Autism & Obsessive Compulsive Disorder- a re-released Morning Minute. Feel free to request a topic of your choice by emailing (more…)
Discrete Trial Therapy- a re-released Morning Minute. Feel free to request a topic of your choice by emailing me at (more…)
The Autism Spectrum- a re-released Morning Minute. Feel free to request a topic of your choice by emailing me at (more…)
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High Functioning Autism: Promoting Social Abilities. If you have a child with high functioning Autism, you may find that your (more…)
Written by Dr. John Carosso
What is the placebo effect?
A placebo is something that has no active therapeutic properties and is given to a patient to make them think they are getting the actual medication. The placebo effect is that some patients, interestingly, actually get better when given the placebo. Medications are compared to placebo because, if not better than placebo, then what’s the point.
What’s hope got to do with it?
If a person is given a placebo and gets better, then it could be argued that the power of hope is coming into play. The person is hoping the medication will work, and maybe even feels confident it will; consequently, they get better. I suppose you could say it’s ‘mind over matter’. The power of words instills hope, especially from somebody we trust, and powerful things can happen. There was a recent study showing that patients did better after discharge if the discharge summary had more positive words in it. What’s more, research has shown that the more confidence the patient has in their doctor, and the more the doctor emphasizes the placebo will work, the better the outcome.
Okay, so what?
So we all agree this is interesting, but what’s this got to do with helping your kids? We must keep in mind that the words we use have great power, can make a big difference in your relationship with your children, and how our kids behave.
Speak of what you want, not only of what you see
Your words shape your child’s behavior, for better or worse. So, be careful when calling your child “bad” or, less aversely, saying your child’s “behavior is bad”. Instead, consider stating the admonishment in a manner that positively highlights your child’s strengths while expressing clear expectations… “Mary, you often do really well getting along with your sister, and I appreciate how much you can be patient with her, so I know you can get along better than you are now, show me what you’re capable of…” Compare that statement to… “Mary, you’re always so bad and rude, you drive me crazy, you can never get along with your sister…” If you want to instill a self-fulfilling prophecy, which is the better way to go? Moreover, the latter statements leave everyone feeling down and miserable.
Similarly, you can enthusiastically talk to your child about how you’re looking forward to seeing him follow directions, clean-up, and get-along. Words have power, as do positive expectations, especially from somebody we really care about.
Some wonderful resources
Two excellent resources that provide examples of speaking to children in this firm yet positive way includes How to Talk so Kids will Listen, and Listen so Kids will Talk. The other is Siblings without Rivalry that focuses on how to curb your kid’s fighting with one another and there are clever phrases to use with your kids that you’ll find very useful.
Making medication work
The same thing holds true in terms of making medication more effective. Explaining to a child how their medication is going to help and doing so with conviction and enthusiasm can go a long way to help increase the effectiveness of the medication.
Now go and instill some hope
Every time you speak to your child, be reminded to speak in a manor that instills hope, high expectations, clear expectations, and that you know they can rise to the occasion. You’ll feel better, and so will your kids. God bless.
Written by Dr. John Carosso
Types of chores
I’m often asked what types of chores are most appropriate for my child based on age, and whether to pay for the child completing chores?
Ages for chores?
Of course the type of chore depends on your child’s developmental level, but children as young as two can start helping to clean-up their toys, and 4-5 year-olds can clean their room (with direction and oversight), and help clean-up around the house. Between ages 7-10 many kids are more than capable of emptying the garbage, putting away the dishes, vacuuming, dusting, and wiping-up the floor. Teens can start doing laundry, cooking…
Allowance for chores?
That can be left up to you, but you may want to consider that children do not get paid for chores that are part of ‘all of us live here together and need to pitch-in’. However, it may seem reasonable to pay for chores that go above and beyond such as washing and waxing the family car, doing windows, cutting the grass, shoveling snow, cutting the hedges… Some of you may not consider these chores to be ‘above and beyond’, which is fine, and others provide an allowance for daily chores such as emptying the garbage - whatever works for you.
Just do it!!
