Family Priority https://familypriority.com Making a difference in the life of a child Fri, 10 Aug 2018 02:23:24 +0000 en-US hourly 1 A Top Mistake Caregivers and Professionals Make When Caring for a Child with Special Needs. https://familypriority.com/a-top-mistake-professionals-make-when-caring-for-a-child-with-special-needs-2/ Thu, 12 Jul 2018 02:31:19 +0000 https://familypriority.com/?p=434 By Eric R. Shuey, M.S, BCBA, LBA As a parent myself I have made many mistakes raising my two daughters. No one is perfect and no one has all the answers. Anyone who tells you they do, are ignorant or oblivious to their surroundings. The fortunate thing is most mistakes we make are small and [...]

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By Eric R. Shuey, M.S, BCBA, LBA

As a parent myself I have made many mistakes raising my two daughters. No one is perfect and no one has all the answers. Anyone who tells you they do, are ignorant or oblivious to their surroundings. The fortunate thing is most mistakes we make are small and easily corrected. My education combined with the last twenty years of experience working with children with disabilities has taught and enabled me to see many different parenting strategies. Some strategies work well and others do not.

One of the most significant mistakes we as parents is to not follow through on our directives or statements. To see if you do this, listen to the things you say to your children or ask a significant other or even your child. At times it is difficult to see and take note of your own behavior and words. Sometimes you have to trust others in your life to give you this important feedback. Parents often attempt to give their child the benefit of the doubt, giving them way too many opportunities to comply with the directive. Often directions are repeated over and over and when a child does not follow, generally there are no consequences.

Here is an example to help illustrate this point. A friend of the family was visiting with her preschool age child. She wanted her child to take medication. Of course her child refused. The mother attempted reasoning with the child. As adults we often see our kids as miniature adults. This is, in my own opinion, the second biggest mistake that parents make. After reasoning did not work, this parent used the promise of a reward should she take her medication. Again, this attempt did not work. She then turned to threats of punishment in hopes of getting her to take her medicine. In this case the parent repeatedly told her daughter that if she did not take her medication she would be packing up her clothes and they would head back home. Well as you might think this did not work either.

Parents often attempt to give their child the benefit of the doubt, giving them way too many opportunities to comply with the directive.

The reason why this did not work is because of follow-through. This parent had no intention of leaving and it became an empty threat. I’m betting that the child knew her mom was not really going to take her home. The child was not consciously thinking to herself my mom is not going to follow through, but I would have imagined in the past her mother has threatened this and had not followed through. Therefore, she was not worried that she had to leave the house even though she was screaming and throwing a tantrum on the floor. I did offer assistance which was quickly dismissed. I took my leave to another room away from all the commotion where my oldest daughter and I had a little conversation about follow through. I am not exactly sure how the situation ended, but it took about another hour and a half before she took her medication.

The moral of the story is do not threaten things that you are not going to follow through on. The mistake in this situation was the person should have never threatened going home to start. There are many other effective ways to motivate a child to take their medication. Due to the child’s past experience she knew and realized her mother did not mean what she said. So if you are in a store with a child who is having a meltdown and ask the child to stop crying or we’re leaving and the child continues to cry, then you need to leave the store. Often, it helps to think of situations where your child has trouble and use different strategies and statements that are effective that you can follow through on. Many times I have to follow through on these just so the child learns in the future that you mean what you say. Generally, this will not happen after the first attempt and in most cases takes many of these opportunities of follow through before you gain compliance. Children with special needs often take more time than typically developing children in learning this.

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Living The Dream https://familypriority.com/living-the-dream/ Fri, 04 May 2018 02:24:06 +0000 https://familypriority.com/?p=408 By Samantha Zitzelberger, M. Ed., BCBA I look back to what my answers were when asked what I wanted to be when I grew up; I would have never guessed I would end up in the field of Applied Behavioral Analysis, known as ABA Therapy. My interest in becoming a marine biologist was fleeting, my voice [...]

