The Discipline You Choose

Have you ever wondered about your discipline choices? You are not alone. This common parental concern is dark, deep, hidden and scary for most parents. It does not have to be. By following certain guideposts and budgeting the time to review your choices you can become the parent you want to be.

Remember you never need to be alone. Find a partner. Ask a spouse, relative, counselor or friend for the support and guidance you need. Read books about parenting styles and discipline techniques. Ask questions, listen, learn and connect with others. Watch the discipline choices others make and ask: “What kind of parent do I want to be? Am I a positive role model for my child?  Have I banned violence from our home? Am I ready and aware of the choices my child will make? Are my parenting expectations reasonable? Do I respond to my child’s behavior with rational and targeted responses? Do I think before I speak and set clear, concise, consistent, confident and competent boundaries?” Answering these questions will help you decide what discipline changes you need to make.

The hallmarks of good discipline are communication and connection. These two cornerstones support the management choices each parent must make to ensure healthy physical, emotional and cognitive development for a child.

Management techniques include distraction, redirection and behavior substitution. These strategies in conjunction with active ignoring are essential for children and teens of all ages and especially important for toddlers and preschoolers. Young children often become confused when parents use verbal explanations and insight directed interactions for redirection. Young children learn best from schedules, routines and rituals. They rely on stability and concrete redirection. By focusing on praise, general encouragement and positive reinforcement negative behaviors fade and are replaced by supported positive behaviors. Parents who anticipate behaviors and provide gentle guidance become the parents who are listened to and learned from.

Avoid discipline choices that rely on guilt or punishment strategies that communicate failure to your child. Never scold, nag or embarrass your child in private or public and remember these choices lead to humiliation, diminished self-worth and anger.

Discipline choices outside your home are especially difficult. Always discuss behavior expectations with your child before leaving home and determine reasonable natural or logical consequences that may be needed. Be aware of the impact of fatigue, hunger and stress on your child. At all times rely on genuine praise and immediate rewards to support and encourage positive behaviors in your child and during times of stress pursue a time out for both you and your child before choosing a penalty. Although safety and security of your child are always the highest concerns the discipline choices you make will always be long remembered.

Hitting Hurts Everyone

Choosing physical punishment as your discipline strategy hurts both you and your child. It does not stop hurting even when the pain, anger and confusion subside. Parents choose physical punishment as a discipline style due to personal, cultural and generational influences.  Often an aggressive verbal or physical response is chosen by a parent due to underlying fear, a lack of knowledge about alternative behavioral responses or because of immediate safety and security concerns.

Every child must learn how to manage emotions, develop relationships and recognize, understand and respond to frustration and disappointment. Unfortunately, corporal punishment teaches the opposite and does not provide a secure stepping stone for the development of confidence, positive self-worth and effective self-regulation.

The fundamental harm of physical punishment is the cycle and culture of violence and bullying that it supports.  Although numerous age specific alternative discipline strategies such as emotion coaching, positive modeling,  reasoned discussions, time out, ignoring strategies and loss of privileges have been shown to be more effective than corporal punishment,  spanking, paddling and hitting persist and are practiced and condoned by up to 75% of American adults. About 200,000 children continue to be paddled each year in US schools. Although corporal punishment has been banned by the United Nations since 1989 it remains unratified by the United States and is still legal in schools in many parts of the US.

Corporal punishment has both short and long term negative emotional consequences. It is a primitive learned behavior that is both biological and passed on across generations.  It neglects the emotional and social skills that are fundamental for the social and emotional development of a child.  Physical punishment relies on the physical responses of surprise, fear, anger, shame and distress to teach a child. It neglects the power of a secure and positive parental attachment to provide a safe, secure and accepting environment to foster healthy exploration while establishing reasonable and acceptable boundaries.

Physical punishment is not necessary for children to learn about limits and routines.  Although spanking and other forms of corporal punishment foster short term regulation these techniques rely on primitive brain pathways based on fear, hostility and discomfort to learn new skills. Physical punishment has been shown to increase aggressive behavior in children and is less effective in teaching positive behaviors.  Corporal punishment increases the risk of hostile, disrespectful and spiteful behavior and fosters the belief that stronger and bigger always wins.

