Best Toys for Autistic Children

The autism spectrum is just that -- a diverse spectrum with many different variables -- a fact that makes treatment for autism wide ranging.  Most commonly, treatment for autism involves bothbehavioral and medicinal interventions.  Addressing the symptoms of autism as well as those conditions often comorbid with autism can provide well-rounded treatment for autism. 

Treatment is often based around the developmental stage of children with autism.  Infants, toddlers, and preschoolers can benefit from early interventionstrategies, while children with autism in school might need to target social skills training.  Teenagers gain skills from transition training, or preparing for adult life. 

Early Intervention

Early intervention treatment for autism often involves Applied Behavioral Analysis, or ABA therapy.  In ABA therapy, children with autism learn skills in areas such as social skills, communication, play and leisure, self-care, motor skills, and cognitive development.  ABA therapists use appropriate prompts to encourage a child to succeed, and they break down concepts into simpler components; when things are in smaller, more manageable steps, children are much more easily able to learn and apply skills to everyday life.  Reinforcement is also a key part of early intervention, as it helps increase the likelihood that children with autism will repeat appropriate and desired behavior. 

In early intervention treatment for autism, children receive structured, therapeutic activities for at least 25 hours per week.  Therapists keep track of goals and desired learning objectives, and they monitor progress and set new goals as current goals are obtained.  Treatment for autism also involves parents, so the treatment procedures can be applied throughout the day.  Early intervention might also involve speech, physical, occupational, and recreational therapists.

School-Age Children and Transitions

Depending on the severity of autism and a family’s preferences, children with autism might be placed in a mainstream classroom (with neurotypically developing peers) or in special education.  While in school, children with autism will be involved with an Individualized Education Plan, or IEP, which outlines treatment goals and what therapy services are to be offered. 

While in school, children with autism will likely continue to receive ABA therapy, as well as physical, speech, occupational, and recreational treatment.  Some children improve so greatly through this treatment for autism that they “outgrow” their autism symptoms such that they no longer meet the criteria for diagnosis.  Current research does not point to a particular percentage of children with autism who will improve this much with their symptoms, but research does point to early intervention as the best tool for improving overall function. 

Other common therapy techniques for autism include sensory integration therapy (as many children with autism have sensory issues), modified diets (gluten-free and casein-free often helps with behavior problems), social story therapy, visual schedules, and 

cognitive behavioral therapy

.  Keeping a routine and remembering appropriate feedback and rewards helps create good habits and increase the probability of wanted behaviors.

As children with autism develop, treatment might need to be reevaluated to match children’s progress and create new goals.  Children with autism do receive therapy through their IEP while in school, but after they leave school, many of these treatments stop.  Working on transitions to adulthood are important skills to learn.  Transition therapy includes more social skills training and teaching children with autism how to interact socially and in an appropriate manner.  Working on independent living skills is an integral part of transition treatment for autism, and many people with autism can work, have relationships, and enjoy adult life.

                                           HOW TO CHOOSE TOYS FOR AUTISTIC CHILDREN

The Best Toys for Autistic Children

As a parent of a child with autism, it may be discouraging at times when your child seems disinterested in several types of toys and games.  Because 

autistic

 children process things differently and at a different level than other children, their playtime needs may be a little different.  Autistic children can love toys and games just as much as other children with the right types of toys.

Don’t Pick Toys Based Off of Age Levels

When choosing toys for autistic children, do not go based off of age levels.  You may find that your nine-year-old child is interested in a toy that is labeled for ages 4-7.  That is okay.  Also, if your child seems disinterested in a toy, do not give up on that toy.  Your child may be interested in the same toy a few months or even years later.  For example, a one-year-old child with autism may not pay any attention to a signing, rolling toy.  However, it may then become his favorite toy when they are three.

Some of the best toys for autistic children are those that teach cause and effect. Many infant toys teach cause and effect by having a reaction to the child’s action. An example of these types of toys is a plush animal that sings if you push its hand or vibrates when you touch its feet. While they are made for infants, your child may still enjoy them as a toddler or older.

