Community Psychiatric Centers

Monroeville, Greensburg, Monessen, and Wilkinsburg Pittsburgh

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When is it typical childhood behavior, and when is it something to be concerned about? Many parents ask this question when they see their child struggling with focus, impulsivity, or high energy. While it’s natural for kids to be active and occasionally distracted, ADHD becomes a concern only when these behaviors clearly interfere with a child’s functioning at home, in school, and socially.

What Makes ADHD A “Disorder”?

A child may be wiggly or inattentive, but for ADHD to be diagnosed, three key factors must be present:

  • Persistent – The behavior lasts at least six months.
  • Pervasive – The issues appear in multiple settings (home, school, etc.).
  • Impairing – The behavior significantly disrupts learning, relationships, or home life.

Sometimes, kids appear far more hyperactive at home than at school. In cases of genuine ADHD, while it is expected that there would be signs of ADHD at school, this doesn’t necessarily rule out ADHD; in fact, many children "hold it together" at school and then release their energy at home. That’s why a comprehensive evaluation is so important.

A Thorough ADHD Evaluation With Dr. John Carosso

Dr. John Carosso, a licensed Child Clinical Psychologist, has decades of experience in pediatric behavioral health. Dr. Carosso performs a detailed, evidence-based evaluation that includes:

  • Clinical Interview with parent and child
  • Input from teachers and caregivers to observe behavior across settings
  • Neuropsychological testing for attention, memory, and executive functioning
  • Review of genetic and family history of ADHD and related conditions

This holistic approach ensures an accurate diagnosis and informs a treatment plan tailored to your child’s needs.

Treating ADHD: Four Core Strategies

An ADHD diagnosis isn’t the end of the story - it’s the beginning of a plan. Effective treatment combines medical, behavioral, and educational strategies.

1. Structure and Routine - Children with ADHD thrive with predictability. Clear daily routines, visual schedules, and consistent expectations help reduce frustration and increase focus. Simple changes—like labeled bins, posted checklists, and fixed homework times—can make a world of difference.

2. Medication - Stimulant medications such as methylphenidate (Ritalin, Concerta) or amphetamines (Adderall, Vyvanse) are often prescribed to reduce ADHD symptoms. When properly monitored, these medications are safe and effective, helping kids focus, stay calm, and better manage their behavior.

3. High-Level Oversight and Monitoring - Children with ADHD often require close adult supervision and frequent prompting. This is known as proximity control. It may involve:

  • Sitting near your child during homework
  • Providing gentle, step-by-step guidance
  • Offering frequent verbal cues and encouragement

These supports help children initiate, persist, and complete tasks, which they often struggle to do independently. Over time, your child will learn to rely more on independent tools such as:

  • Visual schedules and checklists
  • Timers and alarms
  • Color-coded folders and planners

Direct oversight can gradually fade as their self-regulation improves, promoting independence and confidence.

4. 504 Service Agreement at School - A 504 Plan is a formal agreement that allows children with ADHD to receive classroom accommodations such as:

  • Preferential seating
  • Extended time for tests
  • Movement breaks
  • Reduced homework load

These supports level the playing field without altering curriculum standards, helping your child succeed academically.

Final Thoughts

ADHD is not just a phase or personality trait—it’s a real condition that can profoundly affect a child’s development if not addressed. But with an accurate diagnosis and a comprehensive treatment plan, children with ADHD can succeed and thrive in all areas of life.

Ready to Take the First Step?

If you’re concerned that your child may be showing signs of ADHD, schedule a comprehensive evaluation with Dr. John Carosso - he'll help you determine whether ADHD is truly present and guide you toward the right treatment plan.

Click here to schedule an evaluation. We are proudly serving families throughout Pennsylvania via in-person and telehealth evaluations.

The transition from childhood to adulthood can be challenging for any young person, but for those with Autism and ADHD, it often comes with unique obstacles. From navigating higher education and employment to developing life skills and social relationships, the journey to independence requires thoughtful planning, support, and patience. Here are some key ways to help young people with Autism and ADHD transition successfully into adulthood:

Build Executive Function Skills Early

Many young adults with ADHD and Autism struggle with organization, time management, and decision-making. Teaching executive function skills—like using planners, setting reminders, and breaking tasks into smaller steps—can foster independence. Here are some strategies for success.

Strategies:

  • Encourage the use of visual schedules, timers, and checklists.
  • Teach self-advocacy skills so they can ask for help when needed.
  • Provide opportunities for real-life problem-solving, like managing a small budget or planning a schedule.

Develop Vocational Skills Before Adulthood

Career readiness is essential for long-term success. Vocational skills training helps young adults with Autism and ADHD gain practical, hands-on experience that aligns with their strengths and interests.

Strategies:

  • Early Exposure: Introduce career options through job shadowing, career fairs, and mentorship programs.
  • Skill Development: Teach workplace expectations like punctuality, teamwork, and communication.
  • Hands-On Experience: Encourage internships, volunteer opportunities, or part-time jobs in structured environments.
  • Vocational Training Programs: Explore specialized programs, such as trade schools or technical certifications, that provide job training for neurodivergent individuals.
  • Workplace Accommodations: Help them learn to advocate for necessary supports, such as flexible work schedules or quiet workspaces.

By focusing on vocational training early, young adults can develop confidence and real-world experience that makes the transition to employment smoother.

Prepare for the Workforce

Employment can be overwhelming, with unspoken social rules, expectations, and sensory challenges. Finding a good job match and developing workplace skills early is key.

Strategies:

  • Explore internships, volunteer work, or part-time jobs in structured environments.
  • Practice job interview skills, including role-playing common questions.
  • Look into neurodiversity-friendly companies and job coaching programs.

Develop Independent Living Skills for Adulthood

Living independently requires skills like cooking, cleaning, money management, and self-care. These should be introduced gradually during the teenage years. There are many skills they will need for adulthood that are easy to master during this time!

Strategies:

  • Teach daily living tasks through step-by-step guidance and practice.
  • Use apps and tools to support budgeting and meal planning.
  • Consider structured independent living programs that ease the transition.

Support Emotional and Social Growth

Young adults with Autism and ADHD may find social interactions, emotional regulation, and relationships challenging. Building these skills early can lead to better outcomes in friendships, dating, and workplace interactions.

Strategies:

  • Offer social skills training groups or therapy.
  • Encourage participation in clubs, special interest groups, or online communities where they can connect with like-minded peers.
  • Teach self-regulation strategies, like mindfulness or deep breathing, to manage emotions in stressful situations.

Navigate Higher Education or Alternative Paths

College can be an exciting but overwhelming experience, requiring self-motivation and structure. Some may thrive in traditional university settings, while others may benefit from vocational programs, online learning, or apprenticeships.

Strategies:

  • Research disability support services at colleges and advocate for accommodations like extra time on exams or quiet study areas.
  • Explore alternative education pathways, such as trade schools or skill-based certifications.
  • Provide guidance in choosing a career path that aligns with strengths and interests.

Encourage Self-Advocacy and Confidence

Teaching self-advocacy helps young adults understand their needs, rights, and how to communicate effectively in different environments.

Strategies:

  • Teach them how to explain their strengths, challenges, and accommodations to others.
  • Role-play scenarios where they may need to speak up for themselves, like requesting accommodations at work or school.
  • Foster a growth mindset, emphasizing that challenges can be overcome with persistence and support.

What Parents Can Do to Help Their Teenagers Prepare for Adulthood

Parents play a crucial role in guiding their teenagers with Autism or ADHD toward independence. By providing support, encouragement, and gradual responsibilities, parents can set their child up for success.

Ways Parents Can Help:

  • Start Small and Build Independence – Encourage decision-making by allowing teens to make choices about their schedules, meals, and activities. Gradually introduce responsibilities like managing money or doing household chores.
  • Encourage Real-Life Practice – Teach life skills through hands-on experiences, such as grocery shopping, cooking meals, or using public transportation.
  • Support Social Growth – Encourage participation in social groups, mentorship programs, or therapy to build confidence in social settings.
  • Model Problem-Solving Skills – Walk through everyday challenges with them, such as handling unexpected situations or resolving conflicts.
  • Help with Time Management – Use planners, calendars, and reminders to help them track schoolwork, job applications, or appointments.
  • Advocate for School & Workplace Accommodations – Work with teachers, counselors, or employers to ensure they receive the necessary support.
  • Discuss Future Goals Openly – Talk about their interests, strengths, and long-term aspirations to help them explore realistic career paths.

