Autism Sensory Differences and Picky Eating: Hot Seat #8 with Lauren E

Transcript for Podcast Episode: 234

Autism Sensory Differences and Picky Eating: Hot Seat #8 with Lauren E

Hosted by: Mary Barbera

Guest: Lauren E

Mary: You're listening to the Turn Autism Around podcast Episode number 234. I love it when those numbers roll out like that. Anyway, today we have a very special guest, Lauren Emmett, who we are going to do hot seat number eight with Lauren. She is the proud mom of two kids, Wilson, who was diagnosed with autism when he was three. He's now age nine with autism. And then she has a daughter named Charlie. Lauren started blogging and then eventually started an apparel business called Little Rebels with a Cause. The majority of what we talk about in this podcast is helping a nine year old school age child with moderate autism, kind of finding out what his scores are on the digital assessment at MaryBarbera.com/assessment. And then during this hot seat, I take this assessment scores make it into a plan. I talk about strengths and needs, what she can do to help and then make it a plan. We also take a deep dive into feeding issues. He's extremely picky and also we talk a fair amount about transitioning from high preferred to low preferred and having her son having problem behaviors. So it's a combination of a bunch of different topics that parents and professionals are dealing with, with kids who are older than six, who are still functioning in a lot of ways as a much younger child in terms of language, self-care and problem behaviors. Let's get to this hot seat with Lauren Emmett.

Intro: Welcome to the Turn Autism Around podcast. For both parents and professionals in the autism world who want to turn things around, be less stressed and lead happier lives. And now your host, Autism mom behavior analyst and bestselling author, Dr. Mary Barbera.
Mary: Okay, Lauren, thank you so much for joining us today.

Lauren: I am so happy to be here. Thanks for having me.

Mary: Now, we just met recently in person and we met online for a little time, but I don't know and I don't think the well, the audience doesn't know about you and your fall into the autism world. So why don't we start with that?

Lauren Emmett on the Turn Autism Around Podcast

Lauren: Great. Yeah. Hi, everyone. My name is Lauren. I have a son, Wilson, who's nine years old, and he is autistic. We kind of fell into the autism world. He is my firstborn, so when he was about two, we were noticing speech delays and some sensory processing issues. He kind of started speech therapy and occupational therapy, kind of going down that road to check things off the list before autism. So, yeah, we kind of had a long road to a diagnosis because we had just mixed ideas amongst our team. On if it was autism or not, And eventually he was diagnosed when he was three and a half. And at that time I really noticed that there just wasn't a lot of people talking about autism. I didn't know a lot about autism until he was diagnosed. And so around that time is when I started blogging about our journey just to connect with other families and raise awareness about autism and differences in hopes that he will be met with more patience and kindness as he kind of navigates through the world. So we eventually launched our brand Little Rebels with a cause to share kindness and inclusion messages on t shirts about advocacy and making friends and just embracing differences then led us to people like you. So yeah, it's been really fun journey.

Mary: Yeah. So before we talk more about your t shirt merchandise business and where he's at now and how we met and all that, let's talk about his. You said he had speech, delay and sensory differences, which were his first signs of autism. Can you tell us about the sensory differences or the other signs of autism that he was showing?

Early Signs of Autism

Lauren: Yeah. So the speech was the big one and then the sensory stuff he didn't want. He didn't like his hands being dirty or sticky. He didn't want to dive into, you know, finger paint and film projects at preschool. He was always pretty picky about food. He's never wanted to eat hot food or just anything that was new has kind of always been a big just a big thing for us as far as knowing he's got some kind of texture or version things going on, trying to think beyond the cause.

Mary: Or anything like that, walk on his toes.

Lauren: He does now. So he definitely is very sensitive to light. It's a really sunny day. He often walks around with his head down and unless we have his sunglasses and he has his headphones first for hearing stuff, but when he was younger, he would he would cover his ears. That loud sounds like ambulances going by and things like that. But our biggest thing was the speech, because he was definitely very delayed with that. He knew numbers and songs but couldn't say Mama. And so those were our big, big signs to kind of start us looking down that path.

Mary: Yeah, and identifying numbers in letters. It's called hyperlexia. It can be called hyperlexia and I've done a lot of work on that. I've done a couple recent podcasts on it. We can link that in the show notes, but it is confusing, especially as a first time mom and you know, all kids are different. You know, there's a lot of kids that cover their their ears for loud sounds and a lot of kids who don't like stickiness. And, you know, our are ranges of sensory differences. Some kids are very like sensory avoid in some kids are very sensory seeking and they'll crash into things and they want a lot of sensory input. And some kids are more sensory avoidant and that can change. You don't change it. Yeah, it can change as they as they are exposed to different things. So it definitely is confusing. And when you said he had speech delays, did he did he talk?

Lauren: So, you know, when we when I got to listen to you speak recently, I really connected with you because I was counting his words as those numbers one through ten. I'm like, okay, we got and we got a ha and we got another word. So he he's always scripting has been a big means of communication for him. And so beyond the numbers and the songs, the script, little tiny scripts that mostly just labeling was emerging when he was about four or five. But, but pretty much just labeling. So not, not a whole lot of talking. Yeah.