Pick Toys that Help Gross Motor Skills

Another great idea for toys for autistic children are toys that develop gross motor skills.  Toys such as trampolines, tricycles, and bicycles help children with autism with their physical and gross motor skill development. Special attachments are made for bicycles that allow the child to ride with his parents.  Both the child and parent peddle, but the parent can control the brakes and steering of the bicycle. 

Educational Games are Always a Win

Educational computer games are also a fun way to catch your child’s attention.  Pick educational computer games that are animated to keep your child’s attention.  Find games that allow your child to discover and make things happen.  For example, a learning game that plays different sounds or music when a different item is touched is a perfect choice.  Since many children with autism are tactile learners, allow them to experience educational games on devices such as an iPad.  An iPad or other tablet can allow an autistic child to use his fingers to explore the game.

                                                             AUTISTIC BRAIN GAMES

EMOTIONAL COLOR WHEEL

Some other great toys for autistic children include toys and educational items that are predictable and repeatable.  Many children with autism love to watch the same show or movie over and over again.  While parents may find this counter-productive, the predictability of the movie can help your child develop words of his own.  He will take pleasure in repeating lines from the movie, and as a parent, you can say lines from the movie to interact with your child.  Other predictable and repeatable toys are puzzles and books.

When it comes to toys for autistic children, there are no set favorites.  Every child is different and will have a specific toy they love.  Don’t get discouraged if your child doesn’t find interest in the new toy you bought them, but instead, just keep trying, choosing toys that appeal to the senses.

Autism Behavior Problems

                                           What's Triggering Your Child's Outbursts?

Understanding your child’s unique perspective

here’s been a lot of research about how people with autism lack a so-called theory of mind—they don’t understand that you are a different person with different needs than theirs. That may be true, but teachers, parents, and specialists are often just as lacking their understanding of what might be called the child’s theory of sensation and perception.

You don’t “get” why she experiences a flickering light bulb as a bolt of lightning, a doorbell ringing as the sound of a thousand church bells. You don’t appreciate why a child might need to tap his foot and run around the classroom to keep from falling out of his chair. And you don’t grasp how yogurt, because of its smoothness, may be one of the only foods that doesn’t make your daughter feel like she has a mouthful of pebbles.

Your child may have as hard a time figuring out your needs as you have figuring out hers. She may not notice that today is a bad one for you, and so try to be less needy. He may talk endlessly because he can’t read your cues of boredom.

Search for the hidden meaning

Many of your child’s behaviors may not make obvious sense—they don’t seem to serve any clear purpose. But your child doesn’t smear poop all over the walls “on purpose” to make you cry or get angry. Assume for a minute that “crazy” behaviors like this do make some sense, that your child is sending you coded messages about things that are important to him—and your job is to break the code so you can “read” the messages.

By paying attention differently to these actions, you may be able to notice clues you didn’t see before, and find a more effective way to help your child. Taking this approach will also help you respond more carefully to these “bizarre” behaviors, so you don’t inadvertently reinforce them by rewarding your child for activities that drive you up the wall.

The first thing to do is to start recording these outbursts and stunts the way an anthropologist might record the actions of a newly discoverednative people. Suspend your judgments, what you think you know. What time do these events most often happen? Does the same thing often happen first? Perhaps he’s more likely to have outbursts on pizza day in the school cafeteria, or after you’ve just turned on the lights because it’s getting dark outside. Maybe it only happens when you turn on the fluorescent light in the kitchen. Many behaviors are set off or triggered by an event. Just as you might suddenly feel hungry as you walk past a bakery, there are “setting events” in your child’s life—the things that “set off” difficult behaviors. You can use a diary or log to try to identify these setting events for some of your child’s most difficult behaviors.
Instead of looking at the behavior as “bad,” look for how the context, or environment, is out of synch with your child, and explore what you can do about it.