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By Samantha Zitzelberger, M. Ed., BCBA

I look back to what my answers were when asked what I wanted to be when I grew up; I would have never guessed I would end up in the field of Applied Behavioral Analysis, known as ABA Therapy. My interest in becoming a marine biologist was fleeting, my voice ended up to not be that of a Grammy-award winning superstar, and as it turns out, being an actual forensic psychologist is different than what CSI portrays.

Through my undergraduate experience in New York, I worked part-time at a school for individuals with developmental disabilities as a substitute teaching assistant and waitressed at a restaurant on the weekends.  At the school I worked with children ranging from 14-21 of age. The position was a substitute which gave me the wonderful opportunity to work with different children in all classrooms in the building each week.  I eventually graduated from SUNY Stony Brook with a bachelor’s degree in sociology and psychology. I knew I wanted to work in the field of helping people, but was not sure what the next big step was. I applied to the Disney College Program during my last semester and attended the program that following fall. To me, not only was it a great resume builder; it gave me an extra four to five months before I had to figure out “adulting.”

Living the dream is being able to work in the field you’re passionate about and make a difference in the lives of different individuals day-to-day.

I met my husband while working at Disney World. We moved to Virginia the next year and I took a job as a personal care assistant for an individual with autism. Soon after, I found myself at Family Priority. I was extremely excited and quietly laughing to myself that the part-time job I held for most of my college years gave me the fundamental knowledge and experience for the position at Family Priority.  Who could have guessed?

I really loved working with individuals at the school in New York, but providing in-home services is truly where my heart lies. I get to be a part of children’s lives in a way I was not able to when working at the school. Being able to be in the position and working closely with the parents, caregivers, and siblings of these children is the parts I love most about working in homes.

Soon after accepting the position of behavior assistant at Family Priority, I was given the opportunity to take coursework through George Mason University.  This would advance me in the field of behavioral therapy and put me on track to obtain my BCBA.  After completing the course work and working as a behavior assistant for Family Priority for 3 years, I passed the BCaBA exam and began working as a BCaBA. I continued in this position as I finished up the classes required to obtain a Master’s in Education through George Mason and became certified as a BCBA.

Currently, I am working at the Williamsburg office as a BCBA. I find myself thinking back five years ago while I was wearing a Mickey Mouse hand and waving at guests leaving Epcot for the night. I thought that I was living the dream and working at the most magical place on Earth before I entered into the “real world.”  But as it turned out, living the dream is being able to work in the field you’re passionate about and make a difference in the lives of different individuals day-to-day. If I could go back in time, I would tell the younger me, as she flipped through a Rolodex of potential careers, and say, “sit tight and wait….you got this”.  

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School Refusal https://familypriority.com/school-refusal/ Fri, 09 Dec 2016 16:37:00 +0000 https://familypriority.com/?p=256 By Suzyn Jacobson, LCSW Clinical Director, Family Priority, LLC School refusal presents challenges for parents, students and schools. There are many reasons why children refuse to attend school. As a parent, it is important to recognize the function of this behavior in order to determine the particular reinforcement systems that support school refusal. Children may [...]

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By Suzyn Jacobson, LCSW
Clinical Director, Family Priority, LLC

School refusal presents challenges for parents, students and schools. There are many reasons why children refuse to attend school. As a parent, it is important to recognize the function of this behavior in order to determine the particular reinforcement systems that support school refusal. Children may avoid school because something there is making them feel badly, or because they are trying to escape negative social situations or because they are seeking attention. There are underlying mental health problems that frequently impact this behavior. These include: Depression, Separation Anxiety, Social Anxiety, Generalized Anxiety, Oppositional Defiant Disorder and undiagnosed learning problems.

Treatment is critical in order to understand the motivation and reinforcement systems that support school refusal, and to foster healthy social, emotional and educational development. Insecure, anxious and depressed children may need intervention in order to improve their self-esteem and increase the feeling that they are in control of their lives in healthy ways.

An adolescent boy refuses to get up for school because his parents have to leave too early for work to wake him up; a ten year old refuses to go to school because she is being bullied; a six year old refuses because she does not want to leave her pregnant mother; a fourteen year old girl refuses to attend school because she has no one to sit with at lunch; a pre-teen is struggling with school work and wants her mother to home school her.

