Categories
Behaviour Management Inclusion parenting Special Education

What are SEBD, EBD, BESD & SEMH?

What exactly are social, emotional and behavioural difficulties (SEBD)? Many definitions exist and even the overarching term is interchanged with others. You may hear the same difficulties referred to as emotional & behavioural difficulties (EBD). You could potentially hear the term behavioural emotional and social development (BESD). The most recent term that also pops up is social, emotional and mental health (SEMH).

All of the four terms above can be defined in similar ways. The definition that I prefer encapsulates how many children could fall under the umbrella of SEBD:

“difficulties which a young person is experiencing which act as a barrier to their personal, social, cognitive and emotional development. These difficulties may be communicated through internalising and/or externalising behaviours. Relationships with self, others and community may be affected and the difficulties may interfere with the pupil’s own personal and educational development or that of others. The contexts within which difficulties occur must always be considered and may include the classroom, school, family, community and cultural settings.”

(Source here)

I chose this definition because it encompasses the wide variety of difficulties that children may face. It avoids falling into the pitfall of just defining the most severe and shocking elements of SEBD that usually gain the most attention.

It highlights how a social, emotional or behavioural difficulty can impact relationships. Perhaps their relationship with themselves and their self-esteem is severely damaged? Maybe, they can’t build positive relationships with their peers or family because they have trouble regulating their own emotions. They could even be isolated in the community as they explicitly or implicitly can’t access local clubs and amenities because they are seen as different, challenging or strange.

Externalised behaviours get a lot of attention as they are very hard to ignore in a classroom. You may also hear these behaviours referred to as “acting out behaviours”. These include behaviour like defianceaggression, vandalism, bullying, swearing, shouting and running away.

Internalised behaviours can get less attention. These behaviours are easier to ignore or miss altogether. They can also be called “acting in behaviours”. Internalised behaviour may present as withdrawal, depression, passivity, anxiety or even self-harm. 

I also like how this definition highlights the importance of context. It is worth observing where these difficulties occur. Are they just in school and not at home? Vice versa? Perhaps these difficulties manifest in certain places and not in others. 

So if someone says that a child is dealing with SEBD, EBD, BESD or SEMH, you will need to ask them to be more specific. Are their difficulties being communicated through externalised behaviour or internalised behaviour? In what contexts are these difficulties occurring? Which relationships are being impacted? Avoid the trap of thinking that a child who has an emotional or behavioural difficulty must automatically be presenting a certain way. Remain curious and dig deeper.

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Categories
Behaviour Management Inclusion Special Education

Long Read: A Critical Analysis of a Controversial Issue in Applied Behaviour Analysis

           As an Irish primary school teacher who has been working in a special education context for the past number of years, the subject of applied behaviour analysis (ABA) was of interest to me. While reading about the principles of ABA, the topic of punishment emerged as a controversial issue. In this article, the emergence of the issue is discussed alongside a critical reflection on the controversy noting three main observations. Furthermore, I suggest some ways that the issue could progress most productively. As a teacher, the topic of punishment is one of importance as there is a growing debate over how to meet the growing social, emotional and behavioural needs that are in our classrooms. The area of punishment is considered a controversial strategy so I enjoyed reading into the issue in the context of ABA. 

The Issue

ABA could be considered as having lived through a series of controversies, criticisms and debates since its inception. Dillenberger, O’Reilly and Keenan (1997) wrote that there have been incidences where negative views may have been warranted whereas more may have been unjustified. These issues have led to ABA presiding through periods of acceptance and rejection along with spells of crisis. They believed at the time of writing their book that applied behaviour analysis still had not gained widespread acceptance and put forward seven hypotheses for this opinion. One such hypothesis was that ABA’s connections with punishment had led to much controversy over the years. Leslie (2002) subscribes to this theory stating that the use of punishment with individuals who have developmental disabilities had resulted in a controversy lasting over a decade. Central characters championing this view strongly were McGee et. al. (1987) in their writing and public speaking engagements (Dillenberger, O’Reilly and Keenan, 1997). 

McGee et. al. (1987) could be considered scathing in their criticism of applied behaviour analysis and the controversy regarding ABA’s links to punishment could be viewed to peak when their book, Gentle Teaching, was published. In their work, they cite ABA as a practice that is to be viewed as evil and controlling. Their central argument appeared to be that ABA encouraged only contingently valuing an individual if the rules are followed and that behaviour is managed through restraining and restriction. Jones and McCaughey (1992) wrote that in McGee et. al.’s (1987) work, they even compared ABA to a methodology that condones torture. Baker and Allen (2012) remarked that the wider community could be seen to share these concerns as punishment was being increasingly used with examples including electric shocks, forced body positions and the removal of possessions or opportunities to engage in desirable activities.