Discipline strategies that are age and developmentally appropriate focus on the part of a child’s brain that supports patience rather than fear and the ability to control emotions. Positive discipline strategies are essential and must be practiced consistently over many years. Although this part of the brain takes years to develop there are alternative strategies that have been proven effective.  Infants from birth though age 18 months respond best to distraction and environmental and antecedent management. Toddlers respond to modeling, praise and simple requests. Preschoolers respond best to clear and consistent simple rules and the offering of choices to achieve a sought after behavior.  The older preschool child responds well to time outs to provide a calming down period to allow heightened emotions to settle.

Discipline roadblocks are common. Parents must avoid expectations that are too high or too low. Temper tantrums must be expected and the cause of the temper tantrum must be sought and responded to. Temper tantrums are a sign of overwhelming emotion and indicate your child is asserting independence, disagreeing with rules and is unable to communicate underlying needs. Relying on physical punishment in this situation amplifies your child’s discomfort and further delays your child learning how to regulate emotion and develop reciprocal respectful relationships.

What should a busy parent do?  See behaviors through the eyes of your child. Avoid blame and pursue immediate, specific, age appropriate and consistent consequences. Do not forget temper tantrums are a normal part of your child’s development.  They start small and escalate. Always intervene early. For a negative behavior in an older child look for environmental, parental or temperament causes. Respond to the cause rather than the behavior and choose a strategy where you are able to stay calm and set limits that are not be too permissive or too strict.

Rely on praise, modeling, offering of alternatives, distraction and time out to teach your child.  Never lose control of your emotions and step back if you become emotionally upset. Never hit or embarrass your child out of love or anger and avoid both positive and negative punishments.

If you plan for misbehaviors and choose your battles carefully you will become the best role model for your child.

Water Wise

Teaching children about water safety must be on the wish list of every parent.

In the US we take healthy and non-contaminated water for granted. In many parts of the world clean water is not available. Throughout the world, thousands of children die every day due to water-related illness and chemical contamination. Germs, nitrates, man-made chemicals, heavy metals and radioactive particles shorten or end the lives of so many children. Teaching your child the importance of clean water and helping others throughout the world obtain clean water are two of the most important lessons a parent can teach a child.

The ability to be naturally safe around water is another skill parents must model and teach their child from infancy to young adulthood. In the US almost 4,000 people die every year due to drowning. Over half of these deaths occur in children, and children between the ages of 1 and 5 years are at greatest risk. Home swimming pools pose the greatest risk to children under school age, and 80% of those who drown are males. Drowning is the second most common cause of death due to injuries for children under 14 years of age.

Swimming pools must have appropriate fencing that is at least 54 inches tall and have a functioning, self-latching gate that can be locked. Keep all ladders and objects away from the enclosure to prevent children from climbing over the gate or fence.  Choose a swimming pool cover that fits your pool and limits the risk of entrapment. Keep all pool related toys away from the pool when the pool is not in use. Toys attract children and increase the risk for a child inadvertently falling into the pool while trying to retrieve a toy. Make certain the pool your child is swimming in has been treated with the right amount of chemicals, and no matter where your child swims it is a good idea to avoid swallowing the water. Have your child shower with soap and water after swimming in untreated water since many recreational water illnesses including diarrhea and infections of the skin, eyes, ears and respiratory tract are spread in the water in which your child swims.

There should be no diving, pushing or chasing on pool decks. It is too easy to slip and fall on slick surfaces. Children must walk and never run around a pool and should always enter the pool slowly and feet first. If a child is not water-safe, an approved life jacket must be worn. Children under school age must wear a jacket that has a strap between the legs. For all children the life jacket must fit tightly enough so it does not pull up over the shoulders while at the same time does not limit breathing. In 90% of boating deaths a life jacket is not worn.

Every child should learn how to be water-safe. For the toddler and preschooler this means being able to back-float face up before learning how to swim in a face down position with a crawl swim stroke. This face up position decreases fear and panic and allows your young child to breathe and call for help.

Children must also learn about the importance of adult supervision, a buddy system, understanding and following posted regulations, and at all times listening to and following the directions of lifeguards.  Learning how to “read” the water and the weather are also important skills, as is CPR training for the older child.