It’s not so much what chores or whether you pay, it’s that you ‘do it’ in terms of enforcing your kids doing chores, becoming more responsible, not relying on you, pitching in, and having a sense of accomplishment. Think of being on your hammock with your lemonade while your kids take care of the housework 😉
Your feedback
As always, I’d love your feedback regarding what works for you to get your kids to do chores, if you pay, and how that’s working for you? You can email me at jcarosso@cpcwecare.com. Thank you and God bless.
Dr. C's Morning Minute
View Dr. C's Morning Minute Video Getting Your Kids To Do Their Chores Part 1 for more information about this topic by clicking here.
See more of Dr. C's Morning Minute on our Video Blog Page
Written by Dr. John Carosso
Are you feeling like the unpaid help?
Do you find yourself relentlessly cleaning-up, picking-up, putting-away, cooking, transporting, washing, re-washing, doting and doing just about everything else while your kids seemingly are on vacation, watching TV, playing video games, playing with their friends, and not even remotely lifting a hand to help you as they watch you work to the bone? To make matters worse, you never get a thank-you, and perceive that your kids feel entitled that this is the way it should be, with no guilt or remorse. If so, well, if it’s any consolation, you’re not alone.
You know it needs to change…
Okay, you know that this scenario is frustrating for you, makes you feel unappreciated, and it’s not healthy for your kids. You know that, at some point, it needs to somehow be communicated that ‘we’re all in this together’, that everyone needs to ‘pitch-in’, and they need to learn how to care for themselves.
What’s it take to change?
Take heart that this situation is not necessarily difficult to change. You’ll need to be diligent, firm, and consistent. Well, okay, maybe this will be kinda difficult. No matter, have faith in yourself to rise to the occasion.
One step at a time
The first step is to communicate what is expected in a clear, concise manner. Put it in writing for each child and a time when the chore needs to be completed each day.
A few options
If you decide to use a chore chart, then you may want to write down the specific chores, what each chore entails, and the time of day by which the chore needs to be completed. You’ll convey that the chore’s completion will be monitored by you and a sticker, star, or point or whatever will be allocated on the chart accordingly. You will not discuss the matter; either the chore is done, or it’s not. The number of stickers, stars, or points earned each day will determine privilege level the following day; this way, each day starts anew.
Another way
If the aforementioned sounds too ambitious, then there is a simpler method. Lay-out the chores as described above, but use the ‘when/then’ prompt…. “when the chore is done, then you can do….” This way, unfavored comes before favored activities. The same can be said anytime your child asks you for something (a thousand times per day); you’ll honor the request after the chore is done.
Stick to it
The biggest problem is that parents find it’s easier just to do it themselves than fuss about the chores. I can sympathize with that sentiment, but it’s just causing more frustration and angst, and putting-off the inevitable. So, you might as well just stay firm and get it over with. Once your kids know you’re serious, and get into a routine, it will become much easier and you’ll feel more supported, more loved, and the entire household will be more harmonious. Sound good?
Next time
In my next post, I’ll be focusing on what types of chores are most appropriate, at what ages, and whether to pay for chore completion.
Please email your feedback
Let me know what you think about this plan, what you’ve tried, what works for you, and if you try this plan, how it works for you. Your feedback is super helpful at jcarosso@cpcwecare.com. Thanks again, and God bless.
Dr. C's Morning Minute
View Dr. C's Morning Minute Video Getting Your Kids To Do Their Chores Part 1 for more information about this topic by clicking here.
See more of Dr. C's Morning Minute on our Video Blog Page
Written by Dr. John Carosso
Yes, it’s that time
It’s that ‘back to school’ time. Yes, it’s sad to see the summer coming to a close and definitely time to get back to the school routine.
Summer vs. School Routine
Need I mention the difference between summer and school-year routines? If you start about 2-3 weeks out, it’s much easier to ship your kids into shape. Otherwise, it’s a culture-shock for your child, and not too pleasant for you either.
What to do (tips for parents of children with autism, and typical kiddos):
I'd love to hear any suggestions or tips you have about how you prepare your kids for back to school. Feel free to email me at jcarosso@cpcwecare.com. Thanks!!
God bless and enjoy the rest of the summer
Written by Dr. John Carosso
I was recently asked an excellent question from a parent with an adorable, nonverbal child with autism. The concern is that the kiddo does not seem to understand consequences such as time-out, and loss of privilege has little impact. The aggression reportedly often stems from, for example, a sibling being in close proximity, not getting what she wants, or related frustrations.
