By Sheryl A. Isaacs, MS

The affects of separation are numerous.  Each person within the family unit will suffer the loss of separation and grieve differently.  Regardless of whether or not you are married or living together the effects are the same. This can be complicated by many things. Families that have half-siblings, step siblings or children that have built relationships with the parent figures family face unique challenges.  Separation is an ending of a life style that all have become used to.

Children experience the loss developmentally.  How children exhibit this stress in their lives also depends on where they are developmentally.  It is important to note that ALL children are affected.  When you begin to look at the developmental tasks that are faced during different developmental time periods, it is easy to see why children would express stress in a way that is typical for that age group.

Below is a table that is compiled of ages, how stress is expressed and developmental tasks that a child is trying to negotiate that are related to the child’s expression of stress.

You can see that for the infant the main tasks are that of forming attachments and emotional development. 
When separation occurs within this developmental stage the child is unable to experience continuity in attachment with both parents. This will increase crying, eating and sleeping problems.  This can lead to an increase in stress for the parents.  That can result in further loss of the ability to attune and attach to their child.  The child is working out the crisis of trust vs. mistrust.  When a child is unable to negotiate this crisis they form mistrust for their world and those in it.

Toddlers engage in increased fantasy play at their developmental stage.  It stands to reason that a child that experiences separation of parents would naturally become fearful about the separation and ask for the absent parent.  The toddler may be experiencing fantasies that he is unable to convey to parents due to an inability to cognitively share his thoughts and feelings. The toddlers are seeking to negotiate the crisis of autonomy vs. shame and doubt.  The toddler that is unable to negotiate this crisis experiences shame of his behavior and doubt in his
abilities. The toddlers that do not negotiate this stage successfully will have issues initiating and be inhibited.

As children enter into the preschool years they begin to work on gender identification and self-theory. 
Children tend to identify stronger with the same-sex parent.  If the opposite parent engages in negative talk about the same-sex parent it may cause the child to identify that he is “bad” or “wrong.”  During this developmental period children are beginning to identify who they are and where they belong.  The first community that is experienced is the family unit.  This gives the child’s first sense of self and belonging. Preschoolers are seeking to negotiate the crisis of initiative vs. guilt. At this developmental stage children can experience regressive behavior, whining and transition issues. It is at this stage that children begin to experience guilt, which may make it difficult to go with the other parent. 

During the school age years (i.e., early elementary years and pre-adolescent years) children are learning to build friendships and begin self-evaluation of who they are.  The crisis that early elementary children are seeking to weather is competence vs. inferiority.  Parental interactions that are negative can harm how children relate to peers at this stage.  Children are looking to parents to see how to behave as friends.  Children at this stage will exhibit school performance issues which can cause low self evaluation as they compare themselves to peers and their performance.   When this crisis is not negotiated successfully children will develop a sense of inferiority.  It is during this age range that kids seek to know “whose fault” it is and wonder “what did I do.”

During the teen years children are beginning to really understand the consequences of actions, are self-reflective and detect inconsistency in statements. Teens are very egocentric.  Peers are an important part of this developmental stage as the teen finds out “where do I fit in.” They are seeking to negotiate the crisis of identity
vs. role confusion.  Separation at this stage is seen as a disruption to their life.  Loyalty conflicts are expressed in an extreme manner. Having the ability to think through problems causes the teen to think deeply about the changes that will occur as a consequence of the separation. Children at this stage experience anger, school problems, drug and alcohol abuse, depression/suicidality and act out against authority figures. 

Due to the fact that children are affected in various ways at different developmental states it is important to be able to co-parent in an effective manner.  When parents can co-parent together, in a positive manner, children will be able to adjust to the separation without experiencing undue stress. It is important to remember that all
children engage in “magical thinking” and will tend to blame themselves for the separation.  Communication is
extremely important.  Children need to feel that they can discuss their fears, concerns, wishes and desires without
the other parent becoming angry or talking ill of the parent that is not there.

It will not be easy at times.  As parents you will need to put aside your hurts and emotions and focus on the issues regarding your child.  In the beginning it may help to utilize a communication log to report important information to the other parent or email. You can also request a good time to discuss issues when the children are not around. If it is difficult to be around the other parent in the beginning, minimize contact.  Do not allow your conversations to discuss anything other than important issues regarding your child. 