When supervising children around water, alcohol use and all distractions such as a cell phone must be avoided. Stay at the water’s edge, count the children under your care frequently and briefly focus on each child while you scan back and forth over the area where they are swimming. Keep the swimming area small enough for you to remain “in touch” with each child. If a child’s behavior or play activity is placing other children at risk then have all the children under your care exit the water until you are able to resolve the issue with that child. Once the safety issue has been resolved you may allow the children to return to the water. Accidents often happen when a parent becomes distracted. Don’t allow this to happen to you.

Natural bodies of water such as ponds, creeks and streams carry their own risks. Small bodies of water can be especially dangerous since children are often not afraid to be near or enter them. In addition to the wind, weather, waves, currents, undertow and riptides that we see with lakes and oceans these smaller bodies of water often have many natural and man-made obstacles including currents, rocks, broken glass, entangling vegetation and mud. Fast flowing culverts, creeks and streams are especially dangerous due to the risk of fallen trees and branches that act as strainers that can entrap even the strongest swimmer.  When entering a body of water with waves it is important you enter and exit slowly and always face the waves. If you see a storm or hear or see lightening you must immediately exit the water and seek shelter.

When you teach your child to be water wise you are providing your child with skills they will model for other children and their own children. Water wise is water safe.

Rules are Important

Rules are the visible foundation upon which parenting is built. They represent your parenting style and encourage communication between you and your child.

The purpose of rules is to allow you and your child to identify acceptable behaviors and teach the limits of behaviors. The focus of rules is educational and based on consequences rather than punishment. They teach your child how to behave in different environments and serve as a reminder that you are the most important model for your child. The final purpose of rules is to encourage children to teach other children by their own words and actions.

The benefits of rules include parent-child communication, self-discipline and the support of the ability to choose. Clear, concise and consistent rules allow safety and security issues to be addressed while at the same time showing your child that you care. By following rules children learn the importance of safety, security and acceptance.

Parents are best able to establish successful rules when children are involved and engaged in the rule setting process. By involving your child in choosing rules and consequences you support and encourage two way communications. Cooperation improves and supports compliance as well as provides opportunities for genuine praise to be given to your child. In addition, remember to build incentives and rewards into the rules you establish.

Always make sure rules are clear, concise and written down. They must be posted in a visible location that is easily seen by you and your child. Set a positive tone for rules. Include “To Do” statements rather than “Not to Do” statements and decide at the time the rule is established what the logical and natural consequences will be if a rule is not followed.  Natural consequences are consequences that are the direct result of your child’s behavior and logical consequences are consequences that are directly linked to your child’s behavior.

Common tips for parents concerning rules include making sure you remain attentive and responsive to your child while at the same time being attuned and sensitive to your child’s needs and feelings. Praise is important. It increases your child’s compliance and must be genuine. Never be surprised when your child breaks a rule. Expect rule breaking since it is often a way children seek attention. Recognize when a rule is broken but avoid “nit picking.” By being consistent, firm, pleasant and leaving anger and discouragement behind you will model acceptable behavior for your child and increase your child’s compliance.

Lastly, remember to be a parent and not a friend when setting rules. Don’t be afraid of being a “bad guy.” Permissive parents are not successful in the long term and do not prepare a child for future decision-making and problem-solving. They do not teach children that authority must be honored and respected. By accepting your parental responsibility as an authoritative parent you teach your child the value of cooperation and respect and help prepare your child to find good solutions to present and future problems.

Parenting Styles

Responding to misbehavior is one of the greatest challenges every parent faces. Your child does or doesn’t do something, and you must know how to respond. Parents who understand basic parenting styles are better prepared to choose the right response for their child. There are four parenting styles every parent must recognize and understand.

The first style is authoritarian parenting.  In this approach the parent’s feelings, thoughts, words and actions dominate the parent-child encounter.  The feelings of the child are not listened to, dismissed or disavowed. The authoritarian parent says: “I am right, and you are wrong. Do what I say because I said so.” This attitude does not support reciprocity or shared communication.  In this parent-centered approach the feelings, thoughts, words and actions of the child are neglected, unobserved or lost and forgotten.  This approach hinders sincere and honest parent-child communication and neglects problem solving.  It diminishes a child’s self-esteem and self-worth and often leads to hidden anger or hostile and aggressive behavior by the child.