Parents don’t have to do it all alone—seeking support from coaches, therapists at Community Psychiatric Centers, and peer groups can help their teen feel more prepared for the future.

College Programs for Students with Autism and ADHD

Many colleges and universities offer specialized programs to support students with Autism and ADHD. Here are some notable ones:

  1. Rochester Institute of Technology (RIT) – Spectrum Support Program (SSP): Individualized coaching and social skills support.
  2. Curry College – Program for Advancement of Learning (PAL): Helps students with ADHD and learning differences develop essential academic skills.
  3. University of Arizona – Strategic Alternative Learning Techniques (SALT) Center: Offers tutoring, executive function coaching, and workshops.
  4. Landmark College: Specializes in educating students with learning differences, including Autism and ADHD.
  5. Beacon College: Provides degree programs tailored to students with learning disabilities.
  6. University of Idaho – Raven Scholars Program: Offers mentoring and life skills support for students with Autism.
  7. Marshall University – College Program for Students with Autism Spectrum Disorder: Helps students navigate college life and career preparation.
  8. University of Connecticut – Beyond Access Program: A fee-based service that provides academic and personal support for students with ADHD.

These programs provide essential accommodations, coaching, and structured environments to help neurodivergent students thrive in college.

Create a Strong Support Network

Transitioning into adulthood is easier with a solid support system. This can include family, friends, mentors, therapists, and advocacy groups.

Strategies:

  • Connect with organizations that support neurodivergent young adults.
  • Encourage them to build a personal support team, including mentors, coaches, or trusted peers.
  • Help them identify safe and supportive communities, both online and in-person.

Research Insights: College vs. Vocational School for Students with Autism and ADHD

Deciding between college and vocational school is a significant consideration for students with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). Research provides insights into the outcomes associated with each educational path:

Autism Spectrum Disorder (ASD):

  • Postsecondary Education Participation: Approximately one-third of individuals on the autism spectrum pursue postsecondary education, including 2-year and 4-year colleges, as well as vocational training programs.
  • Completion Rates: Autistic students often face challenges in completing postsecondary education. Less than 40% of autistic students successfully finish their postsecondary programs. ​
  • Employment Outcomes: Youth with ASD have lower rates of employment compared to peers with other disabilities. Approximately 55.1% had held paid employment during the first six years after high school.

Attention Deficit Hyperactivity Disorder (ADHD):

Considerations for Educational Pathways:

  • Vocational Training Benefits: For some students with ADHD, vocational training offers a structured environment that focuses on specific skill development, leading to quicker entry into the workforce. This path can provide a sense of independence and may align better with their learning styles. ​
  • College Preparedness: Students with ASD or ADHD considering college should assess their readiness for the less structured environment of higher education. Support programs, such as those offered by certain colleges, can be beneficial in providing necessary accommodations and resources.​

Improving Employment Success for Individuals with ADHD and Autism

Securing and maintaining employment can be challenging for individuals with Autism and ADHD, but with the right strategies, they can thrive in the workplace. Here are some ways to improve employment success:

Choose the Right Job Fit

Finding a job that aligns with individual strengths and interests can significantly improve job satisfaction and performance.

Strategies:

  • Focus on roles that utilize problem-solving, creativity, and attention to detail (e.g., IT, engineering, design, trades, etc.).
  • Consider jobs that offer structure and predictable routines for individuals with Autism.
  • For individuals with ADHD, look for dynamic, fast-paced environments that minimize repetitive tasks.

Build Those Adulthood Workplace Skills Before Job Hunting

All teens can benefit from learning job skills before they are even looking for a job. Developing those essential workplace skills before entering the workforce can ease the transition. Here are a few strategies for practicing those skills before they enter 'the real world' workplace:

Strategies:

  • Internships & Volunteer Work: Gaining hands-on experience before applying for a full-time position.
  • Soft Skills Training: Learning communication, teamwork, and conflict resolution skills.
  • Time Management & Organization: Using digital tools like task planners and reminder apps to stay on track.

Utilize Job Coaching and Vocational Support Programs

Several organizations and resources help neurodivergent individuals find and maintain employment.

Programs to Explore:

  • Vocational Rehabilitation Services – Many states provide employment support for individuals with disabilities.
  • Job Coaching Programs – Organizations like the Autism Society and ADHD-focused career coaches offer tailored support.
  • Neurodiversity Hiring Initiatives – Many companies, including Microsoft and SAP, have programs specifically designed for neurodivergent employees.

Leverage Workplace Accommodations

The Americans with Disabilities Act (ADA) allows employees to request reasonable accommodations to enhance their work performance. It is important to learn what accommodations might be available to your child, and help them navigate the process of making sure they have access to them.

Examples of Accommodations:

  • For ADHD: Noise-canceling headphones, flexible work schedules, written instructions.
  • For Autism: Clear communication of job expectations, predictable work environments, sensory-friendly workspaces.

Much like accommodations in school, obtaining workplace accommodations is a process. Encouraging self-advocacy and working with HR to implement accommodations can lead to greater job success.

Master the Job Interview Process

Interviews can be stressful, especially for individuals with Autism and ADHD! Preparation is key. Many of the communication and socializing skills your teen has been working on come into play in an interview.

Strategies:

  • Practice Common Questions – Role-playing interviews with a coach or mentor.
  • Request Alternative Interview Formats – Some companies allow work samples or skill-based assessments instead of traditional interviews.
  • Use Support Services – Programs like Specialisterne help neurodivergent candidates navigate job interviews.

Foster a Supportive Work Environment

A workplace that understands and embraces neurodiversity improves long-term job success.

Strategies:

  • Look for Neurodiversity-Friendly Employers – Research companies with inclusive hiring practices.
  • Encourage Open Communication – Educating employers about neurodiversity can improve workplace relationships.
  • Find a Workplace Mentor – Having a trusted colleague can help with workplace navigation and problem-solving.

Develop Coping Strategies for Work Challenges

Managing stress, distractions, and executive function challenges is key to long-term job success.

Strategies:

  • For ADHD: Break work into small tasks, take movement breaks, and use productivity apps.
  • For Autism: Establish a structured routine, use scripts for social interactions, and communicate needs clearly.

Explore Entrepreneurship as an Option

Many neurodivergent individuals excel as entrepreneurs, where they can set their own schedules and play to their strengths.

Entrepreneurial Advantages:

  • Ability to create a sensory-friendly workspace.
  • Freedom to set personal routines.
  • Opportunity to work on projects that align with interests.

Programs like Neurodiversity in Entrepreneurship offer guidance and mentorship for aspiring business owners with Autism and ADHD.

Professional Support for a Successful Transition to Adulthood

Employment success for individuals with Autism and ADHD is achievable with the right preparation, support, and work environment. By leveraging strengths, seeking accommodations, and using available resources, neurodivergent individuals can build fulfilling and sustainable careers.

Navigating the transition into adulthood with Autism or ADHD can be challenging, but professional guidance can make a significant difference. If you or your child needs expert evaluation and consultation, Dr. John Carosso, a licensed psychologist, is available to provide comprehensive assessments and tailored recommendations.

Additionally, Community Psychiatric Centers offers therapy and support services designed to help neurodivergent individuals and their families manage this transition successfully. Their team of professionals provides counseling, skills training, and personalized strategies to foster independence, social growth, and career readiness. Seeking professional support can help families and individuals feel more confident and prepared for the journey ahead.

📞 To schedule an evaluation with Dr. John Carosso or explore therapy options at Community Psychiatric Centers, reach out today to take the next step toward a successful transition into adulthood!

Final Thoughts

The transition to adulthood for individuals with Autism and ADHD is a journey, not a destination. With the right tools, support, and understanding, they can thrive in their own unique ways. Every step forward—no matter how small—is a victory.

By fostering independence, building essential life skills, utilizing professional resources, and providing ongoing encouragement, we can help neurodivergent young adults step into their future with confidence and success.

If you’re new to behavioral interventions, you might have heard Applied Behavior Analysis (ABA) and Discrete Trial Teaching (DTT) used interchangeably. While they are closely related, they are not the same. DTT is just one of many techniques used within ABA. ABA is a broad, science-based approach to understanding and modifying behavior, while DTT is a specific instructional method within ABA that focuses on structured teaching.

