Final Post

 Dear Friends,

This is my final post--I've retired. I'd like to thank all my kind readers through the years for their thoughtful comments.

I'll leave the blog up because there's lots of good information here. Keep in mind, though, that things change and that new ideas for resolving self-regulation problems appear all the time. So don't get discouraged if you don't find an answer today. Just continue to search and to ask questions until you find what you need!

Take care,

Teresa

Parenting Styles and Self-Regulation in Autism

The latest issue (October, 2016) of the Autism journal contains an interesting study of how parenting styles affect self-regulation skills in children with autism. The article compares  a child's temperament and ability to self-regulate with the parents' style of discipline and of interacting with their child.

In the study, 40 children with autism were matched to 40 children without autism. The initial assessment of temperament and self-regulation in the children with autism compared to their peers. Not surprisingly:

Compared to their typically developing peers, children with autism spectrum disorder showed more noncompliance and less self-regulated compliance to parental demands and prohibitions and greater temperamental difficulties across several domains.

No differences in parental disciplinary styles were found in the parents of children who were better regulated as opposed to those who were not. But there was a difference in parent-child interaction styles. Parents of children who were better self-regulated were found to offer more support to their children and to request better attention from them.

The authors concluded:

Findings highlight the importance of parental supportive presence in structuring the development of socialization in children with autism spectrum disorder.

The article is titled "Self-regulated compliance in preschoolers with autism spectrum disorder: The role of temperament and parental disciplinary style." The authors are: S. Ostfeld-Etzion, R. Feldman, Y. Hirschler-Guttenber, N. Laor and O. Golan.        

A Quick Fix to Over-Sensitivity

Today was a dentist day. Now, in spite of being over-sensitive to just about everything, I am good with going to the dentist. As a child, I had a great dentist who told me to focus on something else while he worked on my teeth. I did so and got through the procedure without too much discomfort. It was a good lesson.

But I didn't generalize on it until much later. I was in the midst of a home remodeling project and hammered my thumb instead of the nail :{  I was dramatically in pain. A friend told me I was a wuss, and that I should focus my attention on something else until the pain died down. I did it, and miracle of miracles, it worked. How did he know that and I didn't. He had played sports. I had not. Sensory kids don't.do.sports because it's noisy and you get bumped a lot. And that's the point of this post sensory kids naturally react differently to pain, bumps and sounds and they avoid activities like sports where kids get so many life lessons, including "think about something else".

If Zoey is playing in the sprinkler and gets water in her face, she can focus on it with discomfort, or she can shift her attention outward to something else, like the sprinkler itself, her chest or her hands. If Martin is standing next to an alarm that sounds for several seconds, he can bring his attention back into his body (and his hands over his ears) and in that way stay grounded.

This particular lesson is a game changer, and here's why. Our brain operates with great efficiency, always trying to guess what to be ready for. If I focus on sensory discomforts, the brain says, "That's what she wants to pay attention to", and so it prioritizes the brain's focus to discomforts. On the other hand, if I am able to ignore the discomfort, and focus on something else, discomfort loses priority. What a concept. Discomfort loses priority, and we don't attend to it. What a great lesson for our kids!

By the way the circuitry that processes priorities is in the right anterior insular cortex (rAI). It feeds priorities to the anterior cingulate cortex (ACC) which takes action: behaviors, motor and emotional reactions and cognitive redirection. ....but that's a post for another day.

Thoughts on Craving

Just a short post today. I'd like to refer back to the last two posts (here and here) which discussed stereotypy and sensory craving. I forgot to mention in the second post that the intervention used by Rispoli, et al. is the same approach I take to sensory craving in my book, Hands on Activities for Children with Autism and Sensory Disorders. In the book, I discuss how to explore sensory activities to find a preferred type of activity. The book also contains 50 or so fun interventions including crafts.

Pre-Satiation Technique for Stereotypy and Craving?