The second style is authoritative parenting. Parents who utilize this approach demonstrate unconditional love for their child while at the same time setting clear and consistent boundaries. These parents rely on empathy and emotional awareness to see what their child sees and understand their child’s emotions and behavior. By seeing the situation through the eyes of their child they are able to recognize and understand the reason behind their child’s behavior. This allows parental responses to be guided by the child’s emotions. Authoritative parenting supports the development of strong, healthy and trusting relationships and teaches children how emotions work as well as how to manage their own emotions.

The third parenting style is permissive parenting. Permissive parents view the parent to child relationship primarily as a friendship. They avoid rule-making out of fear that their relationship with the child will be damaged and their child will be less attached to them. With permissive parenting parental authority is not supported, and this approach teaches children not to respect or honor their parents. These parents accept their child’s emotions no matter how the child behaves. Boundaries are not identified and often children become confused while their behavior continues to deteriorate. Permissive parenting often leads to extended temper tantrums, acting out behaviors and an inability to handle emotions, recognize social cues and develop reciprocal shared relationships.

The final parenting style is that of the uninvolved parent. Uninvolved parents lack attachment to their child. They act as if they did not know or care about their child’s emotions or actions and often avoid direct touching contact with their child. Uninvolved parents verbally and visually neglect their child or like authoritarian parents use dismissive or disavowing response techniques to distance themselves from their child. This parenting style leads to disengagement, separation, low self-esteem and underachievement. These children have difficulty connecting and listening to others. In rare situations children raised under this style become highly resilient overachievers with over developed coping skills and immature relationship skills. These children tend to hide their own emotions and have difficulty resolving emotional conflicts while at the same time neglecting the emotions of others.

By being aware and understanding these parenting styles you are able to teach your child respect, cooperation and the ability to recognize, understand and respond to personal emotions and the emotions of others. Listening and emotional coaching are the greatest parenting gifts you can give your child.

Healthy Eating

Every parent knows a healthy weight is an indicator of good health and a gateway to chronic disease. Today’s parents, however, are busy and time and finances are limited. This is why it is essential for all parents to model healthy eating for their children.

The first step is to model mealtime as family time. Parents must support shopping, cooking, eating and talking together if mealtime is to be a memorable event.  Boundary setting, consistency and communication stop the tug of war that is commonly seen when parents become the food police. Parents must aim for progress not perfection when pursuing a healthy diet. By planning wholesome and well balanced meals, including a wide variety of healthy foods, eating in not out, planning family meals and not skipping meals, parents set the tone of what and when they expect their children to eat. Mealtime becomes a social event that is as much about one another as it is about the food that is eaten.

Parents must be patient with their children and allow children to serve themselves. The focus must be on avoiding excess portion size rather than forcing a child to “clean the plate” and sample every food that is served.   Water must be the first part of every meal or snack. Milk should be fat free or low in fat for all children over age 2 years. Juice does not need to be part of your child’s daily food intake. It is best to eat the fruit rather than drink the juice. Limit milk intake to three 4 ounce servings per day and consider substituting low fat yogurt or cheese in place of the milk.

Consider using a luncheon plate rather than a dinner plate for meals. Half of the plate should be fruits and vegetables and one fourth of the plate should be a whole grain carbohydrate. There has never been a controversy about eating too many vegetables. The protein you choose constitutes the final fourth of your plate. Half of all protein chosen should be plant based and fish or lean meat is preferable over high fat cuts of meat. In this way meat becomes a garnish to your meal rather than the main course. Beware of certain high fat foods such as cakes, cookies, ice cream, pizza, sausage, cheese, hot dogs and butter.

Consider making vegetable juicing a part of your family’s diet for children of all ages. Homemade vegetable juice that is free of pulp and fiber becomes liquid gold. It is a fast, convenient and efficient way to dramatically increase the intake of vegetables for your entire family. Because you make it yourself it is fresh and unpasteurized. You are able to limit the amount of sugar it contains while at the same time protecting the enzymes and heat sensitive nutrients that are key components of the vegetables. As a general rule try to use fresh vegetables that are locally produced and organically grown. Because you are using a large quantity of vegetables contamination with herbicides and pesticides can be an issue.

