The Autism category compiles any blog related to Autism on the North Shore Pediatric Therapy website.  The blogs in this category are meant to help educate, inform and encourage parents of children with Autism. Readers will learn about Applied Behavior Analysis, Autism-friendly activities, school, appropriate toys, red flags, special needs lawyers, financial planning, multidisciplinary treatment options and more. If you are looking for any information related to Autism, this category will help you get started. If you need additional assistance, please give us a call at (877) 486-4140.

MORE Tips To Help Your Child with Autism Enjoy Halloween

Halloween is fun and exciting holiday for many children. It gives the opportunity to dress up in their favorite costumes and get a lot of candy. While these traditions seem easy and effortless for most children, for a child with autism it may not be so easy. With the proper preparation Halloween can be a very fun holiday for any child with autism and below are a few steps on how to make Halloween an enjoyable experience.

Help Your Child With Autism Have a Happy Halloween With These Tips:

  • Let you child pick out his costume so you know it is something he will want to wear.MORE Tips To Help Your Child Enjoy Haloween
  • Make sure your child is able to wear the costume around the house prior to going trick-or-treating. This will allow him to get used to how the costume feels and allow you to make any necessary adjustments to the costume to make it more comfortable for your child.
  • If you are planning on trick-or-treating, take walks around your neighborhood or wherever you plan on going in the weeks leading up to Halloween. Also, you may want to practice walking up to the doors of people you know and ringing the doorbell.
  • Read your child social stories about Halloween traditions and trick-or-treating.
  • Make a schedule of the events that will take place the night of Halloween. Show this schedule to your child frequently so they know what is coming next. You could even make a map of each house you will be going to and they can cross off each house they go to.
  • If your child has limited verbal skills, make a picture they can hold up that says trick-or-treat, or if possible have a sibling do all of the talking.

Click here for more simple tips to prepare your child with autism for Halloween.

NSPT offers services in BucktownEvanston, Deerfield, LincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Halloween and Autism

Simple Tips To Prepare Your Child with Autism for Halloween

 

It’s that time of year again: the leaves are changing, the weather is getting cooler, and children and parents alike are beginning to feverously plan Halloween activities and costumes. While this may be an exciting experience for most families, it can be a difficult and anxiety-provoking experience for families with children with autism.  Children with autism may interpret and react differently to Halloween festivities and costumes, which can be an overwhelming experience. However, this doesn’t mean that children need to sit on the sidelines and avoid Halloween activities altogether. With the following tips, parents and their children with autism can have a stress-free and enjoyable Halloween.

Costumes

Costumes are a quintessential part of Halloween. It is important to remember that costumes are possible for your Simple Tips to Prepare Your Child with Autism for Halloweenchild with autism, but should be safe and comfortable for him or her to wear. This is especially important if your child has sensory difficulties. Take into consideration how the fabric and the fit of the costume will affect your child: Is it a fabric the child is used to wearing? Is the fit too tight or too loose? A great way to decide if a costume works is by practicing wearing the costume around the house. This allows your child to become acclimated to the costume, and lets you know whether or not the child will be able to tolerate wearing the costume for extended periods of time. With practice and knowledge that a costume works, you can avoid meltdowns and last-minute costume changes on Halloween.

Social Cues

It is not everyday that we ask our children to walk up to a stranger’s house and socially engage with the stranger for candy. This is a break in typical social rules that children normally follow. This break in rules may be difficult for a child with a rigid understanding of rules and expectations of the world. One way to help your child overcome this change in rules is through setting a schedule and script that your child can follow for trick-or-treating. For example, the script and schedule may look like the following:

  1. Ring doorbell
  2. When an adult opens the door, say “Trick or Treat”
  3. Allow the adult to put candy in your candy bag
  4. Say “Thank you” and walk away from the house

This script and schedule allows your child to understand the expectations and rules of Halloween while also creating an easy timeline that they can follow and refer back to with parents. Similarly, you may want to practice this script with your child prior to Halloween at your own household. The child can put on his or her costume, and practice ringing the doorbell and asking for candy to simulate trick-or-treating on Halloween.

Know your Child

Even with extensive preparation, Halloween can be an overwhelming and tiring experience. Know and recognize when your child has had enough and is ready to call it quits for the evening. The point of Halloween is for your child to have an enjoyable time, whether that lasts 30 minutes or 2 hours. Halloween is all about maximizing your child’s fun while spending time together as a family.

With the right knowledge and planning, families with children with autism can have a successful and happy Halloween!

