Have Mental Health Questions? Ask a Psychiatrist Online
Welcome, I'm a professional counselor and behavioral-consultant. I'd like to chat with you for a few moments to better understand your question and the situation you're describing.
You seem to be offline. Please. When you do return. Please leave a good time for us to chat over the next hour or 2. Thank you.
hi - i'm back online right now. just stepped away.
I should be at my desk till about 5pm NY time
Are you available now?
yes, now's fine.
All right. Thank you. Sound's like a fairly complex situation you're describing here. What would you is your most important goal in this situation? For example,....
We want to make sure our two boys get along together because it can be a big problem for us if it doesn't happen.
His son is autistic and i'm not sure we took the right approach of introducing my 3yr old to him, also, my son doesn't seem to understand that he's "different".
Ok. And your son is "neurotypical" right? He dosen't have any learning problems or developmental delays?
no. he doesn't.
What do you mean when you say: his behavior is only when he's with me or his dad and grandparents.?
What behavior are you referring to?
Is that your son's behavior?
my son tends to get "his way" quite often. I'm divorced and he's with his grandparents most of the day and they give in to him..so you can say he's a bit spoiled and the only child so he was never good w/ sharing etc.
My son gets frustrated and angry when he's tired and he hit the 6 yr old autistic boy. I didn't even think much of it other than talking to my son and telling him not to hit, but my boyfriends son is now terrified to be around my son.
he's not always like this either. It doesn't happen in school ever and it seems to be only when he's with me or his dad and grandparents..basically people he knows he can get away with. I'm probably the more strict of them all and i'll give him a timeout.
Well I have worked with both autistic and neurotypical kids behaviorally. Given the age of both children I think a behavioral parenting approach would be very helpful.
If you've read about autism treatment you've probably read about ABA (applied behavior analysis). Well it turns out that this is the same approach for behavior change in a normal 3 year old too.
"behavioral parent approach"?
Yes have you heard about ABA in your autism studies?
i haven't read up much on it.
No problem. Here's a link that explains what I mean by ABA: http://www.polyxo.com/aba/
Do you use teaching and learning strategies with your son? Do you use time out for negative behaviors like hitting?
he will certain get a timeout and is usually fine most of the time except when he's in a cranky/tired mood.
I certainly need to work on his behavior issues but i feel this is a longer term solution and i was concerned with also keeping the boys apart for now and re-introducing them again (as if starting from scratch). What do you think of that approach? We can only keep them apart for so long but not sure what to do about the 6yr olds fear now.
Ok. Well what I'd like to suggest is what's called a "front-end" intervention for both kids. You can decide to apply it to your child to prevent hitting or you can decide with your boyfriend to work with him together....
Does the mildly autistic child get any form of behavioral therapy?
i believe he does at school but his actually quite a good kid. he didn't hit back when my son hit him
he's also much better at sharing and will give up a toy quietly if my son wants it.
ok that's great. What I'd suggest doing is really observing to see what situations and conditions trigger your son's hitting and come up with a plan for what to do when those trigger come up. For example, you mentioned that hitting increases when your son is tired etc.
do you have any info on "front end" intervention? would it require us to work with both boys?
Yes - well one thought we spoke about was just keeping them apart in these situations. The day he hit the boy, he was actually woken up from a nap when we arrived at the park and we were already there for over an hour which may have been too much for him but not for the 6 yr old.
If the real problem behavior here is your child hitting, it would depend on what is triggering the hitting behavior. If I were there as a behavior consultant I would want to agree with the other parent to do some basic behavior observation and even some basic ABC data collection....
This would allow you to see exactly what triggers or comes right before the hitting behavior.
If the autistic child triggers the hitting behaviorally inadvertently you may both want to target those triggering behaviors on the part of the other boy.
The botXXXXX XXXXXne with a front end intervention is that it's preventative...
You really pay attention to what happens right before the behavior to set it off and make sure that that trigger is removed from the environment.
it all started when the autistic boy went down the slide first and my son began to cry, then hit him when he tried to go back on the slide.
