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Autism: Dad is Comming Home
1. Autism: Dad’s Coming Home
Sponsored by: Able Pathways
Military Families:
Deployment, Discharge, Return,
and Change of Duty Station
Pictures and Content Copyright Matthew A. T. Lehman, BCBA
3. What Brings YOU Here?
• Deploying, Returning, Looking at
Retirement?
• Just Arrived? or Heading out?
• Recent Diagnosis /
At Risk Status ?
4. Presentation Goals
– Identify common problems
– How to minimize the impact
– Proven techniques
– Transitioning services
5. The 4 C’s: Consistency
– Consistency
• Maintaining your child’s program
• Adding back in a new team member
• Rules and Regs of the Home
6. The 4 C’s: Concern
– Concern
• Let your kiddo in on the changes
And your spouse too!
• Re-establishing the parent-child bond
• Let your kids feel like they have some
control – within limits
7. The 4 C’s: Change
– Change
• Its Inevitable, it sucks, its life…
– Big Changes Big Behavior
• This is true for all your kiddos
– Consistency
• Here it is again
8. The 4 C’s: Care
– Care
or rather self- and spouse-care
– Take some time
for yourselves
• Use that respite!
• Find the humor
– Setup a Support
System
10. TriCare/TriWest
• Benefits / Limitations
– $36,000 Service Cap
– Limited parent training
• Special Offer from Able Pathways!
– BCBA level supervisors
– Ends when you retire
• Contacts
– Online BCBA Provider List
– FRO, EFMO, STOMP Network
11. San Diego Regional Center
• Benefits / Limitations
– New ABA 101 Class
– Parent training
– Funding limits
– (new) 2 year cap on ABA
– NO social Skills
• Potential Gap Coverage
13. Other Insurance
• Medicare
– Doesn’t often cover ABA or BCBA’s
• Self-Insured Companies
• Takes a LOT of work (Hang in There!)
– Business of denying claims
– SB 946
• Some Success with
Private Insurance – in some places
14. Community
• San Diego is BIG
– Services for You
– Services for your Family
• Agencies and Related Service
Options
15. PEERS (a small service promotion)
Making & Keeping Friends: Program for the
Education and Enhancement of Relational Skills
• 14-week group therapy training for middle and
high schoolers
• Each session lasts 1.5 hrs and includes parent
training
• Evidenced based and research backed
program that makes a BIG difference
• Best of All: Some Insurance programs cover
part or all of this critical service.
16. Enrollment and Group Information
PEERS may be appropriate for teens with:
• ADHD
• Asperger’s Disorder
• Depression
• Other social &
behavioral problems
• High Functioning Autism
• PDD
• Anxiety
17. In closing
“This world is not what I expected it to
be . . . But for all the strains and
struggles, the heart break and
hardships, I wouldn’t change a
single moment – for it brought me
you.” - anonymous
• http://www.wrongplanet.net/
• http://autismdad1966.wordpress.com
Notes de l'éditeur
Establish credentials and emotional/rational connection to audience Parent background in this field. Marshal and tall asian kiddo stories Seeing a kid open up to the world with PECS [Click] Seeing families connect and kids who used to shut everything out reach out to us as we try and pulling them into the world (sometimes kidding and screaming all the way) is what keeps us doing this as providers and as parents.
