Hi Dr. Nelsen

I'll try to brief w/ a very complex issue:

My son is 5 yrs. old and has autism. For lack of a better word, he's fairly "high-functioning". Still, he learns much differently than a typical kid and if he doesn't want to (isn't motivated) to follow through on a request/instruction then he simply won't do it. I've resorted to using edibles for programs like getting him to wait, get dressed, walk next to me, etc. I hate this, but it's working. My real question, however, is that his school program uses a lot of Discrete Trial Teaching drills (based on the principles of Applied Behavior Analysis) - and I get a know in my stomache when they use their feedback like: You need to pay attention; You need to listen; No; Wake-Up; Youre not listening; Youre not paying attention; You need to try...they use No very, very often. While in theory, they are supposed to give "positive" feedback in an 80/20% ration to "negative" feedback (his supervisor says"it's not negative, it's just giving him information"). It is so degrading and while it may sometimes increase my son's targeted behavior (like matching blocks, etc.) I worry about what it's doing to the "whole child". When I've mentioned the damamge to his self esteem that hearing so many critical remarks might cause, they say, "Well, his self-esteem isn't going to be very high if he can't comply or follow directions, either". It's the most awful situation and I've tried to direct them to other models of DTT which are more "errorless" - but my requests fall on deaf ears. The hard part is that my son does have "compliance" and "attending" issues. Still, in my heart of hearts I know that he's effected by this negativity and that he gets increasingly frustrated.

Do you have any suggestions? I figured that "Positive Discipline" is so well accepted that if you had any guidance/leads/resources, that it could help. I wish you had a "Positive Discipline for Children with Autism"!!! Any help would be greatly appreciated.Thank you-

Seneca

Dear Seneca,

Your question is a good one--and a heartbreaking one, at that. I am a licensed marriage and family therapist and one of the co-authors of several books in the " Positive Discipline" series. I am also fortunate enough to work under contract to Nevada's Special Children's Clinic where I work with the families of autistic children. I also have seen several autistic children in therapy.

Autism is a challenge because it includes such a wide range of functions and abilities. "High functioning" children like your son often struggle simply because their greater abilities lead their teachers and peers to expect more of them, sometimes in ways they are not able to satisfy. I too worry about the more behavioral approaches to teaching and behavior management, and believe that no matter what, you must trust your inner wisdom and knowledge of your son and his world when evaluating any program for him.

There are a number of ideas you may be able to share with his teachers and other adults in his life. Yes, autistic children frequently need an organized structure and consistent, firm follow through--but there's no reason that follow through can't be kind as well as firm. Sometimes a gentle touch on the face or chin to establish eye contact is enough of a reminder.

Focus on discovering and emphasizing your son's talents and strengths: they may surprise you. One 8-year-old I worked with became fascinated with the guitar. We altered the tuning so that the guitar always played a major chord, then taught him to hold and strum it. He was delighted, and tolerated a great deal of boring material when he knew it would be interspersed with music time. He learned to count, to clap, and to follow a simple rhythm, all by strumming his guitar. He also developed a surprising amount of fine motor control. His mother's only complaint was that he insisted on sleeping with his guitar and she was afraid he would damage it--or himself! Other children develop interests in art, in building, and in other challenging fields. Those strengths give them the courage to deal with their weaknesses (as is true of the rest of us!).

While I am not an expert in the field of autism, my guess is that your son can be guided by repetition of positive requests without the "no" and negative content. I would also suggest that you do some research of your own on alternative ways of teaching and working with autistic youth. There are any number of new programs and ideas out there, and it's possible one may be better suited to your son.

In the meantime, trust your instincts to pay attention to the "whole child." Special needs or not, your son is a person and deserves to be treated with respect and dignity.

Cheryl L. Erwin, MA, MFT