it is best to speak directly with your medical insurance provider to determine the specifics of the coverage and to ensure that ABA is in fact, a covered benefit. Additionally, some families opt to pay for ABA services out-of-pocket.

The next step to starting ABA therapy is to contact an ABA provider whom you are interested in working with. Depending on your geographic location, ABA agencies exist in many cities across the United States. Your insurance carrier, local support groups, and even a thorough online search can help you find reputable and properly credentialed ABA agencies near you. Our organization, LeafWing Center, is based in southern California and is recognized for aiding people with ASD achieve their goals with the research based on applied behavior analysis.

Once you have identified the ABA provider with whom you wish to work, they should help you facilitate the next steps. These will include facilitating paperwork and authorizations with your funding source. Once the assessment process begins, a BCBA (Board Certified Behavior Analyst) or qualified Program Supervisor should get in contact with you to arrange times in which interviews with parents/caregivers and observations of your loved one can be conducted. This will help in the process of gathering important clinical information so that with your collaboration, the most effective treatment plans and goals can be established for your loved one. This process is referred to as the Functional Behavior Assessment (FBA) and is elaborated on in different blog posts on our website. With regard as to what can be expected once ABA therapy begins, please read our blog post titled: When You Start an ABA program, What Should You Reasonably Expect from Your Service Provider?

Some Considerations and Strategies for Students with Autism in Classroom Settings

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When creating an educational program for students with ASD, each student’s unique characteristics present unique challenges for administrators and school support staff. An effective classroom must include a physical structure that enhances learning opportunities and instructional approaches that facilitate learning, language acquisition, behavior management, social skills, and academic goals. We can apply many of the basic principles of effective instruction that are used in within the general education classroom as we work with students with autism and Asperger Syndrome, however, there are certain strategies that have been proven to be particularly effective. These strategies provide structure and predictability to the learning process, allow students to anticipate task requirements and setting expectations, and teach a variety of skills across content areas in the natural environment, enhancing the likelihood of generalization.

Predictability and sameness are significant factors throughout student’s daily lives. One way to address these elements in the classroom is with “Environmental Supports”. Environmental supports help students organize the physical space in ways that help our students predict any changes in their daily routines or deviations from typical expectations that may take place during the school day; different activities or events, a substitute teacher, or fire drills. We can help students understand expectations, and in general, make sense of their entire environment. Researchers have defined environmental support as “aspects of the environment, other than interactions with people, which affect the learning that takes place”. Examples of environmental supports are: Labels, Boundary settings, Visual schedules, Behavioral-based education tools, Activity completion signals, Choice boards, and Waiting supports.

All of these environmental support strategies are a simple yet effective way to help a student respond appropriately in their day-to-day activities throughout their school day. Environmental supports can be effectively utilized across all environments and all settings to help support individual with ASD. Additionally, environment supports have been shown to increase student independence, and help stimulate language.

The physical organization of the classroom can be a crucial element for them enhancing success. Structure and predictability facilitate the students understanding of the environment, which can help decrease worry or agitation the student might have. This is really important for students with autism who tend to react negatively or really that difficult time with changes and unsent uncertainty in their environment. Something as simple as labeling furniture and objects in a classroom can have numerous benefits for students with autism; label boxes or containers with visual representations such as icons or hand-written labels. Students can then be taught to match the label on the container to the label on the shelf, allowing independents in retrieving or returning an activity to its appropriate place in the classroom.

Again, we want to emphasize that each student is unique and the strategies used need to reflect their unique needs.

How to teach your child with autism to wait

How to teach your child to wait and what you could do before and after telling your child “no”

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Two common difficulties that we encounter when working with families over the years are regarding waiting and when a child is told no.  These two scenarios can be overwhelming as they are often accompanied by the most intense challenging behaviors.  We will go over these on this this post.

First off, the skill of requesting appropriately must be well-established already.  If this skill is not yet in your child’s repertoire then it must be taught first. If the skill is already there, but it’s not as fluent as we’d need it to be, then work on that first.