Vegetables that are high in minerals and beta carotene such as kale, cabbage, romaine lettuce and dandelion greens are good choices. High energy vegetables include carrots, beets, cucumber and celery. For added sweetness add one part fruit for every three parts vegetables and for a palate cleansing flavor consider adding half a peeled lemon. A half-bunch of cilantro or parsley also increase the depth of flavors. Other options include a few drops of honey or maple syrup or a dash of cinnamon or all spice. Always juice the stems and bases of cauliflower, broccoli and asparagus and try to drink the juice slowly or during a meal. This allows your digestion to “catch up” with all the nutrients. Storing vegetable juice is difficult. It is best to drink vegetable juice soon after it is made. If stored, consider doing so in an air tight mason jar that is refrigerated and kept out of sunlight.

Fruit smoothies are another healthy addition into the family diet but be aware of high sugar intake. Fruit smoothies can be made in a high speed blender rather than a juicer so the fiber is not left behind. Always include protein and some healthy fat in the fruit smoothie. Nuts or protein powder are easy protein sources  and extra fiber can be found in flax or chia seeds, Fat can be found in added coconut, avocado, flaxseed oil, fish oil or coconut oil. This allows the sugar to be absorbed more slowly and lowers the glycemic index of the drink. Avoid sweetened yogurt and fruit juices.

By taking the time to plan and eat healthy meals even busy parents can become a model of healthy eating.

Summer Safety Checkup

With the arrival of summer all parents need to perform a safety inspection of the house and all play areas inside and out. It is also the time for vacations, road trips, play dates, sporting events and summer camp. These new opportunities for exploration, experimentation and discovery make the arrival of summer the perfect time for a safety checkup.

A visit to the doctor is often the first step in this process. If your child has not had a yearly checkup, schedule a well-child visit with your pediatrician. Children grow and change so fast that a yearly checkup is essential. Immunizations can be given; vision and hearing screening performed and your child’s growth charts can be reviewed. Healthy lifestyle opportunities can be discussed and dietary, sleep and exercise opportunities can be reviewed.

The next step is to check out all outdoor play equipment. All outdoor playground equipment needs to be inspected and tested. All climbing structures must be inspected for soundness. Make sure rungs, stairs and guardrails are placed appropriately and attached correctly. All openings must be less than 3.5 inches and guardrails must be at least 29 inches tall for preschool children and 38 inches tall for school-aged children. Rope and climbing nets pose a strangulation and entrapment risk and must be inspected. Sliding boards must have at least a 4 inch side and closed slides are preferable.

Make sure all swings are well-attached and are made of soft and flexible materials such as a synthetic rubber or plastic. A full bucket seat is safest for small children and make sure all swings are separated by at least two feet to decrease the risk for collisions. Splinters, loose nuts and bolts and surface padding must all be checked. Having six inches of ground surface padding made out of shredded tires, pea gravel or bark is essential as is making sure the play area is away from trees and other objects that could become a hazard. Having the play area in a clear zone away from brush and trees also decreases the risk for tick bites and contracting Lyme disease.

Summer safety also includes teaching your child about playground safety and learning how to take turns with equipment. Learning how to climb a ladder, use monkey bars, avoid swings and moving away from the bottom of a slide are essential skills to review with your child. Some playground equipment can also become very hot if it is made out of metal and is in direct sunlight. Wooden equipment may also be a source of splinters if it is not well cared for.

During summer the rays of the sun are intense. Skin care is very important. The use of wide brimmed hats, clothing and sunscreen are important, as is making sure your child receives adequate hydration due to increased water intake requirements due to heat and increased activity levels and sweating. Clothing can also be a risk for your child if it can lead to entrapment or strangulation. Avoid drawstrings on all clothing.

Using mouth guards or eye protection while engaging in certain sporting activities is as important as it is to use sport-specific protection such as wrist, knee and elbow guards while rollerblading. For any “wheel” sport including bikes, skateboards and scooters a helmet must be used, and make sure the helmet fits your child correctly. The chin strap must be adjusted to allow only one finger to be placed between the strap and your child’s chin and the helmet must not be able to rock back from your child’s forehead.

