Taming Impulsivity

Those with ADHD, autism, learning disabilities, and other challenges often act in an impulsive manner. They may blurt out inappropriate comments, hit others, or break rules that they understand. While this behavior is due to poor executive function control, there are methods you can use to help them reduce impulsive actions.

• Use visual reminders of expectations

• Practice calming strategies such as deep breathing, walking, using a squeeze ball in the left hand, or taking a time out. 
• Teach the child to recognize when he or she is becoming upset and to use the calming strategies. My friend used a traffic light as an example for a two-year-old. When her daughter started to get anxious or angry, she would say, "You're on yellow, what are you going to do to go back to green?" After a period of days without going to red, there was a reward. 
• Reduce anxiety by giving a clear schedule and warnings of transitions from one activity to another (in 5 minutes, we're going to put the toys away) or one location to another (this afternoon we're going to Grandma's house). 
• Try a point system to encourage good behavior. 
• When the child has calmed down after a problem, discuss the other options he or she had to deal with the situation and what the best choice would be in the future. Use a visual reminder to prepare for the next time. 

How have you tamed impulsivity in your home?

The Cycle of Adaptation for Family Members of Individuals with Disabilities

Discovering that a family member has a lifelong disability can be devastating. Parents and others generally go through a cycle as they seek to adapt to their new living situation, including surviving, searching, settling in, and separating.

Those who are surviving feel helpless. fearful, confused, guilty, blaming, shamed, and angry. These emotions may be expressed physically and through crying or inappropriate laughter. Support groups can help parents learn that others have the same emotions. Support groups, help finding treatments, and opportunities to honestly express feelings all help at this stage. With sufficient time, family members can begin to feel more in control, optimistic, and filled with hope. This stage also includes the beginning of an outward search.

Searching begins with outward research for a diagnosis and services, including attempts to change reality or bargain with God for a better outcome. The inward search involves an examination of personal feelings about having a child with a disability. Some individuals may withdraw from all support or attack those who try to help. These experiences can cause a re-ordering of priorities and altered relationships with others. Emotions during this stage can range from incompetence, fear, and feelings of being overwhelmed. Differences emerge as one person may feel empowered to meet new challenges while others may feel immobilized. Time to recharge helps during this stage. 

As interventions and treatments begin, family members tend to reach the settling in stage. Patience must be exercised as most programs take time. Other aspects of life are often resumed, or parents may become depressed and feel hopeless. Parents in this stage generally have the knowledge necessary to advocate for their child, but may feel it is pointless. Finding programs that take a family-based approach can be helpful at this time. 

Separation technically begins at birth, but it continues in small incremental stages throughout childhood. This process is slower when the child has a disability. Typical peers will initiate some of this separation on their own, but those with physical or cognitive struggles may require that parents start the separation process. Parents may re-experience guilt and grieving at this time and return to outer and inner searching, and additional opportunities to talk will be beneficial. 

Using Visuals to Improve Behavior

Many children with learning differences struggle to understand the spoken word. They may not comprehend teacher expectations, classroom rules, or re-direction. This situation can result in poor behavior when they don't realize what they need to do. Here are a few ways to help:

Visuals can serve to explain what is expected of each student:



Students are less anxious when they see their schedule:



They help remind students of possible consequences:



Visuals can help explain a reward system:



To help deal with problem behaviors:


And to communicate:



How do you use visuals for behavior?

Resources to Reduce Holiday Stress

The holiday season can be especially stressful for those with disabilities, especially mental illness. Expectations for this time of year run high, especially when fed by images of perfect families and idyllic lives provided by the media. There are a number of resources with excellent ideas to help with stress reduction, provide reasonable expectations, and help you deal with psychological challenges.

You may choose to begin with tips to prevent difficulties you've faced in the past. Or, you may need to implement ideas to deal with problems in progress. Take a look at these lists, and chances are you'll find some useful suggestions:

Proactive Strategies

• Psych Central - 8 tips to make the most of your holidays
• Psych Central - Making happy changes for the holidays 
• Web MD - Preventing depression during the holidays
• Psych Central - Simplifying the holidays 
• Psych Central - Spiritual strategies 
• Psych Central - Stress busters 
• Psych Central - Therapist Traditions 

Reactive Strategies

• Psych Central - 8 ways to cope
• Psych Central - 8 ways to take the joy out of your holidays 
• Psych Central - 9 ways to cope with the holidays when you have a mental illness - 
• Web MD - Coping with depressing during the holidays 
• Mayo Clinic - Coping with stress and depression during the holidays 
• Psych Central - Coping with loneliness 
• Psych Central - Enjoying the season 
• American Medical Resource Institute - Overcoming holiday depression for elderly and caregivers 
• Cleveland Clinic - Managing Holiday Stress 
• Psych Central - What not to do 

What are your best tips for managing holiday stress and depression?

