My Child is Suddenly Crying in the Bath: Desensitizing Baths, Doctors Visits and Haircuts with Michelle C.

Transcript for Podcast Episode: 196
My Child is Suddenly Crying in the Bath: Desensitizing Baths, Doctors Visits and Haircuts with Michelle C.
Hosted by: Dr. Mary Barbera
Guest: ​​Michelle

Mary: You're listening to the Turn Autism Around Podcast episode number 196. Today we have Michelle C. back on the podcast and we are talking specifically as a follow up to last week's podcast, All About Desensitization. Michelle and I are talking about real life examples where her daughter was completely freaking out with bath time all of a sudden. And we talk about how the first dental visit, the first doctor's visits were very problematic and how Michelle uses the procedures she learned in the course to completely pair up or repair any situation for both of her daughters, one of whom was diagnosed with autism at the age of two and one who is now two, two and a half and typically developing. So she uses these procedures all the time and she's really she calls herself the desensitization queen at some point in this interview, and I think she's got that title nailed. So let's get to this really great episode with Michelle C.

Narrator: 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: Thanks so much for joining us. Michelle, it's great to have you back on the show.

Michelle: Thank you. I'm so happy to be here today, Mary.

Mary: Yeah. So this is your third time on the show you've previously been on episode 78 and 164, and we can link those in the show notes for today. So our listeners, that wasn't all the time, maybe know your story and that sort of thing, but I'm sure there's a lot of newer listeners out there. So can you very briefly just catch up? Anybody new here? How did you fall into the autism world and why are you on the show three times?

Elena’s Autism Story

Michelle: Yeah, of course. So I am in the autism world because I have a daughter whose name is Elena. She is in Mary's book in chapters eight and 13, I believe. And in 2020 she was diagnosed with autism just before her second birthday. She struggled very much with language. She had severe self-injurious behavior. I really wasn't sure what to do. Honestly, I worked really hard to set up services for her, but COVID hit and one by one, each of those services were shut down and I was devastated. My whole family was devastated. It just felt like such a dark time in our life. And I was scrolling through Facebook at midnight and I found an ad for various courses and thank goodness, because I started to turn autism around approach. And my daughter seriously went from two words mom and doggy that were not very functional. She didn't even really know what those words were. She just kind of echoed them. And she went from those two little words to over 500 words by the end of the course.

Mary: And you finish the course in like record time. Like them the access is 60 days. That's what we plan for. It's about 10 hours in length. But you finish the course in 33 days. And I remember it was during COVID and all of a sudden I hadn't even heard from you and the group and everything. And then all of a sudden in the Facebook group, in our community, you said my daughter went from, you know, basically zero words to 500 words in 33 days and oh, my God. And I was like, oh, my God. Like, I mean, I believe in my approach and I know the techniques work, but that just sounded too good to be true. So I actually asked you for a Zoom call, and that was podcast 78 where I just said, Can I record this just in case it turns into a decent podcast? And one of my absolute favorite podcasts of all time is 78. So now you actually work for me very part time, but you are a high school teacher by training and now you work for me and you help other members. So today we are going to talk about desensitization. And you mentioned that Elaina made it into Chapter eight, and I think she's a little bit in nine, but mostly in eight and 13 and chapter 13 of Turn Autism Around is called Desensitize Doctor, Dentist, and Haircut Visits. And the reason that Elaina made it into a big chunk of this chapter is because once you posted. I don't know if I had already interviewed you for a podcast someday, but right around my time, her language really exploded. Not only did she go from zero words to 500 words, but the words she got after the course were like two word phrases, contractions, pronouns, prepositions, things that you don't even teach. We don't even learn how to teach in the toddler course. We cover those sorts of things in the verbal behavior bundle. But you just got all this natural explosion of language. But what happened was then you posted in the group. I remember that you posted that all of a sudden she was screaming for bath time. So what was that about? Like, what were you seeing back then?