Inspect all bicycles and perform yearly maintenance. Take your child’s bike to a bike dealer if you have any concerns about bike safety such as size, fit, brakes or steering. Children are becoming more adventurous with bicycle stunts, ramps and jumps. Discuss these activities with your child. Set boundaries for what is and is not acceptable and consistently enforce the rules you decide upon.

Do not allow your child to use a trampoline unless it is part of a supervised training program under the direct supervision of a coach or sport specific trainer. Backyard trampolines are dangerous and lead to over 100,000 injuries per year in the US.

Summer can be a time of concussions, broken bones and head and neck injuries. Your attention and preparation can eliminate most of the risk for these injuries and replace these severe injuries with minor sprains, strains, bruises, cuts and scrapes. With a little effort and attention you and your child can be ready for a fun and safe summer.

Sun Protection

The sun can be damaging to your skin. Sunlight contains both ultraviolet A (UVA) and ultraviolet B (UVB) rays that are damaging to your skin and increase your risk of skin cancer. UVA light causes premature aging and UVB light causes burning. Both types of ultraviolet light increase your risk of developing skin cancer. Throughout life the average person has a 1 in 5 chance of developing skin cancer and a 1 in 50 chance of developing the most dangerous skin cancer called malignant melanoma.  Excess and unprotected sun exposure and ultraviolet light exposure from tanning parlors dramatically increase your risk of premature skin aging and developing skin cancer.

Unprotected exposure to the rays of the sun burns your skin. The effects often appear within hours of exposure but may not appear for 6-12 hours after the damage has occurred. Your skin becomes red and warm. Swelling often occurs and is accompanied by pain and in severe cases blistering. This skin damage often leads to peeling and further itching in the days following the injury.

If you are taking various medications including antibiotics (sulfa drugs, tetracycline and doxycycline), acne medication containing retinoic acid (Retin A) or a thiazide diuretic for blood pressure control, you have an increased risk for severe skin rashes and increased skin damage after sun exposure.

Sun exposure may also lead to a skin photosensitivity or so-called sun allergy. Such sensitivity may occur hours to days after sun exposure and can include redness, swelling and blistering of the skin. This type of eruption is called a polymorphous light eruption (PMLE).

The first step in sun protection is to protect yourself and be a model for safe sun exposure for your children. Always hunt for the shade and stay out of direct sun during the high sun periods between 10am and 4pm. Remember that sun rays do bounce off water, sand and concrete and always dress right. Wear a wide brimmed hat and clothes that are light in color and have a tight weave that prevents the UV rays from penetrating your clothing’s fabric. Some clothes have been treated with chemicals to prevent these dangerous rays from reaching your skin. A water or surf shirt that is tight fitting and has a high crew neck and long sleeves is also very helpful especially for those who are in the water where sunscreen is rapidly washed off. Sunglasses that offer 99% UV protection are also helpful and protect your eyes from sun damage.

Choose a sunscreen that provides broad spectrum protection for both UVA and UVB. A sunscreen with a sun protection factor (SPF) of 15 protects you from 93% of harmful UVB sun rays. A SPF of 30-35 is adequate to protect you from 97% of the rays. Higher SPF’s are often not needed and are more expensive. Apply the sunscreen 30 minutes before exposure and every 2 hours while you are in the sun. Some sunscreens are water resistant and need less frequent application. No sunscreen, however, is waterproof and the more sweating or water exposure the more rapidly the sunscreen is washed off your body. Everyone must pay extra attention to high exposure and hard to reach areas. Finally, directly applied lotions are better than spray on sunscreens, but spray on sunscreen is better than no sunscreen.

For young children and sensitive areas of your skin consider using a sunscreen that has zinc oxide or titanium dioxide as the active ingredient. These types of mineral based sunscreen are best for sensitive skin and do not carry the risk of chemical exposure that chemical sunscreens pose. Avoid sunscreens that contain oxybenzone or a class of chemicals called parabens that are included in many personal care cosmetic products as a preservative to decrease the growth of bacteria, mold and fungi. If you need to choose a chemical based sunscreen, choose one that list avobenzone or mexoryl as the active ingredient.