SO, now I have told you a little bit about me, and why I do this. NOW I would like to learn a little bit more about you. What brings you here today. Are you providers, family – parents or other relatives. What are YOUR goals for this presentation How many are military, how many are spouse of military Are they arriving in SD and looking for services? Leaving and need to figure out how and were to go / get them? Family member leaving / coming home? New to autism or leaving the military
Increased Bs’s Return of old Bx’s Familiar rules: Prepare, Prompt, Reinforce, and stick to your guns For those of you looking to transition services, we will talk about that at the end of the presentation and if you provide your contact information we can schedule a detailed individual discussion
Consistency: Maintaining Program integrity – this will take preparation! Let your service providers know what’s happening – they will want to know and can help you prepare [click] Sit down and plan out how your spouse coming home might change even the little things: Who drives your kid places (practice, school, karate, the park) Who serves dinner – what dinner is – WHERE dinner is The temperament of the house Will there be new people coming over? New or different parties (football game, friends over for a beer)? [click] If your spouse doesn’t know the current program, how can he or she help but get in the way – and that will just stress everyone. Think of it as sharing the rules and regs of the home, just like those of a base or ship If you haven’t already made a visual schedule of the rules and routines of the home – things to help your child predict his day - I would recommend doing so. Using a dry erase makes it easy to show your kiddo changes Reminder: This works for EVERYboddy – it for ALL kids, including your NT kids. Ladies, it will even work for your husband. We do this in marriage family counseling too ;-) If pictures feel too young, that’s no problem! use a more adult version! short written sentences or Key Words/ Phrases or combine both. [ if objection raised about well but this still wont help: Remember we are dealing with adjustments to change. The goal here is to minimize the impact and help with the transition. We can’t cure autism yet, this is what people have consistently found to be the most successful in preventing meltdowns ]
Concern: Letting your kiddos know about the changes both those with and without exceptional needs is one of the most important things you can do Have a system for counting down the days till your spouse comes home Let them know that you are concerned too, and that you value their input. Give them a voice in the process – and let your spouse have a voice too! [Click] We live in the age of email, Skype and texts, tweets, smart phones, webcams – more then even I can keep track of. When your spouse walks through the door is not the time to start preparing – NOR to dump a bunch of rules and plans that he doesn’t know about yet. Discuss the plan with him or her before he is even on the plane home We don’t wanna make plans in haste – it’s still doable, but its MUCH harder and usually less effective at the last minute – not to mention more stressful. [Click] One of the things I often hear families talk about in my private practice is the need to Reestablishing the parent-child bond – I caution you to remember that this depends on what you and your spouse are both comfortable with We all know what we’d LIKE to have happen – but we need to set reasonable expectations Not all guys are comfortable with this – they may fall back on old patterns and interactions styles that are familiar and made them feel safe while deployed Sometimes, its your child who has the bigger barrier – anger about the deployment, changes to the system that they know. [click] Lets try and make fun activities that your child enjoys MORE available now that your spouse is home– but LET your kiddo choose the activity and if he or she wants to engage in it. (and only offer things you and your spouse are willing to provide)
Change: Some things Change, but the rules don’t Big changes signal to any kid that the rules may have changed. There is some else to ask permission from – Someone disrupting the routine This is all the more difficult for our kiddos with an ASD. But you can handle this. Your family will survive. Prime your son or daughter as to what the changes will be, establish what rules will stay the same, what will change. Make a visual prompt of the rules and indicate what has changed and what will stay the same Consistency Try and keep as many things about your child’s daily routine predictable (you already do this) keep things the same as much as possible – now is probably NOT the time to work on tolerating change unless your child is far advanced beyond what even a NT kiddo is expected to handle
are: Maintaining YOUR relationship with your spouse Don’t neglect together time with your souse. You need time to re-unify as well. This is an excellent place to use your respite if you have any If you live on base, or just in a child friendly supportive community it might be worth it to coordinate with another family to watch your kids for a night in return for you doing the same later or when their spouse returns Find the humor in life's little things If you have the time, try and set this up in advance so that your child is familiar with and practiced going over to another house. This will take some time! Often another family with a child on the autism spectrum works best.
TriCare – one of the best resources for intensive ABA in home therapy coverage ($ CAP $36k -> What this means) *What to expect, who to contact – talk to FRO officer, Exceptional Family Member Officer *STOMP Network When you retire, ABA services end.
