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.
References:
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.
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.
References
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 http://web.ebscohost.com.ezproxy.library.und.edu
Kenney-Noziska, S. (2008). Feelings hide and seek.Techniques. Retrieved from
http://lianalowenstien.com
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.
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.
References
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.
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.. Addiction, 102,
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.
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).
References:
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.
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 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.
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.
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: www.nih.gov/news/pr/oct2007/nimh-01.htm
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.
References:
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:
www.ncjrs.gov/App/Publications/abstract.aspx?ID=258656
Hiltz, B. & Bauer, G.
(2003). Drawings in forensic interviews of children. American Prosecutor's Research Institute, 16(3). Available at:
www.ndaa.org/pdf/update_vol16_no3.pdf
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
References:
Supporting the use of an ADHD rating scale are the following
resources:
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
References:
Carter, S. Managing
anxiety in children. (2010). Retrieved on April 14, 2012 from: http://www.lianalowenstein.com/articles.html.
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.
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.
Stallard,
P. (2009). Anxiety: Cognitive behavior
therapy with children and young people. Routledge,
London.
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.
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 http://www.lianalowenstein.com/e-booklet.pdf 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 Schools, 37(2), 169-182. Zeman, J., Cassano, M., Perry-Parrish, C., & Stegall, S. (2006). Emotion regulation in children and adolescents. Journal of Developmental & Behavioral Pediatrics, 27(2), 155-168.
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.
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.
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.
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:
