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Celebrating Women in Autism this International Women’s Day

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For decades, women have played a crucial role in diagnosing, understanding, and treating autism spectrum disorder (ASD). As ASD becomes more prevalent, women continue to be instrumental in developing and refining treatment through vast areas of research. There is much to be recognized, not only for women’s incredible contributions to the autism field but also for their experiences living on the spectrum.

In honor of International Women’s Day, check out our top five All Autism Talk podcast episodes featuring notable women.

1. Dr. Temple Grandin – Navigating Autism

2. Dr. Ronit Molko – Girls and Autism: Diagnosis, Treatment, and New Research

3. Devon Sundberg – Women in Behavior Analysis

4. Jennifer Cook – Female Life on the Spectrum

5. Adrienne Bradley – Race and How it Impacts ABA and Our Community

 

All Autism Talk is a leading autism podcast that offers friendly conversation with inspiring individuals in the autism community. To learn more about All Autism Talk, please visit

Successful Models for Assent-Based Vaccine Clinics

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Wisconsin Early Autism Project’s Green Bay region joins us to share about a unique clinic event and what can be learned. Kerry shares details of sensory-friendly covid vaccine events that utilized assent-based practice to create a comfortable experience for children. As Kerry put it, “When it was time for the shot, that was determined by the child. We were very open and honest with the child and let them know it would only happen when they said it was ok.”

5 Tips for Navigating Autism Treatment for Your Multilingual Child

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Maia Jackson, M.S., BCBA
Clinical Development Manager, LEARN Behavioral

Language development is a critical component of the day-to-day lives of young children. It is used within a variety of contexts, including playing with peers, building relationships, functionally communicating needs, etc. As such, there is a heavy emphasis on language and communication built into most applied behavior analytic (ABA) programs. Because such a heavy emphasis is placed on language, it is important that practitioners are mindful of the specific language or languages that are incorporated in the therapeutic setting. In order for ABA programs to be socially significant, services should represent and accommodate for the dominant language of the family. By doing so, children and their families will experience a variety of benefits.

By promoting the use of the family’s native language, children have an increased likelihood of communication opportunities with their immediate and extended families, friends, and community. In addition to having more opportunities to communicate, the quality of the interactions will be more meaningful as caregivers are more likely to effectively express their own emotions, hold their child’s attention, and more thoroughly discuss topics of interest when using their native language (Zhou, et al., 2019). There are also benefits to multilingualism outside of the familial unit. Research has shown that children who are raised in multilingual homes tend to demonstrate higher perspective talking skills than children who do not (Zhou, et al., 2019). Despite all of the benefits to speaking one’s native language, families often face a number of barriers, especially when seeking out autism-related services.

While we live in a culturally diverse country, English remains the dominant language in most regions of the U.S. When children turn on the TV, chances are the shows they watch are in English. When they go to school, they will receive a primarily English education and their peers will speak primarily English. Autistic individuals who receive behavior analytic treatment in the U.S. are likely receiving those services in English. Despite all of these barriers, there are ways for parents and caregivers to advocate for their bilingual children and family.

1. Look for providers who speak your native language. 

One of the first measures to take when selecting a service provider is to request clinicians who speak your native language. Bilingual service providers can be hard to find and it may take time, but let your provider know your preference so they can attempt to hire and/or pair you with appropriate staff members.

2. Request translation services.

In cases where there are no staff members available to provide services in your native language, consider asking for translation services. Even if you are proficient in English, it may be easier or feel more comfortable for you to communicate in your native language. Per the Behavior Analyst Certification Board’s (BACB) Ethics Code for Behavior Analysts, the clinician you are working with should make every effort to effectively communicate with you and provide you with the opportunity to ask questions and participate in the development and implementation of your child’s program.

3. Consider the assessment language.

If your child speaks a language other than English, it is important to discuss the benefits of your child being assessed in that language. Providers use assessment results as a tool to guide the clinical program and decision making. Having the results of the assessment in your child’s primary or dominant languages will give a more accurate picture of your child’s strengths and areas of need. The starting point of the program will be more representative of your child’s language abilities.