Desensitizing Bath Time and Other Self-Care Routines:

Michelle: Yeah, this was a child who loved Bath Time previously. You know, I had just posted all of this success in your group, and I really wanted to make that Facebook post to thank you and your team for the turn autism around approach. Because her language had just exploded in our lives overall, just the whole family. Everyone benefited from this and we were having such a great time. And then all of a sudden my kid was just exhibiting behaviors that she did before she was vocal. And just, like, screaming and, you know, not understanding why we have to take a bath and, you know, refusing to go in the tub. And I didn't know what that was about. She wouldn't even step foot in the tub. And so I had to sponge, bathe her for days. And then finally, like, I was like, well, maybe it's just a phase and she'll just get through this in a couple of days and I'll just sponge bathe her until then. And I was like, How long can I go without washing her hair? Because she just wouldn't tolerate it at all. She used to love the feeling of the water going back and looking up at the ceiling and because she had enough language to look at the ceiling so that I could drain the water behind her head. But yeah, I was like, Oh my gosh. So I posted in the Facebook group and I said, I don't know what to do. I can't get her in the tub. It's getting to the point where I have to put her hair up every day because it's just so dirty and oily. And, you know, she previously loved Bath Time. That was our nightly routine. It was something that she loved. It was a calming activity. And I just couldn't get her to go in.

Mary: Yeah. And, and I remember and and actually during that time, like after the toddler course, we do recommend and we actually made this transition easier and smoother and everything. But we do recommend that people move on to the verbal behavior bundle. And so you had moved on and this was one of your first Facebook comments or Facebook posts in our Verbal Behavior Bundle group. And I remember thinking, oh gosh, we helped her so much with language. And our course is just not about language. It's also about self-care and daily activities like eating, sleeping and bath time. And then it's also about reducing problem behavior. So, I dove in and based on my experience, I mean, this is very common. And because I'm both a registered nurse and a behavior analyst, I do tend and want to tackle these activities of daily living that are intertwined with problem behaviors like I know as a mom of two kids, one with autism. And without that, that can really derail everything. If you've got a child who won't take a bath or won't take medicine that they need or you don't know how to get the eye drops that they need and that sort of thing. And I do have experience with bath time being difficult. One of my clients, Cody, his mom, was on the podcast probably a year or two ago. We can link that in the show notes, but I remember having desensitized the bathtub and make it better. So I did. I remember I asked you, did Elaina have a medical procedure or something happened in the bathtub, but a medical procedure which you would think like did she have to be held down for stitches or for a blood draw or something? You'd be surprised how many times that it's something not in the bathroom that derails something like bath time. And there was a procedure or an MRI or something, right?

Michelle: There was. And I was so obsessed over conditions in the bathroom, I was like, oh, my gosh. Like, was the water too hot? Did I ever put her in, like, scalding water on accident? I always did the elbow check. Like, if that's if that's an acceptable temperature for my elbow, it's an acceptable temperature for my kid. Right. So it wasn't the water. I was just obsessing over what's in the bathroom. I'm like, what is it in here that she doesn't like? So did I buy any new toys that are scaring her? What is that? But then you mentioned medical procedures and she had had two actually two medical procedures, very recent. And one of them was an audiology test. So for speech therapy, they periodically require, or at least in my area, they require you to get a hearing test. So she had to get one of those. And then it was just terrifying to her. She didn't like being in a room separate from me. And they kind of like they told me what they were going to do and I didn't like it, but this procedure had to be done. So they held her head and they put the rotoscope in her ear. I believe that's what it's called. And so they put it in her ear and she just screamed. And because it was a stranger touching her, she didn't really understand why she had to do it. And I mean, she had language at this point, but her anxiety levels were just through the roof. So there was that. And then she also had to receive anesthesia for an MRI because when she was diagnosed with autism, we put ourselves on a waitlist for a couple of different medical procedures just to see what was going on with her, see, make sure we were ruling out other medical conditions at the time. So the MRI and the audiology test were done just before she started being terrified of the tub. And I remember you said that and I thought, what would that have anything to do with it? And it actually had everything to do with it.

