Tag Archives: ASD

Helping Children with Autism Build Skills as They Grow Up

autismAt its core, autism spectrum disorder (ASD, or autism) is a social disability that is present across one’s lifespan. Areas of difficulty and goals for treatment evolve as the child with ASD grows older and social interactions become more complex.

Social skills are highly nuanced and difficult to measure, but one thing is clear; early diagnosis and treatment help. With an infant or toddler, red flags for ASD can include failure to make eye contact, point to or express interest in objects, engage in social games like peekaboo, or use simple language to request, comment, and make social initiations. Although developmental delays are not always symptoms of ASD, concerned parents should seek guidance from their pediatrician. Treatment for young children typically involves using rewards to motivate and reinforce specific skills and behaviors, such as pointing, vocalizing, or making eye contact.

Building skills as symptoms change
As children grow up, the social demands of the world change and become more complex—we expect different skills from a 12-year old than a three-year old! Verbal skills become increasingly important; the give-and-take of conversation with friends that most of us take for granted is tough for them to master on their own.

Children with ASD may be able to hold a long conversation about a topic that interests them, while friendly chatting and two-way conversations on subjects they find less interesting could be a challenge. Progress can be complicated further by difficulty picking up on more subtle, nonverbal cues, such as recognizing when a friend is bored or annoyed by reading his facial expressions and body language.

The importance of teamwork between children, parents, and clinicians
This is where parents and clinicians can help. As children with ASD grow up and face escalating social demands, they benefit greatly from working with a clinician who can measure progress, assess areas for further development, and establish and adjust individualized, incremental, and achievable goals. Parents are a critical component of progress and can be great social coaches for their children.

The Child Study Center
The Child Study Center, part of Hassenfeld Children’s Hospital at NYU Langone, offers a number of evidence-based programs that help children with ASD improve their social skills at each stage of development. All of these programs include an equally important parent group.  We know that parents are by far the most important supporters and coaches for their kids, which is why the parental component is the highlight of our group programs. While the children learn skills through lessons, in-class practice, and homework assignments, the concurrent parent programs show parents how they can reinforce their child’s social development at home.

Children learn social skills at different rates, but as with any skill, the more practice, the better and faster the progress. We encourage parents to make sure that their child has an abundance of opportunities to practice and develop these skills in their day-to-day lives.

For more information on the Child Study Center’s social learning programs, email us at csc.sociallearning@nyumc.org or call 646.754.5284.

April is National Autism Awareness Month. Learn more online at the Autism Society.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Rebecca Doggett, Ph.D. is a clinical assistant professor of Child and Adolescent Psychiatry at the Child Study Center at Hassenfeld Children’s Hospital at NYU Langone.

 

Helping Your Child Make and Keep Friends

friends

Friendship is protective—having just one or two friends can make all the difference to a child’s development. Friends increase self-esteem, confidence, and independence. Having friends can also protect children and teens from bullying and victimization, and help buffer the impact of stressful life events.

But for some children and teens, making and keeping friends isn’t easy. Whether due to anxiety, ADHD, autism, or developmental disabilities, some lack the confidence and social skills needed to make a phone call, join a conversation, or play team sports. They may not pick up on verbal and nonverbal cues or empathize with others’ perspectives. And the consequences can be considerable: loneliness, depression, anxiety and isolation. This inevitably spills over into life transitions, including college, dating, and finding and keeping a job.

Fortunately, these skills can be taught. One place to start is building conversation skills including trading information with the goal of finding common interests, sharing conversations, and building awareness of nonverbal communication skills such as making eye contact and having good body boundaries. Another starting place is helping children and teens to choose appropriate friends by identifying a peer group and identifying extracurricular activities to find sources of friends who share common interests as a basis for building friendships.

The Child Study Center at NYU Langone Medical Center conducts social skills classes for children as young as three through young adults up to age 30 to help teach these skills. Our clinical faculty and staff use evidence-based interventions, the Children’s Friendship Program for elementary school children, and the PEERS® program for teenagers and young adults. The children, teens and young adults learn skills through in-class rehearsal and homework. It is a class; it is not a place to make friends, but a strategy on how to make friends in their real, outside lives.

The classes are developmentally appropriate for each age group. The youngest children learn how to play in groups. Elementary school children practice face-to-face conversations, make phone calls, and learn how to handle rejection. Older teens learn dating skills—how to ask someone out, how to behave, and what behavior is acceptable. All groups have homework, which involves practicing their new skills. This homework helps children gain confidence and solidify their new skills.

Parent participation is integral to the program’s success. In separate, concurrent classes, parents learn the language and skills being taught to their children—a requirement that not only enables them to help their children with homework, but also gives them the tools to be social coaches long after the program is over.

Each group meets weekly, for 60, 75 or 90 minutes, depending on age.
•Preschoolers attend 60-minute sessions for 15 weeks.
•Elementary school children between the ages of 5 and 8 attend 75-minute sessions for 12 weeks.
•Elementary school children between the ages of 9 and 10 attend 75-minute sessions for 14 weeks.
•Teens from 11 to 17 attend 90- minute PEERS® program classes for 14 weeks.
•Young adults with autism from 18 to 30 attend 90-minute PEERS® program classes for 16 weeks.

