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Dear Sara,

Our son is 14 years old and has ASD, and we are not sure how to motivate or discipline him appropriately now that he is older. We want to have him do some basic chores, complete a hygiene routine in the morning, and make it to school on time. In the past, we used lots of pictures, lists, sticker charts, and rewards. These worked, but it seems like now he should be doing these things on his own.

Honestly, I am not up for making a reward chart for his hygiene routine or his chores after school. Sometimes taking away electronics works, but that also creates more tension and seems to increase his anger toward us. No job or college gives a sticker for completing his morning hygiene routine and handing in his assignments. How do we prepare him for his future without having to go back to the old sticker chart?   

Trying to Transition


Dear Trying to Transition,

This is a challenging time for many families. But rest assured that others have made it through and you can, too! The place I would recommend starting is to look at what you mean by "discipline". If you mean punishment (nagging, threatening, taking away something), you need to remember that punishing a behavior decreases or eliminates something, but does not teach or increase the wanted behavior. In contrast, you seem to be looking for your son to be increasing certain behaviors like brushing teeth, putting on deodorant, walking to the bus, etc. There are different strategies that are more effective when you want to increase a behavior. Those often include rewards like the sticker chart you used previously.

It's true that a sticker chart can seem like a waste of time and effort when you know that other environments will not have the same kind of supports, and therefore your son will not be able to keep up the behavior in a new environment. The good news is that there are ways to transfer and generalize these systems across environments. Unfortunately, we professionals have not always done the best job teaching or disseminating why this type of system works and explaining how to fade the system from something like a sticker chart to a more natural system that can be generalized. 

First, you need to ask your son what he thinks would work - why would he want to do those behaviors. What would make it worth his while? If your son does not have the words to answer these questions you can always do a motivation assessment or seek more support from someone like a BCBA to help do a formal reinforcer assessment. The goal is to find what is motivating and what tools are needed. Remember that although you may think he should be able to do certain things, your son likely struggles with executive functioning and social cues. He may not notice that others react when he forgets deodorant, or he may intend to follow through and simply can't. It does not help anyone to punish behavior when he simply does not have the skills yet. 

Charts or token economies are helpful for all ages (the therapists at AuSM use one to make sure they put their ”in and out” magnet in the right place each day). Visual feedback systems help serve as intermediate feedback providing someone with the knowledge and motivation that they are heading in the right direction or may need to put in more effort. If you think about it, we use systems like this all the time in the form of apps that measure our savings accounts, graphs for weight loss, likes on a post, crossing off a to do list, or time management on a calendar. These may seem drastically different from a sticker chart, but they serve the same function: giving visual feedback to help someone track progress.

Start with a simple social story or a clear expectation that is written down for your son to see. It would explain the expectation and the consequence if your son follows through. For example, if your son completes a hygiene routine for three consecutive days without Mom’s help, then he gets an Amazon card instead of a sticker. You may have to be specific about what "without help" means.

To track this you might use a star or checks on a wall calendar (something we all use) that provides the visual feedback. Again, I suggest you start this process by asking your son what would be worth his while to do these things. He may say a new video game that is worth $50. You will need to decide what is possible and how frequently and how much he can earn. The important elements of the system are that there is a reward for repeated behavior, a visual system so that he can see his progress, and continual check in to see if the system is working. If video modeling or social stories have been helpful in the past, include those.

One thing to keep in mind as you look toward the future is that there are many apps for scheduling, to do lists, and the like. Any time you can transfer to an app on the phone or just a simple piece of paper the easier the system will be able to be generalized and used in college or the workplace. When the system is feeling heavy and hard to use, that is the time to ask how you can make this easier and more natural while providing feedback and clear contingencies. Don’t forget your behavior is reinforced and punished as well. If you feel stuck, make it easier - try to seek consultation or support from a therapist who can help you understand what some of the barriers may be. Reward yourself with some down time or favorite activity with your son or remind yourself when your son gets the routine down you will have more time to do the things you want to do.  

Good luck!

-Sara

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