Sunday, August 5, 2012

Using Visual Aid Interventions with ASD students

Social dysfunction or "awkwardness" is often associated with Autism Spectrum Disorders.  Early intervention has been found to be effective with children diagnosed with ASD, although it is not a curable disorder.  Early interventions can include a variety of strategies, but Visual Interventions, such as Social Stories, Social Scripts, Power Card Strategy and 5 Point scales have proven to be most effective in home, school and community setting with ASD children.  Implementation of these skills increase self and social awareness and a competence in social situations.  


Buron, K. D. & Mitzi, C. (2003).  The Incredible 5-Point Scale.  Shawnee Mission, Kansas: Autism Asperger Publishing Co.

Campbell, A. & Tincani, M.  (2011).  The Power Card Strategy: Strength-Based Intervention to Increase Direction Following of Children With Autism Spectrum Disorder.  Journal of Positive Behavior Interventions, 13(4), 240-249.

Gagnon, E. (2001).  Social Stories, Social Scripts and the Power Card Strategy.  Retrieved from:

Feelings Hide and Seek

by Robyn

Feelings Hide and Seek – provides a safe environment for clients to verbalize and discuss their feelings; increase open communication regarding various emotional states; and strengthens family relationship through direct communication.


Hunter, E., Fainsilber, K., Shortt, J., Davis, B., Leve, C., Allen, N., & Sheeber, L. (2011). How do I feel about feelings? Emotion socialization in families of depressed and healthy adolescents. J Youth Adolescence, 40, 428-     441. Retrieved from

Kenney-Noziska, S. (2008). Feelings hide and seek. Techniques. Retrieved from

Tuesday, July 31, 2012

Short, Stop, Close for ODD

This Behavior Modification strategy enables the child to know the expectations for his/her behavior and helps you to maintain consistent positive/negative reinforcement.

Short, Soft and Close: Delivering Effective Reprimands
There are three key parts of an effective reprimand; short, soft, and close.  When used correctly, reprimands can serve to alter behavior without encountering an angry confrontation.
•        Short—The reprimand should consist of the child’s name and one or two additional
         words of direction such as, “Mike, stop yelling.”

•        Soft—The reprimand should be audible only to the child.  This serves to keep the
         adults’ emotions in check and helps to lower the dynamic of the confrontation.

•        Close—The reprimand should be delivered from within a few feet of the child,
         preferably within reach of the child.  A soft touch on the arm or shoulder will prove  
         to make the reprimand much more effective than will shouting it from the next  
         room.  The child will have your full attention and will be more likely to stop the
         targeted behavior.

Finally, after the reprimand is delivered and the targeted behavior has stopped, try to catch the child doing something good within the next few minutes.  Praise him/her for positive behavior in order to reinforce desired, appropriate behavior.

Working with children produces greater effects when we build on the positives and not the negatives.  Children are eager to please, yet adults often only point out when a child has misbehaved.  Children with ODD are used to hearing about all of their negative characteristics.   By creating as many opportunities for positive reinforcement as possible, we set up ways for the child to experience the positive feelings associated with cooperation and praise.  As a general rule, each day children should hear more positive than negative comments about themselves.

Arnold, D. S., O'Leary, S. G., Wolff, L. S., & Acker, M. M. (1993). The Parenting Scale: A measure of dysfunctional parenting in discipline situations.Psychological assessment, 5(2), 137.

O'Leary, D. K., Kaufman, K. F., Kass, R. E., & Drabbman, R. S. (1970). The effects of loud and soft reprimands on the behavior of disruptive students. Exceptional Children, 2, 145-155.

Using a Problem Solving Hand

The problem solving hand is a simple technique that can be used by children to use in conflict situations. Problem solving techniques are incorporated and supported in many evidence based practices when working with children.  In the schools it addresses academic and behavioral problems by utilizing problem solving.  Schools also incorporate problem solving interventions within their social emotional curricula.   An example where problem solving is core to its evidence based intervention is the RTI (Response to Intervention) curriculum.  Click on the link below demonstrating the use of the problem solving hand.

Joseph, G. E., & Strain, P. S. (2003). Comprehensive Evidence-Based Social—Emotional Curricula for Young Children An Analysis of Efficacious Adoption Potential. Topics in Early Childhood Special Education, 23(2), 62-73.