The Broad Scope of ABA

ABA is a scientific approach that applies principles of learning and behavior to improve socially significant skills. It is widely used to support individuals with Autism Spectrum Disorder (ASD), ADHD, developmental disabilities, and other behavioral challenges.

Key Areas of ABA Application:

  • Skill Development – Teaching communication, academics, and life skills
  • Behavior Reduction – Managing challenging behaviors like aggression and self-injury
  • Social Skills Training – Encouraging interaction, play, and relationship-building
  • Functional Communication – Enhancing verbal and non-verbal communication
  • Independence & Daily Living – Teaching self-care, hygiene, and time management

ABA is not limited to a single method—it includes a variety of evidence-based techniques such as:

  • Natural Environment Teaching (NET) – Learning through play and everyday interactions
  • Pivotal Response Training (PRT) – Focusing on motivation and social engagement
  • Functional Communication Training (FCT) – Replacing problem behaviors with effective communication
  • Discrete Trial Teaching (DTT) – A structured teaching method (explained below)

ABA is flexible and can be applied in multiple settings—home, school, community, and therapy centers.

What is Discrete Trial Teaching (DTT)?

DTT is a structured teaching method within ABA where complex skills are broken into small steps. Each step is taught individually and reinforced until mastered. A typical discrete trial consists of:

  • Instruction (Antecedent) – The therapist gives a prompt (e.g., “What’s this color?”).
  • Response (Behavior) – The child responds (e.g., “Red”).
  • Consequence (Reinforcement or Correction) – If correct, reinforcement is given (e.g., praise, a token). If incorrect, corrective feedback is provided.

DTT is especially effective for children with Autism Spectrum Disorder (ASD) because it teaches foundational skills through repetition. It is also sometimes used by therapists for children with ADHD.

Key Differences Between

Videos on Discrete Trial Teaching

To better understand Discrete Trial Teaching in action, here are some helpful videos:

How to Get an Expert Evaluation & Diagnosis

If you suspect that your child may benefit from ABA and DTT, getting a professional evaluation is the first step. For those of you who are new to my articles, I am a Child Clinical Psychologist and Certified School Psychologist, specializing in assessing children with Autism, ADHD, and behavioral challenges. I will be happy to help your family with evaluations, diagnosis, and treatment. To schedule an appointment with me, call (724)-850-7200. A proper evaluation can help determine the best intervention plan, ensuring your child receives the most effective support tailored to their needs.

Final Thoughts

Understanding the difference between ABA and DTT is crucial for parents, educators, and therapists working with children who need behavioral support. ABA is an overarching science, while Discrete Trial Teaching is just one of many effective techniques. Knowing when and how to use it, along with other ABA-based strategies, can significantly improve a child’s learning and development.

Have you used ABA or DTT in therapy or teaching? Share your experiences in the comments!

Weighted blankets and vests have gained significant attention in recent years for their potential to help children with autism and ADHD manage sensory challenges, improve focus, and reduce anxiety. These therapeutic tools are designed to provide deep pressure stimulation (DPS), which can have a calming effect on the nervous system. For parents and caregivers seeking non-invasive interventions, weighted products offer promising benefits rooted in both research and anecdotal experiences.

Understanding Deep Pressure Stimulation

Deep pressure stimulation (DPS) is a sensory input similar to the feeling of a firm hug or a massage. Research suggests that DPS activates the parasympathetic nervous system, which helps regulate the body's "rest and digest" response. This can counteract the "fight or flight" response often experienced by individuals with autism or ADHD when overwhelmed by sensory input.

According to a study published in the Journal of Medical and Biological Engineering, DPS can reduce cortisol levels, the hormone associated with stress, while increasing serotonin and dopamine, which are linked to improved mood and focus. These physiological effects explain why weighted blankets and vests are thought to create a calming and grounding experience for children with sensory processing challenges.

Weighted Blankets: Restful Sleep and Relaxation

Sleep disturbances are common in children with autism and ADHD. Weighted blankets, often filled with materials like glass beads or poly pellets, are designed to mimic the sensation of being swaddled, providing a sense of security. This can be especially beneficial for children who struggle with hyperactivity or anxiety during bedtime.

Parents frequently share positive anecdotes about how weighted blankets have helped their children achieve more restful sleep. For instance, one mother of an 8-year-old with autism shared, "Before using the blanket, my son would wake up multiple times a night, restless and unable to fall back asleep. Now, he sleeps through the night more consistently, and his mood during the day has improved."

A study published in Occupational Therapy in Mental Health found that weighted blankets improved sleep onset and duration for children with autism. The study concluded that the calming effects of DPS may promote the production of melatonin, a hormone essential for regulating sleep.

Weighted Vests: Focus and Self-Regulation

For children with ADHD, maintaining focus in school or during activities can be challenging. Weighted vests are worn during the day and provide gentle, evenly distributed pressure to the upper body, which can help enhance proprioceptive awareness—the body's sense of position and movement. This stimulation may support self-regulation and improve attention spans.

In a pilot study conducted by the American Journal of Occupational Therapy, children with ADHD who wore weighted vests during classroom activities demonstrated increased on-task behavior and reduced fidgeting. Teachers reported that students appeared calmer and more focused, particularly during tasks that required sustained attention.

From a parent's perspective, the benefits can be life-changing. One father recounted his experience with his 10-year-old son: "The vest gives him a sense of control. It's not a magic fix, but it's part of a toolkit that helps him manage his energy and emotions better throughout the day."

Tailoring Weighted Products to Your Child’s Needs

The effectiveness of weighted blankets and vests depends on choosing the right product for your child. Experts recommend that the weight of a blanket or vest should be about 10% of the child's body weight to provide adequate pressure without being uncomfortable. It’s also important to introduce these tools gradually, as some children may take time to adjust to the sensation.

Weighted products should always be used under adult supervision, especially for younger children, to ensure safety and comfort. Consulting with an occupational therapist (OT) can also provide valuable insights into whether a weighted blanket or vest is suitable for your child's specific needs.

Combining Weighted Tools with Other Therapies

While weighted blankets and vests can offer significant benefits, they are most effective when used in conjunction with other therapies and strategies. For example, sensory integration therapy, mindfulness practices, and structured routines can work alongside weighted products to help children develop self-regulation skills and thrive in various environments.

A Valuable Tool in the Sensory Toolkit

Weighted blankets and vests are not a one-size-fits-all solution, but they offer a valuable option for parents and caregivers looking to support children with autism and ADHD. Backed by research and countless personal success stories, these products can provide a sense of calm, improve focus, and promote better sleep—helping children navigate the world with greater ease.

If you're considering a weighted product for your child, remember to approach it as part of a holistic strategy tailored to their unique needs. With patience and the right tools, the journey toward sensory balance and emotional regulation becomes more manageable—and filled with hope.

Share Your Story: Have You Tried Weighted Blankets or Vests?

Have you tried Deep pressure stimulation (DPS) therapy for your child? What has your experience been like? Share your thoughts in the comments and join the conversation about this innovative approach to sensory support.

Summary

Weighted blankets and vests offer a simple yet effective way to support children with autism and ADHD by providing deep pressure stimulation, which helps reduce anxiety, improve focus, and promote better sleep. Research and personal experiences suggest that these tools can help regulate the nervous system, making it easier for children to manage sensory sensitivities and self-regulate their emotions. While not a standalone solution, weighted products can be a valuable part of a holistic approach, complementing other therapies and strategies. By choosing the right weight and gradually incorporating these tools into daily routines, parents and caregivers can help their children feel more secure, focused, and at ease in their environments.

Consult with an Expert

If you're considering weighted blankets or vests for your child and want professional guidance, consulting with an expert can provide valuable insights. Dr. John Carosso, a licensed child psychologist specializing in autism and ADHD, can help assess whether these tools are a good fit for your child’s specific needs. He can also provide a comprehensive evaluation and recommend additional strategies to support sensory processing and self-regulation. To learn more or schedule an evaluation, reach out to Dr. Carosso’s office at 724-850-7200 for advice tailored to your child’s unique challenges and strengths.

Dialectical Behavioral Therapy (DBT) is a specialized form of psychotherapy initially developed by Dr. Marsha Linehan in the late 1980s to treat individuals with borderline personality disorder (BPD). Over time, it has evolved to address a broader range of mental health issues. DBT combines principles from cognitive-behavioral therapy (CBT) with mindfulness practices, emphasizing acceptance and change to help individuals navigate emotional and interpersonal challenges.

What Is DBT Used For?