In the previous post, I looked at the blurred lines across the (ASD) autism symptoms of stereotypy and sensory craving. This post focuses on an intervention that may help both types of symptoms. The intervention is a well-conceived combination of behavioral and sensory techniques that comes from a study by Rispoli, et al (2013).

The research team studied three children with stereotypic behaviors. Five-year-old Antonio has autism and vocal stereotypy in the form of a high-pitched squeal. Twelve-year-old Jeff has intellectual disabilities and seizure disorder. He hits tables, chairs and walls repeatedly with various hand-held objects. Four-year-old Joel has autism and bounces small things (balls, toys and breakable objects) onto the floor. 

All three boys were unable to engage in demanding group tasks because of their stereotypy. The researchers posed the question: If each child were allowed to engage in his behavior until he stopped of his own volition (was satiated), would he then be able to engage in the demanding group tasks.

To test this, they set up a three phases process. First they analyzed each child’s behavior to see if he was a good fit for the study. Second, they looked for toys that matched the child's stereotypy and had him play with them to discover which toy was preferred. Last, they tested over a 4-5 week period to see if pre-satiation with the preferred toy before a demanding 15-minute group activity decreased the amount of stereotypy during the group activity and allowed each boy to focus on his work. (The answers were yes and yes.) The study while small used good methods; it was a blind, controlled study.

The implementation details are below. The interventions (step three) can easily be done at home or school by a parent or teacher. The first two steps are the domain of behavioral or sensory therapists, but may be accomplished by an astute parent or teacher. Let's look at the details for putting this in place.

Step 1: Analysis

1.     Analysis: You note a stereotypic behavior that appears to have a sensory component. Note which senses appear to be stimulated by the behavior. Remember that movement is also sensed by the body. It is the combination of the vestibular sense (head movement) and the proprioceptive sense (body movement). Unless you discover otherwise (see the "unmatched preference" of step three), assume that the child is craving sensation and that his stereotypic activities are satisfying that craving.

2.   To establish a baseline, count the occurrences of the behavior: count the number of times and the total amount of time he engages in stereotypy during a demanding activity. Also note when (time, place, type of activity) the child engages in the behavior.

Step 2: Discovering the Preferred Object

 

1. Identify possible preferred activities for satiation tasks: Put together some optional activities for him to engage in that might be just as engaging as the stereotypy. Attempt to find activities that stimulate the exact same senses in the same way. A good preferred activity may be more intense than his current one.

2.   Put all of the candidate preferred activities (toys to help with stimming) in an otherwise empty room with the child on a few occasions. Let him play and see if a preferred object emerges.
       If you are unable to find a preferred activity that is similar to the stereotypy, then try something else, perhaps access to a computer or a cause-and-effect toy. This is called an unmatched preference. The preferred toy for Antonio was a musical camera. Jeff was given an object he could use to strike walls and tables that would not hurt them. The choice for Joel was obvious; he was given a ball.

Here are examples:

a.       For the child who lines things up, show him how to stack and line-up Legos, and see if that becomes a preferred activity. This is a big one for many kids.

b.      For the child that flicks his wrist, try a punch balloon.

c.       If he is in constant motion, try a small trampoline, a swing (this is huge!), climbing equipment or a ball pit (if you have access to one). An older child may like riding a bike—perhaps on a bicycle-built-for-two with the parent in front.

d.      Finally, an example of an unmatched preference: the child flicks his finger, but you’ve discovered that given the opportunity, he would play with a cause and effect toy for a long time. This is his preferred activity.

3.     Practice with the preferred activity: On successive sessions, let the child engage in the activity for as long as he wants--until he has had enough. You will need to know how long it typically takes for him to be satiated, so keep track of the time. This is the satiation time.

Step 3: The Intervention

The intervention can be done prior to a demanding activity, as a way of helping the child to self- regulate.

