I’ve been thinking a lot about transitions lately as I’m in the process of moving from California to North Carolina. It’s common knowledge that individuals with ASD and other mental health disorders struggle with transitions. After just having gone through a major transition myself, I’m wondering if we all don’t have some level of difficulty […]
I’ve been thinking a lot about transitions lately as I’m in the process of moving from California to North Carolina. It’s common knowledge that individuals with ASD and other mental health disorders struggle with transitions. After just having gone through a major transition myself, I’m wondering if we all don’t have some level of difficulty with transitions. Our routines are off, we’re unsure what to expect, we may be in a new environment with new and sometimes overwhelming stimuli. And in many ways, isn’t it normal to have an adjustment period when things change? I know I’m certainly going through an adjustment period now. My house is new and has some residual construction smells leftover, my personal items haven’t arrived with the movers yet so I can’t find the things I want/need or I’m having to do without, I get lost driving around a new town, and I don’t yet know anyone so I don’t have physically present social supports. All of these things lead to increased anxiety and stress. Somewhere around the middle of central Arkansas, I had the thought that many of these feelings are likely ever present in our kids with ASD and that this experience has given me a greater glimpse at the discomfort caused by smaller transitions in their daily lives. I wonder then if for some of our kiddos, daily changes may feel like cross country moves? Remembering these feelings during moments when I’m asking a child to transition, may help me to connect with him or her more compassionately as I can recall the feelings of confusion, uncertainty, and being overwhelmed. Have you felt overwhelmed with a transition? How can you use that experience to help create more meaningful connections and supports for individuals who may be struggling with a transition?
Dr. Becca
Filed Under: Uncategorized
Each person responds differently to events, including learning about a diagnosis of ASD. This news probably feels overwhelming for grandparents just as it does for you as the parent. There may be another layer there in that it is not their child that has been diagnosed, but rather their grandchild and they may also be […]
Each person responds differently to events, including learning about a diagnosis of ASD. This news probably feels overwhelming for grandparents just as it does for you as the parent. There may be another layer there in that it is not their child that has been diagnosed, but rather their grandchild and they may also be worried about the impact it will have on their child, you, who is now the parent. ASD was not as prevalent during grandparents’ upbringing so they may benefit from learning more about what ASD is and what it isn’t. Learning more may help them feel more prepared which helps decrease anxiety. Helping grandparents to connect with other grandparents of children with ASD can also be a great source of information and support. The Grandparents Autism Network is a great online resource. Ensuring that they are getting the support they may need helps to enable them to be able to provide support to you, their adult child, who has just received this news. You may be unsure how to talk to your parent about the diagnosis or what it means and it’s OK to say that. Sharing your own vulnerability and uncertainty, may help a grandparent feels more comfortable showing theirs. As a family with a child with ASD, you may need additional childcare support. Again, through open communication you and grandparents can talk about what feels manageable to them and helping them set up their home in a way that leads to greater success (i.e. a quiet, cool down area or sensory items). Grandparents can also learn the strategies that are most effective with your child, and likely already know many of them as they’ve likely been around the child his/her whole life. Reminding grandparents that the child is the same child they were before the diagnosis may also be helpful. Sometimes the diagnosis tricks us into focusing on the label and we forget that this is the same delightful, active, and unique child as they were before the diagnosis. Check out Autism Speaks’ Grandparents Guide to Autism for more information. Its an 18 page document available for free to print and share with anyone who may benefit.
Dr. Becca
Filed Under: Uncategorized Tagged With: ABA, autism, behavior analysis, grandparents, parenting
Meltdowns, tantrums, whatever you call them, they are one of the most challenging parts of parenting any child, not just a child with special needs. The difference in kids with special needs is that they likely have meltdowns more often and they are likely more intense and last longer than those of their neurotypical peers. […]
Meltdowns, tantrums, whatever you call them, they are one of the most challenging parts of parenting any child, not just a child with special needs. The difference in kids with special needs is that they likely have meltdowns more often and they are likely more intense and last longer than those of their neurotypical peers. Parents often ask questions about meltdowns wanting to better understand what is happening for their child in that moment and also how they should respond.