DBT is particularly effective in treating individuals who struggle with emotional regulation and self-destructive behaviors. It is commonly used for:

  • Borderline Personality Disorder (BPD): DBT’s primary focus is to address symptoms such as emotional instability, impulsive behavior, and self-harm.
  • Suicidal Thoughts and Behaviors: DBT helps individuals manage distress and reduce self-harming tendencies.
  • Mood Disorders: It is also effective in treating conditions like depression and bipolar disorder.
  • Post-Traumatic Stress Disorder (PTSD): DBT can help individuals process trauma and improve emotional stability.
  • Eating Disorders: It is often used to treat anorexia, bulimia, and binge eating disorders.
  • Substance Use Disorders: DBT teaches coping mechanisms that reduce reliance on harmful substances.

Is DBT Effective?

Research consistently supports the efficacy of DBT in improving emotional regulation, reducing self-harm, and enhancing overall quality of life. Studies indicate:

  • Significant reductions in suicidal behaviors and hospitalizations for individuals with BPD.
  • Improvements in interpersonal relationships, emotional regulation, and distress tolerance.
  • Success in treating conditions beyond BPD, including substance use and eating disorders.

The structured and skills-based approach of DBT ensures that individuals learn practical tools to manage their mental health challenges over the long term.

How Does DBT Differ From CBT?

While DBT and CBT share common roots, they differ in their approaches and focus areas:

  1. Core Philosophy:
    • CBT focuses on identifying and changing negative thought patterns and behaviors.
    • DBT integrates acceptance and change, helping individuals balance opposing needs through mindfulness and dialectical thinking.
  2. Skill Development:
    • CBT primarily targets cognitive restructuring and behavioral activation.
    • DBT emphasizes four key skill modules:
      • Mindfulness: Cultivating awareness and presence in the moment.
      • Distress Tolerance: Managing crises without resorting to harmful behaviors.
      • Emotion Regulation: Understanding and controlling intense emotions.
      • Interpersonal Effectiveness: Building healthier relationships and asserting needs effectively.
  3. Target Audience:
    • CBT is widely used for a broad range of mental health conditions.
    • DBT is particularly suited for individuals with severe emotional dysregulation and chronic self-destructive behaviors.

What Is Mindfulness In Therapy?

Mindfulness is a core component of DBT and serves as the foundation for the other skill modules. In therapy, mindfulness involves cultivating a heightened awareness of the present moment without judgment. It helps individuals:

  • Enhance Emotional Awareness: By focusing on the present, individuals become more attuned to their emotions and can identify them without being overwhelmed.
  • Reduce Reactivity: Mindfulness teaches individuals to observe their thoughts and feelings without immediately reacting, allowing for more thoughtful and deliberate responses.
  • Increase Focus: Practicing mindfulness can improve concentration and reduce distractions, which is especially beneficial for individuals with anxiety or ADHD.
  • Promote Acceptance: Instead of fighting against unpleasant emotions or situations, mindfulness encourages acceptance, helping individuals manage distress more effectively.

In DBT, mindfulness is broken down into "what skills" (observe, describe, and participate) and "how skills" (non-judgmentally, one-mindfully, and effectively). These practices empower individuals to stay grounded, make healthier decisions, and navigate challenging emotional experiences with greater resilience.

Is DBT Suitable For Children?

DBT has been adapted for children and adolescents, often referred to as DBT-C (Dialectical Behavioral Therapy for Children). It addresses emotional and behavioral issues common in younger populations, such as:

  • Oppositional defiant disorder (ODD).
  • Anxiety and depression.
  • Emotional dysregulation.
  • Self-harming behaviors.

DBT-C incorporates family involvement, teaching caregivers the same skills as their children to create a supportive and consistent environment. Therapists work collaboratively with children and their families to:

  • Develop age-appropriate coping strategies.
  • Enhance communication and problem-solving skills.
  • Build emotional awareness and regulation tailored to the developmental stage of the child.

Example: Treating Self-Harm In Children With DBT

Consider a 12-year-old child engaging in self-harming behaviors due to feelings of overwhelm and emotional pain. DBT would approach this situation in the following way:

  1. Assessment and Validation: The therapist would begin by understanding the child’s triggers and emotional experiences, and validating their feelings without judgment. This step helps build trust and reduces feelings of shame.
  2. Teaching Distress Tolerance Skills: The child would learn alternative strategies to cope with distress, such as using the "TIPP" skills (Temperature, Intense Exercise, Paced Breathing, and Progressive Relaxation) to regulate overwhelming emotions in the moment.
  3. Mindfulness Practices: The therapist would guide the child in practicing mindfulness to become more aware of their emotions and bodily sensations, helping them identify when they are escalating toward self-harm.
  4. Emotion Regulation Techniques: Over time, the child would be taught how to label and process their emotions effectively, reducing the intensity of emotional outbursts that lead to self-harm.
  5. Family Involvement: Parents or caregivers would be involved in learning these skills to provide consistent support at home. Above all, they might also work on reducing invalidating behaviors that could unintentionally reinforce the child’s distress.
  6. Problem-Solving and Interpersonal Skills: The child would be taught healthier ways to express their needs and solve conflicts, reducing feelings of helplessness and frustration that often contribute to self-harming behavior.

This structured and compassionate approach helps the child replace harmful behaviors with constructive coping mechanisms, fostering long-term emotional resilience and self-awareness.

Conclusion and Reaching Out

Dialectical Behavioral Therapy is a transformative approach that blends acceptance and change to address complex mental health challenges. Its structured framework and evidence-based techniques make it effective for individuals across various age groups and conditions. Whether you’re considering DBT for yourself, a loved one, or a child, this therapy offers powerful tools to build a life worth living.

Feel free to connect with me at DrCarosso@aol.com for more information about DBT, if you believe your child would benefit, and if you want to schedule an appointment. God bless you and your children.

For children with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), anxiety, and depression, everyday life can be filled with unique challenges. Social interactions, emotional regulation, and focus may often require additional support. One increasingly recognized source of comfort and growth for these children is the companionship of animals. Pets provide far more than just friendship—they can play a transformative role in emotional, cognitive, and social development.

Types of Animals That Help

  1. Dogs: Service dogs and therapy dogs are often trained to assist children with autism, ADHD, anxiety, and depression. These dogs can help prevent meltdowns, provide a calming presence, and encourage social interactions. For children with anxiety or depression, dogs can provide unconditional love and companionship, reducing feelings of loneliness.
  2. Cats: Cats offer quiet companionship, which can be particularly beneficial for children who may be overwhelmed by the high energy of a dog. Their soothing presence and soft purring can help reduce anxiety and promote relaxation, especially for children struggling with depression.
  3. Small Animals: Rabbits, guinea pigs, and hamsters are often great choices for children who may not be ready for the responsibility of a larger pet. These smaller animals can be a source of comfort and teach empathy through gentle handling.
  4. Horses: Equine therapy, also known as hippotherapy, is a popular therapeutic intervention for children with autism, ADHD, anxiety, and depression. Riding and caring for horses can enhance balance, coordination, and emotional regulation while fostering a sense of accomplishment and confidence.
  5. Fish: Watching fish swim in an aquarium has a calming effect and can help reduce stress, making it an excellent option for children who may find direct interaction with pets challenging. This can be particularly helpful for children with anxiety.

More Than Pets: Service Dogs vs. Emotional Support Animals

While both service dogs and emotional support animals (ESAs) offer valuable benefits, they serve different purposes:

  • Service Dogs: These animals are trained to perform specific tasks that assist individuals with disabilities. For children with autism, service dogs might help prevent wandering, interrupt repetitive behaviors, or provide deep pressure therapy. For children with autism, service dogs can help with task reminders, promote safety, and task completions. Service dogs have public access rights, meaning they can accompany their owners into public spaces such as schools, stores, and restaurants.
  • Emotional Support Animals (ESAs): ESAs provide comfort and companionship but do not require specialized training to perform specific tasks. They are often prescribed by mental health professionals, like me, to help alleviate symptoms of anxiety, depression, or other emotional conditions. Unlike service dogs, ESAs do not have public access rights but are often allowed in housing with no-pet policies and on certain airlines.

Understanding the distinction is important when considering a pet for a child with special needs, as the choice will depend on the child’s unique challenges and the level of support required.