First, let the child have unlimited time doing the preferred activity, that is let him do it until he is satiated. Let’s say that he usually requires 22 minutes to be satiated, and then plan to have him start the preferred activity about 25 minutes prior to the next task.

Afterwards, as he engages in the demanding tasks, track his behavior to see if his stereotypy has diminished. Counting the number of times and the total amount of time he engages in stereotypy during the demanding activity. Do this over a period of several sessions. If it appears to be helping, continue with the intervention on a daily basis. If he acclimates to the preferred activity, then try replacing it with something a little more intense or demanding. In some cases, you may see that he no longer desires the preferred activity and that his stereotypy has decreased, as well. This good outcome is possibly the result of increased sensory integration skills.

In the study, the child was used as his own control. By performing the intervention every other session, his behavior on days that he was satiated could be compared to behavior on days that he received no intervention and was not satiated. They noted that after a few weeks, the behavior appeared to improve both on the days that the intervention was done and when it was not done.

Unfortunately, the researchers did not carry out the study long enough to see if the intervention would lead to extinction of the behavior--which is a shame, because it might do so. I have seen satiation work as therapy with children in my setting. I separately treated wo children who craved movement. When given unlimited time on a swing twice a week, both lost interest in the swing after a month. One boy with this result was then capable of sitting at attention in the classroom without getting out of his chair on  most days. Sensory integration theory suggests this outcome, but to my knowledge, this type of scenario has not been documented in the journals.

How long did the effect of the intervention last? Fifteen minutes? A few hours? The whole day? The authors don’t discuss this, but the intervention is similar in nature to the sensory diet which is thought to last 2 hours. In the sensory diet, children are given 15 minutes (or so) of sensory stimulation usually including  a movement activity every 2 hours as a means of increasing self-regulation. A significant difference between satiation and the sensory diet is the inclusion of movement which is on its own self-regulatory. (BTW, the sensory diet has not yet been sufficiently studied to validate its efficacy, but it is generally accepted as a good practice.)

I still have additional articles to review from Behavior Modification's 2013 special issue  on Stereotypy. So stay tuned for that.

An update: Rachel Scalzo's 2015 PhD thesis on satiation of stereotypy has made a significant addition to the literature by clarifying the intervention process. I'll keep an eye out for future journal articles from her. In the meantime, here is her thesis abstract.

References

Rispoli, M., Camargo, S. H., Neely, L., Gerow, S., Lang, R., Goodwyn, F., & Ninci, J. (2014). Pre-session satiation as a treatment for stereotypy during group activities. Behavior Modification, 392-411.

The Confusion of Sensory Craving, Stereotypy, Hyperactivity and OCD

It can be difficult to accurately distinguish between sensory craving and stereotypy. Both symptoms play a big role in autism and both are part of the ASD¹ diagnosis, so you might think they are distinct. But they're not. They can be easily mistaken for each other and even overlap. Does it matter that we identify exactly what is going on? Yes. How can we create successful interventions without pegging the problem correctly?

Look at the descriptions and examples below and see if you can pick out inherent problems. See if you notice the areas of overlap and blurry lines between them, and also with them and hyperactivity (ADHD²) and obsessive behaviors (OCD).

Stereotypy: Rapp and Lanovaz³ say, "Stereotypy is often characterized as repetitious, invariant behavior that generates its own reinforcing consequences (rewards)." Examples are vocalizations, flicking fingers, slapping things, nail biting, and similar habitual activities. The DSM describes it in terms of motor movement or use of objects and gives these examples: "simple motor stereotypes, lining up toys, flipping objects, echolalia, idiosyncratic phrases."

Sensory craving: I'll venture this definition: goal-driven behavior to satisfy a sensory need. The DSM more broadly talks about "unusual interest in sensory aspects of the environment ... such as ... excessive smelling or touching of objects, visual fascination with lights or movement."

Did you catch any problems? Stereotypy is defined in terms of motor, craving in terms of the senses—as if the two inhabit separate worlds or separate people. But they don’t. Let’s look at a few cases and see how the symptoms might occur in real life.