Knoff, H. M. (2009).  Implementing Response-to-Intervention at the School, District, and State Levels. Little Rock, AR: Project ACHIEVE Press.

A brief summary of how to administer the SASSI-A2.

by Todd

The SASSI-A2 was developed by Dr. Glenn A. Miller.  The original adult version of the SASSI was published in 1988 and quickly became one of the most widely used substance abuse screening instruments.  The SASSI-A2 was published in 1994 and became just as popular for screening clients twelve to eighteen years of age.  The SASSI-A2 boasts a 94% instrument accuracy.  However, it is not intended to prove a substance disorder diagnosis, but to be single component of a comprehensive screening process.  The self-report questionnaire takes approximately fifteen minutes to complete, and can be administered by any human service worker trained in proper administration procedures.

Coll, K.M., Juhnke, G.A., Thobro, P., Haas, R. (2003). A preliminary study using the substance    abuse subtle screening inventory: Adolescent form as an outcome measure with adolescent offenders. Journal of Addictions & Offender Counseling, 24, 11-22.

Feldstein, S.W., Miller, W.R. (2007). Does subtle screening for substance abuse work? A review of the substance abuse subtle screening inventory (SASSI). Addiction, 102, 41-50.

Juhnke, G.A., Kelly, V.A. (2005). Addictions counseling with adolescents. In Kelly, Virginia A. (Ed); Juhnke, Gerald A. (Ed). (2005). Critical incidents in addictions counseling. (p 107-112). Alexandria, VA: American Counseling Association.

Lazowski, L.E., Miller, G.A. (2007)  SASSI: A reply to the critique of Feldstein & Miller.. Addiction102, 1001-1002.

Miller, F.G., Lazowski, L.E. (2005). Substance abuse subtle screening inventory for adolescents: Second version. In Grisso, Thomas (Ed); Vincent, Gina (Ed); Seagrave, Daniel (Ed).

Miller, W.R., Feldstein, S.W. (2007). SASSI: A response to Lazowski & Miller (2007). Addiction, 102, 1002-1004.

Sweet, R.I. Saules, Karen K. (2003). Validity of the substance abuse subtle screening inventory-  adolescent version (SASSI-A). Journal of Substance Abuse Treatment, 24, 331-340.

Intervention to begin discussion for CBT with adolescents

This in an intervention I use with my clients to help them open up (a lot of them are anxious and won't talk), particularly in groups to facilitate discussion. Because about 99% of my clients have some type of anxiety disorder, we normally use CBT to treat it, and this intervention allows them to feel comfortable opening up and talking about their feelings. It also helps gather information about the client that they may not have normally told you (without the game).


Masia-Warner C, Klein RG, Dent HC, et al. (2005). School-based intervention for adolescents with social anxiety disorder: results of a controlled study. J Abnorm Child Psychology, 33(6):707-722.

Verhulst F. (2001) Community and epidemiological aspects of anxiety disorders in children. In: Silverman WK, Treffers PDA, eds. Anxiety Disorders in Children and Adolescents: Research, Assessment and Intervention. Cambridge, MA: Cambridge University Press; 273-292.

Anorexia Nervosa and the Maudsley Approach to re-feeding your starving child

The Maudsley Approach is applied to adolescents 18 and under who are living with their families.  It is designed to intervene aggressively in the first stages of illness and is a short term model as short as 20 sessions or six months in duration.

The Maudsley Approach builds on evidence that family therapy approaches are superior to individual therapy approaches with younger patients.  This approach involves the family from the outset of treatment and relies heavily on patient involvement in the re-feeding of the child with an eating disorder.
Parents are empowered to help their adolescent recover from this life threatening illness, rather than having them watch passively from the sidelines.  This treatment involves compassion, yet persistent and firm expectations that your adolescent eat an amount of food that can reverse the state of starvation his or her body is in and help them to gain weight.

In the first stage of treatment, the therapist plays an active and key role in helping parents separate their child from the child’s illness.  Parents are given the task of re-feeding and removing the illness from the child.   
Re-feeding the patient begins as the patient usually has just been hospitalized and is medically compromised.  This phase focuses exclusively on the re-feeding of the patient and other psychological issues are not explored.  Parents are encouraged to set their own goals regarding their child’s weight and health, with the emphasis on physical appearance and menstruation in girls as an indicator rather than precise weight goals.