Autistic children who are quite young, nonverbal, and have notable developmental delay often do not respond well to consequences such as time-out and loss of privilege. They have trouble understanding cause-effect (understanding that their behavior led directly to a punishment), they live ‘in the moment’ and are not anticipating a negative reaction to their behavior, and their expressive language issues are often accompanied by receptive language deficits that interferes with the child’s ability to understand and accept reasoning and problem-solving.
Given these challenges, it’s difficult to develop a ‘one-size-fits-all’ protocol to alleviate the emotion and tantrums. Any given protocol will be highly individualized based on the developmental level, motivations, and reasoning ability of the child. Nevertheless, there are some general principles that can be followed.
In these situations, always start with the ‘triggers’ for the misbehavior and try to avoid these triggers whenever possible. A ‘trigger’ is what tends to cause the misbehavior in the first place, eg. siblings standing too close… However, over the course of time, attempt to desensitize the child to the trigger by having the child experience the trigger in small increments (i.e. sibling stands far enough away to not cause a tantrum, but close enough that it catches the child’s attention). Over time, slowly increase the extent to which the child experiences the trigger. It’s also helpful to pair the ‘trigger’ with something the child enjoys and prefers (“pairing”); for example, the sibling stands close, but is holding the child’s favorite treat and gives the treat to the child. These scenarios can be expanded and generalized to many other ‘triggers’ and, before you know it, the child is consistently tolerating even close encounters with her sibling.
A more common cause (trigger) of tantrums and aggression occurs when a child is removed from a favorable experience (local park, TV…), if a favored item is taken away (loses a toy), or if the child is being punished (time-out). As indicated above, if the loss of privilege or favored item is a punishment, and the child does not fully understand the “punishment”, then what’s the point? Instead, rely on avoiding triggers, distraction, redirection, and replacement behaviors (helping the child to use their words) if the child has at least some verbal skills. However, in the event of aggression, for example, when removing the child from a favored place or taking away an iPad so the child can eat dinner (transitioning from favored to unfavored), then we rely on a few other options. This would include trying to make the transition a bit more gradual and slow, giving both visual and auditory reminders and warnings, and pairing the favored and unfavored and then slowly withdrawing the favored. These protocols are often ‘trial and error’, and based on the child’s individual preferences and tendencies. Consequently, working with a behavioral therapist is vital to develop an individualized and effective protocol and, even then, the protocol often needs regular ‘change-ups’.
In some case, you have to quickly transition from a favored to an unfavored task, and there is no time to make the transition more appealing, and you know your kiddo is going to have a fit. In those instances, you’ll use pre-determined techniques to help your child calm as fast as possible. These techniques will need to be determined ahead of time in that, over time, you’ve learned what strategies are more effective in helping your kiddo to more quickly calm. This may include putting your kiddo in a quiet and safe area to let the emotion run its course, simply snatching-up your child and moving-on toward the next activity, or distracting with favored item or toy (but be careful not to reinforce the problematic behavior). A picture schedule can be very helpful so your child can see themselves, in the picture, having fun in the next activity and this helps to increase motivation to move-on with the routine. It’s vital to have a quiet, safe, out-of-the-way area for your child to tantrum where they cannot get hurt, cannot hurt others, cannot destroy property, and will more readily calm. Sometimes parents have success with a secure car-seat, high-chair, or play-pen. I’ve talked with parents about creating a playpen that is padded and secure, or a small room from which is removed any potentially dangerous objects. It’s often advisable to avoid restraining your kiddo for long periods of time given this often can result in someone getting hurt, and the attention the child receives from the restraint can be reinforcing. A behavioral therapist can be invaluable to guide you through this tricky process. Clearly, however, if the tantrum is brief and with no accompanying aggression, then often it’s best to let it run its course and move forward with the next activity.
This post provided some general ideas of how to manage the challenging issue of tantrums and aggression, and I hope you found it to be helpful. I highly recommend that any parent with such challenges seek consultation from a trained behavioral therapist (feel free to contact me at jcarosso@cpcwecare.com or check out my fb page) where, either in an office setting or through in-home support (wraparound) a thorough functional behavioral assessment can be completed and an array of effective strategies can be determined. God bless.