The Specific Impact of Pets

  1. Social Skills: For children with autism, social interactions can be difficult to navigate. Pets act as social bridges, making it easier for children to engage with others. Research published in the Journal of Pediatric Nursing (2016) found that children with autism who owned dogs demonstrated increased social skills and confidence.
  2. Emotional Regulation: The calming presence of a pet can help reduce anxiety and improve emotional stability. Petting an animal is known to release oxytocin, a hormone linked to bonding and stress relief. For children with ADHD, this can help create moments of stillness and focus. For children with depression or anxiety, the companionship of a pet can alleviate feelings of isolation and provide comfort during difficult times.
  3. Improved Focus and Responsibility: Caring for a pet introduces structure and routine, which is particularly helpful for children with ADHD. Feeding schedules, walks, and playtime encourage accountability and teach time management skills. For children with depression, having a pet to care for can provide a sense of purpose and daily motivation.
  4. Sensory Benefits: Many children with autism have heightened sensory sensitivities. The soft fur of a cat or dog, or the rhythmic movements of a horse, can provide soothing sensory input that helps regulate overstimulated nervous systems. Children with anxiety may also find sensory comfort in cuddling or stroking their pets.
  5. Physical Activity: Pets, especially dogs, encourage physical exercise, which has been shown to improve mood and focus. Regular movement is particularly beneficial for children with ADHD and can help reduce symptoms of depression and anxiety through the release of endorphins.
  6. Emotional Support: For children with anxiety and depression, pets can offer unconditional love and a nonjudgmental presence. Simply having a pet by their side can create a safe and comforting environment where they feel understood and valued.

Backed by Research

Numerous studies underline the benefits of pets for children with autism, ADHD, anxiety, and depression:

  • A 2014 study in PLOS ONE found that children with autism who had pets were more likely to engage in social interactions and respond to social cues compared to those without pets.
  • The Journal of Attention Disorders (2018) published findings that children with ADHD experienced reduced anxiety and improved attention spans after regular interactions with therapy animals.
  • A study published in Frontiers in Psychology (2019) highlighted the positive effects of pet ownership on reducing symptoms of anxiety and depression in children, citing improved mood and decreased feelings of loneliness.
  • Equine therapy has been widely studied, with research in the American Journal of Occupational Therapy highlighting improvements in behavior, sensory processing, and communication skills among children with autism and other emotional challenges.

Final Thoughts On Pets

Pets have a unique ability to connect with children on a deep and meaningful level. For kids with autism, ADHD, anxiety, and depression, they offer not just companionship but also a pathway to growth and healing. Whether it’s the wagging tail of a loyal dog, the gentle nuzzle of a horse, or the quiet observation of fish in an aquarium, the bond between a child and their pet can open doors to a world of possibilities. If you’re considering a pet for a child with special needs, email me at DrCarosso@aol.com to consider your child’s specific preferences and sensitivities to ensure the perfect match.

I Would Love To Hear Your Comments!

I’d love to hear your experiences with animals in your child’s life – comment on my FB page and on Substack. God bless and see you next time.

Disciplining children is one of the most challenging yet essential aspects of parenting. It’s about guiding children to understand boundaries, responsibility, and acceptable behavior. Common discipline approaches include trying to reason with the child (works wonderfully if your child is reasonable), and yelling at the kiddo (not advised). The two other most common methods parents use are taking away privileges and implementing time-outs. Both approaches have their strengths and weaknesses, and the key to success often lies in knowing when and how to use them.

Method #1: Taking Away Privileges

This method involves temporarily removing something the child values, such as screen time, toys, or extracurricular activities, as a consequence of undesirable behavior.

Discipline Method Pros:

  1. Teaches Responsibility: Losing privileges can help children understand that their actions have consequences, encouraging them to make better choices in the future.
  2. Longer Impact: The loss of a privilege over a set period gives the child more time to reflect on their behavior.
  3. Customizable: This approach can be tailored to fit the child’s age, personality, and specific misbehavior.

Cons:

  1. Emotional Resistance: Children may respond with anger or resentment, which can escalate conflict instead of resolving the issue.
  2. Overuse Diminishes Effectiveness: If privileges are taken away too frequently or for extended periods, the child may stop caring or become defiant.
  3. Risk of Power Struggles: This method may lead to a battle of wills, particularly if the child feels the punishment is unfair.
  4. Children May Find Alternatives: One common challenge with this method is that children often find something else to do to replace the lost privilege. For instance, if you take away video games, they might simply shift to reading comic books or engaging in another activity. This can reduce the perceived impact of the consequence, making it less effective as a deterrent.

Method #2: A Time-Out

A time-out involves removing the child from the situation for a short period, giving them a chance to calm down and reflect on their actions.

Discipline Method Pros:

  1. Immediate Intervention: Time-outs address behavior in the moment, helping children connect their actions to consequences right away.
  2. Encourages Self-Regulation: By pausing and calming down, children learn to manage their emotions better over time.
  3. Reduces Conflict: Separating the child from the triggering environment can prevent further escalation.

Cons:

  1. Effectiveness Varies by Age: Young children may not fully grasp the concept, while older children might see it as a punishment rather than a learning opportunity.
  2. Improper Implementation: If used as a punishment rather than a teaching tool, time-outs can create feelings of isolation or rejection.
  3. Behavior May Persist: Without clear follow-up, children might not fully understand why they were in a time-out, leading to repeated misbehavior.
  4. Refusal to Comply: Some children may refuse to go to a time-out, or, if they do, may refuse to stay there. This can lead to power struggles and further escalate the situation. Parents need to remain calm and consistent, and in some cases, use creative strategies—such as offering choices or gently guiding the child—to ensure the time-out is effective.

Choosing the Right Approach

The effectiveness of either method depends on several factors, including the child’s age, temperament, and the specific behavior being addressed. Here are some tips for using these methods effectively:

  • Set Clear Expectations: Let children know in advance what behaviors will result in a loss of privileges or a time-out.
  • Be Consistent: Apply consequences consistently to reinforce the connection between actions and outcomes.
  • Focus on Learning: Frame discipline as an opportunity for growth rather than punishment. Discuss what went wrong and how they can make better choices next time.
  • Balance Consequences with Positive Reinforcement: Acknowledge and reward good behavior to encourage a healthy balance of discipline and encouragement.

Final Thoughts, and Which is Better?

Check out my eBook, “The Most Common Discipline Methods Don’t Work: Here’s Why and How to Make Them Work", which takes on this topic in a far more detailed manner. In the meantime, which approach do I think is better? Well, here’s what I’ve found: for kids 3-12 years of age, there is no better method of discipline than time-out to their room. I’ve found that upon removing privileges, the child simply finds something else to do. However, by the same token, it all depends on the kiddo - both taking away privileges and time-out can be effective tools for discipline when used thoughtfully and sparingly. The ultimate goal is not just to correct behavior but to guide children toward understanding the impact of their actions and making better choices in the future. By approaching discipline with empathy, consistency, and a focus on teaching, parents can foster a positive and respectful environment for their children to thrive. Hope you’ve found this post to be helpful – God bless.

Plus Bonus Christmas Day Post!

This Christmas blog post was first put up on HelpForYourChild.com back in 2012. It has been helping families recognize the role Faith plays in helping families with childhood difficulties, and it is one of my favorite Christmas traditions. In 2023, I expanded upon this classic article, starting with the section titled "Christmas Bonus Post: What Makes Christmas so Special?"

What I’m Expected to Do…

As a psychologist, I’m expected to talk about traditional and clinically relevant approaches to help kids, and parents, work through difficulties. This of course would include helping people to think in more reasonable ways (cognitive therapy), behave in ways that are productive and healthy (behavioral approaches), be a good listener (client-centered techniques), stay in the moment (Gestalt), incorporate the family (systems approach), and use praise in systematic ways (Applied Behavioral Analysis).

Is There More?

Well, yes there is. Help for your child is sometimes more than just a clinical approach. I’m usually not expected to focus on spirituality but, sometimes, it’s like watching somebody drown and tossing a small life preserver when I have access to a large lifeboat. Don’t get me wrong, the life-preserver is effective but, well, wouldn’t you rather be in a boat?