I often start by using Dr. Dan Siegel’s language from The Whole Brain Child of “upstairs brain” and “downstairs brain”. I like this analogy because it is easy to understand and yet rooted in neuropsychology. The upstairs brain is the part of the brain that is responsible for ‘high order’ tasks such as planning, organizing, empathy, morality, and isn’t fully formed until a person is in their 20’s. The downstairs brain is well developed at birth and is responsible for basic needs like “fight or flight” and basic emotions like fear and anger. So let’s say your child is 8. His brain is like a two story home being built. The downstairs is finished and livable and then there are stairs going up but as we go up, we see that the upstairs is only finished up to the drywall – certainly not livable without lots of support like people bringing furniture to share or working hard to get plumbing up there. And this is an 8 year old on an average day! They need support in using that upstairs brain because it’s still developing.
Then throw in a stressor like overstimulation from the environment or not having had enough sleep. These stressors are like putting a baby gate on the stairs to the upstairs brain, event though unfinished, is now completely inaccessible. Our child is trapped downstairs! When this happens, we may get stuck in our downstairs brain too because our child’s meltdown can be a stressor for US!
Here are 3 steps that will help keep everyone safe and help to remove the baby gate blocking each of our upstairs brains.
Meltdowns are tough. Knowing what is happening for your child and how to best respond can help us feel more prepared to manage these events and to be kind to ourselves afterwards
Dr. Becca
Filed Under: Uncategorized Tagged With: ASD, autism, child, meltdown, parenting, therapy
P.R.I.D.E. skills open up doors to increase relationship and control when you are interacting with your child on a daily basis. PRIDE skills are a component of Parent–Child Interaction Therapy (PCIT) which is an evidence based treatment developed by Sheila Eyberg for children ages 2–7 and their caregivers. PCIT happens in the clinic while the parent […]
P.R.I.D.E. skills open up doors to increase relationship and control when you are interacting with your child on a daily basis. PRIDE skills are a component of Parent–Child Interaction Therapy (PCIT) which is an evidence based treatment developed by Sheila Eyberg for children ages 2–7 and their caregivers. PCIT happens in the clinic while the parent wears a “bug in the ear” or speaker and the therapist is in another room coaching the parent on ways to interact most successfully with his/her child. PCIT is build to strengthen the parent/child relationship and once strengthened to help the parent learn and use strategies to increase compliance.
PRIDE is an acronym that stands for:
By using these five communication tools,we can all experience a more satisfying relationship with our children. All of us need emotional connection and control. So the PRIDE skills give an intense dose to both of these needs. Building these skills is the first part of PCIT which emphasizes relationship building. The second part of PCIT is focused on building compliance. This is done by helping parents learn to provide direct, easy-to-understand instructions to the child, with clear, consistent consequences for compliance and defiance. Check out this short video that is a sample from a PCIT session
This is one of the services that we offer at Del Mar Center for Behavioral Health. Contact us today to get started!
Dr. Becca
Filed Under: Uncategorized
Anxiety is a completely normal thing. It is what has kept us alive, quite literally, throughout time. Anxiety is about the anticipation of something bad happening. When we saw a lion, we anticipated that it would try to eat us, so we ran. That anxiety caused us to go into our fight or flight response […]
Anxiety is a completely normal thing. It is what has kept us alive, quite literally, throughout time. Anxiety is about the anticipation of something bad happening. When we saw a lion, we anticipated that it would try to eat us, so we ran. That anxiety caused us to go into our fight or flight response so that we had extra energy necessary to get away and stay alive. It also taught us to avoid lions.
Luckily, we don’t encounter lions on a daily basis anymore. This is where anxiety can get in our way. Our bodies and minds may be responding as if there is a lion in the area when there isn’t. Of course, if there is a lion you want that fight or flight system to work so you can run. Here are some quick tips to help you manage your anxiety and remind yourself that there is no lion.
Hopefully these hints are helpful. I’d love to hear your feedback about how they work for you. Remember, there is no lion
Dr. Becca
Filed Under: Uncategorized Tagged With: ABA, anxiety, autism, behavior analysis, north carolina, parenting, parents
SB 676 in North Carolina is also referred to as the “Autism Health Insurance Legislation”. It was passed by Governor McCory in October 2015 and has an implementation date of July 2016. The information below was taken from the Autism Society of North Carolina’s website What does it do? SB 676 requires health plans to […]
SB 676 in North Carolina is also referred to as the “Autism Health Insurance Legislation”. It was passed by Governor McCory in October 2015 and has an implementation date of July 2016. The information below was taken from the Autism Society of North Carolina’s website
What does it do?
