For parents looking to begin a home program finding an effective consultant is essential.  Find a consultant who speaks of and uses data to make decisions on your child’s programming. Data-based decision-making is a must!

Develop an understanding of the insurance laws in your state regarding coverage. Begin the process of getting your provider set up and approved at least 30-60 days before you begin services to your child.

Decide upon who will be delivering the daily therapy to  you child. For some families parents or other family members can serve as line therapists, for others hiring outside staff to deliver daily services is more effective. In many cases both consultation and line therapy services can be covered by insurance.

For more information insurance coverage or how to start home program. Visit our Q & A forum http://blog.skillsprout.com/ask-a-question/

Teach your child the ability to “volley” back in forth in conversations by asking questions and making statements about comments from their conversation partners. Develop their understanding of the value of maintaining conversations related to the increased liklihood of developing relationships, etc.

Teach skills to transition to new topics of conversation by matching statement, and concepts, or asking new questions.

And most importantly teach your child to attend to the attention of his or her conversation partner. To observe and respond to nonverbal cues of non-interest or lack of attending. Once your child is able to accurately track these behaviors in others assist in developing “repair” strategies such as asking a new question, complimenting, changing topics, etc.

It is not enough to just teach rules of conversations and other social skills. Children with autism need plenty of positive practice opportunities to practice and reflect on these new skills. Provide opportunities to role play new skills. Facilitate “safe” opportunities to practice these new skills to succcessfully practice and execute new skills.

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In many children with ASD, joint attention is a major skill deficit area which contributes to core characteristics of the diagnosis of the disability itself. To assist in developing joint attention skills parents and professionals should consider targeting objectives related to the following:

1) Attending to others

2) Tracking eye gaze of others

3) Sharing eye gaze of others

4) Monitoring and shifting attention 

5) Sharing emotional states with others  

6) Drawing attention too and sharing experiences with others

 Perspective-Taking Skills

 The ability to understand and predict how other people are thinking or feeling is a very complex and abstract skill. Teaching perspective-taking skills to children with autism is a necessary piece of developing appropriate social skills.

Quick Strategy: To assist in teaching perspective-taking skills use visuals of drawings or pictures of people in social scenarios, draw or insert “thought bubbles” above each person indicating what each of the people might be thinking.

Teach your child to reflect accurately on other people’s perspectives using context, clues and background knowledge to draw conclusions on other people’s thoughts and feelings.

Work with your child on developing his ability to “fill-in-the-blank” of people’s thought bubbles both in pictures and during or after social interactions in his or her natural environment.

Try using sequencing picture cards initially to assist in developing your child’s understanding of cause and effect relationships.

Purchase or develop sets of 3-5 pictures representing a sequence of events (EX: child running to school because he is missed his bus, etc.) Pair “why” questions with the sequenced events. EX: “Why is the child running to school?”, etc. Use pictures from the sequence to prompt appropriate responses. Use many examples of picture sequences to develop your child’s understanding of cause effect relationships.

http://www.autismvotes.org/site/c.frKNI3PCImE/b.3909861/k.B9DF/State_Initiatives.htm

Even if your state has laws in place to mandate insurance coverage for children with autism the process of getting services covered can be involved.

Below are some suggestions for simplifying the process:

1) Find a primary care physician who is supportive and understands the benefits of behavioral interventions for your child.

2) Contact your insurance company to find providers in your area, develop an understanding of the provider approval process.

3) Be persistent! Many insurance companies are just beginning to identify providers for these services.  Find people within your insurance company who can answer your questions related to obtaining coverage. If necessary, identify billing codes to share with your insurance company related to your requested behavioral services to assist in quickly communicating your families needs.

Check out this link as an additional resource to assist in the process of obtaining insurance coverage for your child:

http://www.insurancehelpforautism.com/index.html

 Developing the child’s ability to self-monitor targeted behaviors can also serve as a last phase of development toward generalization of new skill. Once a child has developed an ability to engage in a targeted behavior, try using self-monitoring procedures to assist in pushing the skill out into the natural environment. 

The first phase of self-monitoring procedures should work on developing the child’s ability to accurately “track” whether he or she engaged in a targeted behavior. For example, can your child accurately reflect on his or her ability to monitor engagement in perseverative topics of conversations? Or can your child accurately reflect on if he or she remained on-task during a 15-20 minute timeframe?

When teaching this first phase be sure to provide immediate feedback to your child after his or her reflection of their own behavior. Agree or disagree with their reflection and discuss the differences in your perspectives. Work with your child on developing an ability to accurately reflect on his or her behaviors.

Once your child has demonstrated an abily to accurately reflect on whether they have engaged in the behavior or not, work on goal-setting with your child. The ability to set goals and accomplish goals is a life skill. Work on developing this ability with your child related to targeted behaviors. If for example you are working with your child on developing his or her ability to regulate emotions, self-monitoring procedures could be used to set goals related to using de-escalation strategies when he or she  begins to emotionally escalate. 

The ability to self-monitor one’s own behavior is an important phase of skill development.

To implement this strategy in your home simply capture video of your child (or other models) engaging in a desired behavior. For example, capture video of your child  initiating a greeting to another person when they walk into the roomto help teach this skill. Fade out any prompts needed to engage in the skill through a cut and paste video editing process (most computers come with software that has video editing capabilities). Have your child watch the video of the greeting and then immediately practice this skill without the video. Heavily praise and reinforce your child for attempts at imitating the behavior modeled in the video. Provide multiple opportunities for your child to continue to practice this skill outside of watching the video. Review the video frequently until the child begins to engage in the skill independently.

Quick Tip: If your child will not attend to the video intersperse captured images or video of preferred items, activities, etc. throughout the video.

Initially, this can be taught by using a visual to assist in teaching the structure for using this language. For example, create a visual with the words or pictures representing the words “I (picture of the child) see (picture of eyes).”

Take the child’s finger and point to the words/pictures on the visual while teaching the child to point and say the represented words.

Find objects (i.e. ball, shoe, book, etc.) in the home the child is familiar with and place next to the visual. Ask the child what he/she sees and assist him/her in pointing to the visual and object and describing what they say using a carrier phrase. Example: Child points to visual and book and says “I see book”. Increase the number of objects the child shares with you as he/she becomes more independent in using the full-sentence phrase. Once the child begins to be successful in using the visual to share the object with a carrier phrase, work on fading the visual out of the instructional process by asking the child what he/she says and assisting him/her to use the phrase independently.