External environment

Some things in your child’s surroundings are changeable and some are not. Sometimes the problem is a well-meant gesture that’s actually counterproductive, like a teacher popping a candy in your daughter’s mouth to keep her quiet, unintentionally rewarding her for being loud in class.

Sometimes just figuring out what the problem is can help you do something about it. Your refrigerator will always make humming noises, but if you realize that sound is distracting your hearing-sensitive son, you can help him set up a quiet spot to do homework.

Sometimes you will find a mismatch between what’s expected of your child and what she can actually do.

Sensory stimulation

Your child may respond with disruptive behavior if he’s being overwhelmed by too much sensory information. Jimmy is a bright boy with a lot of energy for learning. But he has a classmate who cries for hours each day. The sound and the emotional weight of that crying pushes Jimmy over the edge and makes it very difficult for him to concentrate and learn. His mother has realized this and is trying to switch him into a classroom that will be less disruptive.

Social triggers

Maybe your daughter realizes she has no friends, so recess time is particularly tough for her. Talking to the teacher and even her classmates might make a difference. Tell them what your daughter’s problems are and enlist their help. Yes, kids can be cruel to one another but they can also be phenomenally open and accepting. Reach out to their better natures. Don’t assume they should know how to behave around your child, but teach them how and you may be astounded by how supportive her peers become.

Communication problems

Maybe your son is frustrated because he can’t communicate—about either the bad reflux that’s hurting his throat, or the question he’d like to answer on the blackboard. Using pictures, sign language, or a keyboard instead of talking might help. Here’s where experimentation and a great teacher can make all the difference.

Interests

Maybe your child tunes out because the teacher or the material isn’t engaging. If your son’s preschool class is spending the year talking about dinosaurs and he’s obsessed with machines, maybe the teacher can steer the topic a bit in his direction, spending some class time talking about the machines used to study dinosaurs or dig up their bones.

Internal environment

Here are some of the places to look for clues when hunting for internal triggers of behavior problems.

Sources of pain: Look aggressively for all possible sources of pain, such as teeth, reflux, gut, broken bones, cuts and splinters, infections, abscesses, sprains, and bruises. Any behaviors that seem to be localized might indicate pain. If he always likes to sit curled up in a ball, for instance, or drapes his belly over the arm of the couch, that might be because his stomach is hurting.

Seizures: Some behaviors, especially those that seem particularly odd, unmotivated, abrupt, or out of nowhere, may be due to seizures. If you are concerned about this, keep a very careful record of what you observe, see if your child’s teachers and 

therapists

 have similar observations, and discuss it with your doctor.

Food allergies and sensitivities: Try to identify any food allergies or sensitivities that might be bothering your child. Diarrhea within a few hours of eating a particular food could certainly indicate an allergy; so can red, flushed cheeks or ears. Many people report that their child’s flapping or repetitive behaviors go away when they cut out certain foods. An elimination diet can show you for certain whether specific foods trigger pain or unusual behaviors.

Fatigue, hunger, or thirst: As with anyone, being hungry, tired, or thirsty can make your child cranky. Poor sleep or coming down with a cold could easily explain unusual behavior. A chronic illness or low-grade infection could make her irritable. If your child has a pattern of crankiness at a certain time of day, try offering a piece of fruit at that hour to see if it makes a difference.

Emotions: Sorrow, anger, fear, and anxiety can also have an impact on behavior. Parents who are going through a divorce, a health crisis, a job change, or a move might think they’re handling everything and there’s no reason for their child to be concerned. But if you’re stressed about something, chances are your child will be, too—particularly if he’s powerless to do anything about it, or even communicate his concerns.

Coordination problems can contribute to stress and behavior issues. As anyone who’s ever been picked last or near last for a team knows, grade school gym class can be stressful. If your child has trouble undoing buttons or zippers, the short time allotted for locker room changes or bathroom breaks can add tremendous stress. When you walk awkwardly, negotiating a crowded hallway between classes can be stressful.