Does this law cover all health insurance plans?
This law covers the large group plans for companies in North Carolina that follow state law. As we have pointed out in our policy paper on insurance, state laws can only affect certain kinds of health insurance plans that make up a small part of the health plan marketplace. Employers are more likely to offer coverage voluntarily, even when they are not required to do so, in states where coverage is required.
The law mentions DSM-5. Does this law require that children diagnosed under DSM-IV (4) be re-diagnosed using DSM-5 criteria to receive the autism benefit?
The law does not require re-diagnosis under DSM-5 criteria. DSM-5 changes to the insurance statutes reflect an update in the law. DSM-5 is now in effect, so the DSM-IV (4) language should not remain in the law. The DSM-5 specifically states that “individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder.”
Does SB 676 cover Applied Behavior Analysis (ABA)?
YES. The definition of Adaptive Behavior Treatment includes Applied Behavior Analysis as well as other treatments for autism. By using the broad term and not naming only one treatment option, the law allows for a range of behavioral and development interventions, including ABA, “that have been shown to be clinically effective.”
Does SB 676 allow ABA therapists (BCBAs) to provide ABA therapy in North Carolina and be reimbursed?
YES. ABA therapists (BCBAs) are already providing services in North Carolina and their services are being reimbursed. Even though they are not licensed, current law allows BCBAs to practice in NC as long as they are supervised. This law does not change any ability to work. The House passed a behavior analyst licensure bill to license BCBAs to practice without supervision. That bill is still eligible to be passed during the short session from April 25 to June 30, 2016. Many organizations worked together to come up with the licensure bill, and although the Autism Society of North Carolina does not typically take a position on the licensing of professional groups, ASNC has endorsed the bill and will be working to pass it in the Senate.
Contact us today to start taking advantage of this coverage!
Dr. Becca
Filed Under: Uncategorized Tagged With: ABA, autism, behavior analysis, north carolina, SB 676
Transitions can be tough for all of us. This can be particularly true for kids who are struggling with a mental health disorder like ASD, anxiety, or ADHD. Transitions are difficult because it involves a change in routine. Routines mean that the same things happen in generally the same way or at the same time. This […]
Transitions can be tough for all of us. This can be particularly true for kids who are struggling with a mental health disorder like ASD, anxiety, or ADHD. Transitions are difficult because it involves a change in routine. Routines mean that the same things happen in generally the same way or at the same time. This leads to predictability and there is safety in predictability because we know what to expect. Many mental health disorders have an inability to accurately predict what is going to happen next. So, if we are in the same routine, there is nothing new to predict or predict incorrectly.
Imagine going to another country, perhaps one in the middle east. When we get there we see that the people are wearing different clothes and eating different foods and engaging in different customs. This may increase our anxiety because we don’t know these “rules” and yet everyone around us seems to. We may worry that we will offend someone, or break a law and get in trouble, or miss a meal because we don’t know how to order.
This is how kids with certain mental health challenges may feel in new situations, even in their own house, their own school, or with their friends. Sometimes the smallest change can create a lot of anxiety. So what can we do? Some parents try to not let anything change. I understand this comes from not wanting to upset your child so they can be happy and feel secure. However, the world will not change for your child. So, we want to help your child be more OK with the world around him/her. A way we can do this related to transitions, is to set them up for success. For example, a change is coming, instead of allowing our child to avoid the change, help them lean into it and be successful. Give advance notice so they know it’s coming. Let them know exactly what will be expected of them or what will happen during the event or the change. Explain how it will sound, how it will feel, how it will smell, how it will taste; try to use all of your senses to make the event come alive for your child before actually getting there. Remind your child that they have had successful transitions before and that you believe in them.
After a child has had a change or transition, give them time to self-soothe. This may often include a familiar routine such as a favorite book, or watching a specific video or TV show or doing something “their way”. This is OK! It’s giving them a sense of control as a reward for going through an experience where they weren’t in control. Think of how nice it is to return home after vacation and get in your bed, eat off your dishes, and go back to your routines.