The impact of these criticisms and how they were portrayed had a tangible impact on ABA’s popularity as Dillenberger, O’Reilly and Keenan (1997) discussed particularly in the context of Irish psychology practice. McGee presented his thoughts at the Mental Handicap Group of the Psychological Society of Ireland Annual Easter Workshop in 1989 where he spoke of behaviourism as an evil practice based on punishment and one which would never benefit individuals with learning disabilities. The effects of this presentation were compounded over the next two years by Brandon and Lovett who shared McGee’s views and thus led to Irish psychologists listening for three years to anti-behaviourist views which inevitably affected its adoption rate. The same impact could be viewed in America where parent support groups began to take a stand against the use of punishment while several states banned punishment techniques in treatment (Leslie, 2002). It is clear from reading the literature that this is a keenly contested debate with both sides having their merits.

Critical Analysis

Reflecting on this controversial debate between the side led by McGee et. al. (1987) and applied behaviour analysts bring three key observations to mind regarding the dangers of marrying oneself to an ideology, ambiguity and the value of seeing both sides.

The dangers of marrying oneself to an ideology

Charlie Munger (Kaufman, 2005, cited in Clear, 2019) said that “this business of not drifting into extreme ideology is very, very important in life. If you want to end up wise, heavy ideology is very likely to prevent that outcome.” This piece of advice from a man who has ties to the finance world as opposed to the world of psychology came to mind when reading about the debate that occurred around punishment in the 1980s and 1990s. There were numerous descriptions of this ongoing debate that presented it as one which became rather unsavoury. Dillenberger, O’Reilly and Keenan (1997, p. 94) described the debate as ‘acrimonious and divisive’ as well as featuring misinformation and objectivity while Baker and Allen (2012) also noted the presence of vitriol. One could consider that when tempers flare in debate and discussion turns into attack, reason and objectivity can go out the window leaving the quality of the exchange to be compromised. 

Munger’s quote may be relevant in viewing this controversial debate as Jones and McCaughey (1992) remark on the strength of the language used in the work of McGee et. al. (1987) while also, unfortunately, noting that there was wrongful reporting in their book regarding the use of ammonia spray as a punishment when it was, in fact, water. This could appear as a key point as the idea of spraying water mist in an individual’s face could evoke a different reaction than that of spraying ammonia. Interestingly, when McGee wrote his rebuttal, rather than acknowledging any mistake on their part, he stated that “whether involving water, ammonia, contingent electric shock, or any other aversive procedure, the point was to question critically any practice that might offend human dignity” (1992, p. 870). It could appear that the discussion had become so fraught that facts should not stand in the way of winning the debate. 

There is a shared responsibility between both sides, however, as Jones and McCaughey (1992) conclude that even though gentle teaching and applied behaviour analysis framed themselves as polarising sides which argued vehemently against the other, there are actually a number of overlapping principles that have not been observed mainly due to a misreading of each other’s philosophy. Proponents of the ABA methods who criticised gentle teaching may have been surprised to find that Jones (1990) and Mudford (1985) noted there were many procedural similarities between the two methods such as stimulus control and shaping while the differences existed mainly in the philosophical realm. One could speculate having reflected on this element of the debate that if both parties were less rigid in their devotion to their respective ideology and willing to unbiasedly review the other side’s principles and practices at the time, a less emotive and more valuable discussion may have taken place leading to improved wisdom and practice on all sides.

Defining Punishment

The debate may have been so heated that what was being debated may not have been so clear. Jones and McCaughey (1992, p. 862) believed that a core issue at the centre of the debate was defining the word punishment. This was a view that was mentioned elsewhere in the literature (Leslie, 2002; Alberto and Troutman, 2013). Leslie (2002) elaborated further saying that punishment in colloquial language can refer to an aversive stimulus delivered in no relation to behaviour or contingent to a response. Taking this into consideration, one’s opinion on punishment may differ greatly depending on which type of punishment one is referring to. If people believed that ABA condoned punishment in no relation to behaviour, it would be of no surprise that ABA would gain a poor reputation and people should rightly be vocal in their disdain and Leslie (2002) goes on to confirm that some believed punishment was used in the context of revenge, harm or cruelty.

Alternatively, Fisher, Piazza and Roane (2011, p. 348) present their view of punishment in terms of ABA. They discuss the two contrasting types of punishment: positive punishment and negative punishment. Positive punishment refers to the contingent presentation of a stimulus that decreases the likelihood of a behaviour and negative punishment refers to the contingent removal of a stimulus that decreases the likelihood of a behaviour. Negative punishment typically refers to response cost and time-out. This definition of punishment appears far more reasonable and clearer as punishment is utilised to decrease a target behaviour and if harnessed appropriately, would have many advantages. 