Mary: So let's talk about my talk a little bit. I went out to Minnesota recently and spoke at the more than Project Finding Coopers Voice Conference Retreat, and I did a keynote on the first day and about an hour presentation, and I talked about my early journey and my husband mentioning the possibility that Lukas might have autism when he was 21 months of age. And I asked the doctor how many words he should have, and he said 20 or 25. And I was counting literally E-I-E-I-O as real words. I was counting a little script. He used to do as eight more words. And I was really grasping at straws. And I think probably a lot of our listeners can relate, especially the parents out there. So he got a diagnosis at three and a half, which is not that late. It sounds late, right? But the average age of diagnosis is still four or five, and most kids are don't receive any treatment until kindergarten, which is really missing the critical window. But so when you saw me, that was the first time you saw any of my work. You had listened to the podcasts or read my books at that point. So what was just your general thought besides counting the words which you could relate to?

Turn Autism Around for Older Children

Lauren: Right? There was so much that I could relate to, but it was just really cool to learn about your book, because with Wilson being nine, a lot of those kind of early intervention things and resources and ideas feel a little bit behind us. I mean, we still work with an amazing team of OT speech, ABA, things like that, but it was just cool to hear that it was for school age children as well and things that even though we've gotten through a lot of the potty training, there is still things lingering like some food aversions and tantrums and things like that that you have in your new book that apply to kids that are older than the early intervention age.

Mary: Yeah, and I did make the title specifically. The subtitle really geared more towards young kids. So the book is called Turn Autism Around as same name as the podcast as my online courses. But the subtitle for Turn Autism Around is an Action Guide for Parents of Young Children with Early Signs of Autism, which, you know, when you are trying to write a book, you know, you don't need the chapter on the early signs or, you know, reading it won't hurt anything. But you're past that. But I do want to get the word out that, you know, in my book and my podcast and my courses, I help kids with a 1 to 5 year old level of language. There's a whole chapter on two chapters on language, a whole chapter on problem behavior, a whole chapter on sleeping, eating, potty training, going to the doctors, dentists haircuts without a fuss. So, you know, in the end, should I have subtitled it different to appeal to everybody? But I just want to get the word out that it isn't just for the little kids, it's for our older kids. My son's almost 27. By the time this airs, he'll be 27 or very close to it, and he's still functioning for some things at the level that we're talking about for your son, who's nine and going to be ten, you know, and it's never too I think that was one of my lessons. I gave ten lessons. And one of the lessons was it's never too early and it's never too late. To change, you know, and we have to prioritize. So when we decided that you'd come on the podcast and we are going to talk about your business a little bit too, but when we decided to have you on, I said, I think your best place to start is with our new, improved digital assessment. And then we'll take that assessment and we will turn it into a plan and count this as a hot seat. Hot seat number eight. Because unlike my other hot seats, most of those people have been in my online course. They understand a lot more of my procedures. But I think this is a good opportunity for a lot of our podcast listeners who've never taken a course or even read the book to really think about like, Oh, how can I help a five year old or a seven year old or a ten or 15 year old or 20 year old with Mary's approach because it really is the same procedures. Of course you have to adapt it based on age and size and all kinds of things, family values. Yeah. All right, So let's just dive right into the digital assessment. We can talk about your business later, that will make the most sense for our listeners. So the digital assessment, I had a software company build it in 2022. We just made major improvements with the digital assessment scoring, which then you get a PDF emailed to you, you always got a PDF emailed to you, which looks like the one page assessment which is on page 49 of Turn Autism Around. And then on the second page of the assessment this is new and improved is its digital scores and coloring and some some basic language around like is 75% good? Is it bad? Is it you know what does it mean? So we made some major improvements. So for Wilson, you filled out the digital assessment, which probably took you about 10 minutes or less. And can you tell our listeners that's at MaryBarbera.com/assessment and it is free. I said it was going to be free for the first thousand people. More than 20,000 parents and professionals have taken the digital assessment now. But what was your experience with taking the digital assessment, Lauren?

Lauren: Oh, it was really easy. I thought it was just laid out really well and all the answers were organized and easy to fill out. So. Yeah.

Mary: Yeah. So you, you emailed me your assessment and in my courses and even in my book, I teach people how to take this one page assessment, which does spill over into a second page, depending on how much information you fill in and how to take this and move it into a plan, because I think especially for a nine or ten year old child with autism, you know. You could work on everything, right? It feels like there's so much to work on, and at the same time they're in school and there or in a clinic or there somewhere for probably 6 to 8 hours a day. And then you have activities. You also have a typically developing younger girl. So like if you have a life, you have a business. And so like, at what point do you dive in and try to make changes to what and in what order?

Lauren: Right. It's figuring out the priority list is a tough one.