We’ll start with the example of the child who frequently vocalizes simple sounds or phrases. Is it echolalia--a motor repetition? Or is it sensory seeking: fascination with the sounds she produces, or the sensation in her throat? Or is she doing it for some other reason such as attention seeking? Without knowing what is driving the behavior, it's hard to classify it. In fact, the behavior may be driven by all of these factors. The stereotypy may co-exist with sensory seeking, and once the child learns that her behaviors draw attention, she may use them to do so. 

How do school professionals view this behavior? It will likely be a mixed bag. First, behaviorists⁵ and sensory therapists will agree that the child is being rewarded by the sensation of certain sounds. She is craving sensory stimulation; but she is also engaging in stereotypy: behavior that generates its own reward. While there is definite overlap of stereotypy and sensory craving here, they will probably name it stereotypy and sensory therapists will look for any connection to craving. Teachers, who are with children for long periods and can see patterns in their behaviors, will be more attuned to the possibility of attention seeking.

Now let's explore this a little further. What about the child who has vocal tics. Does he fall into the categories of stereotypy or craving? No. Tics are involuntary speech and are usually the result of stress and anxiety.

How about a child who talks constantly? We see this in Asperger's Syndrome and it is often pegged as repetitive behaviors, but constant talking is also a symptom of ADHD hyperactivity. How do you distinguish between impulsive talking and self-rewarding ("He just likes to hear himself speak") stereotypy? For the unpracticed observer, the signs seem subtle, but the give-away to it being a repetitive behavior is constant talking about a single topic (such as types of aircraft). Finally, is the non-stop talking a sensory behavior? That's possible, but less likely.

Let's look briefly at a few more examples: children who touch everything or sniff things. Are these considered sensory cravings? Almost certainly, but it may be more than that. Some children learn about their world using alternate sensory paths: smell or touch instead of vision and hearing, and so the seeking behaviors may be a form of learning. But which came first: the craving or the learning pattern? It’s hard to know. And to further complicate things, the behavior can also be tagged as stereotypy, if she smells or touches the same things over and over in an “invariant pattern”.

Finally, let’s ask if a behavior that looks like stereotypy is actually obsessive compulsion (OCD). Hmm, it could be. The child who touches things in a certain prescribed way, may have OCD. The motivation for the behavior will be fear-based: "If I don't move in this exact sequence, something bad will happen", rather than the reward-based behavior of stereotypy. (The topic of differentiating OCD from stereotypy is explored in an article by Chok and Koesler in the September, 2014 issue of Behavior Modification journal, a special issue devoted to stereotypy, and I may blog on that at a later time.)

You can see that symptoms can be easily confused. In my years of teaching classes on the topic of self-regulation, I heard numerous accounts of doctors confusing craving or stereotypy with hyperactivity or OCD and giving children ADHD or OCD meds. It's truly important to distinguish the nuanced behavior so that the correct intervention is given.

In my next post, I'll look at the approaches taken by behavioral and sensory therapists to stop these behaviors. Sometimes the interventions are surprisingly alike.

 Footnotes and References

1. Autism Spectrum Disorder
2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Arlington, VA: American Psychiatric Association.
3. Attention-Deficit Hyperactivity Disorder
4. Rapp, J. T., & Lanovaz, M. J. (2014). Introduction to the special issue: Assessment and treatment of stereotypy. Behavior Modification, 339-343.
5. Rispoli, M., Camargo, S. H., Neely, L., Gerow, S., Lang, R., Goodwyn, F., & Ninci, J. (2014). Pre-session satiation as a treatment for stereotypy during group activities. Behavior Modification, 392-411.
6. Chok, J. T., & Koesler, B. (2014). Distinguishing obsessive compulsive behavior from stereotypy: A preliminary investigation. Behavior Modification, 344-373.