NSPT offers services in BucktownEvanston, Deerfield, LincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Valentine’s Day: What You Need To Know

How to Teach Play Skills to a Child With Autism

Play skills are one of the most important areas that children, especially those with Autism, need to learn. These skills provide opportunities for the child to entertain themselves in meaningful ways, interact with others, and learn important cognitive skills. A successful way to teach play skills to children with autism is to initially teach the specific play skill in a very structured manner. Play Skills

  • Break the play skill into small, discrete steps and teach one step at a time. As the child demonstrates success in learning one step, add the next step. (After the child can add eyes to Mr. Potato Head, then add ears, then arms, etc.)
  • Use modeling to teach the skill (e.g. the adult builds a tower of Legos as the child watches, then the child builds his own tower).
  • Always provide reinforcement (behavior specific praise “Nice job putting the piece in the puzzle”, immediately following the child’s demonstration of the skill.). As the child exhibits improved accuracy of the skill, reinforce successive approximations.
  • The child should have plenty of opportunities to rehearse the skill in a structured setting. Practice, practice, practice!
  • In the structured setting, have the learning opportunities be short and sweet, so the task does not become aversive to the child.
  • Fade the adult prompting and presence out gradually, so the child can gain more independence. Systematically fade the reinforcement so that it is provided after longer durations.
  • Remember to keep the activity fun and exciting. You want your child to WANT to play with the toys and games.

Once the child masters the skill in the structured environment by independently completing the play tasks for extended periods of time, he or she can then begin to practice and develop the skill in more natural settings. Bring the toys and games into other rooms of the house, to school, and eventually have peers present, so the child can use the skills learned in a social setting.

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes PlainesHinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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What Are Executive Function Skills?

Many of us have heard executive functioning used in terms of our children at school and at home. But what does it mean? Executive Function Blog

Executive Function – a Definition

Executive functions are necessary for goal-directed behavior. When we use the phrase “executive functioning skills,” we are describing a set of cognitive skills that control and regulate other behaviors and abilities. Our thought processes influence attention, memory and motor skills. (minddisorders.com).

Executive functioning skills help us to learn and retrieve information, plan, organize, manage our time, and see potential outcomes and act accordingly. When these processes work without difficulty, our brains do these tasks automatically, often without our awareness.

High Executive Function

In children and adults, those with high executive function skills are able to:

  • Initiate and stop actions
  • Make changes in behavior
  • Plan for the future
  • Manage time wisely
  • Anticipate possible consequences
  • Use problem-solving strategies
  • Use senses to gather information

For instance, the ability to initiate and stop actions may include working on a project for school or studying for an allotted time. Monitoring ones changes in behavior includes being able to act appropriately in a given situation and alter that behavior as needed. Planning for the future and managing time may include not procrastinating due to understanding the consequences of doing so.

Low Executive Function

When one is deficient in executive function skills, it may be difficult to plan and carry out tasks. The person may seem unable to sustain attention and feel overwhelmed by situations others find easier to navigate.

People with deficits in this area may also have comorbid diagnoses (meaning they go together). These include, but are not limited to: Attention Deficit Hyper-Activity Disorder, Autism, depression and obsessive-compulsive disorder. Executive functioning deficits may run in families (learningdisabilities.about.com).

So, a child with executive functioning deficits may be able to pay attention to a lesson, until something new is introduced that requires a shift in their attention or that divides their focus. Children lacking in executive functioning skills also may have issues with verbal fluency.

Additionally, a child (or adult) with low executive function may have social problems. Executive functioning skills allow us to anticipate how others might feel if we do or say something. Those with low executive function may have difficulty interacting with others. Because they sometimes do not think things through before saying them, people with executive functioning deficits may blurt out inappropriate or hurtful comments, leading others to avoid them.

Working with your child, a therapist, and creating structure at home and accommodation plans at school are all ways to provide help for your child.

Increasing executive functioning skills will enable her to become a more organized, less stressed and less frustrated individual as she grows into a world of ever-increasing pressures.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, and Hinsdale! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

Hand Flapping: When to Worry

Many people correlate hand flapping with only Autism, however this is not the case. All children could exhibit a hand flapping behavior when they are in a heightened emotional state including when anxious, excited, and/or upset.  Many believe that children with Autism will engage in hand flapping as a self-stimulatory activity, which can be accompanied by other stimming behaviors like rocking and/or spinning. Blog-Hand Flapping-Main-Landscape

Children with autism are often extremely sensitive to specific sensations and sounds that may not effect someone who is not on the spectrum. Environments in which there are multiple sounds, loud noises, and crowds can cause distress for some individuals with and even without autism. Hand flapping is seen as a way to escape the over stimulating sensory input present in the environment.