4. Ensure the program is visually representative of your child and your family.

Visual tools and stimuli are often used as prompts, supports, and/or reinforcement systems within many ABA programs. These visual supports may serve to outline a schedule for the day, visuals might accompany a short narrative or story describing a social scenario your child might encounter, or you might see visual images used as reminders or prompts of what steps come next in routine with multiple steps, such as hand washing.  These visual items should be representative of your child and your family. Discuss incorporating your native language and culture into these items in order to promote their use and acceptance by your child. If your child accepts the stimuli and is motivated to use them, effectiveness of their intended purpose will likely increase. 

5. Discuss your language and other cultural values with your team.

Per the Ethical Code for Behavior Analysts, your cultural norms, traditions, and expectations should be extended through all aspects of the ABA program. Social interactions, communication, play activities, and activities of daily living are areas that are addressed in many ABA programs and are going to be affected by language, culture, and traditions. Discussing the ways your language and culture impact your day-to-day routines and expectations will help the clinical team develop and implement a program that is best suited to your child and your family.  
Serving as the navigator and advocator of your child’s services is a huge role. Advocating for language will often be just as important as advocating for hours, goals, or other supports.  Use your team to provide support and to feel empowered to be the advocate your child and your family need.

Supports at LEARN:

  • Document translation services
  • Translation services
  • Language Resource Library
  • Staff training and tools related to Diversity, Equity and Inclusion

Zhou, A., Munson, J.A., Greenson, J., Jou, Y., Rogers, S., Estes A.M. (2019). An exploratory longitudinal study of social language outcomes in children with autism in bilingual home environments. Autism, 23(2), 394-304.

3 Tips for Making Valentine’s Day Special for Your Autistic Child

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As store shelves turn to masses of pink and red, some people get excited and others groan. Valentine’s Day, with all of its joy and complexities, is around the corner. Although love and social connection are important to everyone, Valentine’s Day can be tricky to navigate for many people, including some of our autistic loved ones. Different ages bring different challenges: from the drama of classroom valentine exchanges to the heart-stopping anxiety of having a date. Wherever your child may fall on this continuum of V-Day Life Lessons, a few considerations can help them feel cherished on this day.

Prepare

Consider the potential challenges that your child might encounter that could be helped by some advance skill-building. Think carefully about what your child will encounter that day and what easily-acquired skills might help them enjoy the day more. A younger child whose class is exchanging valentines might benefit from practice; find out how the teacher will approach this (will the kids deposit them into a box or hand them out individually?) and rehearse in advance. A teen attending a dance might benefit from a social story about what to expect, previewing conversation starters, and maybe watching some realistic shows depicting teen dances to help set expectations. If anxiety is a factor (as it can be with anyone of any age!), make sure there is an easy way for them to contact you for an early pick-up. For safety, teens and young adults who are dating should have information about consent and sexual harassment at a level they can understand. Learning about good hygiene practices, manners, and general dating “dos and don’ts” can help to set them up for success.

Accommodate

There will also be challenges on Valentine’s Day that can’t be solved by skill-building. Consider your child’s experience and be creative about the types of accommodations that might help them enjoy the day the most. If your child is on a special diet, find out if there will be school treats so you can arrange for something yummy for your little one. Some children will not enjoy the “typical” Valentine’s Day activities. Remember, it’s once a year, don’t stress over making them go to a class party they won’t enjoy. There may be accommodations that can help make regular activities okay (headphones), or you can simply ditch the regular valentines’ stuff and think of some fun alternatives instead. Perhaps instead of going to the dance, they can rather invite a friend over to bake brownies or watch a movie with their sibling.

Love

Valentine’s Day is an opportunity to show others how much you care. As a parent or caregiver, showing affection for our children is one of the most fulfilling experiences. Think about your child’s preferences and give them a token of your love, whether that be treats, attention, a new Lego set, or a special rock. Giving them choices in preparing for the day (e.g., picking out valentines, choosing a special dessert, etc.), thinking about how to include their preferred interests in your plans, and making plans to accommodate sensory needs can communicate your love and respect.

Some profoundly affected autistic folks will not be affected by the fact the world has turned pink and red; they may not understand or care. But this doesn’t prevent them from receiving your love and affection in the ways they do the rest of the year, so take the opportunity to connect with them on their level. Many autistic folks tend to anthropomorphize; if there are things (e.g., trains, books, electronic devices, etc.) that are the object of your child’s affection, think about how to celebrate these objects that give your child joy.