Regional Center – For military families, may be the best source for additional / more intensive parent training then TriCare allows, MIGHT provide gap coverage after hitting TriCare cap. More general Limits on Funding. Restricted currently to 2 yrs of ABA services in most cases for new clients Can be very difficult to get coverage – only taking/funding more severe cases WILL NOT cover social skills training
Schools: There are many school’s across San Diego County with various strengths, weaknesses, politics, and in this current economy – funding problems Advantage: School are allowed and expected to provide social skills training: Quality and availability varies NPS: Several allow your child to graduate with a real HS diploma (assuming he or she passes the California Exit Exam) and go on to college. Or they can get a certificate of attendance going through the life skills program (possibly till they turn 22) I know of at least one kiddo I have worked with who because of this Hybrid: We worked out a deal with the parents and home school. He had already passed the exit exam, so we gave him he certificate of attendance at 18 and temporarily withheld his HS diploma Currently on track within the life skills program (using it almost as a college prep) and will receive his real HS diploma at 20, when HE is ready An unusual case, but it never hurts to ask. Many NPS are able to more specifically target your child’s needs and provide a better student – staff ratio *THEY ARE EXPENSIVE *Home school will often fight placement and is not required to place until your son or daughter demonstrates a failure to thrive in the home school environment --If this is what your child needs – hang in there! Its worth it!
Other Insurance: What Insurance Carriers currently provide effective coverage and of what? What questions to ask, How to make it WORK MediCare in California generally does not cover ABA nor BCBA providers of services at this time. Aetna, United Behavioral Health, Coventry, First Health, CIGNA, many Self-Insured employers (check Autism Speaks list) Remember that when you change regions, the local state laws may change what coverage private insurance allows you
San Diego is BIG. This means there are a lot of resources out there. You can find other parents, Fun family activities Maybe get additional personal time via respite or other means to “recharge” your batteries Many agencies offer discounted rates or negotiated rates for private pay of ABA or related services *Check with your ABA provider and your service coordinator for what other services might be out there. If you are leaving San Diego, go online and research what is available to your future home. Try and pick an area where you can access services conveniently. Some states are better then others in terms of services, providers, and coverage. Local regs may effect the level of services you can get as well.
We all know how important social skills are to doing well in life. Many of us have recommendations in our children's medical and educational files recommending that they attended social skills training. Most of us have experienced the frustration of inadequate programs that rely on placing kids in a room or on an outing and “hoping” they make friends or A friend, just one REAL friend – that’s is all we ask for – just, somebody. This program teaches our kids what to do and HOW to do it. And it helps them KEEP those friends. Even better, it teaches us the adults what to do to support our kids and make them more successful in this critical area of life. Based on empirical evidence and research out of UCLA this program breaks down what socially accepted peers are actually doing to make and keep their friends and presents it to our kiddos in a way they can understand and follow: a set of accurate social rules. NOT the myths that we as adults have hear all our lives and now repeat back to our kids, but what ACTUALLY WORKS. Quick question for the audience: How do you tell your child to respond to verbal bullying? Expected: walk away, ignore, fight back, tell a teacher. What socially excepted kids do: “tease the tease,” blow off the teasing comment using a specific set of phrases and non-verbals (about 3 times) and THEN walk away. How many of us have asked our kids what group or click they feel they belong to, only to find out our highly skilled computer geek of a child weighing in at 110#s thinks he is a jock – despite never having played a game of football in his life? The very first lesson in this group therapy program is how to identify the right group, and how to join it.
How to use appropriate conversational skills How to find common interests by trading information How to appropriately use humor How to enter and exit conversations between peers How to handle rejection, teasing, and bullying How to handle rumors and gossip How to be a good host during get-togethers How to make phone calls to friends How to choose appropriate friends How to be a good sport How to handle arguments and disagreements How to change a bad reputation
I have been accused of being an eternal optimist and always being too quick to find a silver lining to any set back. I fully embrace that label and because of that, always try to end my presentations on a positive note. I would like to share this quote as a reminder about why we fight so hard as professionals and as providers. We may not always agree on the means, but we all want the best possible outcome for our kiddos. I would also like to share with you this website created by and for adults diagnosed with autism for them to talk and support each other. Sometimes when I need to recharge my mental batteries because of frustration with progress or what have you, I read the conversations they have chosen to share-to remind my self just how far our kiddos can travel and how successfully down the road of life. I have also recently come across this blog posted by a parent, chronicling his own family’s journey. And touching on many of the issues that effect us all. I would like to open the floor to questions, invite you to share any success stories or challenges you are comfortable telling and direct you to the resources available in the back of the room, including contact numbers for Regional Center,