An Important Skill You can Model for your Child

Participating in non-preferred activities, learning a new skill, and encountering unfamiliar people are all situations that challenge children with disabilities. One skill will help them do better in all three areas--having a positive attitude.

The first step to helping your youngster develop a positive attitude is to demonstrate that perspective yourself. Start with a look in the mirror. When you encounter unexpected challenges, do you rant & rave, or look for solutions? After a confrontation with another adult, do you find yourself very upset, or are you able to let the bad experience go? Before attending a meeting with a professional to discuss your child, do you anticipate a poor outcome and make yourself upset before you even leave home?

When going to a non-preferred activity yourself, try modelling a positive attitude by thinking out loud. Are there some aspects of the event that you do enjoy? Will there be someone there you are looking forward to seeing? Focus on the good thoughts so that your child can be prompted to do the same.

Prior to attending an activity your child does not instinctively like, point out things he or she can enjoy. Encourage positive participation, even if you have to start with just 10 minutes. Then you can reward the good behavior by going to a preferred location, or changing to another activity. The time can be increased during subsequent sessions.

How do you model and teach positive attitudes?

Toys for Children with Special Needs

The Christmas season is upon us, and the challenges of finding toys that are appropriate for offspring from tots to teens are complicated when there are special needs. Fortunately, there are many toys suitable for children with different types of disabilities. Here are a few suggestions, but remember to take into consideration developmental age as well as chronological age:

Sensory Needs and Fidgets:

• Tangle (there are many types) and other fidgets
• Specialty sand (Kinetic sand, or sand by Brookstone)
• Building toys (Legos, blocks, Tinker Toys, etc. 
• Games that involve manipulation of small objects
• Maze toys 
• Puzzles
• 3D Feel and Find
• Sensory balls (all types)
• Boogie Board writing tablets
• Balancing boards and balancing balls
• Magnetic Mighty Mind
• Bubbles 
• Pop Toobs
• Pop up tunnels & tents

Language Problems:

• Sensory balls
• Boogie Board writing tablets
• Tobbles Neo
• Toys that pop out balls
• Peanut Ball
• Specialty sand (Kinetic sand, or sand by Brookstone)
• Books of interest (for language exposure)
• Scoot-type riding toys
• Jumping beans
• Books with seek-and-find activities

Social Skills:

Fine Motor Delay:

• Paper or wooden dolls to dress
• Toys with small pieces to manipulate
• Building sets
• Hot Dots pen
• Blocks
• Boogie Board writing tablet
• Craft sets, such as weaving, beading, or sewing 
• Magformers building sets
• Rainbow scratch paper
• Basketball hoops and crayons for the bathtub
• Juggle Bubbles
• Pop Toobs
• Oball Rainstick Rattle
• Simple sports sets (bowling, T-ball, etc.)
• Gyro wheel
• Bean bag and other toss games
• Trunk Show
• Infinite Loop
• Play Foam

Developmental Delay:

• Matching games
• Piano Mat
• Lacing cards and beads
• Plasma Car
• Rush Hour Game
• Puzzles with handles or large pieces
• Bean bag and other toss games
• V-Tech Laptop or other toys
• Duplo and other building sets
• Simple craft sets
• The Gears! Gears! Gears! Lights & Action Building Set

Need more ideas? See the ToysRUs Toy Guide for Differently-Abled Kids, the guide at SpecialNeedsGifts.com, and links on Assistive Technology Corner. 