Mary: Yeah. So, you know, if you think like they're touching her head, it's pretty similar to head washing. And it's amazing how a medical procedure could ruin haircuts. It can ruin picture taking, like just keeping the child still and positioning them. I mean, it's amazing how it can really have an effect on everything. So that was it. And Rachel was on the show fairly recently, a couple of months ago. We can link that in the show notes. And she has a typical son, Everett. And so all of these procedures work for typically developing kids, kids on the spectrum. These are just general procedures that work no matter what. But her toothbrushing got unpaired because somebody else put Everett to bed like her sister came over and put him to bed, didn't know the routine or maybe pushed tooth brushing too much or anyway, toothbrushing got unpaired. So the other thing about the bath is I would look at did you go out, you know, for the weekend and somebody else do the bathtime routine? Did your husband try to give you a break by doing the bath and then did it out of order or, you know, did something that she didn't like? And that was a common issue for Cody is that, you know, they wanted to alternate who was giving the bath. But if you're having a problem. Like a freak out. It's really best for one person to take charge, at least until it gets repaired, and then for both parents to go and to get together and say, okay, this is the way bath time goes. And this order and this we count when we wash hair. Like just all those little things that you may be doing. But in this case, it did seem to be triggered by the medical thing. But in actuality, okay, we figured that out, which doesn't have a big effect. It's like, now what do we do? And so I remember we gave you some advice, like we're not able to even if you join the course and join the group, we're not able to go like exactly do this, but we're able to say generally you have to repair the bathtub, which you got to have to go all the way back. And on page 210 of my book, we actually list the steps that, you know, Michelle actually did from our basic information. Like I said or somebody said, you might have to start with the child out of the bathtub, fully clothed, playing with toys inside the bathroom with water. And so you formulated your own plan based on Elena's situation and what she was going to tolerate. So why don't you just tell us quickly what you basically did?

Michelle: Yeah. So it was very similar to what you just said. It was a process. It took probably a couple of weeks, I would say, for her to be fully in the tub again, happily. But it was definitely worth the patience and it was worth the effort. And really, it's not. I don't want anyone to think that this is like an overwhelming process. It's very simple steps. You just have to think about what your child is willing to tolerate. And end on a good note, every single time, you know, without crying. And that's the goal. So for Elena, I honestly, I would just keep her in her clothes and I let her step in the tub and play with her toys in the tub. No water, nothing. She just played with her toys, and she sat in the tub and she rolled her little cars around and we would do that in there. And she loved that because she's very much a quality time, love language kid she loved. That's my table. Time worked so well for us. I feel like that's why her language exploded when it did. You know, on top of her natural ability is of course, you know, the turn autism around approach is just so wonderful for quality time. But anyway, she would just play in the tub with her toys and then the next day, you know, because she liked that. So the next day I put a little bit of water like an inch or two of water in there. And I let her stand outside of the tub and play with water toys in the tub. And this was a long time ago, so I might have missed something that I actually have in the book, but this is like the general gist of it. So she did that, and then the next day I had her wear just a diaper and she got in the tub with just a couple inches, like a little bit of water. And she got in and she played with her toys while standing in the tub in the water. And then, you know, the next day, this is when I started getting problem behaviors. It wasn't an absolutely perfect process, as was stated in the book. I didn't do this perfectly. And you don't have to do anything perfectly to get progress.