Seems Only Fitting

During Christmas, it's good to remember that God gave His Son not only to rescue us from sin, but also to rescue us from ourselves. And in the process, heal us, soothe us, and relieve us during our times of stress, burden, and strife. Think about it, in Scripture, He’s referred to as our Advocate, the Almighty, All in All, Breath of Life, Comforter, Counselor, Cornerstone, Creator, God Who Sees Me, Goodness, Guide, Hiding Place, Hope, Intercessor, Keeper, Leader, Life, Light of the World, Living Water, Loving Kindness, Maker, Mediator, Our Peace, Physician, Portion, Potter, Teacher, Refuge, Rewarder, Rock, Servant, Shade, Shield, Song, Stone, Stronghold, Strength, Strong Tower, Truth, Wisdom, and Wonderful to cite just a few of His names. Hmmm, I wonder if maybe God is trying to tell us something about turning to Him for help?

Tap Into the Source of Faith

Those strategies I cited above (cognitive-behavioral…) are undoubtedly worthwhile and helpful. God gives people like me lots of ways to help and give relief (not to mention that most of those strategies have a basis in Scripture). However, there is something life-changing about tapping directly into the Source (another one of His names, by the way). As a practicing Christian, tapping into that life-changing Source entails following Romans 10:9. Give it a try, what have you got to lose?

Christmas Bonus Post: What Makes Christmas So Special?

What Makes Christmas so Special?

Christmas is the celebration of the birth of Jesus, and the beginning of what has become known as “Christianity”.

To suggest that the ‘Christian’ movement has been impactful would be an understatement; however, detractors remain. There have always been questions about veracity, reliability, and authenticity.

This post will address those questions.

Basic Questions

Since the beginning of time, dating back to Aristotle, people have asked deep philosophical questions about the meaning of life. Clearly, these questions are worthwhile, however, before we can answer the loftier philosophical questions, there are foundational questions that first need answered. The answers to these basic questions lay the foundation for subsequent philosophical inquiry. In fact, one could argue that the loftier philosophical questions are moot until these basic questions are answered, such as:

Who created the universe? It can be legitimately argued that something cannot come from nothing.

Did “God” create the universe and therefore, in doing so, create our current existence and reality?

Do we exist subsequent to evolution (by chance), or at the intentional hand of God?

There is, in fact, overwhelming evidence for God and Intelligent Design. Among a litany of other questions including the origins of the Big Bang, secularists still need to answer who wrote all the complex and voluminous ‘code’ (DNA) that’s in every cell of every living organism directing the cell on precisely what to do.

If there is a God, and He created everything, then is it not logical that He is the authority of the nature of our reality and existence.

Does God speak to us, and in what ways?

If God Created the Universe and is authoritative, how does He speak to us, and can we trust that it’s true and accurate?

Does God inform us – does He tell us what He wants us to know about our reality and existence?  If so, how does He inform us? In what ways? Are these ways authoritative, convincing, and based on clear evidence as opposed to relying on ‘blind faith’?

God speaks to us through His creation – this fact is rather self-evident, or at least it was until evolution muddied the waters.

It could be argued that the world, universe, earth, people, organisms, plants, and formations… are beyond compare and breathtakingly complex. The entire eco-system is inter-connected and exquisitely balanced. Creation is beyond our understanding and, as it’s clearly indicated in the Bible, He intended that we would be in awe of Him with every glance at what He created.

Scripture that speaks to God’s glory being revealed in creation:

The heavens declare the glory of God, the skies declare the work of His hands, day after day they pour forth speech, night after night they display knowledge. There is no speech or language where their voice is not heard, their voice is heard through all the earth, their words to the end of the world.   Psalm 19:1

From the beginning of creation, God’s eternal power and divine nature, though invisible, has been understood and known by the things He has created. Therefore, they are without excuse (for not believing).    Romans 1:20

God also communicates with us through His written Word

God communicates with us through his creation. He also communicates with us through His Word

God provided us a clear and concise owner’s manual and an understanding of our history and our future – through the Bible. Take time to read the Bible, and see for yourself.

Is the Bible credible?

All Christian denominations acknowledge the same 66 Books of the Bible. Remarkable, these 66 books were written over thousands of years, by over 40 writers of at least three different languages, spread over three different continents, yet the Bible is inextricably interwoven to tell ONE coherent, logical, inerrant description of God and His personality, His people, what He wants for and from us, and His plans for us. The Bible has many writers, but only one Author.   

It’s also important to appreciate how wonderfully and powerfully the Bible is written – its phrasing is beautiful and poetic, and the most complex spiritual and philosophical concepts are clearly explained by people who were not exactly trained in writing and literature.  For example,

John 1:1 – (John was a fisherman) - please take a moment and read this- it’s truly remarkable both in content and beauty:

In the beginning was the Word, and the Word was with God, and the Word was God, He was with God from the beginning. Through Him all things were made, without Him nothing has been made that has been made. In Him is life, and that life is the light of man. The light shines in the darkness, but the darkness has not understood it. There came a man sent from God, whose name was John (the Baptist), he himself was not the light, he came only as a witness to the light. The true light, the light of every man, was coming into the world. He was in the world, and though the world was made through him, the world did not recognize him. He came to that which was his own, but his own did not receive him. But to everyone who did receive Him, whomever believed in his name, He gave the right to be called children of God; children born not of natural descent, or human decision, or a husband’s will, but born of God. The Word became flesh and made His dwelling among us. No one has ever seen God, but God the One and Only, who is at the Father’s side, has made Him known.

Is the Bible authentic (has the Bible been altered)?

The Bible is derided by some as unsubstantiated fiction, however, there are over 24,000 early manuscripts of the Bible dating to within 100 years of Christ’s death. By comparison, the works of Homer, Ceasar, Plato, Tacitus, Thucydides, Herodotus, and many other ancients are often accepted as truth in secular culture and are taught in school. However, there are only 7 copies of Plato’s work from 1,300 years after his death; Ceasar – 1000 years and only 10 copies; Aristotle 1,400 years after his death and only 49 copies; Homer – 500 years with 643 copies; Thucydides 1.300 years and 8 copies…  there is really no comparison. It is clear that the Bible is accurate, true, and authentic dating back to the original text. 

Between His creation and His Word, God made it crystal clear that He is God, that He is real, and that we can know Him.

But He did not stop there.

Prophecy

No other theological book has such prophecy to back up its authenticity.

There are about 2,500 prophecies in the Bible, and about 2000 have already been fulfilled to the letter. The remaining 500 are regarding our future, and we can rest-assured Jesus is coming back to fulfill those as well.

The odds of these prophesies having been fulfilled by chance without error is less than one in 10 to the 2000th power (1 with 2000 zero’s after it).

Look to Genesis, Exodus, Daniel, Isaiah, Jeremiah, books of Kings and Second Kings, actually, it’s hard to find a book in the Bible that does not have prophecy, and they all came to pass.  There are also prophecies fulfilled in the New Testament – Jesus fulfilled hundreds of Old Testament prophecies and He also made many others – too many to recount here in this post.

No other religion has such compelling evidence – how can all these prophecies be explained except that they came directly from a God who wants us to know, without a shadow of doubt, that He is real - wants us to know about Him and that He wants to engage with us if only we’ll open the door to Him.

Need more evidence?

God makes Himself ‘real’ in our lives through the Holy Spirit; by adopting us, being our Father and friend, and changing our lives.

The testimony of changed lives

It’s difficult for unbelievers to understand this concept of the Holy Spirt and His impact on our daily life – it’s like trying to explain the breathing of air to a fish, which is sad because this ‘breath of life’ is beyond compare and there is nothing as powerful, satisfying, rewarding, or convincing as the Holy Spirit directly impacting one’s life. There is no mistaking or denying the presence of the Holy Spirit that is without compare and life-changing.

For the message of the cross [the Gospel] is foolishness to those who are perishing, but to us who are being saved it is the power of God

1 Corinthians 1:18

God changes lives - there are countless Christians who testify that their relationship with Jesus changed their life, delivered them from sin and any number of addictions, changed and renewed their mind, and opened their eyes to a new spiritual reality.  Christians describe their experience and world as unequivocally ‘different’ after encountering Christ - not perfect, but getting better and different from the old self. Sometimes that ‘difference’ is extraordinarily, sometimes more subtle, but always there is a change.