Attia, E., & Walsh, B. T. (2009). Behavioral management for anorexia nervosa.New England Journal of Medicine, 360(5), 500-506.

Couturier, J., Isserlin, L., & Lock, J. (2010). Family-based treatment for adolescents with anorexia nervosa: a dissemination study. Eating disorders,18(3), 199-209.

Wallis, A., Rhodes, P., Kohn, M., & Madden, S. (2007). Five-years of family based treatment for anorexia nervosa: The Maudsley Model at the Children's Hospital at Westmead. International journal of adolescent medicine and health,19(3), 277-284.

Stop, Watch, and Copy: A modeling technique

Stop, Watch, and Copy is a modeling technique that can be used with any child, but is particularly useful with children who have a diagnosis of autism or asperger’s syndrome.  Children with autism or asperger’s often tend to miss social cues which result in them not being able to exhibit appropriate behaviors in social situations.  Not being able to act appropriately in social situations creates added stress in the life of a child who already is dealing with the symptoms related to the autism or Aspergers syndrome.

To implement Stop, Watch, and Copy, you can use visual cue cards (like the one’s below) or verbally talk with the child about stopping when they enter a social situation, watching what is going on around them, and then copy the behaviors (positive) that they see other people doing.  It is important that the child can identify the difference between positive and negative behaviors so that they do not copy the negative behaviors that may be occurring. 

Bellini, S., & Akullian, J. (2007). A meta-analysis of video modeling and video self-modeling interventions for children and adolescents with autism spectrum disorders. Exceptional Children, 73(3), 264-287.

Charlop-Christy, M. H., Le, L., & Freeman, K. A. (2000). A comparison of video modeling with in vivo modeling for teaching children with autism. Journal of autism and developmental disorders, 30(6), 537-552.

Nikopoulos, C. K., & Keenan, M. (2004). Effects of video modeling on social initiations by children with autism. Journal of Applied Behavior Analysis, 37(1), 93-96.

Shipley-Benamou, R., Lutzker, J. R., & Taubman, M. (2002). Teaching daily living skills to children with autism through instructional video modeling. Journal of Positive Behavior Interventions, 4(3), 166-177.

The Stop Light Model: Cognitive Behavioral Therapy

by Jessica

Depression will affect between 3-8 percent of the population by mid-adolescence.  Research supports CBT to be used with significant success with mild to moderate depression.  The National Institute of Mental Health has found that when treating major depression in adolescents with medication, CBT not only aids in a faster recovery, but also provides additional safeguards for those vulnerable to suicide.

CBT gives the adolescent a way of better understanding how their negative thoughts affect how they respond to different situations, and in turn, how they feel.  With the use of specific tools to change negative thoughts, youth are able to work their way out of depression.  One of the goals of CBT is cognitive restructuring which asks the client to identify his or her negative, unrealistic or unhelpful thoughts, evaluate evidence for and against these, and generate a more positive, realistic or helpful thought based on this evidence”
 This video gives one example of a CBT tool that can be used to aid in cognitive restructuring.

Cognitive Behavior Therapy and Medication. (n.d.). Retrieved July 15, 2012, from Worry Wise

Friedburg, R. D. (2009). Self-Instructional and Cognitive Restructuring Methods. In Cognitive Behavioral Therapy Techniques for Children and Adolescents (pp. 121-128). New York: The Guilford Press .

Gledhill, J., & Hodes, M. (2011). The Treatment of Adolescents with Depression. Current Medical Literature - Psychiatry 22(1) , 1-7.

Labbe, C. (2007). Depressed Adolescents Respond Best to Combination Treatment. Retrieved July 15, 2012, from National Institutie of Mental Health:

Rapport Building Developmental Assessment

The video demonstrates the use of drawing "Face Circles" and "Family Circles" in order to conduct a developmental assessment of a child while also building rapport.  Completing a developmental assessment allows an interviewer to later tailor questions to a particular child's competence and overall functioning, including motor skills, language, and cognitive skills.  This will aide in collecting the most reliable information from the child during later interviews.