Intro Post: Distinguishing Sensory Craving, Stereotypy, Impulsivity, Tics and Obsessive Compulsion

The ASD¹ (autism) symptoms of sensory craving and stereotypy are described separately within the ASD diagnosis in the DSM-5², so you might think they are distinct from each other. But that is not the case. They can be easily mistaken for each other, and at times they overlap with each other. In the next two posts, I’ll take a look at the blurry lines between them and with other similar issues: the hyperactivity of ADHD³, tics, and obsessive compulsion. I'll discuss the implications for both assessment and intervention.

References

1. Autism Spectrum Disorder
2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Arlington, VA: American Psychiatric Association.
3. Attention-Deficit Hyperactivity Disorder

Environmental Enrichment (Multisensory Enrichment for Autism!)

Environmental Enrichment (EE) is an awesome protocol that has been shown to decrease autism symptoms and sensory issues and to increase receptive language and cognitive skills in children with ASD of all ages. It was designed as a low-cost program for parents to do at home. But, it can also be done in a school setting, or better yet, shared between home and school.

EE is a 6-month protocol with activities that change every two weeks. Parents/teachers select several multi-sensory activities from a list of 34 activities and do them for the two week period. They work with the child twice a day for about 15-20 minutes each. As the sessions progress, the child gains awareness of sensation and gains multi-sensory integration skills. The activities also build joint-attention skills, which are known to decrease autism severity.

The protocol is simply described in two published papers (listed below). They are open-access (available for free online). In addition, my Hands-On Activities book devotes 80 pages to the protocol, providing perhaps 200 activity variations and talking through program implementation details.

Give it a try and let me know how it goes!

References:

Woo, C. C., & Leon, M. (2013). Environmental enrichment as an effective treatment for autism: A randomized controlled trial. Behavioral Neuroscience, 487-97.

Woo, C., Donnelly, J. H., Steinberg-Epstein, R. R., & Leon, M. (2015). Environmental enrichment as a therapy for autism: a clinical trial replication and extension. Behavioral Neuroscience, 412-422.

My latest book, Hands-On Activities for Children with Autism and Sensory Disorders is available through my publisher, PESI.com, and at Amazon. It has all new interventions and focuses on sensory, especially multi-sensory, activities. Topics include Environmental Enrichment for children with autism, sensory enrichment for all children, and aerobics for the classroom. It's great stuff. Check it out!

As I begin to work on my next book: self-regulation strategies for the Pre-K to grade 2, I'll be previewing topics in my blog posts. So stay tuned for lots of great new material!

Teresa

I will be at AOTA. Stop by my poster session 9:00 on Saturday. I'll be at poster station 6066.

I'm very excited about my new book, Hands-on Activities for Children with Autism and Sensory Disorders. It presents a range of sensory activities for sensory awareness, desensitization, immersion and regulation. It's out in April. Click on the photo on the right for more info.

Also, I am giving a new workshop this year in New Jersey and Chicago called, Regulating Children with Autism or Sensory Disorders: Cutting Edge Interventions to Satisfy Sensory Cravings and Sensitivities. The material is based on the content of my new book. The workshops are being presented by PESI.

Sensory and Autism - Differences in Brain Wiring

Today is a good day for research results. Here is a science digest synopsis of research showing that sensory and autism issues can be distinguished from each other using MRI DTI techniques. The entire article is open access and can be found here.

Food Intolerances; Brain Inflammation

Autism Speaks Science Digest is a great source for keeping track of research findings that affect the day-to-day lives of parents of children with autism. This issue had two interesting articles I'd like to share with you. The first talks about food intolerances and behaviors. The second is about brain inflammation and autism.

You can subscribe to the digest to an email version that shows up twice a month in your mailbox.