Mary: Like a dance. Whether you have a BCBA standing right there, it's still a dance. Whether you have, you know, a list of desensitization, you're going to have to push it enough to keep any problem behaviors at bay. If you get a little whining, you know, you push a little too far, but you don't want to take it back down right that second. So it is a real big dance and we do have the actual steps. And the steps are going to be different for Elena versus Johnny versus whatever some kids put in bathing suits and then they can play in the water. You know, you're eventually going to have to get back to hair washing and again doing that as quickly as possible by keeping the problem behaviors at bay. You might, you know, get new tub toys or crayons for the bathtub or, you know, a spicket with the elephant on it, a new hose. If you're used to, you know, pouring with a cup, you might want to have an elephant hose that attaches to your thing. You know, they might have for Cody, for instance, he really minded the water in his eyes and he wore glasses. And so we're thinking sensory wise, what he was feeling like he couldn't see without his glasses. And then he's in the bathtub and then he's having all the sensory input on top of it. So for him having a dry washcloth that he or the adult held over his. Eyes while they wash their hair. So, you know, there's so many different techniques. But I will say that it ended with her within a week or two actually requesting more baths and staying in the bathtub and got back on track. Plus, you learn the steps. But I mean, basically desensitization. It sounds like a big word and confusing, it's pairing or repairing anything. So whether it's the bathtub, whether it's Mr. Potato Head, that suddenly the child doesn't like anything: a person, a room, a toy, anything can be paired or re-paired with this desensitization process. So in Chapter 13 of Turn Autism Around, we have the steps Michelle used for the bathtub. We have the steps used for our haircut for Max, which is a story I tell at the beginning of the chapter, how he screamed during haircuts and how we had to break everything down. So. And you learned how to desensitize everything. Not only for Elena, but for her typically developing sister. I mean, one thing we didn't say or maybe we said it in the other podcasts is Elena has a sister.

Michelle: She's two and a half. She'll be three on December 16th.

Mary: Okay. And Elena is four and a half.

Michelle: Yep, she's four and a half. She'll be five in February.

Mary: So they're two years apart. And you were at home. You're a high school teacher and you were at home on maternity leave with the baby and with Elena, who was just diagnosed. And your husband is a police officer, so he was out working and you were basically home with zero intervention, zero Zoom calls, zero people coming in. You didn't take your girls out at all. I mean, you were basically in a very silo situation. And the only intervention was you taking my course, which you also have some pretty in addition to your pre and post language sample, which is part of my course, in which you had documented her two words in one hour and then her 180 words or phrases. So we actually know what those words and phrases were. You also had standardized speech assessments before and after the course. And I, in addition to my BCBA mentor, Dr. Rick Kabina, wrote up a white paper about Elena's amazing transformation during that period, and that is that MaryBarbera.com/whitepaper. We will link that in the show notes as well. But you had your hands full and you know, like right after we taught you how to repair the bathtub, you had the information to get anything repaired for both of your girls, is that right?

Michelle: Yeah, it is. And thank goodness for that, because even Elena's BCBA because eventually when COVID restrictions were lifted just a little bit toward the end of the summer of 2020, Elena was able to go to ABA therapy and clinic, and I was just so empowered by that point, by the way, I had already taken most of the I took all of toddler course and I had already taken most of the verbal behavior bundle by that point. So I was just so empowered and I would look at my BCBAs goals and I would say, and this is appropriate, this is not what this gap and level two in the VB-mapp. I want to talk about that because you skipped that and I'm meeting, you know, so I just felt so empowered. But where was I going with that before I had a tangent. So her backpack even said, I've never done more desensitization programs with any kid than with Elena. So I would tell them exactly how I wanted them to be done because she was such a sensitive kid. Now she's a lot more easygoing. It's much easier to talk to her about things and prepare her, like just verbally, just talk to her about things. But there had to be a lot of practice for things like the dentist and, you know, those kinds of things.

Mary: Let's talk about the doctor first. So what were doctor visits like when she was 18 months, two years, right, when she was diagnosed?

Desensitizing the Doctor, Dentist, and other Medical Procedures:

Michelle: So doctor's visits and that's actually one of the reasons why I was in so much denial for a little bit, because at her eight month appointment, she was toe-walking and, you know, there was no language, no nothing to speak of. And she stopped waving. She had stopped doing things that she used to do for attention. So I thought that was so strange. But she was on her phone the whole time during her 18 month appointment.

Mary: Not her phone.

Michelle: No, I'm sorry. My phone, not hers.