Let’s say your child can already ask for a cookie—this is great, but what can you do if for some reason, you child has to be told to wait?   If your first thought given that question you just read is along the lines of “oh…” then do consider the following.  There is this passage of time that happens between being asked to wait for something and finally getting that something.  The key here is working on that gap.  Depending on how your child “understands” that concept—time—you may have to be more hands-on when helping out your child go through it.   Instead of simply saying “wait,”  try giving your child something that he likes to “kill time.” This is not something out of the ordinary. Case in point: look at long lines of people at a grocery store, a theme park ride, at a bank, et cetera.  It is very rare to see a long line of people, waiting, just starting blankly at the back of the head of the person in front of them (unless you’re in the military or something similar) and just “wait” for their turn.  Perhaps you’ll notice a handful dealing with waiting in not-so-positive ways but for the most part, people will do something to pass time.  From being on their phones, talking to someone whom they are with, looking around, reading a book—we, again, most of us, can handle waiting because we fill that gap with something else.  And that is something that you can try out—offer your child something that they will not mind doing while they wait.  The more reinforcing that activity the better. When starting to teach your child to wait while engaged in something, make sure to keep the wait-time very short. How short?  It depends on each child really, but a good rule of thumb is to end the wait when your child is still behaving well (i.e., before your child starts that path to a full-blown tantrum). Let’s say that time is around one minute—great. Keep it around that time limit and systematically increase the time just a bit and stay on that higher limit (e.g., from one minute to about two minutes) until your child gets used to it.  From there, you can once again increase the limit to say three minutes.  This does not happen without any difficulty—the key here is you being consistent.  Also, avoid a situation wherein the wait time had been too long that your child “forgets” about whatever it is he or she is waiting for.  You need your child’s motivation for whatever it is he or she is waiting for for the learning process to “click.”  Once that motivation goes away, the teachable opportunity is lost so it is best to be realistic on how long you really want your child to wait.

Again, teach waiting only if they can truly have that cookie, but at a later time (or after a number of activities).  If they cannot have that cookie, then don’t say wait (after which they do) then tell them no in the end. Hence, the next topic: what can you do when you are about to tell your child no (i.e., denial).

True: a no is a no and that is something our children must learn; however, before we get to that lesson, let’s take a few steps back.  If you know that your child cannot have that cookie, give your child’s behaviors a chance to not escalate.  Offer your child something she likes instead of whatever that is she wants at the moment.  The key here is you offering an alternative that she truly wants—whatever that is given that moment.  If your child accepts the alternative—great!  If your child does not like your attempts to compromise—and if your child is capable—ask her to choose her own alternative item/food/activity.  Be prepared to honor her choice.  If your child accepts that scenario—great!   If not, time to roll up your sleeves—it’s time to teach your child that no means no.  There is no going around this.  You have offered her alternatives. You have also given her a chance to choose her own alternative.  If those fail, you have done your job but despite your efforts to teach alternatives, the tantrums will happen. As those behaviors are happening, the worst thing that you can do is give in—no.  Don’t give in as that will only reinforce all those not-so-nice behaviors.  It will be difficult, but a no is a no.

When your child’s behaviors start to de-escalate, it is still possible to offer her alternative and/or giving her a chance to select her own, but never give in.

If your child already engages in the most extreme challenging behaviors such as self-injurious behaviors or property destruction or any other behaviors that compromise the safety of others during times when he or she is denied access to something, we highly recommend that you immediately seek assistance from a trained professional.

What should you do IN RESPONSE to your child engaging in challenging behavior?

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Remember those four reasons why people may engage in challenging behaviors discussed in the previous post?  People may want attention from other people, may want something, may want to get out of something, or may enjoy how the behavior feels.  If you haven’t already read it, we suggest reading the prior post so the information below is as useful as possible.

This post will focus on reactive strategies, based on the reason your child is engaging in the particular challenging behavior.  In other words, what should you do in response to your child engaging in the behavior?  This is probably the most stressful for parents as they may wonder if what they are doing is right.  They may wonder if they are hindering or helping their child.  Hopefully we can provide some guidance.

If your child engages in a particular challenging behavior to get something that he/she wants, it is important for him to learn that his behaviors do not lead to getting what he/she wants.  You should avoid giving them what they want when engaging in the problem behavior, and even after the behavior ends.  The child should only be allowed to get what they want if he engages in a more appropriate behavior, which we will discuss in a future post. This can be difficult for parents as giving the child what they want quiets them down and relieves much of the stress in the home or community setting.  The problem is that your child will learn this connection and continue to engage in this behavior in the future when they want to same thing. It will become a repeated cycle.

If your child engages in a particular challenging behavior to get out of something, such as homework or eating dinner, it is important to not allow him to get out of the situation until they engage in a more appropriate behavior.  If the child hits and screams while doing homework, it is important to follow through, require them to complete a few more problems without hitting and screaming, and then they can leave.  More appropriate behaviors to get out of doing things they don’t want to do will be discussed in future posts.

If your child engages in a particular challenging behavior to get attention, you should avoid providing attention to them until the behavior is not occurring or he engages in a more appropriate behavior to get your attention.  Providing attention only teaches them that this bad behavior leads to what they want.  This connection needs to be disconnected and the child needs to be taught more appropriate ways to get attention.

Last, if your child engages in some challenging behavior because it feels good, such as head banging, it is important to block this behavior so that this particular behavior does not provide the sensory satisfaction that your child is receiving (in addition to preventing them from doing harm to themselves).  You can physically block the behavior or there are many devices created for this purpose.

Stay tuned for a future post providing suggestions for what to teach your child to do instead of engaging in the bad behaviors they currently know will get them what they want.  Just reacting how we have described above will not teach new, appropriate ways to get what they want.  Teaching a new, more appropriate behavior is the key to decreasing challenging behaviors.

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