Therefore, if anyone is in Christ, he is a new creation; old things have passed away, behold, all things have become new. 2 Corinthians 5:17

Not only changed lives, but a changed world

Judeo-Christian teachings, values, and tenets shaped and guided Western culture and civilization as we know it today. We take-for-granted our God-given freedoms, rights, and civil-liberties that have changed the course of human history. The Declaration of Independence, our Constitution, and capitalism - all driven by Judeo-Christian concepts and teachings; and our very concept of morality – what is right and wrong, comes from the Bible - how else do we genuinely know what’s ‘right’ unless God tells us; otherwise, it’s only opinion. Also, our concepts of marriage, the family, respect for women, racial equality and equal treatment for all – come from the Bible. The abolishing of slavery was spear-headed through the work of Christians (the abolitionist movement was largely a Christian movement and churches often served as hiding spots that made-up the Underground Railroad). Our justice system and due process is based on the Bible, as-is our current hospital and university system (most hospitals were started by churches and many of our top universities began as seminaries). Our current foster and adoptive care system is based on the work of the church. In fact, the concept of a middle-class work-force is based in Christianity; prior, there was only the very rich, very poor, and slaves and that model, by the way, continues to exist in most of the non-Christian world. What about respect and care for children – yep, a Biblical standard. Moreover, the world’s greatest artists, musicians, writers, and architects all claim their work as inspired by God. Moreover, the greatest scientists were inspired by God and His creation. Not to mention that most charity work is Christian-based. Finally, of course, no one has sacrificed more, and changed more lives for the better than Jesus Christ.

That’s a wrap

Those are just a few things that make Christmas so special. He came humbly to this earth as a baby in a manger, but no one has so dramatically changed lives and changed the world. He left us with His Spirit and His church; and His Word has been shown to be true and authentic.  So, in the light of this glorious Christmas Spirit, I wish you the happiest and merriest Christmas season, and that you and yours would not only know about Him, but personally come to know the one whose birth we celebrate - all you have to do is ask.

“When you come looking for me, you will find me” 

                                                            -Jeremiah 29:13

Merry Christmas.

This classic holiday article shares timeless tips and observations about encouraging a sense of gratitude and thankfulness in children, teens, and young adults. It has been updated for 2024.

The holiday season is a time for lots of family and celebrations. It can feel like the modern world emphasizes the excesses of festivities and gifts that often come with those celebrations. In a season where material things are advertised at every turn, how do you provide a balance between helping your children be thankful for what they have, and providing them with that ‘Christmas morning magic’ of a pile of presents? It’s a tough balancing act!

Practice Gratitude Year-round

I imagine many of us try to keep that sentiment of thankfulness at the forefront of our minds and would prefer our kids do as well. However, do we find that, at times, our kids don’t seem so thankful? They can have a weak sense of gratitude because gratitude is not always something young children inherently experience. Ironically, the more you do for your kids, the less thankful they may seem.

An All-Too-Common Problem…

It’s sort of a trap. We love our kids so much and want them to be happy and content. At the same time, we live in the most prosperous and affluent country in the history of the world, so we have ample opportunity to give our kids lots of stuff.

So what transpires? As we give them more, we find that they tend to expect more. There comes a sense of entitlement and more expectation as opposed to a gracious and genuine “thank you!!”

Yes, it’s true, and clearly evidenced in our daily lives. The more someone gets, often the less gracious they become. Moreover, the lower the expectations to be able to obtain items (don’t have to work for it), the higher a child’s sense of entitlement.

Managing Entitlement

People who feel entitled and come to expect things without a strong sense of gratitude are typically unhappy people. In that respect, gratitude is a barometer for happiness. The more gratitude a person feels in life, the happier they are going to be. It’s hard to be happy when you ‘expect’ more, and aren’t happy with what you already have. Unfortunately, being a dependable and loving parent to your child can make something they would naturally be thankful for seem more like an expectation. So, what do we do to keep that thankful feeling?

How Do We Help Them Practice Feeling Gratitude?

Practice makes perfect: this can be true for feelings as well as any physical task. Sometimes to feel thankful about something, you need to acknowledge all the things you have. Here are some ideas:

1. Give with a little more restraint.

We don’t give a child everything they ask for. Remember the old adage: “give a child everything they need, but very little of what they want.”

2. Have kids work for what they want.

This can be through an allowance, and they can save their money. It's worth considering that there are two different sets of chores in any home; chores are important because we all live together and have to pitch in to run the household, such as cleaning one’s room, emptying the garbage, running the sweeper… and those chores that may be considered ‘above and beyond’ for which an allowance will be considered: such as raking leaves, pulling weeds, shoveling snow, washing the car, cleaning windows… for younger kids, the list of chores for which an allowance will be allotted may be a bit longer, but as a child gets older, that list will get smaller so it will be harder to earn an allowance. Developing a work ethic is an important life skill.

3. Show them what it’s like for those less fortunate.

Local churches have myriad opportunities for this type of service; we can sign up our kids (and we go along) to volunteer at a shelter (with direct parent oversight), at the Goodwill, or go on a mission trip. This offers an opportunity to give back, see how good they have it, and see firsthand how others are living. Donating toys/ items that the child has grown out of can be a powerful motivator to keep an uncluttered household, and it helps to cement the idea of helping the less fortunate. It is especially beneficial to do this around this time of year to clear out older toys and clothes while also making them available for those who need them in time for the holidays.

4. Practice thankfulness.

We make sure that, weekly, they write down all the things for which they are grateful. Also, it is good to get them in the habit of writing well-thought-out and gracious thank you cards for any gift they receive. This can start at a very early age, even if they are not yet able to write the cards themselves.

5. Seek out gratitude-building church messages.

Get your kiddo to church, synagogue, or temple (wherever you worship). at least once if not twice a week. Most churches have a kid’s program that also meets Wednesday evenings). If a church is doing its job, the preacher(s) are teaching about gratitude, thankfulness, self-sacrifice, the 10th Commandment (okay, I’ll give you a hint – that one about not-coveting and, rather, being happy with what God's given you), love, patience, humility, being meek, and caring for others. Can you think of better messages for our children?

It’s Not Too Late to Teach Your Kids About Gratitude!

Okay, so I know what you’re thinking. It’s too late. Your child is already an over-indulged tyrant who is running the household. Well, even in that seemingly dire situation, it’s not too late. You may need to take it a bit slower, but you can do it!! Follow the pointers above and, slowly but surely, things will begin to change. Your child will not be happy as you begin this process, they will fuss and try to wear you down. If you need help and guidance along the way, and maybe some moral support, that’s what I’m here for (and your local church with help from the Children’s Pastor). If you want to make a change in the direction of enhancing gratitude, you have to start sometime. How about today?

Here is wishing you and yours a relaxing and delightful Holiday Season with your family and friends, and with your ever-increasingly grateful children. For more tips on surviving the challenges that can come up during this time of year, check out my post: Managing the Holiday Season.

😊 God bless you.

When a child with autism has difficulties with eating, it can be due to a variety of reasons, including sensory sensitivities, routine rigidity, or difficulties with new textures and tastes. Addressing these eating challenges requires patience and strategic approaches. Today I share some tips for helping a child with autism who won't eat, as well as some ways a professional might help, and some easy recipes.

Understand Sensory Sensitivities

Children with autism often have sensory processing challenges that affect how they perceive food. Certain textures, smells, or even the appearance of food can be overwhelming.

  • Tip: Identify the sensory triggers. Keep a food journal to track which types of foods or sensory elements (e.g., crunchy, mushy, strong smells) they avoid or prefer
  • Tip: Gradually introduce new textures. Start by adding small amounts of a new texture to a preferred food and slowly increase the amount over time.

Create a Comfortable Mealtime Environment

A calm and predictable eating environment can help reduce stress and encourage eating.

  • Tip: Minimize distractions. It's best to minimize distractions such as loud music or TV during mealtimes.
  • Tip: Stick to a consistent routine. Serve meals at the same time and place each day to build comfort and predictability.

Offer Sensory-Friendly Utensils and Plates

The sensory experience isn’t just about the food—it includes how it’s presented and eaten.

  • Tip: Use utensils and plates that are sensory-friendly. Choose ones with bright colors or textured grips that the child finds comfortable.
  • Tip: Try plates with portion wells. Try different types of plates, such as ones with divided sections, to separate foods and avoid overwhelming the child.

Introduce New Foods Gradually

Children with autism may be resistant to change and new foods can be intimidating.

  • Tip: Start small. Introduce tiny portions of a new food alongside a familiar one. Celebrate even small steps like touching or smelling the new food.
  • Tip: Try "food chaining." Use a step-by-step approach called “food chaining,” where you build on a food they already like by gradually changing it. For example, if they like plain pasta, introduce pasta with a mild sauce next.