Jones and McCaughey (1992, p. 862) put forward the thought-provoking view that depending on your perspective, many strategies can be considered punishment and cite O’Brien’s (1989) theory that any treatment that results in decreasing a target behaviour may be considered punishment regardless of how else an individual may describe it. Building on this point, Iwata (1987, p. 363) discusses how it can even be difficult to distinguish between positive and negative. If a stimulus is removed like in negative punishment, a stimulus must take its place which could be considered positive punishment. This discussion can result in a debate comparable to “is the glass half full or half empty?” where neither answer is correct or incorrect and could be considered dependent on your outlook on life. 

With all these different interpretations of the word punishment and the terminology surrounding it during such an important and worthwhile discussion, it would be difficult to ensure a coherent discussion. Agreeing a single definition of the word may have provided the most productive first step to an agreement as to how appropriate it is to use punishment as a strategy.

A Debate Worth Having

Bearing in mind the tone of the debate and the ambiguity surrounding the content, there is an apparent consensus that the nucleus of the discussion is one worth having as even within ABA, there are polarizing views regarding punishment as some applied behaviour analysts acknowledge that using punishment can be aversive and repressive – as can many therapeutic approaches (Dillenberger, O’Reilly and Keenan, 1997). Jones and McCaughey (1992) reinforce this view stating that there have been cases where behavioural principles have been applied in aversive and undesirable circumstances. To demonstrate how truly divisive the use of punishment concerning ABA is, one needs only to read that Skinner – a founding father of behaviourism – believed that punishment should ideally not be used at all because he believed that it does not work (Staddon, 2014).

Leslie (2002) endorsed the view that critiquing the validity of using punishment was important. Acknowledging that there were controversies attached to its use, the case was made that ABA had learned from these and had developed a set of principles that could aid the prevention of such circumstances occurring again. Best practice was developed through the guise of six fundamental rights (Van Houten et. al., 1988) for the individual being treated including the right to the best treatment available. The use of punishment was discouraged unless considered the best intervention to cause a significant behavioural change. This could be considered an important step in the right direction as ABA had acknowledged the need to mitigate the overuse of punishment or its inappropriate use. Of course, writing down a principle is very different from applying a principle and whether this principle is consistently used remains to be seen, as the literature states. Fisher, Piazza and Roane (2011) pointed to thirty-five years of applied research related to the use of punishment which divulged there were advantages and disadvantages to its uses. Whilst many applied behaviour analysts noted these disadvantages and the need to use punishment sparingly, Jarmolowicz and Tetreault (2015) note that in large-scale program reviews, punishment is still used more regularly than should be expected. They also provide an alternative view to that of Fisher, Piazza and Roane (2011) stating that punishment is underexplored in applied research and therefore, it is hard to advocate the use of punishment as an evidence-based approach of any value. Taking both sides of the debate into consideration, there are some ways that applied behaviour analysts could decide to progress this issue to a fruitful conclusion. 

Moving Forward

Throughout this article, there have been minor suggestions to move this controversy to a satisfactory conclusion or at least, facilitate a productive debate. These suggestions include being open to alternative and conflicting views along with defining punishment clearly for anyone outside of the applied behaviour analysis realm so they may better understand what is being discussed. Furthermore, I would also suggest that more comprehensive applied research be conducted around punishment procedures whilst always ensuring that punishment is only used in alignment with Van Houten et. al.’s (1988) principle that people receive the most effective treatment available.

Although Donnellan and LaVigna (1990) believe that there is no need for further research in the area of punishment because alternative methods such as extinction and reinforcement exist, one would agree with Vollmer’s (2002) assertion that there is no benefit to be gained from ignoring punishment as it is something that happens in everyday life. With this in mind, applied behaviour analysts have a responsibility to understand these procedures and their impact on behaviour change. As Jarmolowicz and Tetreault (2015) stated that punishment was an under-researched area, there are also concerns over the quality of the research that does exist. Research around the area of punishment can be difficult to interpret as it is often confused by its unwitting combination with extinction or verbal reprimands (Lerman and Vorndran, 2002). 

Regarding what specific elements of the punishment should be researched, there are many suggestions. Horner (2002) warns against over-specific and narrow analyses and instead points in the direction of analysing the most common and complex uses of punishment to ensure a more effective technology of applied behaviour change. Lerman and Vorndran (2002) alternatively recommend focusing on less intrusive punishment procedures and how to fade them out. I believe combining the two suggestions by analysing the most common punishment procedures and how to fade them out successfully would provide the most benefit at this time as this is an area of interest to all people – not just behaviour analysts. Indeed, Iwata et. al. (1997) experienced some success moving from a continuous schedule to an intermittent schedule of punishment and broadening this type of research would be of great intrigue.

It is worth noting that this article does not seek to unequivocally condone the use of punishment but merely cite the need to research its use. Vollmer (2002) believed that punishment should be avoided until avoiding it would be of greater cost than engaging with it which appears a reasonable view. Iwata et. al. (1997) were also wary of punishment and the ethical issues surrounding it but believed that it may be necessary when the reinforcers that maintain a behaviour cannot be identified or controlled.

