Monterey Bay Forum

Some simple techniques can assist children with attention deficit hyperactivity disorder (ADHD) and/ or autistic spectrum disorder (ASD)to be happier and achieve appropriate goals. These techniques are easy for parents and teachers to implement.

Of course a child is not a car but think of the following analogy:

Every car to get to a destination needs a driver. Parents can assist children to get into the driver’s seat and drive their ‘car’ to appropriate ‘destinations’.

Here’s how to assist children who have difficulties with focus, attention, concentration, ‘executive functioning’ or ‘working memory’ difficulties. Executive functioning and working memory are words used by school psychologists. What the parent sees is a child who can’t seem to figure out what comes first and appear disorganized.

What to do: Get a pad of 8 by 12 inch lined paper.

On one per sheet of paper —
1) Write at the top, a Goal that parents/teachers want the child to achieve.
2) Write out all the Steps required to accomplish the Goal.
3) Order the steps from first to last using KISS (Keep It Simple, Simple)
4) Figure out an appropriate Reward for child accomplishing the steps.
Set it up so child can get partial reward for partial completion.
5) Decide the number of Days child needs to complete the Goal.
6) Draw up a Graph with Days across Top of Page and Goals listed on left.

Here’s an example of a Behavior Plan for a child who shows symptoms of both ADHD and ASD:

Gina is 8 years old and was exposed in utero to illegal drugs and alcohol. Her biological mother lost parental rights and Gina has been in foster care since age two. Since age four, Gina has received County Mental Health therapy and medication to assist with focus, attention and concentration. The therapy provided by County Mental Health focuses only on helping Gina to label emotions and better express her emotions appropriately.

Gina’s foster mother and her teacher agree that Gina’s adaptive functioning abilities are considerably below what they expect for her age. Her foster mother wants Gina to 1) wash her face & brush her teeth; 2) make her bed; 3) put toys in basket in her room; 4) set the table with utensils and plates before dinner.

Goals:

Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Wash face & clean teeth
Make bed
Put toys in basket
Set table with utensils & plates

Spiritual/ religious beliefs need to be integral to a successful Behavioral Plan.
For example, Gina’s foster mother goes to church and rests on Sunday. Therefore the behavior plan is for six days a week and no work on Sunday, their day of rest. Six days a week time four goals = 24 Goals for Gina to achieve. For each Goal achieved she earns one (1) dime. During the week she puts stickers on the sheet and gets her motivators (dimes) which she puts into a plastic, clear jar. That way she can see exactly what she has earned towards a new toy on the weekend. Her foster mother believes Gina can find age appropriate toys for around $2.50 to $3.00 a toy.

What makes a Behavioral Plan successful?
The answer is simple: practice and more practice so the Steps are as simple as possible and the child gets rewarded for partial and then complete finishing the Goal.

For example, Gina when we started could not make her bed said her foster mom. Well, the cover was too big and too heavy for a thin, small 8 year old to move around. Thus, by simplifying and making a bed simply tossing a light duvet (down comforter) on a twin bed and putting the pillow in place — then making a bed by an 8 year old is simple and possible.

A second example:
Gina has never set the table for dinner. Part of the reason is that the plates are too high for her to reach and they are china easily breakable. Also, the utensils are not easy to get to. This is easily solved by moving plastic plates and smaller folks and spoons to one drawer that the child can reach. The point is to set it up so the child can successfully achieve the Goals.

Overall point: Parents can set simple ‘destinations’ for their child to drive their ‘car’ towards and by keeping the steps simple and practising the steps again and again their child can achieve those destinations to goals that parents set.

Very important: the hugs and ‘You did great!’ and ‘Keep trying!’ are as important and at times more important than any reward system. Parents – whether biological parents or foster parents – are the fire to ignite important, life long change in children.
Send comments to DrCameronJackson@gmail.com

A mother of child with special needs (Asperger’s Disorder) emailed me asking for help. She lives in Redlands, CA. Her child has an Autistic Spectrum Disorder, is hearing impaired and has epilepsy. The child is in elementary school.

Parenting a child with these kinds of problems can be overwhelming. As there are many parents who face these difficulties, perhaps a general post may be helpful both for this one mother and for other families. Most importantly, know that there is help, there are resources and you don’t have to do this job alone.

The mother wants an advocate to assist her in the IEP process. She asks for immediate help. (more…)

Sufficient, restful sleep and absorption of appropriate food is crucial to health and well being. True for every one and particularly difficult for many persons with autistic spectrum issues.