As I hope you can appreciate by now, there are many things you can do once you look for ways to fix the context and not just the behaviors.

Stabilization, regulation, and sensory breaks

Once you have addressed your child’s physical needs, it’s time to consider sensory and emotional regulation. Your child’s sensory experiences are probably very different from your own. She is likely easily overwhelmed by information coming in through some senses, perhaps upset by loud noises, and isn’t getting enough input from the senses responsible for self-awareness and regulation.

In school you learned about five senses: taste, smell, sound, sight, and touch. Two more senses are important to understand your child: the vestibular sense, which controls balance, and proprioception, or the sense of one’s body in space. In many people with autism, some of the information from these senses is too much, too little, or distorted, leading to feelings of terror, pain, or disengagement.

To overcome the confusion, your child needs help stabilizing his senses. Author Judy Endow, an adult with autism, recommends sensory breaks—moments during the day when your child can fill sensory needs.

What type of sensory break does your child need?

Observe your child and see what they gravitate to when they do repetitive behaviors. That might give you some clues to what sensory activities help them regroup. Depending on your child’s needs and strengths, a sensory break might include:

spinning rocking doing push-ups against the wall rubbing something with texture wearing a weighted vest or blanket

listening to music sucking through a straw chewing something crunchy taking a visual break in a quiet environment using an assistive technology

Exercise is also a great way to calm the nervous system and to teach physical self-control. Team sports that require advanced skill and social interactions probably aren’t a good idea, but depending on your child’s age, skills, and fears, going to the gym or the pool, rolling a ball across the floor, or heading out for a family walk or run can help reduce stress and feed sensory needs.

According to one study the benefit of proprioceptive information lasts for about two hours, so your child might need a sensory break like this approximately every two hours. Some children need to get stabilized much more frequently. Of course every child is different and their needs are likely to change daily. Judy talks about her need to get sensory information proactively—before there’s a problem—and reactively, if there’s something in the moment that’s causing her stress.

One goal of therapy is for your child to develop enough self-awareness to know when they need to stabilize, self-regulate, and take a sensory break—and to know how to do these things. Then, regardless of their issues, they will manage better in the world.   

Age at autisms diagnosis depends on specific symptoms

The age at which a child with autism is diagnosed is related to the particular suite of behavioral symptoms he or she exhibits, new research from
UW-Madison shows.

Certain diagnostic features, including poor nonverbal communication and repetitive behaviors, were associated with earlier identification of an autism spectrum disorder, according to a study in the April issue of the Journal of the American Academy of Child and Adolescent Psychiatry. Displaying more behavioral features was also associated with earlierdiagnosis.

                                      Autism Spectrum Disorders

"Early diagnosis is one of the majorpublic health goals related to autism," says lead study author Matthew Maenner, a researcher at theWaisman Center. "The earlier you can identify that a child might be having problems, the sooner they can receive support to help them succeed and reach their potential."

But there is a large gap between current research and what is actually happening in schools and communities, Maenner adds. Although research suggests autism can be reliably diagnosed by age 2, the new analysis shows that fewer than half of children with autism are identified in their communities by age 5.

One challenge is that autism spectrum disorders (ASD) are extremely diverse. According to the criteria outlined in the Diagnostic and Statistical Manual of Mental DisordersFourth Edition — Text Revision (DSM-IV-TR), the standard handbook used for classification of psychiatric disorders, there are more than 600 different symptom combinations that meet the minimum criteria for diagnosing autistic disorder, one subtype of ASD.

Previous research on age at diagnosis has focused on external factors such as gender, socioeconomic status, and intellectualdisability. Maenner and his colleagues instead looked at patterns of the 12 behavioral features used to diagnose autism according to the DSM-IV-TR.

He and Maureen Durkin, a UW-Madison professor of population health and pediatrics and Waisman Center investigator, studied records of 2,757 8-year-olds from 11 surveillance sites in the nationwide Autism and Developmental Disabilities Monitoring Network, run by the Centers for Disease Control and Prevention (CDC). They found significant associations between the presence of certain behavioral features and age at diagnosis.