Punishment should always be used in adherence to the principle of being the best practice available and when used be in line with Lerman and Vorndran’s (2002) guidelines. They recommend “the least amount of punishment that is effective (i.e lowest intensity, shortest duration) should be used” (p. 441). As a relatively unpopular practice (Iwata et. al., 1997), there are concerns over the acceptability of punishment and this may explain why applied behaviour analysts have under-researched the area. There is a suggestion that an unwillingness to publish failed punishment studies exists (Lerman and Vorndran, 2002) and this is understandable as successfully researching punishment is contentious enough without drawing criticism for research conducted that has demonstrated unfavourable side effects. Despite this, applied researchers need to make their work known for the procedures to be improved.

Conclusion

The topic of punishment and its efficacy is one which emerges in teaching staffrooms regularly. It is interesting to research the topic through the lens of applied behaviour analysis. Much like in teaching, there is no black-and-white answer to its use but there are guidelines to ensure it is not misused. Punishment is best served to reduce behaviour when other methods of intervention such as extinction or differential treatments have been used and proven ineffective. It may also be necessary when the reinforcer that is maintaining a behaviour cannot be identified or controlled. Using the least amount of punishment necessary is, of course, most appropriate and when punishment is used, it should be viewed as an intervention that is phased out as soon as possible. With this in mind, there is still far more scope for applied research to be conducted in this area and teachers – along with parents and other caregivers – would be served well by keeping abreast of the results if this occurs.

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Reference List

Alberto, P.A. & Troutman, A.C. 2013, Applied Behaviour Analysis for Teachers, Ninth edn,
Pearson Education, New Jersey.


Baker, P. & Allen, D. 2012, “Use of positive behaviour support to tackle challenging behaviour”, Learning Disability Practice, vol. 15, no. 1, pp. 18-20.


Clear, J. 2019, , 3 ideas, 2 quotes, 1 question (October 31, 2019) [Homepage of Jamesclear.com], [Online]. Available: https://jamesclear.com/3-2-1/october-31-2019 [2019, November 1st]


Cradden, J. 2014, May 20th 2014-last update, The battle over ABA: autism education in limbo [Homepage of The Irish Times], [Online].
Available: https://www.irishtimes.com/news/education/the-battle-over-aba-autism-education-in-limbo-1.1798534 [2019, November 15th].


Dillenberger, K., O’Reilly, M.F. & Keenan, M. 1997, Advances in Behaviour Analysis, University College Dublin Press, Dublin.


Donnellan, A.M. & LaVigna, G.W. 1990, “Myths About Punishment” in Perspectives on the use of nonaversive and aversive interventions for persons with developmental disabilities, eds. A.C. Repp & N.N. Singh, Sycamore, Sycamore, IL, pp. 33-57.


Durkin, T. 2010, July 27th 2010-last update, Failure to tackle autism epidemic is a scandal [Homepage of The Irish Times], [Online].
Available: https://www.irishtimes.com/news/health/failure-to-tackle-autism-epidemic-is-a-scandal-1.628310 [2019, November 15th].


Fisher, W.W., Piazza, C.C. & Roane, H.S. 2011, Handbook of Applied Behaviour Analysis, Guilford Publications, New York.


Horner, R.H. 2002, “On the status of knowledge for using punishment: a
commentary”, Journal of Applied Behaviour Analysis, vol. 35, no. 4, pp. 465-467.

ICEP Europe 2019, , Applied Behaviour Analysis – Critical Exploration and Practice [Homepage of ICEP Europe and University of East London], [Online].
Available: https://uel.icepe.co.uk/course/view.php?id=82 [2019, November 15th].


Iwata, B.A. 1987, “Negative Reinforcement in Applied Behaviour Analysis: An Emerging Technology”, Journal of Applied Behaviour Analysis, vol. 20, no. 4, pp. 361-378.


Jones, R.S.P. 1990, “Gentle Teaching: Behaviourism at its best?”, Community Living, vol. 3, no. 1, pp. 9-10.


Jones, R.S.P. & McCaughey, R.E. 1992, “Gentle Teaching and Applied Behaviour Analysis: A Critical Review”, Journal of Applied Behaviour Analysis, vol. 25, no. 4, pp. 853.


Kaufman, P.D. 2005, Poor Charlie’s Almanack, First edn, The Donning Company, Brookfield


Lerman, D.C., Iwata, B.A., Shore, B.A. & DeLeon, I.S. 1997, “On The Status For Using Punishment: Implications For Treating Behaviour Disorders”, Journal of Applied Behaviour Analysis, vol. 30, no. 2, pp. 187-201.