For those autistic children who understand the social nuances of Valentine’s Day, it can create pressure around feelings of popularity and acceptance. If your child is experiencing these common hardships, do your best to shift the emphasis away from romantic love and toward other satisfying relationships in your child’s life. For some, that may be a friend, or for others, it may be family. Reassurance that they are accepted at home and loved unconditionally is paramount.

Have Happy Valentine’s Day!

Last but not least: show yourself some love as well. Parenting isn’t easy and requires many qualities, including patience, empathy, and, most importantly, love. The love we give our children isn’t always returned in the moment, making it hard sometimes to reflect on all the wonderful things you do for your child. Remember, you’re raising a human, which is stressful yet important and incredible work. As you nurture your relationship with your child, you build their capacity to love and show love to others. This Valentine’s Day, take some credit for all you do for your child in the name of love and find a way to treat yourself, whether that means setting aside time to read or exercise, getting an extra hour of sleep, or calling a friend. You deserve just as much love on this special day.

 

For research-backed strategies on managing stress, check out “How Parents and Caregivers of Kids with Autism Cope with Stress.” To dive deeper into the topic of love and autism, learn more at “Myth: People with Autism Don’t Feel Love.”

Myth: Autistic People Lack Empathy

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Katherine Johnson. M.S., BCBA
Senior Director of Partnerships, LEARN Behavioral

 Note: This article is about a form of ableism that affects one part of the autistic community: autistic people who are proficient verbal communicators. Those who communicate with AAC devices, typing, sign, or who don’t yet have the communication skills to engage with the wider world face other forms of ableism and discrimination not described in this article. 

 

The Double Empathy Problem

Remember the game “telephone”? One person whispers a message to another, that person whispers to the next, and on down the line until the last person announces the message so everyone can laugh at how many times the original sentence has been distorted.

Using a variation of this exercise, a study looked at how a message fared if the string of people in the telephone line were all autistic, all neurotypical, or a mix of both. It turns out that the rate at which the message degraded among the verbal autistic people was no greater than that of the neurotypical people.  It was only when the message was sent through a mix of autistic and neurotypical people that the meaning deteriorated significantly faster.

What does this tell us? 

If effective social communication was objectively deficient (not just different) in verbal autistic people, we would expect that the all-autistic string of people would produce the worst decline in messages in the study; that wasn’t the finding. Instead, the autistic people received and passed along messages amongst themselves just as well as the neurotypical people. The faulty communication resulted not from the autistic participants but from the mismatch between autistic and neurotypical communication.

This small study illustrates a theory by Dr. Damian Milton that he calls the “double empathy problem.” Challenging the assumption that neurotypical people have social skills that autistic people simply lack, he posits that the disconnects between autistic and non-autistic people are not the result of a one-sided skill deficit; they are instead a mismatch of neurotypes.

Reframing

This is a dramatic reframing of the common belief about these communication breakdowns, which placed the fault squarely on the social skill profile of the autistic folks. The “empathy” part of the theory’s name refers to the widely-held idea that autistic people lack empathy, when the theory would suggest that autistic empathy is simply expressed differently. Slowly but surely, researchers are beginning to look at that other side of the coin: how the social skill profiles of neurotypical people might also undermine relationships.

For years, research has demonstrated that autistic people have difficulty interpreting facial expressions; a 2016 study finally looked at the reverse. They asked neurotypical people to interpret facial expressions of autistic folks – and they were unable to do it. The results of a series of studies in 2017 suggest that one reason people of different neurotypes have difficulty connecting is because neurotypical people form negative first impressions of autistic people (based upon appearance, not conversational skills), and subsequently avoid them. This indicates that some of the social isolation that autistic people face is due to ableism and discrimination.

Missing Out

The difficulties autistic and non-autistic people have connecting negatively impact both sides. Since autistic people are in the minority, disconnection from the neurotypical portion of their community can increase their feelings of loneliness and isolation. For its part, the neurotypical world is missing out on the unique, often innovative, autistic perspective.