For instance, if you're boy hits when he's tired, you may be able to prevent hitting by making sure that the boys only play together when your son has had a nap or is otherwise not tired.
I see what you are seeing with observing the current situation. I honestly feel it's a result of him being tired. he gets angrey and throws tantrums when he's in that state and both times it happened that was the situation.
I agree with you. that was my initial thought too as a short-term solution for it.
Well, I would want to test that theory, and set up get togethers or play times earlier in the day.
So do you think keeping them apart is a bad idea..was our initial thought, temporarily keep them apart..but seems like we'd be going backward.
You could then observe to see if the hitting persists, or even better if the grumpiness sets in at times and what triggers the grumpiness.
the 6yr old needs to overcome that fear now. he got physically sick when my sons name was mentioned.
Ideally both parents would agree to really work on understanding and changing the problem child behavior. For example, you can usually see precursors to hitting in neurotypical kids. I think that until the hitting is under-control that you agree to really provide strategic supervision when the boys are together.....
Experts on JustAnswer are not permitted to provide formal assessments or clinical suggestions. Ultimately the decision of having the boys be together is one for you parents. The vomiting for example that I would want to explore more if I were working with you as a behavior consultant. Is that a new behavior for your boyfriend's son?
no - he's always done that when he gets upset.
What is your relationship and communication like with your boyfriend?
it's fine. he spoke to me about this on friday after a visit with his. he mentioned that he might be seeing Nicholas (my son) over the weekend and his son got that upset. he came to me about it so we could try to fix it together. he thinks it was because of nicholas hitting.
My concern here is about the vomiting. I have no way of assessing the safety risk it represents. What are you and your boyfriend like financially? The best thing you guys could do is work with a board certified behavior analyst in your area and they are very affordable. You could get a tailored intervention to address exactly this problem. You may even be able to get an ABA intervention with a well supervised BCBA student who is working to complete practicum hours. What are your thoughts?
...at a very low hourly rate or even free.
we're ok financially and both have good insurance that would cover most things.
would it be something to work with both children on?
the vomitting he says is due to his acid reflux, seems to trigger when he's upset.
how would we even go about finding someone?
Yes BCBA's are the most underutilized professionals on the planet. You could probably get some very helpful suggestions for some of the other behaviors you mentioned in relation to your son with grandparents and at his father's etc. But you could definitely have an effective intervention designed by an BCBA expressly for the problem you are describing here today with your son and your boyfriend's son....
May I ask what city and state you are in?
we're in New york city.
Ok thank you. Here's what I mean by "A board certified behavior analyst": http://www.bacb.com/index.php?page=2
Let me see how many there are in NY...
Yes there are many BCBA's in New York : http://www.bacb.com/index.php?page=100155&by=state
i'm sorry that link doesn't work well. did you click on "Find a Certicant" from the main page.
actually see it. there are many in the nyc area.
this may sound like a stupid question but do they just analyze the kids or would sit with us to come up with a plan or techniques to work with them.
(sorry so many typos today).
Yes I did select the find a certificant. I would check this list and find some BCBAs in your area. I'd then call and or e-mail a few of them and let them know that you would like to find a way to solve this hitting problem. I would expressly ask if they know of any BCBA student's in your area who are getting practicum hours for certification. Not only would you save money here or get a free behavioral intervention, but, you also get some one who is being supervised by a senior member then you get 2 for 1 BCBAs!
You just type in your state and city to get the list on the find a certification page. The link I posted for you didn't open because of that new agreement pop up. Sorry about that.
Have I answered your question ok today?
yes you have. Just one more though..the BCBA's they will work with us on techniques for the behavior issues or just analyze the boys
i'm sorry i have a meeting and will be back in about 20 minutes. But thank you to above. i just needed that 1 additional answer and i'll "accept" when i get back. i'll stay online. You've been very helpful. thank you very much.
They will either come in person and observe the behavior and/or guide you in some basic behavioral observation and data collection. They will also be better be able assess any risks associated with the behaviors in question (i.e. hitting/vomitting) in your specific situation. They will then suggest the best available intervention based on the available behavioral science for those behaviors.
hi. thank you again for the info. it was quite helpful.