Lerman, D.C. & Vorndran, C.M. 2002, “On The Status Of Knowledge For Using Punishment: Implication For Treating Behavior Disorders”, Journal of Applied Behaviour Analysis, vol. 35, no. 4, pp. 431-464.


Leslie, J. 2002, Essential Behaviour Analysis, Oxford University Press Inc., New York.


Leslie, J. & Tierney, K. 2013, “Behaviour Analysis in Ireland”, The Irish Journal of Psychology, vol. 34, no. 3, pp. 156-162.


Maglieri, K.A., DeLeon, I.G., Rodriguez-Catter, V. & Sevin, B.M. 2000, “Treatment of Covert Food Stealing In An Individual With Prader-Willi Syndrome”, Journal of Applied Behaviour Analysis, vol. 33, no. 4, pp. 615-618.


McGee, J.J., Menolascino, F.J., Hobbs, D.C. & Menousek, P.E. 1987, Gentle teaching: A nonaversive approach for helping persons with mental retardation, Human Sciences Press, New York.


Mudford, O.C. 1985, “Treatment selection in behaviour reduction: Gentle teaching versus the least intrusive treatment model”, Australian and New Zealand Journal of Developmental Disabilities, vol. 10, no. 5, pp. 265-27.


O’Brien, F. 1989, “Punishment for people with developmental disabilities” in The treatment of severe behaviour disorders, ed. E. Cipani, American Association of Mental Retardation,
Washington, pp. 37-58

Switzer, E.B., Deal, T.E. & Bailey, J.S. 1977, “The Reduction of Stealing in Second Graders Using a Group Contingency”, Journal of Applied Behaviour Analysis, vol. 10, no. 2, pp. 267-272.


Van Houten, R., Axelrod, S., Bailey, J.S., Favell, J.E., Foxx, R.M., Iwata, B.A. & Lovaas, O.I. 1988, “The right to effective behaviour treatment”, Journal of Applied Behaviour Analysis, vol. 21, pp. 381-384.


Vollmer, T.R. 2002, “Punishment Happens: Some Comments On Lerman and Vorndran’s Review”, Journal of Applied Behaviour Analysis, vol. 35, no. 4, pp. 469-473.

Categories
Inclusion

The 4 Stages of Inclusion

What stage is your school? How inclusive is your classroom? Are you integrating or including? Maybe, you’re segregating. Consider these four different stages of inclusion. Read each one and reflect on which best describes your teaching, your classroom or your school.

Stage One: Exclusion

No effort is being made. Children cannot access the curriculum or interact with their peers. They are refused entry to the school or classroom. They are told implicitly or explicitly that they do not belong and must go elsewhere. 

Stage Two: Segregation

The children are allowed into a class but are kept separate from the mainstream. They may be in a special classroom where their needs are being met by a teacher. They may attend a specialised school for their specific need. They do not interact with mainstream pupils.

Stage Three: Integration

The children are in a mainstream setting occasionally or permanently. The language used is distinctive from inclusive language. Adaptions are made and support put in place to “fit” the children into the existing classroom. An activity is planned and teachers wonder if or how the child might be able to do it. The children are seen as having to adjust to the activity, classroom and teacher as opposed to the other way around.

Stage Four: Inclusion

There is a child-centred approach. Everyone’s needs are being addressed. Everyone is engaged meaningfully. Everyone is physically involved and actively participating. The classroom and curriculum are designed to fit the children. The teacher selects activities and methodologies to suit the children. The focus is on what each child can do. Everyone is viewed as having the right to participate.

Which stage do you recognise in your school? Could you make it to the next stage? What steps would you have to take? Reflecting on these stages, you may come to realise you’re integrating when you thought you were including. Knowing the four stages will help you reflect on your practice and what you could do to get to the next level. Food for thought!

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Categories
Anger Management Behaviour Management Inclusion parenting

4 Key Questions Before Using Break Cards

Using break cards can be a fantastic strategy if a child is having a true meltdown when faced with work or a situation that they feel is challenging, new or too demanding. The Break Card is a simple, easy-to-use strategy that allows a child to opt-out of a task for a short time before reengaging with the situation afterwards.

Although the concept sounds simple, I have made numerous mistakes over the years trying to implement it successfully. It is easy to fall into the trap of designing an attractive card, laminating and displaying it without ever really putting in the groundwork to ensure it is a success.

To avoid the mistakes I made, here are four questions you need to answer clearly before using a Break Card successfully:

Who will supervise their break?

A fundamental principle of a break card is that the teacher has to honour it as soon as the child asks for it. If the child is opting to take a break, the teacher cannot tell them to wait for five minutes or that they “may” get it later when someone returns to take them. The teacher cannot decide that the child does not need it. Ensure that a break is granted instantly if you are implementing this strategy. If you do not have an extra pair of hands in the room, create an area inside the classroom for taking a break.

What will they do on their break?