Other times when hand flapping can be observed in children (both verbal and non-verbal) is when they are trying to express or communicate to others around them. It is viewed as them trying to express that they are: happy, excited, anxious, or angry. In cases like these, families and professionals often feel that hand flapping should not be a concern, stopped, or corrected.

Hand flapping would be something to worry about when and if it impacts a child’s functional daily living ability, for example if it impacts their ability to navigate their environment safely.

NSPT offers services in the Chicagoland Area! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

5 Things to Keep in Mind When Potty Training a Child with Autism

Potty training is a big milestone for any child. It definitely is an important milestone for parents as well! No more diapers!! However, there are some things to keep in mind prior to considering potty training as well as during potty training. Blog-Potty-Training-Main-Landscape

  1. When should you consider potty training?
    • On average you would consider potty training when the child is around 2.5 years of age and above, can hold urine for 60-90 minutes, recognize the sensation of a full bladder, and show some form of awareness that they need to go to the bathroom.
    • Do at a time when you can spend large amounts of time at home! Some parents find it best to do in the summer (less clothing!).
  2. What schedule should you use when potty training?
    • You want to take your child to the bathroom every 90 minutes, if your child urinates then you wait for the next 90 minute interval, if not you reduce the time by 30 minutes.
    • Consistency is extremely important to ensure success.
  3. While on the toilet what should we do?
    • Praise your child for sitting appropriately on the toilet.
    • You can do activities with them as long as they are not too engaging or involved.
    • If they do urinate you want to CELEBRATE!
    • You need to wait up to 15 minutes if there is still no urination, then you let them get off and bring them back after 60 minutes (this keeps decreasing by 30 minutes each time there is not urination).
  4. What should you do when there is an accident?
    • It happens! Make sure you have your child help you clean it up, this is not meant to be punishing but more a natural consequence of having an accident. Keep a neutral tone and assist your child if needed to clean up the mess.
    • If your child is having too many accidents you may need to shorten the intervals of going to the toilet, or it may be that your child is not ready to be potty trained yet. Always rule out any medical reasons as well!
  5. Things to remember!
    • When starting potty training you want to make sure you child can sit on the toilet for up to 15 minutes with minimal challenging behaviors.
    • The goal is INDEPENDECE, you want to work towards your child walking to the bathroom on their own and removing and putting on their underwear and pants independently as well as washing their hands.
    • Make sure you child is in underwear throughout potty training! NO DIAPERS/PULL UPS!
    • Diapers and pull-ups are okay during nap time and bed time.
    • Number one thing to remember is PATIENCE, try to be consistently upbeat and encouraging to your child and deal with accidents as calmly as possible!

It is important to ensure that potty training is as positive an experience as possible for your child! Maintain your positive energy and constantly praise appropriate behavior seen throughout the potty training process! This will encourage your child to become more independent as well as want to go to the bathroom more often on their own!

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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IEP Legal Rights

This guest blog was written by Sandra Strassman-Alperstein.

As a special education attorney, I am often asked by parents of children with autism about their children’s legal rights at school. Fundamentally, children with autism are entitled to the same Blog-IEP Rights-Main-Landscapeeducational rights as other children with disabilities, namely FAPE (free appropriate public education).  What constitutes “appropriate” education is at the crux of many special education disputes regarding students with autism as well as other students with disabilities.

Let’s take Michael, a boy with autism severe  on the spectrum. Michael is 10 years old. He is not yet toilet trained. Michael demonstrates unsafe behaviors at school, such as self-injury, violence toward peers and staff, and elopement (running). Michael is rapidly becoming a danger to himself and others at school.

At Michael’s IEP meeting, the district recommends Michael’s current self-contained life skills classroom with a student/teacher ratio of 6:1. While many of the goals appear to be appropriate, Michael has made no progress this year. But we know Michael can learn in a 1:1 setting because he has made good progress with a private tutor at home. Also, the proposed IEP contains no goal for toileting skills, which are critical life skills, and no behavior intervention plan (BIP) to keep Michael and others safe when he displays unsafe behaviors.

What types of questions should Michael’s parents be asking at the IEP meeting? I’d suggest questions designed to elicit how the team proposes to educate Michael safely and appropriately, and how the proposed IEP is designed to accomplish this.

Let’s start with Michael’s present levels of performance in the IEP. Are they based on current data, and are they accurate reflections of Michael’s current abilities? How about his goals: do they address all areas of deficit? (For instance, the proposed IEP does not address Michael’s lack of toileting skills and unsafe behaviors – goals will need to be added to cover these areas.) Are the proposed goals reasonable given Michael’s present levels of performance? Are they SMART goals? (SMART goals, according to Pete Wright, are goals which are specific, measurable, use action words, are realistic and relevant, and are time-limited. (See http://www.wrightslaw.com/info/iep.goals.plan.htm#sthash.HUUaBQ3V.dpuf.) What about the proposed services – are they sufficient to allow Michael to achieve his IEP goals?