Drawings can assist in building rapport with a child because drawing, typically, is an engaging activity and is an appropriate tool of communication with all ages of children.
The video also demonstrates the skill of inviting narrative from the child while both are engaged in drawing.  This allows the child to practice answering in narrative form while discussing neutral or positive topics.


Anderson, J., Ellefson, J., Lashley, J., Lukas Miller,  A., Olinger, S., Russell, A., Stauffer, J., & Weigman, J. (2010). The CornerHouse Forensic Interview Protocol: RATAC®. The Thomas M. Cooley Journal of Practical and Clinical Law, 12(2). 193-331.  Available at:

Hiltz, B. & Bauer, G. (2003). Drawings in forensic interviews of children. American Prosecutor's Research Institute, 16(3). Available at:

Monday, April 23, 2012

Using an ADHD rating scale

          As many as 3-9% of school aged children in the United States suffer from ADHD.  The use of an ADHD rating scale can help practitioners with the diagnosis for ADHD.  An ADHD rating scale can be filled out by any two different people who see the child on a regular basis in two different settings.  Most popular choices are parents and teachers.  There are a number of ADHD rating scales available; this is an example of one of them.

by Kristin Petersen


Supporting the use of an ADHD rating scale are the following resources:

Saturday, April 21, 2012

Anxiety Body Signals in Children

Children seen in a mental health setting have an estimated occurrence of anxiety between 12-20% (Carter, 2010).  Often feelings of anxiety and its concurrent physical discomfort  can cause feelings of fear and confusion which may cause children to have avoidant or distracting responses. 

The therapeutic treatment in relation to anxiety in children and having primary efficacy is Cognitive Behavioral Therapy (CBT).  In the preliminary phase of CBT treatment, psycho-education, the clinician can assist the child to identify their body’s signals when anxious.  By being able to focus on their body’s responses to anxiety (e.g., which signals are the strongest and most noticeable) they become more self-aware and able to promptly use calming or relaxation techniques. 

The below-referenced articles provide more research regarding up-to-date information about anxiety and  children, Cognitive Behavioral Therapy (CBT) approaches, intervention techniques and applicable worksheets. 

Click here for a worksheet for discussing anxiety body signals with children.  This worksheet appears in the book called Anxiety by Stallard, referenced below.

by Tara Shirek

  1.  Carter, S. Managing anxiety in children. (2010). Retrieved on April 14, 2012 from:
  2. Jongsma, A. E., Peterson, L. M., & McInnis, W. P. (2006). Eating disorder. In T.J.Bruce (Ed.), The adolescent psychotherapy treatment planner (4th ed., pp. 109-117). Hoboken, New Jersey: John Wiley & Sons.
  3. Beidas, R.S. , Benjamin, C.L., Edmunds, J.M., Kendall, P.C., Puleo, C.M. (2010) Flexible Applications of the coping cat program for anxious youth. Cognitive Behavioral Practice 17(2): 142–153. doi:10.1016/j.cbpra.2009.11.002.
  4. Stallard, P. (2009). Anxiety: Cognitive behavior therapy with children and young people.  Routledge, London.

Friday, April 20, 2012

Reducing Pica Behavior

   Studies have found that some children may engage in Pica behaviors, because they receive an oral stimulation from the texture of the inedible item.  The use of a Pica Box follows this theory and attempts to replace inedible items with items that are edible, but have the same texture as the inedible item.  The video will demonstrate how to use a Pica Box to help reduce Pica behavior in children.  It will give examples of edible items that can be exchanged for inedible items and it will also give examples of verbal cues that can be used when intervening with the Pica behavior.

The linked articles below provide more information and research on the concept of exchanging edible items for inedible items to help reduce Pica behavior.

by Cassandra Dale

  1. The Use of a Pica Box in Reducing Pica Behavior in a Student with Autism
  2. Reducing Pica Behavior by Teaching Children to Exchange Inedible items for Edibles

Managing Anger- Exploding Balloons

by Amanda Gustafson

     Often times, children and adolescents are not taught the coping skills necessary to manage anger.  It may be common for them to be told their behavior is “unacceptable” in how they react to the situations in which they experience anger.  These children then hold in their feelings and as their anger builds inside, they explode, just like an overfilled balloon, when acceptable coping strategies are not utilized in their anger management.  Through this exercise, these children and adolescents are shown a symbolic example of what happens when anger is kept inward.  Through this example and discussion of alternative coping strategies, counting back from 10, relaxation techniques, thought stopping, etc.; more appropriate  behaviors will be learned and reinforced as the child begins to better manage feelings of anger.