Wilson’s One Page Assessment

Mary: Right. Right. And we're going to post Wilson's actual assessment in the show notes. So this is going to be available at MaryBarbera.com/234. And we will also post the brief plan that we made based on the assessment. And Lauren hasn't seen the brief plan we've had, but I'm going to go over how we made it and then we'll talk. We're going to take a deeper dive into Wilson's food issues and maybe we're going to take a deeper dive into other things as we go through the assessment and make our plan. So the big thing with the assessment. Is we want to go from the left hand column first, then the middle column, then the right hand column to figure out strengths or needs. So the beginning of the digital assessment is just like the age when he was diagnosed. If he has a diagnosis, what kind of is he in? A clinic is in school. Does he get OT one day? We you know, whatever the situation is with services. So you're real when you do strengths and needs. It starts with safety concerns. And so I get down to safety concerns. And the question is, do you have safety awareness concerns? And Lauren answered yes. And check all that apply. And Lauren is concerned about traffic, strangers, wandering, and water. And so that safety goes right on the one page plan, which will also put his plan and we can put a blank plan up there as well. And we have resources. First need being traffic, strangers wandering and water are all safety concerns. And it's not uncommon. And I think I think when Lucas was ten was like the last time. He escaped. Eloped. The last time we called the police because of escaping eloping. Last time we really were on such high alert. And like, as Wilson ever, like, eloped. Got wandered. Got lost, called police, anything like that.

Lauren: Luckily, we haven't had to call the police for actually getting lost or anything. But the hypervigilance that I have felt as a mom has just not worn off. And I would venture to say he's probably like Lucas where we're on the verge of. There hasn't been a lot of eloping. He's doing pretty well with safety in the community as far as holding hands and parking lots and listening about, waiting to get in a body of water, things like that. But I just feel like it's still so hard to trust that that safety piece is truly ingrained in him, though. It's just kind of more the hyper vigilance as a mom, how to let go of that a little bit and trust that he really does have those safety skills at the forefront of his mind all the time.

Mary: Yeah. And have you ever done like swimming lessons for him?

Lauren: Yes. Those were brutal when he was little because he didn't like getting his head wet. That was the other sensory piece I was forgetting to mention to you. He really did not like getting his hair wet or face wet. So we were a swim school dropout pretty young and have tried to work on it with different therapists over the last few years. Just private lessons. And then just in the last two months, he's been fine diving and jumping in, Cannonball, floating on his back. So we've suddenly had this breakthrough with the wet hair. And for years he was fine with going swimming and if someone splashed him, he would just get out and dry off and tear with a towel and get back in. And that's the same kind of process he would do with bathing. He was fine to do it, but he just wanted it dried off right away before he could continue on with his play. So yeah.

Mary: Yeah. So I do have a former client who wandered away from his house and he drowned in the neighbor's pool. So I am, you know, that is always with me escaping the house, you know, like I said. But it is this hypervigilance that people don't understand unless you're in the situation. I know when Lucas was little or when he was very much like Dirty and eloping and, you know, I'd be at a picnic and I'd have, you know, both my kids. But Spencer would listen and stay put, you know, and I'd be like, Hey, I. Or under the bathroom, can you watch Lucas? And somebody would say, Yes. And I go to the bathroom and I come back and they they had lost Lucas, but they're watching or keeping an eye on him wasn't the same. You know what I mean? And so it's really hard.

Lauren: It is. It's so hard. And that's the kind of child care piece or just like you're mentioning, being able to go to the bathroom for a few minutes and trust that someone knows that, you know, you really do actually have to keep your eyes on him, like all the time. Like we had the upper lock up, three locks, double locks on the house and things like that. And I do feel like at ten he is slowly moving away from that. And there was never anything malicious about his eloping. It's just he would just leave without feeling the need to tell anyone. And and that's the part that you know we needed the video cameras and the double locks and things like that.

Mary: Yeah. So his scores he does also the next category is eating and he has a lot of problems with picky eating and food aversions, which we're going to talk about. He also mouths objects. Is that frequent? What does he mouth?

Lauren: Yeah. He seems to really enjoy chewing on plastic like hard things. Like Legos and toys and markers. Yeah, pencils, erasers, things like that. We've we've tried to find different. We call them Chewys is like sensory chew toys over the years, he seeks to destroy them. So we haven't really found one that holds up well enough.

Mary: Yeah. So I did a podcast, a two part podcast with Zulekah, and we can link that in the show notes. But her son was was four and he was doing having a lot of mouthing and he would even ingest things sometimes, which is called pica done a lot of work on on mouthing, chewing and pica. We can link those in the show notes. But one of the things I told Zulekah is to make sure to get a medical evaluation for kids that are really chewing. Zinc is sometimes low magnesium and also iron and lead could be an issue. And she specifically went to the pediatrician days later to both her kids and then posted on TikTok, which I don't we didn't do a follow up, but both her kids, her her son with autism was four and her speech delayed. Toddler both had high lead levels. And so I am I'm a registered nurse and a behavior analyst. And I really think that a lot of the mouthing is medical. So I would urge you to look into that. We actually, after Zulekah's podcast, we actually added that mouthing question on to our digital assessment. And I don't think that, of course, we have to keep the kids safe. So I'm not saying like, get rid of all the Chewy's if, if you have a chewy and it's working, but you still need to medically evaluate because it's not normal, it's not sanitary. There's just nothing really good about it. You know, sometimes you can transfer kids to chewing gum or giving them input another way. But I would really look into at least and I'm not here to give medical advice, but at least the zinc, copper, magnesium, iron and lead, among other things. But I would definitely check that if you have a chewer, chewing on clothing, chewing on toys, chewing on markers. Lucas used to be a big chewer and he doesn't chew anymore. Okay, So, um, so on our plan here, his needs include picky eating, safety concerns, picky eating, mouthing of objects. On the strength side, though, are some other self-care skills such as he sleeps well, which is huge. And how about self-care? Um, like toileting. So he is toilet trained so that can go on the strength column. And how about dressing and grooming?