Treatment for these challenges may involve a combination of individual and family work and/or pharmacological interventions. Individual work focuses on desensitization, relaxation therapy, cognitive work and social skills training. Family work stresses communication patterns within the family and the examination of rules and structure within the home. Treatment is critical in order to understand the motivation and reinforcement systems that support school refusal, and to foster healthy social, emotional and educational development. Insecure, anxious and depressed children may need intervention in order to improve their self-esteem and increase the feeling that they are in control of their lives in healthy ways.

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Strategies to Help with Repetitive Behaviors https://familypriority.com/strategies-to-help-with-repetitive-behaviors/ Tue, 15 Nov 2016 18:03:47 +0000 https://familypriority.com/?p=248 Strategies to Help with Repetitive Behaviors M. Ashley Lynch M.Ed., BCBA, LBA Repetitive behaviors. This can be a tough one to treat because children and adults often engage in these behaviors to get internal feedback (like biting your fingernails when you’re nervous). When you can’t control the feedback that someone is receiving, it can be [...]

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Strategies to Help with Repetitive Behaviors M. Ashley Lynch M.Ed., BCBA, LBA

Repetitive behaviors.

This can be a tough one to treat because children and adults often engage in these behaviors to get internal feedback (like biting your fingernails when you’re nervous). When you can’t control the feedback that someone is receiving, it can be challenging to make the behavior go away.

I’ve had several clients in the past eight years that engage in some type of stereotypy. I just read a great article that had some awesome, evidence-based tips. It’s a literature review titled Evidenced-Based Behavioral Interventions for Repetitive Behaviors in ASD (Boyd, A., McDonough, S., & Bodfish, J., 2012). Click here to read the full article. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3709868/

children and adults often engage in these behaviors to get internal feedback (like biting your fingernails when you’re nervous).

One of my favorite strategies mentioned was having a client go through a short exercise before doing an activity that is associated with stereotypy. For example, jogging, yoga, or jumping on a trampoline before having to take turns during a game or doing a difficult worksheet.

A few other successful strategies they discussed include:

  • Diversion – blocking the client from doing the behavior and trying to divert their attention to something else.
  • Differential reinforcement – giving the client lots of praise, positive attention and things they like when they are doing just about anything besides stereotypy.
  • Visual schedules – letting the child know what is coming up next and what can be expected, which helps reduce the anxiety and stress that can lead to stereotypy.
  • Response cost procedure – something is taken away from the child (preferably something the child is highly interested in) when the problematic behavior occurs. It is recommended that this mild form of punishment should be left as a last resort when all other positive forms of interventions have not worked.

What have you found works best for your clients?

 

 

 

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Why Children and Adolescents Need Structure https://familypriority.com/structure/ Tue, 25 Oct 2016 17:52:15 +0000 https://familypriority.com/?p=238 By Suzyn Jacobson, Clinical Director Children need predictable rules and routines to make them feel loved and safe. Families sometimes struggle with creating this sense of predictable and reliable routine and structure because they are overwhelmed by the pressing needs of everyday life. Family Priority counselors and therapists assist families in creating consistent [...]

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By Suzyn Jacobson, Clinical Director

Children need predictable rules and routines to make them feel loved and safe. Families sometimes struggle with creating this sense of predictable and reliable routine and structure because they are overwhelmed by the pressing needs of everyday life.

When children know what to expect, they are more cooperative and less likely to argue and dispute parental authority.

Family Priority counselors and therapists assist families in creating consistent expectations and boundaries in the home through educating and coaching parents. Parents develop rules and consistently implement them and find that children respond to this sense of reliability and feel safer in the home, having less need to act out to get their needs met.

When children know what to expect, they are more cooperative and less likely to argue and dispute parental authority. The Family Priority counselor is trained to engage families in establishing bottom line priorities and in the implementation of rules and consistent schedules.

Parents, who previously believed that routines and structure were beyond their control, find that they exert less energy in arguing with their children once expectations are clear. Family Priority counselors are trained to assist families in communicating their expectations clearly and firmly, and in translating these priorities into structure in the home. Counselors demonstrate and model non-reactive communication skills so that parents and children do not get bogged down in arguments about the rules.