Mary: I hope she doesn't have her own, but no that's very common. So you gave her your phone to keep her busy while you chatted with the doctor about her delays? Yeah.

Michelle: Yeah, I did. And so the doctor didn't seem concerned about anything except speech because she should have had approximately six words at that point. And but if the main point that I was trying to make, that I was if I took my phone away, my phone, not hers, if I took my phone away, it felt like hers. Because she had it so much back then. But if I took that phone away, she would be all over the office, running all over the place. And that's exactly what happened at her 23 month appointment. It was supposed to be like a two year well visit, like a 24 month well visit. But we took her a month early because we were just so concerned about what was going on with her. And so we took her in and she was all over the doctor's office screeching. Stimming very heavily had zero functional language. You know, she was just like doing anything she knew how to do to comfort herself without a screen. She was very addicted to the screen. But we wanted the doctor to see these behaviors and tell us what they thought it was. And immediately she goes, I think it's autism. And I was just floored. My husband expected it. My husband thought that for a while, but I was just like, no you're making me think my child has autism. She didn't just say it, and I'm just in my mind. I'm like, No, she didn't just say that. I, you know, I, I was so shocked. It just floored me. But, yeah, her doctor's visits went very poorly before I learned about desensitization through the Turn Autism Around program. And we just left the pediatrician two days ago. That's why my voice is a little bit off today. We've all had a bit of bronchitis, so we brought our daughters and both of them for the same appointment. And my little Isla, poor thing. She didn't want to take her shoes off because she loves them. And she's just, like, yelling and screaming and, like, not handling it well. But my four and a half year old Elena, the girl who used to screech and cry and scratch herself until she was bleeding, threw herself on the ground, rip her shoes and clothes off. This girl couldn't wait to go to the doctor, tell her about how she was feeling. Tell her how her throat hurts. And she was very happy to get her blood pressure checked. So to have the stethoscope on her back and on her heart and to have her ears looked out and her eyes and her. It took some time, of course, to get her used to the doctor, because it's not somewhere we go every day. There are ways to desensitize. There are ways to talk about it. And as your child's language improves, hopefully, you know, with a turn autism around program, you know, the understanding makes such a huge difference that receptive understanding of this is what's going to happen.

Mary: And did you use tools like playing doctor? Did you use visual little books? Did you use video modeling? Like what kind of techniques did you use to pair up the doctors?

Michelle: I did. The kids have tons of doctor's kits and we would play doctor together and I would have Elena's cousins, who are a little bit older than she, as they're typically developing. I would have them play doctor with her. And Elena loves a show called Daniel Tiger. And there's several episodes in Daniel Tiger about going to the doctor and what's going to happen. And it helps to talk about it first. And so it took a little bit of time and the doctor's office, the dentist was a little bit smoother because I was able to bring her to this pediatric dentist that specializes in special needs children and special needs patients in general. So she was able to go in without an appointment and just kind of look around and sit in the chairs and look at the fun waiting room and see her name on the white board. They have the names of all the patients for the day. And so it made her feel so much better about going to the dentist. The doctor's office didn't offer that, but like we talked about at home, we played doctor, we talked about it. And fortunately, Elena's language was such that we could talk about it and she would get more comfortable with it the more we talked about it and the more I bought books, I bought seasons of Daniel Tiger and other kids shows that helped her with that.

Mary: So. Right. When did you go to the dentist for the first time?
Michelle: So the first time I took her to the dentist was a complete disaster. I will say it was I did not know a lot about desensitization then. I was in your community, but I just thought we could. I thought since her language developed so much, I thought we could wing it and it would be okay. It wasn't. She was two and a half..
Mary: Two and a half, so you went to the dentist and it didn't go well.

Michelle: No, it didn't. She screamed the whole time. It was exhausting. We were both sweating. Her hair was wet because she was crying and sweating and we had to hold her. The only reason they cleaned anything is because she was screaming and I'm laughing now. It wasn't funny then, but I mean, now it's just like, oh my gosh, like, what was I thinking? So it just did not go well. So it took some time to repair the dentist.