Lauren: He's doing really great with dressing and we're we help a little bit with the brushing of the teeth but he's really doing he's doing well practicing brushing his face with the washcloth and starting to practice using deodorant. And we kind of intentionally make time to practice a lot of the self-care stuff.

Mary: Awesome. And for toilet training, is he capable of doing the whole routine himself like including wiping and Yeah.

Lauren: Yeah. He's a super clean, clean guy. He likes his room clean and his clothes clean and yeah.

Mary: Great. So for the scores here, Wilson scored a 75% for self-care and daily activities. Living. That's a pretty good percentage. We like to see 85% or higher. So, you know, if you could tackle the picky eating and any last remnants of that, you'd be in pretty good shape. But that is definitely a strong area besides the picky eating. Okay, so moving on with the assessment. So we did self care and now we work on we assess language and learning skills and he is talking. He does put some two word phrase together. He's not conversational. He's not answering questions without photo prompts. You do have social concerns and he can imitate and he can match. So what kind of language does it use? Is he is he requesting things? Is he spontaneous? Is it clearly articulated language?

Lauren: Yeah, he is. He can speak pretty clearly. I still feel like he uses a lot of scripts, but he can definitely communicate some basic needs and wants. I want a towel or I want a sandwich, things like that. There's not a lot of future or past, you know, You couldn't really be like, What did you do at school today or anything like that? But yeah, his sentences are getting a bit longer than three words and and I would say he can get his needs across. He can't say something like, my stomach hurts, or he might say his arm hurts or something, I guess. But I guess it's that whole like if there's something that doesn't feel good inside, that's still hard for him to articulate. But yeah, so much more language has emerged than what we used to have.

Mary: But nice. Okay. And I would say for pain, for describing pain, kids can usually describe external pain, like if they do get a brush burn or you visibly see them bang their elbow or, you know, I've done a video blog we can link, but you know, putting a Band-Aid on your daughter or on a big sized picture of a person, oh, they have a booboo on their arm or they're a boo boo on, you know, where I hurt my arm. You know, like as you're getting older, if they have the language and can echo, you know, my arm hurts versus boo boo on my arm. You know, either way, it is harder for kids to describe internal pain. But there are definitely ways to get there for sure. And one of the things is has to know body parts, which I'm assuming he can label his body parts.

Lauren: Yeah. Yeah.

Mary: So if you have a child, that can't label a body parts. That's why I suggest even for older kids, if they're not fully conversational, using things like Potato Head to make sure they can mand intact body parts. And that sometimes really helps with pain and talking about pain. So it's good that he has clear articulation. There are a lot of ways to get kids that are talking but not conversational to get more conversational. I'm sure that's a goal of yours.

Lauren: Yeah.

Mary: Yeah. So he scored on his assessment a 76% on language and learning skills, which is again, pretty good score. But you know, a typically developing three or four year old would have near 100% in all three categories. So the fact that he's, you know, nine still we want to take that 75%. These are just his strengths and needs. It's not to rate him or not to compare him to anyone else. It's definitely some definite skills that we can use to get more skills. Right. So one of the things that I would suggest is to do what we call an intraverbal subtest, which was created by Dr. Mark Sundberg. It is a supplement to the VB-Mapp assessment. And I think where your son goes to his clinic school situation, it doesn't sound like you're familiar with like the VB-Mapp assessment, but a map was created by Dr. Mark Sundberg, and it was published in 2008. I started helping field test the VB-Mapp in 2006. A lot of insurance coverage relies on the baby map assessment for assessing. My courses really help people, parents and professionals learn what to do to program, to create teaching opportunities for kids based on where they are at. And while I created my one page assessment, which turned into the digital assessment even way before the VB-Mapp was ever created, it's very much in line with the Vhb map. So those of you that are out there that are skilled at the VB-Mapp have made me map so their children. I was still urge you to complete a digital assessment and make a plan because, you know, you probably have reams of assessment over the years. Lauren Right. Yeah. But in order to go like, what should I do in the summer of 2023 to help my nine year old or to help my 12? You're old with autism. You know, you're not going to get that from reams of assessments over the years. You're going to get that from easy to do assessment and then figure out his strengths and needs and make your priority. So we have a school age course and we have a toddler course. And that's pretty new because we used to have a toddler course and then we didn't have a really good, easy to follow 60 day plan for a school age course. But now school age kids. But now we do. So that would be your best path forward where you would learn how to do additional assessments, including the intraverbal subtests. But what the insurable subtest does. Is it's grouped into eight different subgroups. We did a hot seat with Katty. We can link in the show notes and it was a lot was about this inter verbal subtests. So you can learn more about it. But it starts out with just fill in the blanks to songs like or fill ins like Ready Set.....Go. That's an insurable fill inl, and that's in group one. And then in Group eight, which is the hardest is why do we use a bandaid? And then throughout is where do you find a refrigerator or what's in the bathroom or what flies in the sky? Or what's your last name? These are all within various groups in terms of difficulty, because the intraverbals aren't just inter verbals. They get harder. So if I say, What do you eat? That's relatively easy. But if I say, What do you eat for breakfast? Now you've got to filter down different categories. And then if I say, What do you eat for breakfast, that's warm. Now we've got more categories. Now what does he what does your brother eat for breakfast or your sister for breakfast that you don't like? Now that integration into all these other filters and if you think about like us learning a foreign language, well, then it makes sense. It's like, well, I'm not going to be able to answer. What do you eat for breakfast that your sister doesn't like in a foreign language until I can answer the easier questions first. So anyway, a big part of the puzzle to helping kids go from not conversational to hopefully more conversational is to really learn about the intraverbals.