Holiday Tips for Children with Disabilities

Holidays can be stressful for all families, but changes in routine, contact with unfamiliar people, and altered diets can be especially hard on children with disabilities. Here are a few tips to lower everyone's stress level:

Travel
Did you know that the TSA has a page with information just for people with disabilities? For example, children with disabilities can be screened without being separated from their parents, and in a manner that best meets their needs. Medically required liquids (medications, breast milk, etc.) can be brought on board an aircraft, although they may be subject to additional screening. Those who have difficulty being touched can undergo a special pat down. Individuals who need special assistance can be provided with a passenger support specialist to provide help. For more information on other accommodations, go to http://www.tsa.gov/traveler-information/travelers-disabilities-and-medical-conditions

Events
Preparation is key. Inform guests and relatives of the child's needs, including unusual behaviors or dietary needs. Teach your child who will be in attendance, including their names. Create a visual schedule of events and teach "party rules". You should also role-play typical scenarios such as greetings and how to accept a gift properly. Bring quiet activities to prevent meltdowns, and make sure there is a quiet place to de-stress or take a sensory or movement break. Try to keep to as much of a typical routine as you can. Some families choose to spend the holidays at home and choose to visit during a less busy time.

Foods
Part of the festivities is the opportunity to eat special foods. This can be a challenge for those with sensory food problems related to type or texture. You may want to have the child help select and prepare food, introduce new foods in a gradual manner, and use a schedule for behavior support.

Family
Sometimes the child with special needs requires so much time and attention that the siblings may feel overlooked. Take some time to enjoy yourself with your loved ones, and have some well-earned relaxation.

What are your best holiday tips?

Collaboration - The Key to Helping Your Child

During a recent trip to an amusement park with my family, we were entertained while waiting in line by a video game. This activity involved getting those in line to steer a bird around obstacles by leaning left, right, or backwards. There were three groups competing, and success depended on the willingness of complete strangers to work together.

I did briefly wonder if this was some sort of social experiment, but was soon lost in the fun as we leaned, laughed, and ultimately won the race.

I have to admit I was surprised that so many people were willing to cooperate at the drop of a hat. And I began to consider how this related to the families of those with disabilities.

The answer is pretty simple. We need to learn to work with others, even complete strangers, to help our family members live the best life possible.

How does this work? Consider the following scenarios:

Someone misconstrues your child's disability-based actions. Remember that they have little to no comprehension of your situation and need education. Simply reply that your child has a disability and this particular situation is a special challenge. This gives you a chance to improve understanding in a way that doesn't put people off from your message.

You are trying to get additional evaluations or services. Begin in a collaborative manner, and remember that the people you speak to are employees who have directives. If you listen to their responses and seek understanding, you will get farther than if you scream, which will get you labeled as a "problem parent".

You object to something someone has written (possibly even this post). Take time to read the entire article and then respond without name-calling or insults. This is a good way to get your voice heard.

How do you best collaborate with others?

Generalization of Skills - Can They Do It?

Over the course of a student evaluation, I often get information from parents and teachers about what a child can and cannot do. This data may cover academic abilities, or life skills such as independent dressing, social skills, or safety information. Sometimes it's difficult to get a good picture of what the child has actually accomplished.

Gathering your own information (or to share with others):
The child can do the task, such as making a bed, if it is done independently without reminders. If you have to give prompts, indicate how many times, or if you need to supervise or help with the chore. Don't guess--if you haven't seen it happen, we need to assume that's an area of need.

How can you tell if the youngster has something mastered? We look for skill generalization. In other words, can the same task be accomplished in multiple environments?

For example, a young man with an autism spectrum disorder recently wanted to make a request of me. He approached me, shook my hand, and made his request in an impressively polite manner. He gave very good reasons for the expression of his need, and thanked me for my time. I would say that teen has mastered greetings, self-advocacy, and conversational skills. He did this independently without prompting.

Another young lady can greet others appropriately in the school setting, but requires prompts in other areas. She has not yet mastered this skill, but prompts can be removed, or faded, over time to increase her independence.

Try tracking some basic life skills, including social skills, to celebrate accomplishments and identify areas of need. You can find a list of age-appropriate behaviors here.

Dangers of Pornography for Those with Disabilities....and Everyone Else!

In the words of Jeffrey R. Holland,

"Most days we all find ourselves assaulted by immoral messages of some kind flooding in on us from every angle. The darker sides of the movie, television, and music industry step further and further into offensive language and sexual misconduct. Tragically, the same computer and Internet service that allows me to do my family history and prepare those names for temple work could, without filters and controls, allow my children or grandchildren access to a global cesspool of perceptions that could blast a crater in their brains forever. (Place No More for the Enemy of My Soul, April 2010 General Conference).