Distractions techniques work best as a break. This can be engaging with one of their special interests. It can be breathwork. Their break can entail some light or intense exercise. The idea of the break card is that it is a true break. Make it engaging and take their mind off the task that was agitating them so when they return, they have rid themselves of any negative emotions.

What changes after their break?

This is an area that needs attention also. The work that was presented before the break was a trigger. It will still be a trigger after the break so teachers need to make a change. We can reduce the difficulty of the task. We can reduce the quantity of work. We can change how it is presented. Perhaps a worksheet could be changed to a similar task on an iPad? We can make it look less scary. A good rule to keep in mind is the 80/20 rule for children who find task completion difficult. Keep the first 80% of the task easy and achievable before having the final 20% as the challenge.

How will I implement the Break Card?

Take the time to explicitly teach how to deal with a task or situation that is new, challenging or too demanding. Teach them to:

  1. Try a little.
  2. Ask to watch someone else do it or ask for help.
  3. Take a break.
  4. Try again.
  5. Make a deal or negotiate how much has to be done.

We need to teach this repeatedly. Remind the child of it. Before assigning them a task, ask them how they are going to try it. Reward them when they follow the steps. It is so important to teach this skillset and then constantly remind them and reinforce it before they become stressed at a task. We do not let them tantrum to get their break. We ensure they ask for it calmly. Constantly reinforcing them for attempting difficult tasks despite whether they get the right or wrong answers will help them overcome their trigger point. The break card can be a key step in this process if harnessed correctly.

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Categories
anxiety Inclusion parenting Special Education

Help Children With Autism Return to School

Anyone who sifts through social media will see an abundance of quotes and inspirational photos. I love the area of personal development and can’t get enough of podcasts, videos, articles and anything related to the area. One common thread running through all of them now is;

Control the controllables.”

Its a phrase that looks slick and is easy-to-remember. But what does it mean? How can we apply it at this very moment?

Children with autism are likely to be struggling with all the changes in routine and uncertainty of this pandemic. I wrote an article about the 9 essential questions that children with ASD like to know and as hard as we may have tried, it is impossible to give definitive answers to them as we ourselves can’t predict the future.

One thing we do know, however, is we will return to school. We don’t know when but we know we will. Talking to parents of children with autism, a common concern they have is about trying to get their children to return to school after the long lay off. How we try to smooth this transition is a definite controllable.

I suggest that schools prepare small stories for their children with autism (or any child they feel may struggle with a return to school) and aim to answer as many of the nine questions as possible. These include:

  1. Where do I have to be?
  2. Who will I be with?
  3. Where exactly in the place will I be?
  4. What will be happening there?
  5. How much will I have to do there?
  6. How will I know when I have finished?
  7. What will I be doing next?
  8. What is the expected behaviour?
  9. What if? (questions guided by the child and their concerns)

It should be relatively easy to find out where their classroom will be and who the teacher will be in the next few weeks. Their favourite school activities can be included. The month (or date) of return can be included. The times that school starts at and finishes at can be included. The story can be made in conjunction with the parents to answer questions worrying them and start a conversation about returning to school. With this made and distributed to parents, they can start to read it with their child in the weeks leading up to a return. Each page should contain photographs of the information to increase the impact. This is a controllable.

Although we can’t predict the future, we can prepare for it. This is a strategy to promote inclusion and hopefully, prevent issues arising before they have a chance and an ounce of prevention is worth a pound of cure.

If you’re a teacher, you can begin this process now and have it ready in lots of time. If you’re a parent or know someone that would benefit from this strategy, you might consider suggesting it to the appropriate person.

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Categories
Inclusion Special Education

9 Essential Questions for Children with Autism

Children with autism need extra support to be included in day-to-day life. The social cues, rules and routines that neurotypical children pick up without explicit teaching do not come as easily to a child with ASD. Without the appropriate support, these children may look to be “misbehaving” or “difficult” when really, they just require a helping hand to get involved and be included.

There are nine key questions when preparing a child with autism for a new event or skill:

  1. Where do I have to be?
  2. Who will I be with?
  3. Where exactly in the place will I be?
  4. What will be happening there?
  5. How much will I have to do there?
  6. How will I know when I have finished?
  7. What will I be doing next?
  8. What is the expected behaviour?
  9. What if? (questions guided by the child and their concerns)

If you are going to a school assembly later in the day, an adult should sit down with the child and move through the nine questions to ensure that the child knows exactly what is going to happen, how it will happen and what is expected of them specifically. This can prevent issues before they arise and prevention is always better than cure.

Visual resources like timetables and social stories benefit children with autism massively as it can reduce their anxieties by providing clarity. Timetables (app recommendation here) are easy to prepare and implement but having every single social story ready is not always possible. A lot of preparation can be required preparing a story about the event or skill you are trying to teach. They are extremely worthwhile but how can you predict every change, social skill and event that will happen in a school year? You can’t and this is where MagnusCards come in.