Lauren: Okay.

Mary: So that's a little, little, little side trip there. But I think it's important. So I would focus on that. We also, within our courses, we have people do a baseline language sample. We have we request people to get videos of their child or clients playing alone and then interacting. If your child is like a huge script or any scripts from the same things that he watches over and over again and has a lot of free access to, there are techniques where you don't have to stop everything but to get him watching different things that would not be so scripty and then using his scripts like now, even if Lucas bangs his elbow, he might script 'Are you okay' from an old arthur movie? But so instead of saying. Okay. He's a good start language learner, which we also did a podcast on. You know, we're just going to use that as a clue. Oh, okay. He heard himself, Luka, say, you know, Booboo on my arm or I hurt my arm. So transfer it from, you know, what the script means and then just try to get his language more and more functional. Yeah, I think it's all about the whole intraverbal. Okay, So what questions do you have before we move on to problem behavior and then we dive more into picky eating?

Lauren: I don't think I have any so far. Yeah. This is all sounding, it makes sense. And some of it we've done a little bit of before and it's just kind of a good reminder to keep doing that. You know, keep pulling that language out in different ways even if he is scripting so.

Mary: Yeah. Yeah. And to use his scripts you know it's we all script, we all stim, we all have, you know, whistling the same song or singing songs is scripting. You know, it's fine. It's not like it's this bad, abnormal thing that we need to stamp out. But if it's happening all day long, his brain is not available for new learning. And maybe it's you know, I also heard somebody speak once and I don't even know who to credit this to, but it was like, pick one thing you're going to work on from each main area. Like if you're going to work on adding flossing to your dental thing or adding deodorant, you know, that's what you're working on for dressing, you know what I mean? Then you've got to do the intraverbal subtasks and that's what you're going to work on for language at least to assess that, you know what I mean? And don't take off take on too much.

Lauren: All right. You can do it all, but not all at once. Yeah. Yeah.

Mary: Like making your plan and prioritizing, I think.

Lauren: Yeah.

Mary: Okay. Yeah. Let's move on to behavior, which is the lowest score for Wilson. He scored 39% in problem behaviors. And instead of me reading all of this, you know, he whines, he refuses, he makes noise when it happens. Can you just describe, like, what the main concerns are with problem behaviors and how. Frequent they happened kind of when you would get, you know, the worst behaviors.
Lauren: Yeah, I would say it's a lot of times it's often about denied access or things around his schedule, which is either leaving a preferred activity or waiting for a preferred activity is a really tough one. So there will be screaming. And it does seem like when he gets anxious about things on the schedule or waiting, that seems to be when he doesn't use as much of his verbal communication that I have seen him use before. But I think it just makes it harder for him to access so he'll resort to screaming or putting himself on the ground. Luckily, we have haven't had as much self-injurious behavior as we've had in the past, but that can sometimes be something that occurs once every month or so. But the screaming and the daily thing here and there, it just varies on how long and. And yeah, so it kind of varies.

Mary: So when he's self-injurious. Is he banging his head? Biting himself? What?

Lauren: That's. Yeah. We've seen biting in the past. He'll usually hit his head or hit his arm. In the past, he has run towards like, a wall or a window to hit his head. But luckily, he's not doing that stuff as much anymore.

Mary: That's good. Okay, So do you have at his school situation, Do you have a BCBA there or..... So and that's the other thing is like, you know, we're not here. I'm not here to program for Wilson. I'm not here to give you any advice because it's complicated, right? It's complicated for a three year old, but it's a number, especially a complicated for a nine year old. And everything in our podcast and in our courses are for informational purposes only. So I would say a couple of things. We all have trouble waiting and transitioning from super high preferred to low preferred. And so one of the things that you want to do with transitioning and I have like a five step guide to transitioning and basically one of the biggest things we want to do is we all want to take a kid from a ten on his reinforcer scale to a two. So I equate it to like me being on the beach with a good book and a nice drink and it's a sunny day. And then abruptly, you know, somebody comes up and says, It's time to unload heavy boxes in my car.

Lauren: Yeah.