Exposure to pornography does significant damage to the brains of everyone who views it. The impact is far greater for those with disabilities, especially if they struggle with comprehension, impulsivity, or are primarily visual learners. Parents of students with cognitive struggles such as an intellectual disability, ADD/ADHD, or autism, need to be especially vigilant.

Everyone needs to take appropriate steps to ensure Internet access is safe in their homes. See the Internet Safety Handout created by the Church.

Give your children and teens a “gospel vaccination” by following the lessons provided in “A Parent’s Guide” to help them understand the importance of moral cleanliness and how they can remain in that state. Encouraging participation in seminary, youth programs, and Sunday School to reinforce what you've taught in the home.

Then you must teach your youngsters what to do if they are exposed. Unfortunately, seeing these terrible images is almost unavoidable in 2014. Take away the shame of accidental viewing by explaining that everyone runs the risk of a sighting, just as we all have hands that need washing at some point. They should stop the experience within 3 seconds by closing their eyes, turning off the device, leaving the room, or in other ways removing themselves. This should be followed by prayer and recalling the words of a favorite hymn or Primary song to reduce the chances that these images will be permanent.

If your child with a disability has been exposed, understand that the compulsion to return again and again to this type of content becomes an addiction. These compulsions will wash over them in waves similar to those felt by other types of addicts. Strong intervention is needed to treat this condition.

First, contact your bishop or branch president. You should also carefully review the information available at http://overcomingpornography.org. Recovery meetings may be available in your area for those over the age of 18, and other options have been provided for teens. See the documents in the “Internet Safety and Avoiding Pornography” section of ldsdisabilitieshelp.com for additional information.

 Pornography is a plague upon the land. Far too many parents don’t take the threat seriously enough, especially when the child has a cognitive disability. Follow the steps outlined above to protect your children before they become the latest victims of those who would ensnare them in the net of pornography. 

Reducing Anxiety in Children

Anxiety serves a useful purpose. It helps us to be careful of danger or on alert when we need to be at our best. But it can also reduce our ability to cope with stress, cause overreactions to minor problems, or be the impetus to total meltdowns and shutdowns.

Children with many different types of disabilities experience elevated levels of anxiety. Those with autism have an overall elevated level at all times. Children with ADHD are often worried that they don't know classroom and home expectations. Youngsters with a specific learning disability are concerned that they are just stupid and unable to change their circumstances.

New methods have been developed to help youngsters learn to reduce their own anxiety. These strategies involve unlearning the thought processes that create undue anxious feelings.

Theories regarding the source of anxiety now include both genetic and learned patterns of both thoughts and behaviors. A change in behavior can short circuit these patterns and lower the emotional impact.

Rational emotive behavioral therapy is a treatment method in which patients are taught to identify, challenge, and replace, thoughts that may be self-defeating. Rooted in methods of Cognitive Behavioral Therapy, this technique begins by having the child name their fears.

Once they have identified the mental "bully", they are taught to distance themselves from it. This begins with instruction in skills that helps them handle the bully.

To motivate these youngsters, they are helped to create a flowchart showing how their excessive fears are impacting their lives. They discover that anxiety keeps them from favored activities, friendships, and even schooling.

Triggers are identified and ranked according to impact. Therapists then work through cycles of exposure and response prevention with the patient. As the youth faces his or her fears, they become habituated and learn to control reactions such as escape or tears.

Parents play an important part of the process as they learn that shielding their child from the anxiety-provoking stimulus reinforces the harmful pattern. By protecting the youngster, they are actually reinforcing the concept that the object, event, or person really is dangerous and worthy of fear. They also must learn to support the therapeutic methods by encouraging their offspring to face their fears.

For more information on these techniques:
Effects of Psychotherapy for Anxiety in Children and Adolescents: A Meta-Analytic Review Shirley Reynolds, Charlotte Wilson, Joanne Austin, and Lee Hooper in Clinical Psychology Review 32(4), 251-262.

Treating Childhood and Adolescent Anxiety: A Guide for Caregivers. E.R. Lebowitz & H. Omer. John Wiley & Sons, 2013.