Source: Lauren Snailham Published in Creative Family Therapy Techniques Edited by Lowenstein, 2010

Kendall, P. (Ed.). (2011). Child and adolescent therapy: Cognitive-behavioral procedures. Guilford Press.

Miranda, A., & Jesús Presentación, M. (2000). Efficacy of cognitive‐behavioral therapy in the treatment of children with ADHD, with and without aggressiveness. Psychology in the Schools37(2), 169-182.

Zeman, J., Cassano, M., Perry-Parrish, C., & Stegall, S. (2006). Emotion regulation in children and adolescents. Journal of Developmental & Behavioral Pediatrics27(2), 155-168.

Thursday, April 19, 2012

Feel Good Files- a Self-esteem intervention

    Children of varying ages including adolescents can benefit from creating a “Feel Good File.” The primary goal of creating this type of file is to encourage positive self-talk through the identification and verbalization of positive self-qualities. This activity provides a child with an opportunity to focus on their strengths while learning how to release negative self-thoughts and images by focusing on positive affirmations.  The feel good file can be used in the therapeutic setting as well as within the child’s home. The child can also learn how to use their file on their own and continue to add to the file over time. This video will demonstrate how to create and use a feel good file with a child in a therapeutic setting.        

by Shawna Hall

Clin Child Psychol Psychiatryvol. 13 no. 3 395-407

Wednesday, April 11, 2012

1-2-3 Intervention for Autism to increase communication

   The intervention that is used in the video is the 1,2,3 intervention designed to help children with Autism. The intervention helps children learn eye contact, gestures and words. This helps children improve quality of communication and social interaction. The intervention also seeks to help parents reduce stress dealing with lack of communication.

by Kellyn Morlock

Wong, Virgina and Kwan, Queenie. (December 18, 2009). Randomized Controlled
                    Trial for Early Intervention for Autism: A Pilot Study of the Autism 1-2
                    -3 Project. Journal of Autism & Development Disorders. 677-688.

Saturday, March 24, 2012

Yoga for Children's Mental Health

by Rhonda Callahan

Children who experience attention issues and/or anxiety issues can be benefitted by yoga. Studies have found that yoga can help increase focus and to reduce anxiety. Yoga can be used to enhance and complement other interventions in a therapy setting, a classroom setting or in the home. There are many great resources including videos and classes that children and their “helpers” can use to do yoga. Yoga can also be a very connecting experience for children and their therapist, parent or teacher. The video will give some tips that can help a therapist in doing yoga with a child and demonstrate some simple poses while using kid-friendly terminology and making the relaxation exercise a fun experience.

Please see these articles for more information:

Arnold, L. (1999). Treatment alternatives for Attention-Deficit Hyperactivity Disorder (ADHD). Journal of Attention Disorders. 3, 30-48, doi:10.1177/108705479900300103.

Harrison L.J., Manocha R., Rubia K. (2004). Yoga Meditation as a family treatment programme for children with attention deficit-hyperactivity disorder. Clinical Child Psychology and Psychiatry, 9 (4) ,479-497.

Friday, March 23, 2012

Mindful breathing with children

Children as young as three or four can benefit from mindful breathing.  Mindfulness practice can help relieve anxiety, depression, and help a child calm down.  It can be used in any setting, and children can be reminded to use it on their own when they are worried or anxious.  This video will demonstrate an easy mindfulness breathing technique.

If you are working with kids just a bit older, you can include more visual examples such as asking them to imagine themselves breathing in good energy through their noses and breathing out all the stress and negativity through their mouths.

by Melanie Sage

This article offers several scripts for introducing mindfulness to children.  If you would like to read more about research that shows the benefits of mindfulness with children, check out these research articles:
  1. Treating anxiety with mindfulness: An open trial of mindfulness training with anxious children
  2. Mindfulness based approaches with children and adolescents: A preliminary review of current research  in an emerging field
  3. Mindfulness with children and adolescents: Effective clinical application
  4. A randomized trial of mindfulness-based CBT for children: Promoting mindful attention to enhance social-emotional resiliency in children