Mary: What? You know, So and then I have full language, I have full comprehension, I have full everything. And I'm like, What are you talking about? Like, No, I'm going to refuse. And then if you start, like manhandling me to prompts me to do it, I'm going to get aggressive or, like, literally refuse, throw myself to the ground, you know, like. So I think what we need to do is a couple of things dangle the carrot before problem behavior. So like I use the example of like getting Lucas out from the ocean used to be a problem. I loved the ocean. He loved to be out for hours on end. So stressful because somebody had to be out with him. He didn't understand the current or, you know. So I'm not going to say, come out of the ocean abruptly. I'm going to say the next thing on the schedule, which has got to be a nine or ten. So now it's it's time for pizza, right? So I don't say get out of the ocean and I get problem behaviors. Now I'm offering pizza. So you have to plan, use a promised reinforcer or a visual of promise reinforcer to get kids moving. We don't like to use the word work for my programs. We like to pair up the learning table. If kids are having trouble transitioning into from recess or they don't want to go out to recess, then basically what it's telling me is the reinforcement isn't high enough for where you want them to go. So if he has trouble transitioning from the iPad to take a bath, we've got to make maybe transition from the iPad to a snack and then we get new tub toys. So that is highly reinforcing to play with the new tub toys in the bathtub. So we're constantly trying to get every situation to be an eight or nine or a ten on the reinforcement scale. So it's not the struggle of constantly taking kids from high to low would be my best transition advice in terms of waiting. We all like if we're waiting in line, we're scrolling through Facebook, tiktok, we're, you know, thinking about planning, talking on the phone. We're not sitting there waiting. And so I don't really love like, wait programs or accepting no programs I like. Transitioning, going from an eight to a nine to a back to an eight, maybe to a seven, then back to a ten, then eight, nine and waiting, you know, could he watch his favorite scripty thing while he waits for the thing, keep him busy while he's waiting on something preferred and then also use like we have the shush and give procedure or the count and mand procedure where if he starts screaming, we can't be then delivering, running around, negotiating. We've got to we can't talk about it until you're calm. Okay. Now, sit up. We need to get you up off the ground. Now we are quiet. Let's count to ten. We're calm. We're counting to ten. And now we can deliver. Or we can negotiate or we can explain. So if he's screaming, you shouldn't be moving. Trying to make things better. That's just my off the cuff, never meeting him, knowing nothing about his plan, but just to think about and to have, you know, the professionals that are working with him also listen, because my courses are not just for the parents, because there's a lot to decipher. We do give credits to behavior analyst and early intervention provider. We give contact hours. So I really do think that it's a whole system. So, yeah, you can improve your feeding or do they intraverbal subtasks or you try the transition programs. Everything should help to some degree, but I do have a whole system of that. Any questions about weighting or.

Lauren: No, I think a lot of the tools you're describing are ones that we try and especially your point about not trying to negotiate with him when he's in a heightened state. That's so true? Just recently, we're having more issues around waiting like several days for something like a vacation or a toy delivery in the mail, things like that. So we've reverted back to more visual schedules and are trying to work on the calendar and the days of the week checking things off as we get closer to the day that he's excited about. And that seems to be helping. But if you have anything else to add to that, that would be great.

Mary: And I think he's on some medication, right?

Lauren: Yes. Yeah, he's on Lexapro and guanthasine.

Mary: Yeah. And I'm not an expert on any of these meds, but I tend to think kids that obsess some separate on things coming, you know, that sort of thing. It could be a medication. Medication might be part of the answer and not just a behavioral thing, like just settle his nervous system down. I did a really good podcast with Lucas's psychiatrist, and he's on a med, a cardiac med for autonomic nervous system dysfunction because he used to have problem behaviors related to being startled or in pain. So he was already at a heightened state and then something would happen like a fire alarm or somebody kicking a metal trashcan near him and he would escalate to a problem behavior. So they also use this cardiac med just to settle kids down. And I'm not saying everybody go out and ask your doctor about a cardiac med to settle them down, each child is so different. But if into the episode with Dr. Michael Murray, we talk about medications and just like how to assess if medications can be a part of it. I think the idea of using a calendar and that sort of thing is good, but you don't want to constantly, 50 times a day be explaining and and explaining while he's getting agitated. And that can tend to happen. So now the calendar becomes part of the script, part of the 50 times a day that is not settling him down. It's actually ramping him up. So I don't have like a lot of good advice. Just make sure it's not a medical thing that you can just settle his nervous system down or even a supplement. You know, part of it could be part of. I mean, stranger things have happened. Like kids that have sleep problems and chewing problems and perspiration problems. It might be a med or a supplement that could settle their nervous systems down. I don't know. The other thing in terms of a calendar and I did present this at the conference, I have a video blog on this is keeping your own physical calendar of the interventions you're trying the any changes to dosing any problem behaviors. You can write in there to help you keep track of it, because when you get a kid like Wilson, who's having screaming every day and maybe flopping to the ground every couple of days and self-injurious behavior once a month, it can get very confusing. And then you go to try to change things and then it can be like a whack a mole where you don't know what's helping and what's hurting.

Lauren: Yeah, that was a really good way to lay it out, just to see it visually and look for trends and do it that way because I feel like I've done it more in list form before about changes where making or behaviors and dates. But when you had it out on the whole calendar, I feel like it's a much easier way to like find out what kind of trends are happening.