Dr. Becca
Filed Under: Uncategorized
As parents your days are spent caring for everyone else; making sure everyone else’s needs are met. As a parent of a child with special needs, research has reported that at times the stress experienced rivals that of veterans who have spent time in a combat zone. The stress you experience on a daily basis […]
As parents your days are spent caring for everyone else; making sure everyone else’s needs are met. As a parent of a child with special needs, research has reported that at times the stress experienced rivals that of veterans who have spent time in a combat zone. The stress you experience on a daily basis is very real and despite the stress, your responsibilities do not bend and so you must continue to do all the tasks; childcare, work, therapies, housework, maintain a relationship with your partner, eat, sleep, and even bathe. All of these may feel like chores at times and overwhelming, even bathing! So, if you’ve felt this way, you are not alone.
The thing about stress is that we often withdraw when we experience a lot of it. We often turn inward and avoid other people. This also happens frequently when a child is diagnosed with a mental health disorder or even a chronic medical condition. Families withdraw into themselves because of all of the appointments and perhaps the the different needs of their child which makes it difficult to go many places. This separation, which initially is meant as self-protection against the outside world, the world that doesn’t understand, can end up feeling isolating and lonely.
Creating a space where parents, specifically parents of children with mental health disorders or chronic illnesses can come together and gain support is imperative to a parent’s health and therefore the entire family’s health. There’s a quote I read on Pinterest, “You cannot serve from an empty vessel”. You are called to serve others daily, sometimes all day every day. If you’re feeling like you’re running on empty, or notice yourself hitting “ignore” when people call, or can’t remember the last time you talked about your needs not those of another family member; we want to see you. We want to listen. We want to help you fill your cup and find some ways to add more self-care in your daily routine. We have some ideas and would love to combine them with yours to come up with a plan that is realistic for you and will be a step towards greater balance.
Dr. Becca
Filed Under: Uncategorized
This is one of the most common questions I’m asked as a school psychologist. With the school year rapidly approaching, I thought I’d give some brief information about each and provide some places you can go on the web, that are reliable, to get more information. “504 Plan“: A 504 Plan comes from Section 504 […]
This is one of the most common questions I’m asked as a school psychologist. With the school year rapidly approaching, I thought I’d give some brief information about each and provide some places you can go on the web, that are reliable, to get more information.
“504 Plan“: A 504 Plan comes from Section 504 of the Rehabilitation Act of 1973 that prohibits discrimination based on disability. A 504 plan is about “leveling the playing field” for a child. This means that the curriculum used and output created the student are the same as the other students in the class. The student may receive accommodations, to account for his/her disability, such as taking a test in a different room to reduce the distractions for a student with ADHD or maybe the child will receive multiple breaks during the day to test his/her blood sugar for a student with diabetes. A 504 Plan is a written document that outlines the accommodations that a student will be allowed to use. It can/should be updated yearly to be sure that what is listed is being used and is also the accommodations that still work best for the child. Read more about about eligibility for 504 Plans here.
IEP: An IEP stands for Individualized Education Plan and comes from the Individuals with Disabilities Education Act (IDEA) which is aimed at making sure a student with a disability receives the specialized instruction and related services necessary to be successful in the educational setting. There are 11 disability categories according to IDEA. You can read more about them here. An IEP is an education plan that is created for a student after a thorough assessment including psychoeducational assessment, speech / language assessment, occupational therapy assessment, and academic assessment. An IEP provides modifications for the student such as additional instruction, adding related services like speech/language therapy, and may modify the curriculum the student is taught from and the output they are required to create. An IEP is a written document that is updated yearly to ensure the plan is the most appropriate for the student at that moment in time.
Want to learn more? Wrightslaw is a wonderful online resource with information about special education law and education law. http://www.wrightslaw.com/
Dr. Becca
Filed Under: Uncategorized
It’s almost that time again – Time to return to school! This can be a stressful time for both students and parents. Here are 3 quick things we can do to help make this transition go as smoothly as possible. Give advance notice. Let your child know what class they will be in. Show them a […]
It’s almost that time again –
Time to return to school!
This can be a stressful time for both students and parents. Here are 3 quick things we can do to help make this transition go as smoothly as possible.
Remember, you know your child best. If there’s something that you think might benefit him/her, give it a try!
I’d love to hear any other ways you’ve helped make the transition back to school easier for your family!
Dr. Becca
Filed Under: Uncategorized