Maenner

"When it comes to the timing of autism identification, the symptoms actually matter quite a bit," Maenner says.

In the study population, the median age at diagnosis (the age by which half the children were diagnosed) was 8.2 years for children with only seven of the listed behavioral features but dropped to just 3.8 years for children with all 12 of the symptoms.

The specific symptoms present also emerged as an important factor. Children with impairments in nonverbal communication, imaginary play, repetitive motor behaviors, and inflexibility in routines were more likely to be diagnosed at a younger age, while those with deficits in conversational ability, idiosyncratic speech and relating to peers were more likely to be diagnosed at a later age.

These patterns make a lot of sense, Maenner says, since they involve behaviors that may arise at different developmental times. The findings suggest that children who show fewer behavioral features or whose autism is characterized by symptoms typically identified at later ages may face more barriers to early diagnosis.

But they also indicate that more screening may not always lead to early diagnoses for everyone.

"Increasing the intensity of screening for autism might lead to identifying more children earlier, but it could also catch a lot of people at later ages who might not have otherwise been identified as having autism," Maenner says.

The new study was supported by grants from the Autism Science Foundation and the CDC. In addition to Maenner and Durkin, co-authors include Laura A. Schieve and Catherine E. Rice of the CDC, Christopher Cunniff of the University of Arizona, Ellen Giarelli of 

DREXEL UNIVERSITY

Children With Autism Diagnosed at 5 or Older

1. Less than 20% were diagnosed by age 2. The American Academy of Pediatrics recommends that pediatricians screen children for autism at 18 months of age. The CDC estimates that 1 in 88 children in the U.S. has anautism spectrum disorder.
2. May 24, 2012 -- New research provides a snapshot of what life is like for school-aged children with autism spectrum disorder in the U.S.

The findings, which appear in the NCHS Data Brief, highlight areas where there is room for improvement, including earlier diagnosis ofautism spectrum disorder and access to behavioral therapies and other services. The new study looked at children aged 6 to 17 with special health care needs and autism spectrum disorder in 2011.

More than half of school-aged kids were age 5 or older when they were first diagnosed with autism spectrum disorder, the study showed. Less than 20% were diagnosed by age 2. The American Academy of Pediatrics recommends that pediatricians screen children for autism at 18 months of age.

The CDC estimates that 1 in 88 children in the U.S. has an autism spectrum disorder. This is the umbrella term for a group of developmental disorders that can range from mild to severe and that often affect social and communication skills. Treatment is individualized, and often involves behavioral therapies to address developmental delays along with medication.

Earlier Diagnosis of Autism Is Possible

Of the children in the study, about 9 of 10 received one or more therapies. Most commonly these included speech or language therapy and/or social skills training. More than half of these kids took at least one psychiatric medication, including stimulants, anti-anxiety drugs, or antidepressants.

"Our data indicate that many children with autism -- the majority -- are getting some sort of services such as speech or other individual-based interventions," says researcher Lisa J. Colpe, PhD, MPH, of the National Institute of Mental Health in Bethesda, Md. "That is great news."

Outside experts say there are still many gaps in the diagnosis and treatment of autism spectrum disorder among school-aged kids in the U.S.

"Research tells us that children who start intervention earlier do better in the long run," says Geraldine Dawson, PhD, in an email. She is the chief science officer at Autism Speaks. "We can reliably diagnosis autism by 24 months, so professionals need to do a better job, including screening all children at 18 and 24 months."

Data Highlight Gaps in Autism Treatment

In the study, 12% of kids with autism spectrum disorder didn't receive any of the suggested services. Less than half received the kind of behavioral therapies that are believed to be most helpful.

