Behavior Solutions for the Home and Community: A Handy Reference Guide for Parents and Caregivers
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Behavior Solutions for the Home and Community - Beth Aune, OTR/L
AUTHOR
Introduction
As a pediatric occupational therapist, it is an honor and a privilege to work closely with parents and caregivers of children with a variety of special needs. This partnership is a valuable and critical component in helping children develop vital skills for them to be effective and active participants in the daily activities of their lives. Challenges experienced by children with autism spectrum disorder, Sensory Processing Disorder, attention-deficit disorder, attention-deficit/hyperactivity disorder, and other diagnoses must be addressed within the context of the family. This approach is both necessary and beneficial to foster the children’s increased independence, improved behavior, and healthy self-image, as well as to promote improved peace and harmony for the entire family at home and in the community.
In my work with children and their families, questions and concerns that consistently require guidance, strategies, and support arise in the areas of:
Self-care
Eating and mealtime issues
Bedtime and sleeping concerns
Community outings
Relationships with family and friends
My two previous books, coauthored with Beth Burt and Peter Gennero, Behavior Solutions for the Inclusive Classroom and More Behavior Solutions: In and Beyond the Inclusive Classroom, focused on providing solutions and strategies for teachers and school personnel. The straightforward format of the books, What is the behavior, why is it occurring, and what can we do to help?
has been extremely well received and found to be effective by offering practical solutions for challenging behaviors.
Parents, as well as educational professionals, have also expressed a desire to understand why their children exhibit behaviors like meltdowns and overstimulation, rigidity, controlling behaviors, avoidance, disorganization, limited independence during self-care, and decreased social interaction. They are interested in learning and implementing strategies that are practical and relevant to their child’s specific needs, with the added element of considering that child within the context of the family’s daily life. Comments such as, I need ideas that don’t add more work for me
and I have three other children—I don’t have time to implement a complicated plan
are becoming a theme in my work with parents.
This book, the third in the Behavior Solutions series, was conceived in response to those desires. There are numerous, extremely helpful resources for families that delve more deeply into the areas discussed in this book, and some are included in the appendices. This book is intended to provide general, practical solutions for busy (and often overwhelmed) parents who can benefit from a handy reference guide to help them address common behaviors at home and in the community. These solutions have been implemented successfully for years by a multitude of parents and caregivers with whom I have been honored to work, as a partner, to foster their child’s growth and progress. This book is a labor of love, dedicated to the families and to the wonderfully unique children who have challenged and inspired me to become a better occupational therapist—and, even more important—a better person.
Part I
Self-Care and Promoting Independence
It can be very challenging for parents to address a variety of concerns related to their child’s abilities or behaviors during dressing tasks. Some children with Sensory Processing Disorder (SPD) have difficulty with motor planning and sequencing: They may have challenges coming up with a plan and don’t even initiate the dressing task, or they may exhibit over-reliance on a parent’s help. Others may have a plan, but they can’t figure out the order of the steps (which is termed poor sequencing). Some children want to dress themselves, and they know the correct order of steps, but they lack the necessary motor skills, such as balance, strength, and fine-motor function, to dress themselves effectively in a timely manner. Other children can manage putting on the basic upper-body and lower-body clothing, but they put the items on backward, inside out, or twisted, because they lack awareness of their body senses. These children are described as sensory under-responsive. Many children master basic dressing skills but cannot manage small fasteners, such as buttons, snaps, zippers, and tying shoelaces. Some prefer to be underdressed or naked, while others prefer wearing layers or tight clothing. Many children with SPD are very picky about clothing and can be sensitive to certain fabrics, tags, seams, or odors that are present in clothes. These children are described as sensory over-responsive. They may avoid and resist dressing and might even have a tantrum at the idea of getting dressed. Many children with autism spectrum disorder may insist on following a theme with their clothing, such as wearing only the color blue or wearing garments with a favorite video or television character on them. Other children are described as sensory seeking, and they have a high level of energy and prefer playing, running, and jumping around to slowing down and getting dressed.
Learning how to dress oneself is an important developmental skill that, unfortunately, can be frustrating for both the child and the caregivers. Some parents end up simply dressing their child because it is easier, which can create learned helplessness and over-reliance on assistance. Or, a battle of wills between parent and child can ensue, which can start the day off in a negative way. Fortunately, when parents understand why dressing is challenging, they can develop strategies to encourage the child’s increased active participation, willingness, and sense of mastery.
Chapter 1
Getting Dressed
Many children can be described as sensory under-responsive. They lack awareness of general body senses and appear clumsy and uncoordinated. They can seem aimless, disorganized, and distracted. The children may try to dress themselves, but parents end