Use basic communication skills when talking to the other parent.  Listen and clarify what the other parent is saying.  Do not be vague about pick-ups or drop-offs.  Make an effort to stick to a routine schedule.  If the schedule needs to change give ample time for the other parent to adjust their schedule. Keep the other parent informed about school events and activities.  Your child will do best with both parents involved in his academic endeavors. Discuss doctor appointments and health issues. For your child to thrive you will both need to be on the same page. Discuss rules that can be reinforced at each home to make transition between houses easier. Never send messages to the other parent through your child.  Communicate directly yourself. Remember, that it is not about you but your child. 

The most important thing to remember is that you cannot control the other parent.  You can only control what you do. You will not parent the same way and that is okay. If you have an issue that you are concerned about, talk to the other parent without the child present. Children do not need the added burden of being caught in the middle. Do not interfere with the other parent and their parenting, unless there is a concern for the child’s well-being. If there is an issue of safety for your child document it and report it. Physical and emotional abuse, neglect and domestic violence in the home are never appropriate and cause lasting harm to children.  The most important job that we have as parents is to protect our children and keep them safe. 

If you are having a difficult time with the transition, seek out someone to talk to.  It is important to talk to someone that can listen objectively and put the needs of your child first, such as a therapist.  Therapy can give you a safe place to work on the strong emotions that you may be experiencing away from your child.  Therapy can also increase your ability to set boundaries and communicate in a clear manner with the other parent. In time as you work through your emotions it will be easier to co-parent in a healthy manner. 

By Sheryl A. Isaacs

Studies have shown that when early intervention occurs with children that experience developmental delays it will change the outcome for the child. In this article I will focus on the specific benefits of early intervention behavioral therapy (EIBT) for children that have autism. 

The signs of autism can be insidious and hard to recognize. In order to recognize the a-typical development that occurs with autism, it is important to know what typical development looks like.  This can be difficult, especially for first time parents. With an infant that has autism, it is a slight deviation from normal development. Many times it is the lack of or lessened occurrence of a typical pattern of development that occurs. Infants with Autism can be categorized as good babies that are not demanding. Many signs of autism can be seen before 2 years of age. 

Studies have shown that when early intervention behavioral therapy (EIBT) occurs before the age of two many
children can be mainstreamed in typical classrooms.  Intensive EIBT before the age of two has been shown to help “rewire” a child’s brain and in some cases reverse the signs of autism. When the deficient areas are targeted, such as imitation, joint attention and play skills, there is an increase in expressive and receptive language by the child who has autism. When imitation, joint attention and play skills increase it opens up a whole new world of interaction for the children. An increase in these areas enables the children to test better on developmental test and effectively can raise their IQ scores when tested.

The most effective EIBT program will increase the parent’s responsiveness to their child through therapy and in
home treatment.  Parents are given the tools to continue treatment on a daily basis with their child, which will
benefit the child and parent.  When a parent is taught to follow their child’s lead in communication, non-verbal communication will increase and possible verbal communications occur.  Parents will learn to require the child to vocalize during interactions and requests. At first these vocalization requests will be far from the targeted word, but in time closer approximations to the word will occur. As parents continue to utilize the skills that are learned through the EIBT program they will be more effective parents for their child with ASD.  

Parents must also learn to “scaffold” various skills. Scaffolding occurs when a larger skill is broken down
into smaller components. Help is provided to the child until they become familiar with the new items that have been introduced within the larger skill. Teaching continues in this manner until the child masters the task. This type of teaching will enable the parent to focus on their child’s level of learning and have the knowledge and ability to help their child reach the next level of learning, regardless of the present skill level.  This technique can increase many skills: play skills, self-help skills, language skills, motor skills and cognitive skills.  As parents continue to “scaffold” the child’s learning will solidify in these areas because they are always beginning the learning task at a level that is just above their acquired level, which increases success and a level of
mastery. 

Further research continues to be being done to increase recognition of autism at an earlier age. All research
points to early intervention being the key in providing the best outcomes for children with autism. One exciting study links weak head and neck muscles to ASD.  Here is a link to the video and information on the study.  This study was done the Kennedy Krieger Institute.