"There are many reasons children with autism are not receiving the interventions they need, including lack of insurance coverage and inadequate numbers of trained professionals," Dawson says. "It is critical that we address the barriers that are preventing children from receiving early intervention. "

Daniel L. Coury, MD, agrees. He is a professor of clinical pediatrics and psychiatry at Ohio State University and Nationwide Children's Hospital in Columbus, Ohio. He says that doctors need to do a better job of identifying autism earlier and getting these children into services at younger ages.

"If we can get more physicians to do that, it would be a start," he says. This is not going to pick up every child, as those more mildly affected may not be identified until their school years.

Amy Keefer, PhD, is a clinical psychologist in the Kennedy Krieger Institute's Center for Autism and Related Disorders in Baltimore, Md. She says that parents need to advocate for their children.

"Be involved with practitioners who are experts in autism at the first concern, and if a diagnosis isn't given, ongoing monitoring, assessment, and checking in can help guide parents through the developmental stages," she says.

This is a post in the weekly Autism Hopes series by Lisa Quinones-Fontanez, a mom who blogsover at AutismWonderland.

Norrin was diagnosed with autism when he was 2 years 5 months old – right around the age most kidsstart potty training. But at the time Norrin was diagnosed, he couldn’t even point his finger.

Or clap his hands.

Or wave hello/goodbye.

Or speak.

While potty training should have been at the bottom of the list of things I wanted Norrin to learn, there was this desire to be like a typical parent – for him to be a typical kid. And I wanted to start potty training Norrin at the age the other parents did. So a few months after the 

therapists

 started working with Norrin – we started.

And then we stopped. Because potty training a kid who couldn’t speak or have the motor coordination to clap, point, wave can be…difficult (among other things).

I realized that with everything else, I needed to take potty training step by step. So if you’re thinking of potty training your kid with autism – here are some things to keep in mind:

1. Ignore what the other kids/parents are doing. Parents of typical kids love to talk about potty training – how they did it and how long it took them. I remember talking to one mom who expressed her frustration with the process because it took a whole two weeks. And I felt like a failure because we had been working on potty training for months (with little success). I couldn’t think about other kids. I had to concentrate on mine.

2. Start when your child is ready. Aside from being emotionally ready, they need to be physically ready. One of the things our Applied Behavior Analysis (ABA) therapist stressed was Norrin learning how to to pull down his pants and underwear. Think about all the physical movement required to use the bathroom especially for boys. Potty training requires a certain amount of independence and if a child cannot remove his undergarments to go to the bathroom then it may be best to hold off until they can.

3. Everyone needs to be on board. When we started potty training Norrin, we started at home. We communicated with his teachers about potty training and asked for tips. We used to send Norrin to school wearing underwear with a Pull-Up underneath. Once he got to school – the Pull-Up was removed and his teachers took him to the bathroom throughout the day. Pull-Ups that have side openings worked best for potty training as it allowed teachers to remove it without removing all the clothing. It was a collaborative effort.

4. You need to be consistent. Once you determine your child is ready. Once you get everyone on board – teachers, sitters, grandparents – whoever. You need to be consistent. So even when you’re out  and about on the weekends, even if your child has a Pull-Up on (just in case), take them to the bathroom – get them accustomed to public restrooms.

5. Be patient. It took us more than two years to potty train Norrin. Don’t think potty training will take a week, two weeks, or a month. Do not put your child (or yourself) on a deadline. Start when you start and finish when you finish.

6. Have a sense of humor. Potty training is messy business (so be sure to stock up on paper towelsand cleaning wipes). Accept it. Laugh it off whenever possible. Though I know, sometimes it can be hard. If you want to laugh at one of our potty training adventures, check out this post - Norrin and the Royal Flushing Privies. 

Norrin is 7-years-old. He’s fully potty trained during the day. Yes he still needs help (with buttons and zippers and cleaning), and he still needs prompting (washing hands). Night time potty training is a whole other ball game. We’re not even trying. And I’m not going stress about it, because I’m sure Norrin will get it. In his own time.

If you’d like a resource book on potty training special needs kids, Toilet Training for Individuals with Autism or Other Developmental Issues was really helpful