Mary: Right. So I recommend that physical, big physical monthly calendar that's just for Lucas, just for his allergy shots, for his medication changes and for self-injurious behavior or even for agitation. There's hopefully you could get rid of this all the self-injurious behavior. You get rid of the flopping which could cause injury, and now you have just screaming, which is disruptive. But as you tone things down, you're going to want to just keep track of that. Otherwise, yeah, it'll be harder. All right. Let's talk about feeding quickly. So when Lauren and I were planning the podcast, we talked about how picky eating is a big problem for him. And I asked her to complete the easy, medium, difficult food list. And this will be in the download the podcast to 34 Highly preferred things are like things like chips, popsicles, certain brand, gluten free bread, strawberry jam, veggie straws, cheddar cheese, almond butter, sun butter, fruit and green beans, applesauce and lollipop. So he sounds like he's very brand specific, very rote. And then some medium foods is he'll eat them sometimes a specific coconut yogurt, white go-gurt, peanut butter, corn chips, other jams. Is he physically is he normal weight, normal height? Is he small? Is he big?

Lauren: He's probably normal. He's in that normal range, too. Maybe a little bit bigger.

Mary: And this is all he eats morning, noon and night. Yep, yep, yep. Yeah. So you can see there's really very specific, like Lauren was saying, like they can't really go out to eat because there's nothing that he would try. And then the difficult foods are pretty much all the foods, all the veggies besides these canned green beans. So but he does like fruit and that's easy. And he, well, he drinks smoothies either.

Lauren: We're working on it a little bit right now and that he's working on it at his therapy center, too, which has been good for him to, like, try things with peers around, like they'll make it together and then try it. And we've noticed that's helpful for him tasting a little bit of something. But he won't drink a smoothie. He'll drink juice like apple juice or orange juice.

Mary: And what does he drink throughout the day? Apple juice. Orange juice.

Lauren: He usually drinks water.

Mary: Water. Good. And would he prefer water over juice?

Lauren: Um, he would probably prefer apple juice over water, but he's always been really good about drinking a lot of water.

Mary: Okay, that's good. How about milk or anything else?

Lauren: No milk, No almond milk.

Mary: Okay, so what about does he just eat at a kitchen table or therapy table? Or does he ever eat or drink juice with calories while he's roaming around?

Lauren: He eats meals at a table, but he will have snacks maybe on a couch while he's on his iPad or in the car.

Mary: Okay. So one of the biggest things I would say and this is in chapter ten of my Turn Autism Around book, there's a whole chapter on feeding is I would stop having him have any food or drinks with calories outside of the table, outside edible prepared meals and snacks, or like a therapy table where you're working on intraverbals or, you know, working on natural environment, teaching and stuff like that if you need edible reinforcement. But one of the things is that, you know, if. You want him to be hungry during meals? Not. He just had a bowl of eating? No. Snacks or a bowl of fruit. You know, even if it's good for you eating things, grazing throughout the day, you're just not going to get the hunger like you will or, you know, if you wait for your meal. So that's a big thing. Don't let them graze anything with calories. And they might be like, All right, Mary, But if I'm driving 2 hours, like, there's no way I can deal with that. You know, it's not like all or nothing. Just make a plan. Okay. After this weekend, we're going to, you know, tell the therapy center like we want to have plan snacks planned. And then not, okay, I'm going to feed him and then just feed him easy stuff and maybe sprinkle in some medium stuff. Forget about the difficult stuff for a while. Just get him eating the easy and medium stuff. Yeah. And maybe make him a little smoothie.

Lauren: Yeah.

Mary: Well, he drank out of a, like, a straw and an open cup.

Lauren: Yeah. Yeah. Yeah. I think it would be a great thing to have. And he does take a lot of supplements and applesauce or yogurt, which is nice. So he I think that's why the food has always kind of gotten bumped down on the priority list. He eats fairly, fairly healthy things and from a couple of different food groups. But there's just no variety. That's where we get a little stuck.

Mary: Yeah. So and then maybe the canned green beans. Then you get a different kind of canned green beans, and then maybe you're like, Oh, we're out again, green beans. We're going to make, you know, frozen green beans and, you know, yeah, maybe eat fresh ones and, you know, try, try a couple of them. I mean, you don't want to get into battles with kids about food, but and definitely, you know, kids that are crying should not be eating. So I'm very like we need to to to stop the you know, we need to stop thinking about, like playing with food. Keith Williams, who was on one of my podcasts and read my chapter. He's an international feeding expert and he is like the therapies for feeding that are like touching food, playing with food. He's like. Foods need. Kids need to taste something 15 times before they decide they don't like it. And so foods aren't going into their mouth even for a bite. It's not a fair test. You know, first time that kid's hungry and then I think it's a great, great idea. Therapy center where they're making the food and having other other kids do things. But my son Spencer, who's in medical school now, he was always a picky eater, too. But then he went to Boy Scout camp where they didn't eat, like, all day. They were allowed an apple or something. And then. And then they served them like pot roast, which I'm like, You ate it. He's like it. It was it's amazing how how much you can eat when you're really hungry. It's like, yeah, it's I mean, it doesn't have to be all or nothing. Just think about some of those tips when you're talking about. Yeah. And get him healthier with this food. All right. So let's talk really briefly. You started your business, which is little rebels with cause it's littlerebelscause.com. You sell t shirts and other apparel with great phrases. You have a shirt on? Yeah, some of the phrases and why you started your little business. Well, it's a big business.