References:

1. Food and intolerances: http://www.autismspeaks.org/blog/2014/07/18/can-food-allergies-aggravate-autism-symptoms?utm_source=email&utm_medium=text-link&utm_campaign=sciencedigest

2. Inflammation: http://www.autismspeaks.org/science/science-news/researchers-target-inflammation%E2%80%99s-role-brain-disorders?utm_source=email&utm_medium=text-link&utm_campaign=sciencedigest

New Materials from CDC on Autism

There are a few new items worth checking out on the autism page of the Center for Disease Control (CDC).

**  Autism Case Training is a program to train health practitioners in "identifying, diagnosing, and managing autism spectrum disorders through real life scenarios." There are 5 training segments with lessons, videos and printable handouts. What I like best is the series of back-to-back videos showing development and behaviors of typical children versus that of children with autism. The training program was developed with pediatricians in mind, but it is valuable for others working with children with ASD.

**  The CDC's Seed II Study is conducting a large, multi-state study of the risk factors in autism and developmental delays. The study focuses on the differences in children ages 2-5 with and without autism. It looks at environmental factors, genetics and physiological data including saliva, blood samples and bowel activity.

** A report on the state of autism based on the large study that the CDC conducted in 2008 is also available.

Identifying safe products for families - EWG

Hello to all and a Happy New Year!

I have written about EWG before, but let me put in a plug for them one more time. These folks are making a difference.

There is ample evidence that environmental factors are at play in many disorders  -- autism is associated with air pollution and landfills. ADHD has known links to lead, pesticides and food additives and coloring. Alzheimer's is similarly affected by toxins in the environment. And of course, there is cancer. Research continues to establish risk factors, but how do we keep track of what is safe?

EWG is a non-profit organization devoted to doing just that. They maintain large data bases of consumer products (cosmetics, soaps, foods, etc.) that provide for each product an overall safety rating, a list of ingredients and associated health and environmental risks due to using that product. 

They make the database available to all, and they are easy to use. You can look up products you are using or research new products you intend to buy and make decisions based on factual data as opposed to advertised claims.

EWG does fund raising throughout the year and are currently conducting their year-end drive. They are worthy folks. Check them out at EWG.org. If you like what you see, consider sending them a gift via Paypal at donations@ewg.org.

Teresa

Autism and gut microbes

Here is a quick bit of info about autism and gut microbes and MAYBE the start of some very important medical interventions. Hang onto your hats, it's going to be a ride.

A new and very important bit of research shows that:

Gut bacteria in kids with autism differs greatly from that of their peers.

Recent work with mice showed that probiotic therapy alleviates autism-like behaviors in mice.

Another story confirms the importance and calls it groundbreaking.

In Canada, one study is using a vaccine (uh-oh, the "V" word) to control Clostridium bolteae bacteria in the gut.

Hope some of this (dare we hope, all of it) pans out!!

Happy holidays, everyone!

A Quick Look at Barkley's Theory of Executive Functions

Here is a post for theory lovers.

 

Psychologist Russell Barkley's new book, Executive Functions (Guilford Press, 2013), contains a large-scale theory of executive function and self-regulation skills. 

He begins the book by arguing that we do not have a clear picture of what executive function is. Next he uses logical reasoning and a method derived from the work of evolutionary biologist, Richard Dawkins'(The Selfish Gene) to create a model of executive functioning consisting of five distinct layers or levels that we move through as we develop and mature. Finally, he describes each layer, how it works, what can go wrong and what types of interventions are helpful. The material in this last section rests firmly on the advances of neuropsychological research. Before he has concluded the book, he claims that executive function and self-regulation are equivalent and further claims that ADHD is the chief disorder of executive function.  

Here are the five levels:

 1. Pre-EF underlies true executive function (EF) in the brain. This is our raw sensing, attention /awareness, motor, emotions, language and our automated responses. We may respond to what we feel, see and hear but do not exert anything but primitive control over our reactions.