Now let’s examine Michael’s proposed placement (the 6:1 life skills classroom). Is this classroom appropriate for Michael, or does he need a smaller class setting with more adult supervision and structure? Michael clearly needs a BIP – can an appropriate plan be implemented in the proposed placement, or should the team be recommending a therapeutic day setting or even a residential placement for Michael?

Now take the case of Michelle, a 10 year old girl with what used to be called Asperger’s Syndrome (AS), a form of high-functioning autism (AS was eliminated as a separate diagnosis in the DSM-V that was recently released; however, it remains a useful descriptive term). Michelle can read and write, her grades are good, and she does not display unsafe behaviors in school. However, Michelle demonstrates social skills deficits that impact her in school: she sits alone at lunch, does not seek out friends or engage in reciprocal conversations, and often misreads social cues, causing conflicts with both peers and staff. Other students are starting to tease her and call her “weird.” This causes Michelle to withdraw socially, and sometimes to shut down and refuse to do her work in class. Michelle is beginning to develop a negative self-image, as she has been observed to say “I am dumb” or “I am weird” at least several times a day in school.

Because Michelle – like Michael – has autism, the team proposes the same self-contained life skills 6:1 classroom. However, it should be clear that while both children have autism, their needs are nothing alike.

Both Michael and Michelle have the right to be educated in the LRE (least restrictive environment). However, what that will look like is very different for each of these children. For Michael, it is very possible (even likely) that the self-contained public school classroom will not be restrictive enough; for Michelle, it is likely to be too restrictive. (The LRE is the setting in which the student has maximum access to typical peers, but in which the child can be appropriately educated. Thus, what constitutes the LRE will vary from child to child.)

So in Michelle’s case, the parents should be asking similar questions regarding present levels (are they accurate?), goals (do they cover all areas of deficit – such as social/emotional needs – and are they SMART goals?), services (are they sufficient to enable Michelle to meet her goals?), and placement (is the self-contained classroom the LRE for Michelle when she is able to progress in the general education setting?).

What these examples demonstrate is that different children have different needs, regardless of an autism diagnosis/label. The fact is, as the saying goes, if you’ve met one kid with autism, you’ve met one kid with autism.

For each child, parents should critically examine the key elements of the proposed IEP, namely:

  1. Present levels of performance (are they based on data and do they accurately reflect the child’s current performance?);
  2. Goals (are they SMART goals that address all areas of deficit?);
  3. Services (are they sufficient and tailored to meet the child’s unique needs to enable the child to progress toward the goals?)
  4. Placement (is it the LRE?)

Parents are their children’s best advocates. They are the experts on their child and have much to contribute to the IEP team. Hopefully this information will help parents fulfill their critical roles in their children’s education.

Sandra Strassman-Alperstein holds a B.A. in English from the University of Florida and a J.D. from the University of Chicago Law School (cum laude 1990). More importantly, Sandy is the mom of four wonderful kids, three of whom have received special education services in the public school setting via IEPs and 504s. Sandy has been practicing special education law & advocacy for the past 15 years and is an active volunteer on the national, state, and local levels. Sandy’s website is http://www.spedlaw4kids.com.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Divorce When There is a Child with Special Needs

This guest post is from Benjamin Rubin.

When parents of a child with special needs get divorced there are many additional complications beyond a traditional divorce involving children. First and foremost, child support must be very Blog-Divorce-Main-Landscapecarefully considered to ensure that there is no loss of benefits. Child support payments that are required to be paid by a parent in accordance with Illinois state law by Court order, may result in a reduction or the complete elimination of a child’s SSI (Supplemental Security Income) benefit as well as the child’s Medicaid, which provides the child’s medical coverage, therapy, employment support, and home or residential support services (such as group homes) needed for the appropriate support for that child with special needs, and the custodial parent. For a child age 18 or older one hundred percent (100%) minus $20.00 of the child support payments ordered by Court, count as a reduction against SSI.

Government benefits can be protected, however, if the court order directs that child support payments are to be made to a “special version” of a Special Needs Trust for the sole benefit of that child, known as a self-settled special needs trust (also known as a 1st party, “pay-back,” OBRA, d4A, or d4C special needs trust). It’s important to note that this is different than the type of special needs trust most commonly established by parents for gifts and inheritances which is often called a 3rd party special needs trust.