Secure children know what to expect and structure provides them with the necessary sense of self to interact successfully in the world.

Limits and rules allow children to internalize structure and to feel secure in approaching the world on their own. Secure children know what to expect and structure provides them with the necessary sense of self to interact successfully in the world.

In my work as Clinical Director, I am amazed to see previously dysregulated children flourish under this approach. Families find that they have more cooperation, fewer arguments and can enjoy each other more. In over fifteen years of doing this work, I have seen children blossom once they get over their shock at their parents being kind, but firm and consistent.

 

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How to Parent With Grace https://familypriority.com/how-to-parent-with-grace/ Wed, 05 Oct 2016 17:39:53 +0000 https://familypriority.com/?p=223 By Lavinia Michael-Bollinger In our field, it is not uncommon for practitioners to gain accolades from others for the work we do.  We are praised for being kind, dedicated, and having big hearts for working with our children with special needs and their families.  I do not diminish the work that my colleagues and I [...]

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By Lavinia Michael-Bollinger

In our field, it is not uncommon for practitioners to gain accolades from others for the work we do.  We are praised for being kind, dedicated, and having big hearts for working with our children with special needs and their families.  I do not diminish the work that my colleagues and I do, and that they are some of the kindest and most dedicated people I have met.  In this blog however, I would like to address the often unsung heroes within the field of special needs.  The families themselves.

As behavior analysts, we have been given the incredible privilege to be that proverbial fly on the wall; to observe and study human behavior in its natural setting in a way that many scientists dream of, but never get to do. While I have observed many things over the years, the biggest lesson I have learned from these families is that of unconditional love, perseverance and humility. Many anecdotes come to my mind, but this particular one stands out, as it taught me the meaning of Grace.

I served a young man and his family in Florida some years ago.  He was diagnosed with severe intellectual disability, cerebral palsy, was blind and deaf with limited ambulatory abilities, and was confined primarily to his bed and wheelchair. The family struggled fiscally and the home was modest, small and very crammed, with this young man’s bed situated in the living room.  I entered his home one day, grumpy at the thick Florida heat and the broken air conditioner in my car.  My mood lifted upon entering the home as I was greeted with a loud exclamation of delight.  The next 10 minutes was taken up by our ritual of examining each of his toys, talking about his meals, and whatever upcoming celebration he was looking forward to. The joy and love that radiated from this young man always moved me. As if in direct spite of the hand dealt to him, he was determined be as happy as he could with his life.

The joy and love that radiated from this young man always moved me.

In the midst of my visit, he had a toileting accident on his bed.  I stepped back and watched his family move into action. What I witnessed on that hot and sticky Florida day still plays in slow motion, like a movie reel in my mind.  It may seem mediocre to some as they read this, and some may blame delirium from the heat for romanticizing the moment, but for me, it was the sign that said “Alert! Grace is heading your way and this is what it looks like”!

I stood back and watched the perfect orchestration occur between father, mother and son. Not only did this 230 lbs young man need to be changed, he needed to be escorted to the bathroom, cleaned up and placed into fresh clothes.  His bed needed to be stripped, sterilized and fresh linen placed back down.  All of this had to occur with the most precise timing and engineering of movement due to the limited space in the home. I watched this scene unfold, in perfect synchronization, like a well-rehearsed waltz.  The mother fetched the sheets, and rolled the chair to the bed.  The son held out his hands, swung his legs over, and braced himself against the strong back of his father.  His mother gently lowered him into the chair, double step, turn, sashay, and switched placed with his father.  His father rolled him into the bathroom and proceeded to clean his son.  The mother stripped the bed, placed it in the wash, sprayed down the mattress, wiped it, and pulled out her son’s clean clothes for him to change into. The father came back, held one end of a clean and white cotton sheet as his wife held the other and together, they snapped the sheet up in the air.  This scene remains vivid in my mind’s eye.  The sound and smell of a freshly laundered white cotton sheet snapping in a tight space that barely held four people, billowing above the bed, and the tan, lined and sun worn faces of his parents that appeared on the horizon as the sheet cascaded down.  Their faces held no frustration, no anger, and no irritation.  Only love, patience and acceptance.  They placed him back in the chair and rolled him back into the living room. Double step, turn, sashay and step, they switched places. His mother hoisted him up; the brace on her wrist the only indication of the strain her body had gone through over the years of caring for him.  The son sat on the bed and his father placed his hands under his armpits and pulled him up as his mother swung his legs back onto the bed. The bed was adjusted, the pillows fluffed, the son rattled out the litany of toys that he wanted on the bed with him.  With ever present patience, his parents found him each and every toy he requested.  As he settled in grinning, pretty satisfied with life, his mother leaned over and kissed him on the head.  He reached over with one arm, encircled it around her head and pulled her close for another kiss.  He exclaimed, “Momma . . . I love you Momma”, and she blew a raspberry on his cheek.  And it struck me. Grace in Motion. I had just bore witness to Grace put into Motion.