MagnusCards is an app that has a wealth of scenarios and skills that answer a lot of the generic questions that will occur throughout a school day and home life. 

For example, if you want to teach a child how to come in from lunchtime, there is a 10 picture story on how to do this. Want to teach a child how to engage with pairwork in a class? There is a 7 picture story that can be used.

The events and skills range from school to social skills to personal care and safety along with much more. The pictures and text are not specific to your child’s school or home but the stories are readily accessible at your fingertips if you need them. 

I would recommend this app for three reasons. First of all, having a look through the app will help you predict what stories you could personalise, prepare and print in advance for your child. Secondly, when a change occurs or unforeseen event happens, you have a quick-and-easy visual aid to support the conversation you need to have to support a child with autism. Finally, if you see a child with autism acting inappropriately during lunchtime or somewhere unstructured, you can pull out the app and use a social story to incidentally teach an alternative way to behave in that scenario with clear, visual prompts. MagnusCards is an app that is simple, free and practical. These apps are always welcome in a teacher’s toolkit.

To download MagnusCards:

Android Version here.

Apple Version here.

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How Can We Help Children Missing Occupational Therapy?

Perhaps we are concerned about children who made great progress over the year and are now missing their physical education with their class, their active time on yard and their one-to-one time with a teacher or occupational therapist. We may worry that they may not be progressing and could even be regressing. How can we help maintain this progress and extend them where possible? Enable Ireland can help.

Enable Ireland provide services to children with disabilities and have expert teams that support them and their families through each stage of life.

With the current restrictions, their clinical experts and therapists have made a playlist of 44 videos that can provide a focus for anyone looking to improve movement, balance, core strength, flexibility or motor skills. The full list is available here but here are some popular areas which you can use as a parent or recommend as a teacher:

Wiggly Warm-Up

Lower Limb Stretching: Range Of Motion

Core Exercises For Junior Age Children

Core Strength: Jigsaw Challenge

Squish the Duck Challenge for Balance

Lower Limbs: Strengthening

Balance at Home

Pilates

Movement Regulation

Fine Motor Therapy At Home

Gross Motor Skills: Animal Walks

Wheelchair Exercises

With the great range of resources here, parents and teachers can consider the priority needs, age and personality of the child to select suitable activities that will ensure any progress achieved to this point can be maintained. 

Anyone who finds these resources useful should look at the Enable Ireland website for further guidance around the area of speech and language, social stories and more.

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anxiety Behaviour Management Inclusion parenting

The Difference Between Constructive and Destructive Anxiety Management

I came across some quality content from Dr. Tony Attwood on anxiety management related to children with autism. I love any information that is easy to understand and relay to people and has the potential to make a difference. This content fits the criteria.

Dr. Attwood discusses the two types of anxiety management. Constructive habits succeed in mitigating the potential impact of anxiety whilst destructive habits also does this but to the detriment of relationships with others. Dr. Attwood details three destructive strategies to avoid and promotes six constructive alternatives. If constructive strategies are not being used, a child may naturally fall into using destructive ones.

Three Destructive Anxiety Management Strategies

  1. Excessive Control: When children are feeling anxious, they may seek to exert control through defiance or threats to property, self or people. The impact this has on relationships is clear. Excessive control to manage anxiety may result in a diagnosis of Oppositional Defiant Disorder (ODD). Is this a reason to move away from labels? (Full article here)
  2. Rituals: An anxious child may insist on sameness and become intolerant and inflexible to any change. They can become over-reliant on rituals and routines when they are too prolonged detracting from their ability to engage in other tasks.
  3. Emotional Explosions: When fight-or-flight reaches a certain point, a child rife with anxiety may release the emotional energy pent up through an outburst which hurts others and damages friendships and relationships. This also takes an emotional toll on themselves in the aftermath.

Six Constructive Anxiety Management Strategies

These six strategies are necessities for anxious children. They are not rewards. The child requires them to engage with day-to-day life successfully. Analyse each one and consider if you are making the best use of each strategy.