In this article EIBT was addressed as an early intervention for children that have autism.  It is important to remember that any child that is experiencing any delay in any developmental domain (physical, cognitive, social and emotional) should receive early intervention services. Below you will find warning signs for autism
and a list of links that can help determine what steps you can take in getting your child the help they need to succeed!

The following list was taken from helpguide.org:

 Early signs of autism in babies and toddlers

 

Doesn’t make eye contact  (e.g. look at you when being fed).
Doesn't smile when smiled at.
Doesn't respond to his or her name or to the sound of a familiar voice.
Doesn't follow objects visually.
Doesn't point or wave goodbye or use other gestures to communicate
Doesn't follow the gesture when you point things out
Doesn't make noises to get your attention
Doesn't initiate or respond to cuddling
Doesn't imitate your movements and facial expressions
Doesn't reach out to be picked up
Doesn't play with other people or show interest and enjoyment
Doesn't ask for help or make other basic requests

Physician guidelines:

No big smiles or other warm, joyful expressions by six months or thereafter
No back-and-forth sharing of sounds, smiles or other facial expressions by nine months
No babbling by 12 months
No back-and-forth gestures such as pointing, showing, reaching or waving by 12 months
No words by 16 months
No meaningful, two-word phrases (not including imitating or repeating) by 24 months
Any loss of speech, babbling or social skills at any age

If these signs are seen in your child then it is important to get them to your Doctor for a thorough examination.

Helpful Web Sites:

Developmental milestones birth through 12+ months

Overview of what early intervention is and has many helps and information.
 
MCHAT will help you determine if a professional should evaluate your child

Autism Speaks 100 Day Kit for newly diagnosed families

By Sheryl A. Isaacs

Play Therapy with children is a very important therapeutic tool because it utilizes the child's natural language, the language of play.  Children naturally seek to express themselves through play. Stories, metaphors, problem solving, fears and experimenting with new roles occur when a child plays. The Play therapist engages the child in this natural language of childhood to help the child process strong emotions, trauma and role play difficult situations that the child may face. Every day through play children are working out a myriad of problems that occur in their world.  
 
When participating with a child in their play, the therapist enters into the world of the child, accepting the play and the child unconditionally. The therapist follows the child’s lead, allowing them a sense of control that they might not otherwise feel. This integration into the child’s world allows the therapist to deeply connect with the child. The child can act out any situation that needs attention in their lives without fear of the therapist rejecting them.  When scenarios are acted out that are difficult, it gives the therapist the opportunity to empathize with the child's experience through play and gently mix into play therapeutic concepts and tools.  Utilizing the play format makes disclosure of severe experiences and strong emotions easier for the child to express to the therapist.  
 
The therapist can then help the child make sense of their world by finding metaphors that relate to the
child's life hidden within their play. Through this process the therapist can eventually help the child "restory" their play, which enables a child to move through difficult situations in their life. As play therapy continues, one can
see a normalization of play.  The child’s play becomes more typical developmentally and the child’s play becomes
more reciprocal in nature with the therapist. Often the themes that had been so important in play are abandoned. 
The child does not feel the need to work out through play the metaphors that he had been. For now, the issue has been resolved. 
 
However, it is important to note that when children experience a trauma they will continue to process this trauma
throughout their development. This occurs due to the changes that occur developmentally.  The trauma will most likely need to be processed again at key developmental stages or changes in their life, such as when a child begins
Kindergarten, enters into puberty, or becomes a teenager.  The child that processed trauma through play may need to verbally process this trauma as a teenager.  A young child will not feel the same feelings or have the same questions that a teenager might have in regard to their trauma experience.

 This of course, is just a general overview of the play therapy experience. There are many theories and
developmental models that are utilized as well as different models of play therapy. Play therapists engage in many different varieties of play as well, again following the child’s lead. Expressive arts, lego play, doll house play, imaginary play, active play, puppet play…any type of play that you can imagine is utilized in the play therapy room. The key is to allow the child to be who he is, express his story the way he needs to express it and follow his lead. 

By Sheryl A. Isaacs

Many people hear Applied Behavior Analysis (ABA) and think that it is "doggie style" training for children that have Autism.  It is definitely not.  While I was working at the Bay School in Santa Cruz, I was able to learn about ABA while working under a Board certified Behavior Analyst.  I worked primarily with children that were under five in the Early Intervention Classroom.