Autistic people who have had huge cultural impacts on our society (environmental activist Greta Thunberg, actor Dan Akroyd, and Pokemon creator Santoshi Tajiri, to name a few) have had success in spite of a society that is largely unsupportive of and, at times, openly hostile to, the social profile of autistic folks. Imagine what brilliance we miss out on when autistic people are looked over, avoided, not hired, etc.

Even those who are not destined to become one of the famous few mentioned above have a perspective that can deeply impact those around them. Autistic people see the world from different angles, which can be an advantage in everyday problem-solving. They generally have a strong sense of justice, an unwillingness to be cowed by hierarchy, and a drive for honesty, sincerity, and specificity, all beneficial qualities in social relationships and the workplace.

Expanding Neurotypical Empathy

The solution to the separation between people of different neurotypes has largely been to teach autistic people how to understand the rest of the world better. But by considering the double-empathy problem, we can see that this is only part of the issue. The other part is that non-autistic people also have skill deficits: interpreting and interacting with autistic people.

Just as history is written by the winners, social norms are written by the majority. If we want to work toward a future where people of all neurotypes better understand one another, we must listen to the experiences of the minority. It’s important to recognize that neurotypical “social norms” exist because they’re most common, not because they are inherently superior. These dominant “social norms” directly result from how neurotypical people think, behave, and process the world.

“Empathy” is about understanding another person’s experience. Ironically, to succeed in our society, autistic people must display empathy nearly constantly: decoding others’ unwritten rules and learning to approach the world in a way that works for others. To bridge the divide, nurture the gifts of the autistic people in our society, and for everyone to benefit from the valuable perspectives of the neurodivergent, those with neurotypical brains must follow this example. By challenging themselves to work toward understanding and adapting to the way autistic people see and experience the world, neurotypical folks can open themselves up to new friends with an intense devotion to honesty. Employers will find innovative autistic employees with rare specializations and a knack for accuracy. And society will benefit from recognizing and celebrating the valuable and previously underappreciated gifts of the autistic mind.

 

Damian E.M. Milton (2012) On the ontological status of autism: the ‘double empathy problem’, Disability & Society, 27:6, 883-887, DOI: 10.1080/09687599.2012.710008

Sheppard, E., Pillai, D., Wong, G.TL. et al. How Easy is it to Read the Minds of People with Autism Spectrum Disorder?. J Autism Dev Disord 46, 1247–1254 (2016). https://doi.org/10.1007/s10803-015-2662-8

Sasson, N., Faso, D., Nugent, J. et al. Neurotypical Peers are Less Willing to Interact with Those with Autism based on Thin Slice Judgments. Sci Rep 7, 40700 (2017). https://doi.org/10.1038/srep40700

A Closer Look at The BHCOE

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Dr. Ellie Kazemi is the Chief Science Officer at Behavioral Health Center of Excellence (BHCOE), an accrediting organization focused on improving the quality of behavior analytic services. She is also a professor at CSUN, where she founded the M.S. in Applied Behavior Analysis (ABA) program. Dr. Kazemi joins us to share about the accreditation process and the importance of assessments and measuring outcomes in the field of ABA. As Dr. Kazemi discusses the value of connecting the perspectives of the families and the clients, and shares, “To measure outcomes you should see progress from different perspectives”.

 

For More Information:

https://www.bhcoe.org/ 

 

All Autism Talk is sponsored by Learn Behavioral. 

7 Tips for Snow Day Fun

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While no one can argue with the fun of traditional activities, such as building snowmen or snow angels, keeping your kiddo occupied throughout an entire snow day while confined to your house might require a few more tricks up your sleeve.

Consider the unique opportunities the snow can provide for you and your kiddo to explore different language concepts, social skills, academic tasks, and leisure activities. Think about bringing what winter has to offer indoors, where it is warm, for a unique way to learn and play together.

To get started, grab a few safe bowls (think plastic Tupperware), some pots, a muffin tin, and a few spoons of different sizes. Fill one bowl with cold water and another with hot water. Throw a big beach towel on the floor and grab some of that white, powdery stuff! Here are seven tips for snow day fun.

     1. Let your child explore, figure out what they like about the activity, and add to what they find fun. If they’re watching you and waiting for what you will do next, you’ve got it right!