Mary: Repaired, which to a pediatric special needs dentist. At that point, did you try a regular dentist?

Michelle: So I tried my regular dentist down the street, the one that I go to, and he's just a very nice man. But, you know, he's very, you know, like prim and proper. And I don't think he gets a lot of child patients, or at least not special needs child patients. So it was just something that he just kind of didn't, wasn't prepared for.

Mary: Yeah, yeah, yeah. And even if you have a special needs dentist, you know, Lucas, we've had problems with haircuts early on and we made a visual book and we have reinforcement at the end? We had my typically developing son, Spencer go and model and do videos and like, you know, we had to work with that, the dentist. We do go to a special needs dentist and that's really good now because now he's an adult. So because she does pediatric and special needs, he could go there through adulthood, which is really great. I mean, Elena is such that I mean, she has full language and she's, you know, in school without support. So she's probably not going to need a special needs dentist her whole life. She can transition to a regular dress at some point. But it is a good idea to have a pediatric dentist, at least for your kids, especially if they're on the spectrum or having any kind of problem behaviors. But yeah, the techniques you learned about bath time and playing doctor, you can also play dentist. I do have a video blog where I modeled with Lucas laying in a recliner chair and got a little dental kit from the dollar store where I could practice a little bit. But in the end, you know, especially with a dentist, it's not you know, it's every six months or every year. And Lucas is a full grown man at this point. And even when he was a teenager and a child, you know, over £100 and he can tolerate going, opening his mouth, letting her count them. But in terms of like holding things in his mouth for x rays or in terms of getting a cavity filled like that would never fly, you know? I mean, I guess if somebody, you know, put a gun to my head and said, you have a week or a month to make this happen, I could probably with my behavior, analytic skills make it happen. But it's like for everybody's, you know, safety and and just it's just not worth it to me. Like, it's not worth it to him, like, I don't think it's worth it. I am very much a no cry, you know, don't hold kids down for anything unless it's an absolute emergency where their head is gushing and, you know. But get them out. Get them under. You know, you don't have time to repair everything when this goes south. So if you are listening and you have children or clients who are screaming during the day for anything, screaming because they don't want to be at the table, screaming about bath time, screaming about going to the doctor, screaming about not having TV time, whatever they're screaming about. I consider that a major problem with screaming and self-injurious behavior like Elena was experiencing. Like we cannot do that for our kids or our clients, that things get unpaired. I mean, that quickly, you know, the bath time became unpaired, required, you know, weeks of struggle, weeks of fixing. You know, right now, if they wanted to hold either of your girls down for a non-emergency procedure, what would you say?

Michelle: I would say no, thank you. Just please. And that's what I did when I actually because Elena stems in a way or she doesn't anymore, but she used to stim in a way that scared me a little bit. Her face would tense up and her body would kind of shake a little bit. And I just kind of wondered if seizure activity was an issue. So we did have her when she was I want to say like closer to three, but still two. We had her get an EEG done, which is a little bit intimidating, but I had enough knowledge with the Turn Autism Around program to you know to pair it up and make it really fun. I said that her and I were going to have a pajama party at the hospital for two days because it was a 48 hour video monitoring EEG.

Mary: How old was she at that?