Support payments to a 1st party special needs trust do not displace SSI, nor jeopardize Medicaid and Medicaid Waiver programs (such as group homes and day programs), greatly benefitting both parents and the child. It should be noted that for smaller child support payments (if total child support ordered is currently less than $14,000 per year) an ABLE account may be used. For more information about ABLE accounts please see ABLE article.

Again, for a child age 18 or older, one hundred percent (100%) minus $20.00 of the child support payment counts as a reduction against SSI; unless the court order provides that such support be paid irrevocably to an appropriate special needs trust or to an ABLE account in some cases (see above).

There are other considerations that have particular importance in the context of a child with special needs which should be discussed. First, health insurance coverage can be crucial. In Illinois it can be maintained by the parents of a child with special needs, in most cases, until the parents retire. Second, life insurance proceeds may be ordered by the court to be paid to a special needs trust, however, under current POMS (Social Security’s rules) and Medicaid regulations it does not need to go to a 1st party special needs trust as is the case with child support. It is highly recommended that a special needs planning attorney be consulted on all of these matters.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Benjamin (Benji) Rubin’s older brother Mitchell has Autism and lives in a Clearbrook CILA. Benji graduated from the University of Illinois College of Law, Magna Cum Laude, received his undergraduate degree from Northwestern University, and currently is pursuing his Graduate Law Degree, an LLM (Tax), at Northwestern University. Benji, a partner in the law firm, joined the practice in 2010. Benji is a member of the Academy of Special Needs Planners, a member of the Special Needs Alliance, is Vice Chairman of the American Bar Association Special Needs Planning Committee, serves as the President of SIBS (Supporting Illinois Brothers and Sisters), the Illinois chapter of the national Sibling Leadership Network, is a member of the Board of Directors of The Arc of Illinois, is a member of the Clearbrook Associate Board, and serves on the Advisory Council of Encompass(Encompass in partnership with Jewish Child & Family Services, Jewish United Fund, JVS Chicago, JCC Chicago, Keshet, and The Center for Enriched Living and Center for Independent Futures, seeks to provide adults with I/DD a full array of financially sustainable, community-based services and supports), and is a member of the Board of Directors of the SEDOL (Special Education District of Lake County) Foundation. Benji is also a Faculty Member for the Illinois Institute for Continuing Legal Education (IICLE). Having Mitchell as a brother profoundly shaped who Benji is today, and thus the type of law he chose to practice. His personal experiences as a sibling offer a unique perspective into the responsibilities that come with caring for a sibling with special needs. Now, as an adult, those sometimes present and future responsibilities he will have regarding his brother’s care are a concern that he shares with all brothers and sisters of individuals with special needs.

Traveling With a Child Who Has Autism

The word “travel” can bring a sense of excitement and joy, because you are going on a vacation or to visit relatives or to explore something new. However, the word “travel” can also bring feelings of anxiety or stress. Blog-Traveling-with-Autism-Main-Landscape

Traveling with a child with autism spectrum disorder (ASD) can seem overwhelming, especially when it comes to flying.

Here are some tips that can help a family prepare for flying with a child on the autism spectrum:

  1. Call the airport prior to your travel date and see if you can schedule a “trial run” to acclimate your child to the surroundings. During one of my therapy sessions I took a child to O’Hare with his parents to prepare for the many transitions involved in navigating an airport. We were able to start from the beginning of pulling up to the parking lot, riding the train and walking up to the security desk. We took pictures of each step so the child had a schedule and felt comfortable the day of the flight. Many large airports have guides to assist families with special needs children through the airport experience. Call to find out how to set up a guide for your family on your travel day.
  2. Provide your child with a schedule of “what’s going to happen, once you are on the airplane.” Make your child aware of what boarding the airplane will look like, what your seat number will be, what waiting for the plane to take off is like, the pre-flight security guidelines, take off and what to do during the plane ride.
  3. Have your child help plan activities during the plane ride. Bring favorite toys and games to help keep your child occupied.
  4. Have your child watch videos and listen to sounds of the airplanes. This is especially important for those kiddos who are sensory avoiding. Prepare your child for all the sensations he or she may experience on the airplane including the noise, ears popping, the vibration of the plane, what the seats will look like, what standing and going to the bathroom may feel like, etc.
  5. Finally, prepare your child for what happens when the plane lands and collecting your luggage.

Talk to your therapists and ask them to participate in the planning process. Talking about the process a few sessions before the travel date can instill confidence and help eliminate fear. Call the airports that you are flying in and out of for any resources and help available for your family.

Lastly, enjoy the vacation!

Check out these valuable resources for popular vacation spots and how they accommodate families:

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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