     2. In the beginning, don’t demand your child’s attention. Show them some fun ways to play with the snow and “kitchen stuff” and talk about what is happening. “Wow, you smashed the snow!” “Did you see it melt in the hot water?” “You got more snow!” “Stir, stir, stir, good job stirring!”

     3. Language Concepts: Once you’ve got the activity going, use the snow to start talking about fun, related language concepts like hot/cold, wet/dry, and melting/frozen.

     4. Social Skills: Take turns using the spoons, stirring, and playing. Encourage and model social skills by commenting about the activity and what you or your child enjoy. “Watch it melt!” “Wow, that is cold!” “I like playing in the snow!”

     5. Academic Tasks: Discuss weather, precipitation, seasons, and states of matter (solid, liquid, gas). Use your muffin tin and practice counting as you fill each cup.

     6. Leisure Skills: Feel free to step away from the activity and let your child dig in on their own. Sustaining a play activity and incorporating newly learned play skills modeled by an adult play a crucial role in learning.

     7. Be sure to set boundaries about where the snow must stay. We suggest prompting all snow activity back to the area of the beach towel.

Most importantly, have fun and enjoy this new experience!

8 Tips for Planning for a Successful Holiday for Your Autistic Child

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The holidays are an exciting time as we share traditions, spend time with family, and navigate the different gatherings and celebrations. Holiday spirit can also bring holiday stress. We want to help you and your family have the most successful (and least stressful) season by offering our best practices and tips.

BEFORE THE HOLIDAYS

Start with Expectations

Having a positive and realistic mindset about what you want to create can make a big difference. What could go right this season? Keep an optimistic view of the possibilities for special moments you want to share. A winning holiday doesn’t have to mean extravagant plans. Consider what would be ideal, be prepared to accept when flexibility is needed, and look for the wins along the way.

Consider Comfort and Safety Needs

When visiting events or other homes, bring items you know will bring comfort for your child—things like earplugs (or headphones), fidgets, and soft clothes. When traveling, ask for needed accommodations from your airline and hotel. Make sure you are aware of possible water nearby and review crisis plans with loved ones.

Practice Before Events

Now is a great time to discuss upcoming changes to schedules and routines. Involve your child in the process whenever possible. Playing memory games with photos of those you will see this holiday season allows your child to identify matching names and faces. Establish a phrase or code word with your child to practice using when they need to take a break from events to calm down and relax.

DURING THE HOLIDAYS

Maintain Routines

During the holidays, change is inevitable but find ways to create or maintain routines for your child. What are things you can build into every day? Perhaps it’s something you do together each morning, afternoon, and evening (regardless of location). Utilizing visual supports like calendars and independent activity schedules can be helpful too.

Build in Fun!

Whether days are filled with errands or time at home, consider letting your child choose a couple of activities each morning for the day ahead. Here are some suggestions that might work for your family:

  • Bake something together
  • Do holiday arts and crafts
  • Take a drive to see holiday lights in your neighborhood, zoo, or garden
  • Help with decorations or gift wrapping
  • Sing along with holiday music

Consider Sensory Needs

Holiday meals can be tricky for some. Plan ahead for alternative foods that you know your child will eat. As we mentioned earlier, being mindful of dressing in (or packing extra) comfortable clothing can be helpful. Preferred items, such as toys or other objects that help promote calm for your child, are a good idea too. Consider making a sensory box that includes things to stimulate your child’s touch/sight/sound/taste/smell. Finally, establish a quiet “break space” that your child can utilize when needed.

WRAPPING UP THE HOLIDAYS

Plan for Rest and Recovery

After each scheduled big event or outing, try to allow time for a quiet evening that follows. Start a list or document on your computer of things that went well that you want to repeat and ideas about what would make it easier next time.

Transition Back to School

Packing holiday decorations and unpacking clothes can be helpful signals to your child that things are moving back to the normal routine. Other visual cues like a countdown calendar for back to school can help prepare them. Show them when school starts and have them mark off the days. Leave extra time the first morning back to school so you can have a nice breakfast and move with ease into the day. If possible, organize a nice, calm activity after school and focus on what went well at the end of the day.