Little Rebels with a Cause

Lauren: Yeah, Yeah, No, we started a couple of years ago, and it really kind of started with me wanting to help conversations happen around embracing differences, and I didn't want Wilson to walk around with autism stamped on his forehead or his shirt, really. But I did want conversations to start in environments like the park or an airport or a restaurant. If there are behaviors happening that people think are odd or staring and things like that. So we started with one that said we should be friends, hashtag inclusion. And that kind of just started to snowball into one is that say advocate or I will raise my kids to love your kids and just a lot of different messages about raising kind humans and teaching kids to use their voice to stand up for others and that their voice matters. And really topics like inclusion and advocacy and kindness that can be started with kids that are really, really young. We just really wanted to promote that. So yeah, yeah.

Mary: I got a couple. I got a t shirt and a sweatshirt at the conference. At Kate's conference. Mine says more kindness changes everything.

Lauren: More kindness.

Mary: And then I have a sweatshirt that said, Be the change. And I already got a couple compliments on it. And I think you know, positivity and just and then also when you like when you were at the conference and when you do campaigns, you donate a portion to a nonprofit which you know, Finding Cooper's Voice has and Kate and Amanda have the more than project. So 10% of the proceeds went to them and which is great. So I think it's a great business and it's a great idea to, you know, spread positive messages throughout with us wearing shirts and on you also kid sizes of different shirts.

Lauren: Right? Yeah. We've got kids, adults, teachers and therapists have really loved it all. So they're loving starting those conversations in schools and classrooms. And and yeah, we love donating to different nonprofits. We changed the nonprofit we donate to about every quarter so that we can support different ones that work in disability services or advocacy. So it's been fun to learn more about a bunch of those different organizations.

Mary: Right? Yeah. And we you and I met about possible merchandise that we might collaborate with on in the future. So stay tuned for that. But so I think that was hopefully that was helpful to you, Lauren.

Lauren: Yeah, this was great.

Mary: So the planning form would have the strengths and the needs and then a plan based on that. So, you know, I think working on feeding is good. Doing the insurable assessment is good, and considering taking the school age course or which is included in the school age course, we have a mini course called Turn Tantrums Around and that is less than 2 hours and it could give you a jumpstart with all these little things that, you know, maybe inadvertently shaping them up. Nobody you're not doing anything wrong, the therapists aren't doing anything wrong. But we all get into just you want to turn off the screaming, you want to get the kid off the ground and you probably inadvertently reinforcing it because it wouldn't wouldn't be continuing if people weren't reinforcing it. So. Probably good to dive in. Doesn't have to be drastic. It doesn't have to be overnight. I think this is a good first step. Do you have any final questions for me before I ask you my final question?

Lauren: I don't think so. I'm just excited. I like we've talked about before. We're always learning and circling back around. And sometimes as parents, like we talked about with the hyper vigilance, we get exhausted and in routines, like you said, and sometimes things are right in front of us and you just need that extra resource or, you know, someone to tell us, like, try this, try that. And so I'm excited to try this new resource for him.

Mary: Yeah. And I think you know it. And our kids are changing, you know, from the time six until he was nine, you know, now he's doing cannonballs in the water and now, you know, kids will change and they'll progress and they'll their sensory differences will change, their likes and their language. You know, a lot of times improve. So we just have to continue to prioritize. You sound like you're a great mom and and will, you know, just keep chiseling away. And it's just to make his life better, to be as safe as possible, as independent as possible, and as happy as possible. Those are my three goals for all of our kids out there, whether they have autism or not. So part of my podcast goals are not to just help the kids, but also to help the parents and professionals be less stressed and lead happier lives. So. Do you have any self-care tips or stress management tools that you use that others might benefit from?

Lauren: Oh, wow.

Mary: You seem like you're very calm. So, like, what calms you?

Lauren: What calms me is, I mean, sometimes just the self-talk that this isn't forever. I do think self-care is really important. And I know that that term as an autism mom or any mom out there can be frustrating because we don't all have time to go get pedicures and massages and we go on walks on the beach and stuff like that. So I do think just prioritizing time for yourself in some way or another, that might be 5 minutes on a little walk or reading a book or just getting time out with girlfriends. Time away from being in full time mom mode is always good for everyone. And so getting those breaks in and remembering that these phases and things you're going through aren't forever and that things will change like you just touched on. Like everything changes and just hang in there and stay positive.

Mary: Keep moving forward.

Lauren: Right.

Mary: I think that's a great message to leave everybody with. Well, thank you so much, Lauren, for your time. Everything's going to be in the show notes can be packed in there for hot seat number so you can get all of those resources at MaryBarbera.com/234 including Wilson's a digital assessment and his plan and his food list and Lauren's got a lot of homework to do now.

Lauren: I know I'm ready. All right thanks.

Mary: Ready and moves forward So. All right. Have a good one. Thanks again for joining us.

Lauren: You, too. Thank you.

Mary: If you're a parent or professional and have listened to this whole podcast episode, perhaps many of the podcast episodes, I am here to tell you that your next best step is to most likely join our online course and community. We have a course now for toddlers and preschoolers. We also have a course to help older school aged children who are still struggling with talking tantrums, picky eating, sleeping, potty training and so much more. The courses have very similar modules, very similar themes, but different case studies, different examples, different success stories. It is 60 days access in eight weeks. You can literally turn things around for your family or at your school in homes, helping families. Either way, it's an amazing community filled with parents and professionals from over 100 countries. I hope you check out all the details at MaryBarbera.com/courses, and I hope to see your introduction in our community today.