 2. Self-directed EF is the first level of true EF. With this level's set of skills we create our first set of reactions to what is happening within us and around us. These reactions are directed inward rather than outward to others. This level allows us to regulate our response to our body, emotions and environmental input (via our senses). The functions are:  Self-awareness, self-restraint (inhibition), sensory-motor actions, private speech or self-talk, appraisal including calculating the emotional cost of an action, play, reconstitution of memories and thoughts, and problem-solving.

Here is an example: if I am confused and don’t want anyone to know, I will work to keep my face from showing confusion. To the degree that I keep my body still and hide my emotions, no one is privy to what I am feeling.

3. Self-reliant EF gives us the self-management skills necessary to be independent with activities of daily living (ADLS) such as dressing, preparing food, eating and so on. Barkley compares the person operating at this level to Robinson Crusoe who was able to manage his life on his own without social support. However, at this level, we may find ourselves occasionally competing for resources. People operating at this level are performing in a social context, but it is “everyone for themselves.” A child at this level will be competing for toys or play-space during parallel play, or competing with a sibling for a parent’s affection.

 4. Tactical-reciprocal EF: At this level, we use social relationships to achieve our goals. We learn to share and we provide mutual help to friends. We learn what it means to be a friend, and we begin to act accordingly. We begin to regulate our actions, emotions, sensory behaviors, and social behaviors for the purpose of successfully interacting with others. For the first time, moral rules come into play.

5. Strategic-cooperative EF is more an extension of tactical-reciprocal EF than a set of new functions. At this level, our actions have a larger scope. We may make career decisions, volunteer to help with a community project, get involved with political activities, or organize a large group for a united goal. The concerns of this level are adult-oriented, but an older teen can begin to work through issues that involve strategic-cooperative EF skills.

Knowing these five levels of executive function can guide those of us who work with children and young adults with ADHD. It helps us select interventions that are appropriate to their EF development level as opposed to their age level. In this way, we can help them move from where they are stuck into the next level of their growth.

 

 

 

 

Nurtured Heart Approach

When I mentioned Howard Glasser's work, The Nurtured Heart Approach during one of my seminars as an example of a program for developing positive parenting/teaching/therapy skills, someone in the back asked, ‘Is that back in style again?’

The question caught me by surprise. Things go in and out of fashion, it’s true. But this method seems to have a great deal of relevance today: 

     “Parenting skills training helps parents learn how to use a system of rewards and consequences to change a child's behavior.Parents are taught to give immediate and positive feedback for behaviors they want to encourage, and ignore or redirect behaviors they want to discourage.”

 There are other “flavors” of positive interaction programs including Love and Logic and Positive-Parenting. It is the simplicity of the Nurtured Heart Approach that draws me to it.

 Glasser’s three big lessons are:

1)      Do not feed a child’s negative impulses with attention to him when he is acting-out

       2)      Give tons of positive attention to the child at times when he is not acting out

3)      Absolutely follow through with consequences when a rule is broken rule so that there is no confusion regarding what is okay and what is not okay.

 A 6-hour internet-based training class (for CEUs) is available from Glasser that very clearly describes his philosophy and shows how his techniques can help the challenging children and adults in your life.  

The Book is Written

It is great to be back writing the blog again. My book, Self-Regulation Strategies and interventions, is written and edited. The publisher, Premier Publishing, is prettying-up the graphics and laying out the book. They haven't given me a release date, but I believe it will be late December or early January. 

Content is similar to the topics I cover in this blog and in my PESI course, Self-Regulation in Children -- but with much more theory and a ton more interventions than I have time for in my class. I'll announce the publication date when I get it. 

OT Self-Regulation BlogTaking a Break for the Summer

Dear Readers,

I will be on break from the blog until sometime in September while I complete a book on Self-Regulation and help see my ailing mother through a bit of a crisis. See you then!

Teresa

The Sun and ADHD Diagnosis

Another brief post: the Questioning Answers blog has a nice discussion on the topic of solar intensity and the occurence of ADHD. Also go here for a discussion of the research on this topic by its key author.

*Corrections made to links on 6/2/13