Remember grandmother – or mother – with the spoon of that awful tasting cod liver oil? Research shows that cod liver oil helps many children with autistic spectrum disorder difficulties. Ever had problems with jet lag and difficulties re-establishing a natural sleep rhythm? Melatonin is a natural enzyme your body produces which may be low or lacking in persons with autistic spectrum difficulties.

Many children and adults with autistic spectrum disorders have sleep and digestive disorders as well. Many are “picky eaters”. Many as children had constant diarrhea. Many have difficulties falling asleep and difficulties staying asleep.

What help is there? Autism Research Institute compiles information from parents as to what helps. Go to Autism Research Institute and take a look at the non drug supplements that help.

Of note, cod liver oil made 55% Better and 4% Worse for N = 2,550
folic acid made 45% Better and 5 % Worse for N = 2, 505
melatonin made 66% Better and 8% Worse for N= 1, 687

Of course, first consult with your pediatrician and read the literature.

Please comment what works for your child or spouse with autistic spectrum issues. What about the liquid vitamins? What about iron supplements?
DrCameornJackson@gmail.com

Ritalin helps about 70-80% of children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) with a 1 1/2 percent who discontinue due to side effects. Now research shows that Ritalin helps children with Autistic Spectrum Disorders — not to the same extent and with more side effects. A 2005 study shows that Ritalin helps 50% of children on the spectrum with a an 18% discontinue rate due to side effects.

My question: What is helped the most? Executive functioning abilities (attention, planning, sequencing) or impulsively or what? (more…)

Let’s imagine what might happen were President Obama given an ADOS assessment. An ADOS is administered one-to-one — not done here.

What the ADOS is: The ADOS assesses for autistic spectrum disorders. Adolescents or adults assessed with an ADOS are asked to do various tasks including: 1) play interactively with the person who is assessing; 2) demonstrate how to do an activity; and 3) tell a story based on a picture book which has no words.

One ADOS task is engaging in interactive play that involves joint attention and ability to change based on what the other person does. President Obama seems to engage in a lot of “my way or no way” behavior which is not interactive. When President Obama got the stimulus bill signed he immediately turned it over to Speaker of the House Nancy Pelosi to figure out how to distribute the “pork”. President Obama did not wield his mighty pen and interactively “cut” out pork. Overall global assessment: As Obama’s abilities to interactively “play” appear low, he gets a score of 2 for the joint interactive task.

A second task on the ADOS: The person must demonstrate both verbally and non-verbally how to do something in daily life. Getting bills such as ObamaCare passed has been part of President Obama’s daily life. Can you imagine President Obama — without a teleprompter — explaining with use of gesture and words how he got ObamaCare passed? On the demonstrate a Daily Activity task Obama scores another 2. The total score is now 4 points.

A third task on the ADOS: The person assessed must tell a story based on a picture book that has no words. So, imagine a picture book showing the Tea Party movement at various rallies. How might Obama tell that story? Can Obama see a series of pictures and make a coherent story about a major political event, i.e. the Tea Party movement? Doubtful. Hence, on the Tell a Story task President Obama gets another score of 2.

On just three ADOS tasks Obama is already up to a total score of 6. There are about 12 or so tasks on the ADOS.

Let’s hypothetically assume that President Obama can meet the ADOS cutoff score for a possible diagnosis of an autistic spectrum disorder. More information is necessary to assign a diagnosis of autism or some variation.

The foregoing gives you an idea of the kind of tasks persons must perform during an ADOS assessment. (more…)

Do you work with children with Autistic Spectrum Disorders? Parent of a child? Join A-Autism Net for Testing at www.freedomOK.net/wordpress Tell your stories. Get support. For northern CA parents and professionals. Dr. Jackson is a member of the Asperber’s Ring which is a group of blogs that focus on Asperger’s Disorders and similiar issues.

Dr. Cameron Jackson wants to collaborate with other professionals who screen and treat children with autistic spectrum disorders. One other psychologist is listed in the Monterey Psychological Association as working with autistic children. Contact Dr. Jackson at: cameronjacks@gmail.com

For other resources go to: Web Ring

Aptos, California
(831) 688-6002

* Begin educational services as soon as a child is suspected of having an autistic spectrum disorder.

* Services should include a minimum of 25 hours a week, 12 months a year.

* What constitutes those 25 hours will vary according to the child’s chronological age, developmental level, specific strengths and weaknesses and family needs.

* Each child needs sufficient individualized instruction on a daily basis so objectives are implemented effectively.

* Objectives include achieving functional spontaneous communication, social instruction delivered throughout the day in various settings, cognitive development and play skills, and proactive approaches to behavior difficulties.

Source: Educating Children with Autism, Natioal Academy Press, 2001