My experience was amazing.  I saw each child grow in all areas of development.  Children that were not verbal were able to begin to vocalize, those that could not reciprocate in relationships began to seek out attention.  It was at the Bay School that I became a firm believer in early intervention.

ABA principles are utilized everyday in many different circumstances.  The major premise of ABA is that each and every behavior is reinforced either by positive reinforcement or negative reinforcement.  Behavior is increased by the presentation (positive reinforcement) or removal (negative reinforcement) of an object.  The trick is to find something that is super motivating to the person that you are trying to increase behavior in when utilizing positive reinforcement. 

Let's say that you want to increase the likelihood that Timmy will complete his school work without fussing by using positive reinforcement.  What is the most important thing to Timmy, what is his "carrot."  You need a big enough carrot for him to comply.  Let's suppose that he loves his video games.  Now you link playing his video game to finishing his homework.  Little Timmy will be reinforced with video game play ONLY after he completes his homework.  The trick is to not let Timmy play too long, then you might weaken the reinforcer.  You also do not want to allow Little Timmy to play at other times.  That will increase the likelihood that he will STAY motivated for his video games. Be sure to amp up the verbal praise...get REALLY excited when there is compliance. Are you beginning to see the value of ABA principles?

What about negative reinforcement?  Well, let's say that Little Timmy throws a fit and screams when he has to put his shoes on.  Mom, who is embarrassed by this behavior, allows Timmy to not put on his shoes.  Here we can see that Mom has unwittingly utilized negative reinforcement with Little Timmy.  Timmy's screaming caused Mom to allow him to escape the demand to "put your shoes on." Timmy has learned that if he engages in this behavior he will NOT have to put the shoes on.

This is where it is important to understand the ABC's of ABA.  Collecting this data can help us see what the function of the behavior is. There are four main functions of behavior: escape, attention, access to something and sensory need. The A in ABC's of ABA stands for antecedent. Antecedent just means what happened BEFORE the behavior you are looking to change, by being specific we can see patterns that occur.  The B in the ABC's of ABA stands for behavior.  What is the specific, observable behavior? When we look at a behavior we have to look at it in a non-judgmental manner and describe what we see.  The C in the ABC's of ABA stands for consequence.  That means what happened right after the behavior.  It is important to be very specific here as well.

Let's talk about Timmy again.  Timmy's mother reports that he has been having increased "meltdowns." Mom begins to collect data on an ABC data form when the "meltdowns" occur.  Mom notices that every time before the "meltdown" she is doing something, talking on the phone, doing laundry or cooking.  She records Timmy's behavior in a non-judgmental, observable manner.  Timmy drops to the floor, kicks his legs, screams and rolls back and forth.  Now Mom can be clear about the specific behavior she wants to change.  The consequence that is noted, is that mom stops what she is doing and picks Timmy up. Hmmm...do you see what is going on here?  What type of function is this behavior serving for Timmy?  Yep, it is attention.

Every time Mom stops what she is doing she is negatively reinforcing Little Timmy.  He learns that when he engages in "meltdowns" that Mom will stop what she is doing and give him the attention that he desires. What is Mom to do?  This will not be easy.  Mom will need to continue to do what she is doing regardless of Timmy's meltdowns. She will need to be consistent to extinguish this behavior. What if Mom decides to give in to Timmy a few days a week?  Well, she is teaching Timmy that his behavior WORKS.  Now poor Mom will have to work even harder to extinguish the behavior.  If Mom allows Timmy to "meltdown" for five minutes and then give in, it will be at LEAST a five minute "meltdown" next time. 

Mom could, of course, choose to use punishment to decrease the behavior, such as timeouts.  Mom could also utilize positive reinforcement, making a chart or giving Timmy a treat for every five minutes he is quiet while she is busy.  I myself prefer to utilize positive reinforcement first, then negative reinforcement and finally punishment.

When you begin to think about how a behavior is reinforced you see many relevant situations where ABA principles could be utilized. What about behaviors that our spouse, girlfriend or boyfriend engage in?  Are we reinforcing their behaviors at times?  Looking at the function of behaviors help us to understand a need that is not being met.  How can we increase attention at other times with our children to help alleviate acting out behavior?

Of course there is much, much more to ABA than this. I hope that you have begun to see the daily implications that positive reinforcement, negative reinforcement and punishment have in our daily lives!