Avoid Power Struggles

Forcing a child to eat or making mealtime stressful can increase food aversions.

  • Tip: Keep mealtimes positive and low-pressure. Offer praise for small achievements, even if they don't eat the food but interact with it in some way.
  • Tip: Give choices! Give them some control by offering choices, such as picking between two different foods. This helps them feel more in control and less resistant.

Involve the Child in Meal Prep

Getting a child involved in preparing their meals can encourage interest in trying new foods.

  • Tip: Make it age-appropriate. Let them help with age-appropriate tasks like washing vegetables or stirring ingredients. The exposure without pressure can make them more inclined to try the food.
  • Tip: Help make it engaging. Create fun shapes or arrangements with food that may be more appealing visually.

Work on Oral Motor Skills if Needed

Sometimes it isn't the food that is the issue. Some children with autism may have challenges with the physical process of eating, such as chewing or swallowing.

  • Tip: Get an assessment. Consult with an occupational therapist or speech therapist who specializes in feeding issues to help strengthen oral motor skills
  • Tip: Build those skills! Introduce foods that promote oral development, such as chewy or crunchy snacks if the child is comfortable with those textures.

Use Visual Supports

Visual schedules and cues can help children with autism understand what to expect during mealtimes.

  • Tip: Try visual cues. Use a picture schedule that shows each step of the mealtime process, from washing hands to sitting down and taking a bite.
  • Tip: Build a menu. Create a visual menu of foods they can choose from. This adds an element of fun and helps build predictability.

Encourage Slow Progress and Patience

Change takes time, especially for children with autism. Celebrate any progress, no matter how small.

  • Tip: Progress can be slow. Be patient and avoid expecting immediate results. Consistency is key.
  • Tip: Analyze the results. Document progress with a chart or notes to track what works and what doesn’t, helping refine your approach.

Consult a Specialist

If eating issues are persistent and significantly impact the child's nutrition or health, consulting with professionals like pediatricians, dietitians, or feeding therapists is essential. Don't be afraid to reach out for help when things get tough.

  • Tip: Strategies can be individualized. A feeding therapist can provide tailored strategies and support to address the child’s specific challenges.
  • Tip: Nutrition is important! A registered dietitian can help ensure that nutritional needs are met through creative alternatives or supplements

Conclusion

Helping a child with autism who won’t eat because of sensory sensitivities can be challenging, but with the right strategies and patience, progress is possible. Understanding their sensory needs, keeping mealtimes stress-free, and gradually introducing new foods are all important steps. Don’t hesitate to reach out for guidance at DrCarosso@aol.com or on Facebook. Or check out some additional reading about how we treat Autism.

Bonus Post: When to Enlist a Therapist, Plus Some Tested Recipes

Sometimes, you need to enlist a professional to make sure you are meeting your child where they are ability-wise. Here are some detailed strategies and recipe ideas tailored for children with autism who have sensory sensitivities or feeding challenges:

Therapies for Feeding Challenges

Therapy 1: Feeding Therapy with Occupational or Speech Therapists.

Feeding therapy is designed to help children who struggle with eating due to sensory, motor, or behavioral challenges. Therapists use techniques that target the underlying issues, such as desensitizing oral sensitivities or improving motor skills. These techniques are similar to the tips I shared earlier, because they have a history of success regardless of who implements them. Some techniques the therapist might suggest include:

  1. Desensitization Techniques: Therapists may gradually introduce different textures to help a child become more comfortable with varied food experiences, using tactile play with non-food items or sensory activities like finger painting with puree.
  2. Oral Motor Exercises: These exercises strengthen the muscles involved in chewing and swallowing, helping children who may struggle with these functions.
  3. Positive Reinforcement and Play-Based Techniques: Therapists often use play to make food exploration fun and non-threatening, encouraging interaction with foods in ways that don’t require immediate eating.

Therapy 2: Behavioral Therapy

Behavioral interventions can help address food aversions and refusal. Techniques include:

  1. Gradual Exposure (Food Chaining): Gradually change a preferred food to introduce new flavors or textures step-by-step.
  2. Reinforcement Strategies: Use rewards for trying new foods or engaging in desired eating behaviors.
  3. Modeling and Peer Interaction: Watching others eat the same foods can sometimes encourage children to try them.

Recipes for Children with Sensory Sensitivities

Getting your child to eat well is a challenge for all parents. Here are some simple recipes that can help round out your child's nutrition while also incorporating some of the tips I shared for children with Autism who may have food aversions.

Smoothies can be a great way to pack nutrients into a sensory-friendly form. You can adjust the consistency to suit your child’s preferences.

Smoothie Bowl Basic Recipe:
Ingredients: 1 banana, 1/2 cup frozen berries, 1/4 cup spinach, 1/2 cup almond milk or yogurt, and a touch of honey (optional).
Instructions: Blend until smooth. Serve with a spoon and allow your child to choose a few toppings like sliced fruit or granola to make it interactive.
Sensory Tip: Adjust the thickness by adding more milk for a thinner texture or more yogurt for a thicker consistency.

It is not uncommon for kiddos with Autism to be attracted to processed foods that have a consistent taste and predictable texture. Homemade chicken nuggets are perfect for kids who prefer familiar, crispy textures but may benefit from healthier homemade versions.

Homemade Chicken Nuggets Recipe:
Ingredients:
1 pound chicken breast, cut into small pieces
1 cup crushed cornflakes or breadcrumbs
1/2 cup gluten-free flour (if needed)
2 eggs, beaten
Salt and mild seasoning to taste
Instructions:
Preheat the oven to 400°F (200°C).
Dip each chicken piece in flour, then the beaten egg, and finally coat with cornflakes or breadcrumbs.
Place on a baking tray and bake for 15–20 minutes until golden and cooked through.
Sensory Tip: Let the child touch or help coat the nuggets to become familiar with the texture before eating.

Sometimes it's about packaging unfamiliar things in a familiar form. For kids who prefer crunchy textures, veggie chips can be an excellent alternative to standard potato chips.

Rainbow Veggie Chips Recipe:
Ingredients: Thinly sliced sweet potatoes, beets, and zucchini, Olive oil, Salt or mild seasoning
Instructions:
Preheat the oven to 375°F (190°C).
Toss the slices with a small amount of olive oil and arrange them on a baking tray in a single layer.
Bake for 15–20 minutes, flipping halfway through, until crispy.
Sensory Tip: Try different veggie types for various colors and tastes. Allow your child to help choose which veggie slices to bake.

Pizza can be a well-loved childhood staple. DIY Mini Pizzas Pizzas can be customized with toppings and textures that your child is comfortable with, allowing them to experiment at their own pace.

DIY Mini Pizza Recipe:
Ingredients:
Pre-made mini pizza crusts or gluten-free alternatives, Tomato sauce, Shredded mozzarella cheese, Toppings of choice (e.g., bell peppers, pepperoni, olives)
Instructions:
Preheat the oven to 400°F (200°C).
Spread tomato sauce on the crusts, sprinkle cheese, and add chosen toppings.
Bake for 8–10 minutes or until cheese is melted.
Sensory Tip: Allow your child to create their own pizza. Even touching or smelling the ingredients without eating them can help desensitize sensory sensitivities over time.

Sometimes, something simple that resembles a "treat" will get the best traction for new experiences. Popsicles are great for introducing new flavors in a cold, smooth format that many children with sensory challenges find enjoyable.

Fruit and Veggie Popsicles:
Ingredients:
1/2 cup pureed fruit (mango, strawberry, or banana)
1/2 cup vegetable juice (e.g., carrot or spinach juice, if tolerated)
1/4 cup yogurt or coconut milk
Instructions:
Blend all ingredients together until smooth.
Pour into popsicle molds and freeze for at least 4 hours.
Sensory Tip: Start with familiar fruits and gradually add small amounts of vegetable puree to introduce new tastes.

Some Additional Tips for Sensory Sensitivities

Some last parting tips to help any picky eater, but especially a child with Autism who may struggle with sensory eating issues.:

  1. Temperature Control: Some children with sensory sensitivities prefer food at specific temperatures. Experiment with serving foods warmer or colder to find what’s most comfortable
  2. Presentation Matters: The way food looks can be as important as how it tastes. Use fun shapes, bento-style containers, or colorful plates to make food more visually appealing
  3. Introduce New Foods Outside Mealtime: Allow your child to explore new foods in a non-meal context, such as playing with raw vegetables during an activity or helping prepare ingredients.
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