Just started seeing a little guy (not 2 yet) he was diagnoised with autism, he has no speech, many sensory issues (will not explore with hands) and he stims a good part of his day. I want to increase his attention to task and also decrease his high stims as his only motivator. The team is using a somewhat structured approach, we are not using aba as his parents do not want this, he is currently receiving only about 13 hours of service a week, parents do not want a school program yet. Any help would be appreciated. He also bangs his head a lot.
I would try any type of motivator possible. does he walk or ambulate at all? I would focus on only one thing at a time to find a motivator. Also, hit on a good sensory diet, the OT should be able to help with that. Then work toward reinforcing attention to task, probably through shaping. Maybe he would enjoy raisins, crackers, animal cookies, etc. to shape his behavior toward the task. Maybe bubbles, it is okay to use sensory items to reinforce his attention to task. Later those can be faded.
As this child is so young and has alot of sensory issues and stims I would recommend at least reading an article in Autism Today by a woman called Olga Bogdashina. She has also published a number of books ie. Sensory and Perceptual Differences in Autism and Aspergers. This will help you understand what his under sensitivities/over sensitivies/agnosias are, or at least give you an idea of what to look for (because again he is very young, but he will quite quickly learn how to 'reduce' external sensory bombardment so that he can cope/function, and stimming is a good indication of this). It also then gives examples of different learning styles due to sensory issues such as gestalt, fragmentation,mono-processing etc.
At the back of the book I have mentioned, there is a sensory questionnaire which the parents can complete to give them a sensory rainbow chart showing where their child is eg. main areas of difficulty with hyper/hypo auditory and hyper tactile sensory information, gestalt and mono-processing learning styles. This professional has been used by the autistic SEN department in our City to lecture to professionals and parents and her checklist is also completed by parents to be seen by all professionals involved with that child.
I cannot stress how important it is to first get an idea of where the child is from a sensory point of view because otherwise certain strategies/approaches may be painful to the child and alot of stimming behaviour is necessary to them from a sensory modulation point of view (but this can be looked at by OT). So if you get a better understanding of the 'function' of the stimming/sensory behaviour you are in a better position to try to replace it with something useful that still allows the child to 'cope' with the stimulation. If you just try to 'stop' a behaviour it is rather like taking away the white cane a blind person uses and wondering why their performance deteriorates and their frustration/anger increases.
I also agree with the other post and would suggest using any interest/obsession as a motivator. Autistic people have a different kind of attention and focus. They can concentrate for hours on things that interest them. They cannot 'make' themselves interested or attend to things they are not interested in. Whatever his interests are they can be used to teach practicably every subject/idea. Eg. Thomas the Tank Engine can be used to teach colours, shapes, travel, geography, science, friends, numeracy, literacy etc etc.
How does the boy communicate, gestures, pictures, sign, etc? I think that expressing his wants and needs should be the primary objective for the team working with him. Often times, this can lead to a decrease in negative behaviors because sometimes the function of negative behaviors is that the child is trying to get access to something he wants or needs. There is a form of ABA called Verbal Behavior. It is different from a more traditional Discrete Trial Instruction approach. It might be useful for the parents to look into that. We do know that the soon the intervention for a child, the better the possible outcome for that child. 13 hours a week is not a lot.
In my discussions with OTs and Behavior Analysts, the function of "stim" behavior is to get some sort of sensory stimualtion. It can be difficult to get rid of these behaviors as the reinforcement for them is internal. One thing that has worked for me is to provide frequent opportunities for the child to do activities that are sensory-based. Some examples are: trampoline, swings, play doh, shaving cream, wheel barrel walk, climbing, etc.
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