This young man and his family taught me more than I could ever teach them.   My expertise in the field helped them understand how to prevent and de-escalate his target behaviors. Because of that, he was able to go out into the community without aggressing, take his medicine without an issue, and decrease his self-injurious behaviors.  Their unconditional love, however, taught me how to parent with grace.  They bore their yokes with dignity, love, acceptance, and dare I say, even joy. Grace in Motion.  Would I ever have the grace, patience and courage to care for a loved one that way?  Would I ever be able to humble myself to complete and total care of my loved one without complaint, preserving their dignity and mine, the way the parents of children with special needs often do?  The heroes are not us.  We are simply a few lucky ones, given the privilege to work alongside these unsung heroes.

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No Means No https://familypriority.com/no-means-no/ Thu, 07 Apr 2016 14:30:44 +0000 http://familypriority.com/?p=18 By Eric Shuey M.S., BCBA, LBA We all can improve upon our parenting strategies. This may or may not apply to you, but my hope is you find this blog a little helpful. I’m a parent myself and have made many mistakes in raising my two girls. No one’s perfect and no one has all the [...]

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By Eric Shuey M.S., BCBA, LBA

We all can improve upon our parenting strategies. This may or may not apply to you, but my hope is you find this blog a little helpful. I’m a parent myself and have made many mistakes in raising my two girls. No one’s perfect and no one has all the answers, but one common mistake that we parents and caregivers make is that we often think we can reason with our children. Wouldn’t it be wonderful if we could sit down and explain the merits of whatever it is we are trying to have a child do and they simply say “yes mom or dad I completely understand and that makes perfect sense.” But that rarely happens. Most of us have been in a store with our child when they are demanding that we buy them some toy or stuffed animal that they cannot live without. The toy is placed ever so conveniently by the cashier’s register so that your child can’t miss it. Any attempt to explain to your child that they don’t need another “Shop-Kin” or whatever toy is popular will go in vain. We try to explain we need to use the money on something else, other than toys, and yet this is not effective. We further continue to debate with our child. Just using the word “no” is a good strategy, but your child just needs to understand that “no, not now” means “no, not now.” This blog ties in well with the last blog about following-through from past experiences. It is important to note, if your child is one that will become aggressive or self injurious when told “no” or denied access to toys or items in the grocery store, then it may be time to seek professional help. As it may be typical for a child to cry, whine, and complain, it is not typical for a child to become aggressive or hurt themselves in attempts to have their parents give into their demands.

Just using the word “no” is a good strategy, but your child just needs to understand that “no, not now” means “no, not now.

Many children may lack the communication skills or the appropriate coping skills to handle being told “no.” This is a specific replacement skills that your child will need to learn and practice. There are certain strategies you can use that someone can assist you with. Don’t be afraid to ask around and seek support. Continue to work on following through on what you say and not looking at your child as a small adult, as they have had very few experiences to draw from to guide their decisions. We as parents must train them how to respond in specific situations and how to tolerate every day let downs and anxiety. Being able to say “no” and have your child understand this and not engage in disruptive behaviors is priceless. This happens not by lengthy discussions but by following through when you say “no” and not going back on this.

 

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