Lastly, when you or your child are are spending time in the sun always be on the watch for heatstroke especially if you are engaging in intense physical activity. Make sure you take frequent breaks and drink plenty of water. If you are not urinating frequently or your urine has a strong color or odor you need to rest, get out of the sun and increase your water intake.

Quality of Life in Autism

For children and adults with autism an inspired quality of life is essential. For this to be achieved physical, psychological, social, spiritual and practical living and leisure components must be recognized, understood and addressed. The focus must be on optimizing communication skills, the ability to live in a community, the learning of functional skills that support employment and group engagement and elimination of behavioral challenges that lead to self injury or inhibit family and community functioning.

Quality of life is determined by the person with autism and not by you. Safety, legal and health issues must be identified and solved but the focus must be on the perspective of the individual with autism rather than your perspective.

The role of the community is to be supportive, available and non-judgmental. Early identification and acceptance are essential as is the provision of all reasonable and non-restrictive services that open the doors of opportunity for the persons of all ages with autism.

For the person with autism quality of life support must include personal and social opportunities that allow and foster the initiation and maintenance of relationships with individuals and with the community. Environmental and financial supports are also essential and must be individualized and reassessed on an ongoing basis.

An inspired quality of life focuses on strengths rather than difficulties. It must be skill and interest based rather than deficit dependent and must provide opportunities for the individual with autism to live, work and create as a member of a family and a community. The availability and access to leisure fun activities and everyday living opportunities such as shopping and transportation must be a priority. Intellectual disability and deficits of reactivity and regulation that are often the cause of behavioral challenges must be dealt with. Access to and participation in medical care that responds to both physical and mental health issues must also be integrated into the daily life of those with autism.

A quality of life balance can only be achieved if job opportunities, day care, group home and supportive training programs are available that allow a matching of needs, skill sets and interests. The avoidance of high risk situations that lead to cumulative stress and behavioral reactivity and challenges is essential as is an awareness of organizational skill deficits and sensory sensitivity.

An inspired quality of life is the dream of every parent whose child is diagnosed with autism. It is your role and the role of every community member to help every person with autism find an inspired quality of life.

Autism Treatment

The first step in autism treatment is identification. Look for the common signs of autism and talk to your pediatrician. Make sure screening is done by your doctor at your child’s 18 month and 24 month visits. Treatment and intervention can only begin after a diagnosis is made. The average age of diagnosis is after age 4 years yet present screens that can be performed by you at home or in your pediatrician’s office have the capability to identify children under age 2 years.

Once you have a concern the next step is a comprehensive medical evaluation and vision and hearing testing. Make certain your child is tested by a professional who has the skills to test young children and children with behavioral or developmental problems. Further developmental testing by Early Intervention, a Child Neurologist or a Developmental Pediatrician should then be pursued. This allows individualized testing to be obtained based on your child’s examination and history. Such testing may include specialized laboratory testing and neurological testing.

Intervention must include services to respond to the social, emotional, educational and physical needs of your child. All services must be supportive of your whole family and must respect personal, religious, cultural and ethnic preferences.

The most common intervention includes child focused intensive behavioral intervention that is also family supportive. Services must be provided both in and out of home and include parent and caregiver training. The purpose of all services is to provide intensive and child specific intervention that supports community and in home functioning. Specific attention must be directed to behavioral challenges that commonly exist and a focus on age specific group integration that is provided under the supervision of a highly trained individual.

Services should be evidenced based and provide outcome information to aid parents in choosing services. These services must be highly structured, individualized and include positive reinforcement while avoiding negative reinforcement. Service ratios are very important and in the initial treatment phase 1:1 supervision is often required if there is to be success in transitioning from a controlled to a naturalistic environment both in and out of the home.

Parent education and support services must also be part the treatment program. The focus must be on fostering collaboration between everyone involved in the care of the child or adult and identifying and pursuing reasonable and non-restrictive strategies that “work.” Connections and networking with available community services and the development of unavailable necessary community services are also essential if the transition from child to adult care is to be successful.