Michelle: She was almost, almost three. She was closer to three, but still two. Okay. So she was still very young. And I told her I talked to the hospital on the phone. They're like, don't worry, we'll wrap her up in a sheet and we'll just hold her down and then we'll get all of them. I forgot what they were called the EEG. Yeah. Elena called them stickers. She thought it was so cool that she was getting stickers on her head and that she got to wear a cool backpack with her with all her cords. And she was kind of like that, but we had our own room. And it was a very pleasant experience because I did not let them wrap her in a sheet or restrain her in any way. I said, It'll be okay. Let's talk to her about it. Just tell me how I can... You know what's going to happen so I can talk to her about it and then we'll talk about how this goes. And she was so excited to spend two days with me at a pajama party at the hospital because I made it sound like it was going to be this fun camping type, like a glamping experience. And it was just so it ended up being such a great experience because she was excited to be there and fortunately there was no seizure activity recorded. I'm just the type of person that wants to rule out any other medical issues. So desensitizing to these pretty big medical procedures became very urgent for me because if I was going to go through all of these medical things, I had to make sure she was okay with it and that we didn't have to hold her down. Unfortunately, for the first couple of medical procedures, I didn't have the knowledge from your course, so I kind of just forced the issue and let the audiologist, like, hold her head in place. And it was just so awful for her. And then for the MRI, you know, they're holding her down in the bed and giving her the anesthesia to do the MRI, which she woke up from screaming because she was terrified, because the last thing she probably remembered was being held down in a hospital bed. So it was horrible, but the EEG went so well because of that. And she even got blood drawn and it went well because we talked about what was going to happen.

Mary: And I do want to talk about blood draws a little bit because that was an issue for Lucas and he still likes ear checks. We don't look in his ears and no doctor looks in his ears because when he was six, six people held him down to look in his ears. And I was just like, forget it. And. Like I said, I could pair that up. But at this point, he's an adult. Not many times do you look in adult ears. And we decided to talk to the pediatrician. I'm like, I don't think we should just look in his ears, ever. And blood draws are important, though. And so we did practice with that. Got a turnakit, and we practiced. Obviously, we didn't puncture the skin or anything, but we just. And the other thing, especially because Lucas doesn't have the language and understanding that Elena has, is we want to make sure we have a big reinforcer for sure at the end of things, like when Lucas is going to do something new, even if we're going to, you know, he goes to a haircut. He's used to that, but he kind of minds the spray. You know, it's too cold and stuff. So at one point we're like, let's try to wash his hair in the sink. That's a big change for him. So now, even though I don't have to offer a huge reinforcement for haircuts when I'm adding something new like hair wash in the sink or a blood draw, I am going to have what I call a promise reinforcer, a reinforcer at the end. And for Lucas, that's usually food going out to eat, a Pop-Tart, which I know there's people out there rolling their eyes because who would give a child the Pop-Tart? But he knows if he does something big and new, he gets a pop tart. For instance, he had to have a COVID test. I actually tested him a couple of times. And, you know, that's not good. Like how do you practice that and we set the reinforcement as a drive thru for McDonald's, which is not always open and you know, when he would get a COVID test. So if I asked him today and the COVID test was like more than a year ago, if I asked him today when the doctor did the nose test, what did you get afterwards? McDonald's fries. It's like he remembers what you like so he's like not understanding all the language about what's going to happen. So for kids with less language, you're going to have to use pictures. You're going to have to go on YouTube. I mean, you can go on YouTube and find anything, getting your hair washed in the sink at the hairdresser. You can get videos of that. This is how it's going to look. This is what you're going to do. You're going to lean back. We're going to count. We use counting a lot. We use singing songs a lot during Blood Draws or that sort of thing. And then we are reminding him of the promise reinforcer before it starts when it's ending. So those are just some of the techniques. I mean, it's really very similar. No matter if you have a typically developing child, a child with a lot of language or a child with minimal language or even no language, it doesn't matter. You still should not expect crying, should not expect to hold kids down because if you have to hold kids down, they get bigger and bigger and it becomes a very dangerous procedure that, you know, you can't do.

Michelle: Exactly. Elena is projected to be about five foot 11. Wow. almost 6 feet. Yeah. My husband is six foot three. I am five foot three. So I know how to give everyone a little glimpse into all of our size differences in our family. If I have a daughter, if I had held her down all of these years, I would not be able to continue to do so when Elena grows up as she's 17 years old, you know, if I would have just carried her kicking and screaming through the parking lot every single day of her life, she would never have learned to walk with me. I would never have. You know, and then I would have this issue when she is 16, 17, 18 years old or, you know, a person who is significantly larger than me running in the street. And I know a lot of you have sons and you know they're going to grow up and be big. Lucas is a grown man, and it's just so important that you take desensitization seriously.

