Children with ASD often exhibit rigid behaviors. They have their own rituals and routines. They won’t settle and will be upset if these rituals are broken. No matter how their parents have explained the issue to them, even when they comprehend it, they won’t accept it.
In fact, many parents thought their children would have learnt their lessons from the previous incident of similar or same issue; and they thought their child would understand more and more, and their reaction would be less intense over time. Yet, instead of being calm, their reaction seemed to be intensified and giving them a pre-talk in advance seemed not effective.
To increase their tolerance, parents can practice the following activities with their child:
- Pick a time that your child is calm and relaxed, for instance, when he is listening to favorite songs or enjoying his snacks. Put a sticker on his/her clothes for a few seconds and take it off. If your child remains calm, praise him and provide reinforcer.
- Practice a few times, if your child can still remain calm, gradually increase the difficulty by lengthening the time. Practice putting the sticker on his skin instead of his clothes and switch the stickers to band-aid.
- After a series of systematic and structured practices, your child’s tolerance on putting something on his skin will be improved. Over time, the feeling of wearing something on his skin and being relaxed will be associated.
Tips:
- • In the beginning of the practice, to increase children’s motivation, allow them to choose their favorite stickers to put on.
- • Parents should conduct practice during relaxed times (as in relaxed for both parents and child) and provide ample practice opportunities. Avoid doing one-off practice during challenging situations, for example, before you are in a rush for outings
- • Practice putting different kind of clothing, can be a hat, an apron, a coat or even a theme park pass, etc.
The above is an example scenario to help increase your child’s tolerance in a particular matter. If your child has got other tolerance problems in other areas, such as hates brushing his/her teeth, is a picky eater, same principles apply with training his/her tolerance skills. Please be mindful that we need to be analytical enough to know which issue the child is rigid about, eg. he refuses to brush his teeth can be because he hates things in his month or watery feeling on chin, or the taste of the toothpaste. After finding out the particular issue, we can provide ample practice opportunities and systematically adjust the difficulty of the tasks to train the child’s tolerance skills.
Information provided by Autism Partnership
Autism Partnership (AP) is one of the most established Applied Behavior Analysis (ABA) service providers for Autism Spectrum Disorders (ASD) in the world. Formed in 1994 in the United States, AP is run by professional clinicians and specializes in providing one-on-one therapy, group interventions and overseas consultation for children with ASD and their families.
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[:zh]相信很多家長都有一些類似的經驗：孩子不小心弄傷流血了，家長才剛幫他們貼上了膠布（創可貼），不到2秒鐘又被撕下來了，無論如何游說，孩子都不肯把膠布（創可貼）貼上。孩子似乎十分抗拒身上被放上東西，如家長堅持要貼上，孩子會大發脾氣。
自閉症孩子常有固執行為，對一些規則或常規有特定堅持，別人一旦破壞了，他們會非常生氣，無論當下我們如何解釋給他們聽，他們也不接受，有時家長以為孩子會從上次汲取教訓，會明白及理解狀況多些，下一次的反應會沒有那麼激烈，但他們好像沒有改善，反而越來越激烈了，連事先準備跟他們預告也沒有用。孩子遠遠看見家長來，已經開始生氣了。
家長可以跟孩子練習以下的小活動
- 先選上孩子比較輕鬆的時候，如他在聽兒歌或在吃零食時，把貼紙貼在衣服上數秒，然後再拿下，當孩子能保持冷靜，誇獎他及給予強化。
- 連續幾次練習都能冷靜，就可逐漸把難度增加，把時間拉長及由貼上衣服上轉到貼在皮膚上，也從貼紙轉回膠布（創可貼）。
- 經過有系統及結構化的練習，孩子對身上被貼上東西的忍耐力會越被提高，久而久之，身上被放上東西及輕鬆的感覺也會連結起來。
- • 練習初期可讓孩子選自己喜愛的小貼紙，以增加參與練習的動機
- • 家長應選大家都比較輕鬆的時間做訓練，避免只在緊張關頭作一次性的練習
- • 應經常改變放在身上的東西，可以是帽、圍裙、外套、主題公園的入場證等
膠布（創可貼）只是例子之一，若孩子拒絕刷牙或有挑食問題等，我們也可應用同樣的原則，先清楚分析孩子固執行為的原因，例如，他拒絕刷牙可能是因為他討厭嘴裏有東西或者水黏在下巴上的感覺，又或者是因為他不喜歡牙膏的味道。找出原因後，透過有系統地調節任務的困難度，及提供充足的練習機會，提高孩子對這些事物的接受度。
資訊由Autism Partnership提供
Autism Partnership （AP）於1994年在美國成立，是全球最具規模為自閉症患者提供『應用行為分析』(ABA) 治療的專業機構。AP是由多位專業臨床心理學家、應用行為分析治療顧問及治療師管理，為患有自閉症譜系障礙（ASD）的兒童及其家庭提供一對一治療、行為干預小組訓練及海外諮詢服務。
請分享，讓更多人了解自閉症及學習更多應用行為分析（ ABA）的治療技巧。
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