  1. Physical Activity: Often underestimated, being physically active has a significant impact on anxiety. This can be through team sports, individual sports, movement breaks or walks. The options are endless and finding the medium that the child enjoys exercising through will aid them in coping with their anxiety.
  2. Relaxation: An anxious child has never relaxed just because they were told to. They have to be taught how to relax. This could be through a meditation app like Mindful Gnats (Android link here and Apple here), teaching the art of journaling, yoga or engaging in a range of activities depending on the child’s personality (Article: 6 strategies to help an anxious child here). A highly anxious child might never have learned to relax so it must be a priority to teach them.
  3. Special Interests: Allowing a stressed or anxious child to engage with their special interest is a powerful tool to relieve building anxiety. Depending on the interest, this can be easily implemented into day-to-day life. Allowing an anxious child with autism to engage with their special interest is not time wasted. It is time-efficient as they will be able to re-engage with activity after a short break.
  4. Favourite Person: An anxious child can experience relief when they are afforded some quality time with their favourite person. If the person is an SNA, teacher or child, this strategy can be utilised without extensive planning. If the person cannot be present, we can use audio messages, phone calls and emails. The child’s favourite person can be a great sense of comfort and relief.
  5. Diet: The benefits of a good diet go beyond the scope of this article. Needless to say that a balanced diet will have a positive impact on a child’s anxiety compared to a diet of junk food, sugar and refined carbohydrates.
  6. Sleep: Much like a healthy diet, we all can appreciate the positive effect of eight to ten hours of sleep on an anxious child. Weighted blankets, avoiding screen time before bed and a consistent nighttime routine can contribute to good sleep hygiene.

When you consider the child, ask yourself which type of strategies are being used to manage their anxiety. Are they destructive or constructive? Can we improve on how we use constructive habits? Which constructive habits can I control if I am a teacher or a parent? Focus on these and lean away from destructive behaviour.

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How to build your child’s routine in 30 seconds

In a time of so much unknown, controlling the controllable things can have a huge benefit on our young children. I discussed in a previous article how the deterioration of family functioning can lead to anxiety disorders in children and how parents can mitigate the potential damages of the coronavirus on their children’s mental health (article here). Establishing a stable routine is one strategy that we can use to maintain family functioning and reduce the air of uncertainty in the household. Visually representing this timetable and showing it to your child maximises the benefits but how can we do this if we have no time to sit at a computer or lack a printer and laminator to ensure its pretty?

This is where the app picturepath comes to the rescue. This is a predominantly free app and is extremely quick and easy-to-use. You simply set up an account and input your child’s first name and you start to build their routine with the pre-made most common activities and symbols. If you’re missing an activity, you can create your own and add images or icons from the icon library.

Once you have created the routine, you can switch the app to child mode where they can view the timetable in its totality or a “Now and next” mode. The child can then tick off activities as they are completed and start to work their way through the day.

I would highly recommend this for children with autism or younger children who are missing the structure of school. I am an advocate of the phrase that an ounce of prevention is worth a pound of cure and when it comes to behaviour, providing routine and structure is certainly a preventative measure.

For those interested, the links are provided below for both android and apple:

Android Version: https://play.google.com/store/apps/details?id=com.acorn.picapp&hl=en_IE

Apple Version: https://apps.apple.com/us/app/picturepath/id1339643269

Note: I have no relation to or knowledge of the app developers. I just love things that make life easier and promote positive behaviour. This does both so I’m pumped!

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For the teacher stressed about inclusion

A double-bind message is a message that sends conflicting information. An example would be when a parent tells a fearful child verbally that there is nothing to fear while their facial expression and body language is full of concern. A second example is when a teacher or a parent is told that mental health, calm and happiness is the number one priority while also being given a mountain of work to complete. Two different messages that are very much in conflict with each other.

I do not think education should be ignored right now, I just believe education needs to be streamlined for everyone involved: teacher, parents and students. I have already written about Pareto’s Principle and the idea that 20% of our actions produce 80% of results. This means the other 80% of our actions produce very little and should be stripped away to free up time to practice self-care and care for others.

Anecdotally, I know that stresses on teachers are slowly increasing as schools find their feet and begin to realise what is possible. Just because we can, however, does not mean we should. 

Inclusion and differentiation are, of course, at the forefront of our mind as we look to meet the needs of our students that require it most. Instead of looking for complicated and time-consuming strategies, I suggest we primarily look to UNESCO’s document Learning for All: Guidelines on the Inclusion of learners with disabilities in open and distance learning and Pozzi’s article The Impact of m-Learning in School Contexts: An “Inclusive” Perspective which provides simple ways to include that fall into the 20% of our action achieving 80% of results category.

These two documents suggest we include using the following simple strategies:

  1. Awareness: Find out where the children need help to be included so you can adjust to their exact needs.
  2. Communicate: Facilitate regular contact with parents to see where strengths and needs are arising.
  3. Personalise:
    1. Allow children to complete work at their own pace.
    2. Reduce workload.
    3. Set up online reminders or calendars to begin or complete tasks.
    4. Pre-record explanations so it can be rewatched as necessary.
    5. Send specific positive praise to students to reinforce engagement and effort.

The caveat here is that there is no one-size-fits-all solution. I do believe with these simple strategies, however, that we can cast our net around a huge body of students and meet their needs without having any part of the chain bending over backwards. There will be students that need additional support but using the above simple strategies to address the needs of the many will free up teacher’s time to address the needs of the few with the more detailed support they need.

This is a marathon and not a sprint.

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