Mary: Right. And it's never too early to start. And it's never too late to start. And just because they're a baby or an infant or toddler and you can carry them or you can hold them down, you should not. You should really work on pairing and repairing and trying to have a calm situation. And if that means, you know, visiting the doctor, I mean, initially looking in the ears and stuff, you know, it shouldn't be such a big issue. But I mean, I'm also a nurse and I know my husband, you know, is an emergency medicine physician. And in an emergency, you do have to hold him down. If if Elena is flopping at the Walmart parking lot and you can pick her up, pick her up, get out of there, get to safety. If Lucas is mean, Lucas doesn't pop. But if he all of a sudden had a problem, even though I would be reinforcing it with a pop Pop-Tart bribe to get him out, like I got to get him out. I got to get us both to safety, and then we have to be the Monday morning quarterback. So if you're like, this is too much, my child screams for everything. Okay, deep breaths. You're not going to be able to solve everything, especially if your child is very large. But no matter what the age of your child or clients or ability level, there are things you can do. You can read Chapter 13 of Turn Autism Around. You can listen to last week's podcast all about desensitization. You can watch some of the videos underneath here MaryBarbera.com/196 I'm going to post the dental visit. The visit we're going to post a screenshot of Michele's most recent trip to the dentist. There are things you can do and especially if your child's larger, you're probably going to need to work also with a behavior analyst, where medical people who embrace the slow easy desensitization processes. It really doesn't have a lot to do with age or ability. It really is the same proven processes, but it does take time and it does take analysis. If you push too far and you may have to back it up a little bit. So anything else? I think this was a great episode that highlights some of the really actionable things that, and you see it all the time too, Michelle. You're in our community. You see people struggling with this every day.

Michelle: Absolutely. And I feel since I've been in the Turn Autism Around community, I feel like a desensitization queen because Elena has had to go through every single possible desense program made by me mostly, and then a little bit with her ABA clinic. But she no longer goes to ABBA and I just take care of it all on my own because of the Turn Autism Around approach.

Mary: Cool. And I know she just started preschool there.

Michelle: For the year, she started a four year old preschool.

Mary: Four year old preschool. Typical preschool. No support?

Michelle: Yep. Typical preschool, no support. This is her second year of typical schooling. Last year she did three year old nursery school, which is another pre-K program, but four, three year olds. And so she did that and had no support there. She just did her first day of preschool. She loved it. She told me all about her day. And I just cried because two and a half years ago, I wasn't sure she would be able to go to school at all, even with support for her self-injurious behavior. When I first joined this program, I really wasn't sure that anything was going to be possible for her in the realm of the normal world. So, I am so grateful to this community and so happy that I can give back a little bit and work for Turn Autism Around as well.

Mary: Now, while we are extremely happy to have you and our team supporting other parents, it's really great to see not only improvements in language but improvements in self-care and problem behaviors. But you know, you, Michelle, sharing your story, being really vocal about the progress, being vocal about the diagnosis. You know, a lot of parents in your shoes would be like riding off into the sunset. And, you know, she's really functioning really at a more of a typical level than a child with autism at this point. And I appreciate you sharing your success and sharing the struggles that you had to get here, because it definitely does help others. So thank you so much and look forward to seeing you again soon. I don't think this will be your last time on the podcast and keep being that desensitization Queen. I love that.

Michelle: Thank you so much for having me here today.

Mary: If you're a parent or an autism professional and enjoy listening to this podcast, you have to come check out my online course and community where we take all of this material and we apply it. You'll learn life changing strategies to get your child or clients to reach their fullest potential. Join me for a free online workshop at MaryBarbera.com/Workshop, where you can learn how to avoid common mistakes. You can see videos of me working with kids with and without autism, and you can learn more about joining my online course and community at a very special discount. Once again, go to MaryBarbera.com/Workshop, for all the details. I hope to see you there.