We perform an initial screening of all applicants and then meet with each child and parent to see if the child is appropriate for the group. Minimum requirements include approximately average cognitive and verbal functioning; a parent willing to participate; English language knowledge; and the child’s expressed interest in making and keeping friends.

Manhattan groups are conducted at One Park Avenue, 7th floor, New York, New York 10016. For more information, please call 646-754-5284 or email csc.sociallearning@nyumc.org.

For group offerings at our Long Island campus in Lake Success, please call 516-358-1808 or email Bonnie.Schwartz@nyumc.org.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Sarah Kuriakose, PhD, is a clinical assistant professor in the Department of Child and Adolescent Psychiatry and the clinical director of the Autism Spectrum Disorder Clinical and Research Program at the Child Study Center at NYU Langone Medical Center.

Sarah Kern, LCSW, is a clinical assistant professor in the Department of Child and Adolescent Psychiatry at the Child Study Center at NYU Langone Medical Center.

A Picture’s Worth a Thousand Words: Creating the Perfect Visual Schedule for Your Child with Autism Spectrum Disorder (ASD)

asd

Establishing a predictable and structured daily schedule for your child with Autism Spectrum Disorder (ASD) can make a huge difference in her ability to meet behavioral expectations throughout the day. Unexpected changes in schedule may be upsetting and trigger challenging behavior that impacts the whole family. Follow these simple steps to create a thoughtful daily schedule:

1. Review your child’s daily activities: Begin by writing out your child’s activities on a typical day. Make note of the activities that are associated with challenging behaviors and focus on those activities first.

2. Choose prevention strategies that make sense for you and your child: Consider whether any of the following strategies could be used to prevent problem behavior from occurring.
• Reorder activities: Sometimes children engage in their most naughty behavior when they are asked to stop a favorite activity and transition to a nonpreferred activity. For example, a child might scream and protest when his father asks him to turn off the TV and begin homework. To prevent challenging behaviors that arise during these difficult transitions, simply reorder the activities (i.e., ask him to complete his homework and then offer TV time as a reward).
• Provide warnings: To reduce challenging behaviors associated with transitions, use visual and auditory cues to remind the child about the upcoming change in activities. Setting a timer that signals the end of activity at the 10-, 5-, and 2-minute mark—or simply stating the remaining number of minutes left in the activity—will prepare them for the end of the activity.
• Change the timing of activities: Children may engage in challenging behavior when they are asked to do a difficult task in a short amount of time. If your child engages in disruptive behavior when he is asked to quickly pick out his clothes in the morning, have him complete this activity at the end of the day, when he has more time and there is less pressure to get out the door and catch the school bus.
• Modify the environment: Children sometimes become more distractible when tasked with activities that require sustained mental effort, such as homework or practicing an instrument. Help minimize distractions for your child by creating a distraction-free zone for activities that require continued attention (e.g., provide a quiet work space away from siblings, give your child special headphones, remove technology from the room).
• Build in breaks: If your child engages in problem behavior or is very active when asked to sit down and complete schoolwork, schedule short breaks for her in advance. For example, after completing 10 math problems or engaging in 15 minutes of homework, provide your child with a 2 minute break. During breaks, encourage your child to do something relaxing, like look at a book, or release energy through short exercises or games, such as jumping jacks or a quick round of Simon Says.
• Establish routines: Creating daily routines for activities that are associated with challenging behaviors may help increase compliance and independence with daily living skills. For example, many children demonstrate behavioral difficulties surrounding bedtime; establishing a bedtime routine that incorporates 4-6 steps, which may be completed in the same sequence each night (starting with the more demanding and ending with the more enjoyable), will help your child learn the expected and appropriate behaviors.

3. Set up a visual schedule: After you have developed the schedule of activities for your child, you can create a visual schedule with basic art supplies (e.g., foam board, markers, and Velcro) or on the computer that may be shared with him. Visual schedules promote predictability and increase comfort and independence with daily activities. You can draw pictures of the activities, take photos, or find images online—incorporating simple pictures into the schedule may increase your child’s understanding of the behavioral expectations and the appropriate sequence of activities. Print the pictures, laminate them, and apply Velcro to the backs so they can be placed on the board.

4. Introduce the schedule to your child: Decorating the schedule with your child can be a fun way to introduce the idea. Gather some art supplies that she enjoys and encourage her to make the schedule her own.

5. Post your schedule in a high traffic area: To maximize the impact of the schedule, find it a good home! Posting the schedule in a place where you and your child spend time regularly, such as the kitchen or his bedroom, will facilitate greater exposure. Be sure that the schedule is at his eye level so he can reference it with ease throughout the day.

NYULMC-2011_2CP_RGB_300dpiFrom the Real Experts at NYU Langone Medical Center:

Rebecca Shalev, PhD, BCBA, is a clinical assistant professor in the Department of Child and Adolescent Psychiatry at the Child Study Center at NYU Langone Medical Center.