Archive for March, 2012

We are ferociously working on a grant application to help picky eaters with our friends over at ACES. Come back and visit us tomorrow when we review a research study on the effects of fish oil on human behavior. And no, taking fish oil will not make your swim around in your yard!



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Inclusion is not just for children with disabilities. Inclusion has something to teach each of us.

1. Inclusion teaches us how to be more accepting of others.

By learning and playing alongside of children with different abilities, children learn to accept everyone regardless of their adaptive equipment, computer assisted speech, hand flapping, or different facial features.

2. Inclusion teaches us how to be more tolerant of differences.

When children see that some students read better than others, and others run faster, and still others play the piano better, they learn to recognize that each person has something to offer. They also learn that everyone has an area for improvement. Soon, they recognize that differences are a good thing and that those differences are actually what makes the world a better place.

3. Inclusion teaches us how to help others who may need assistance.

Children learn to incorporate a variety of strategies to help each other. When they learn alongside children with different learning abilities, they are also learning how to help others succeed. Jesse Jackson said it best, “The only time you should look down on a person is when you are helping them get up.”

When Inclusion Does Not Teach Us

Dumping children with disabilities in to general education settings without the necessary supports and services causes harm to everyone.

  • The student with disabilities does not receive the necessary support and as a result struggles in environment both socially and academically.
  • The peers in the classroom are negatively affected when their teacher and classmate are not supported.
  • And finally, the general education teacher needs training to know how to teach and include children with disabilities, how to manage a variety of challenging behaviors, and how structure a class that welcomes children of varying abilities.

We all have something to learn from inclusion. But each of us can only learn when the context supports learning. Educators and administrators in education have the responsibility of providing the appropriate supports and services to ensure that everyone can benefit from inclusion.

We are linking up again over at Yeah Write. Hop on over there and check out all the other great blog posts.

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Hi and welcome to Ask Missy Mondays where I respond to email questions from readers who have questions about their child’s behavior. Today’s question comes from Tom and Alissa who write,

“We have been told by a number of other parents that nutritional supplements are important and that we should be giving our child supplements every day. Which supplements should we give? Which supplements actually help with behavior? Which supplements help with autism?”

First, thanks for writing. I think you are being smart by asking the right questions regarding nutritional supplements. We know that the use of nutritional supplements has become more popular in recent years, and not just for children with autism. For example, a typical google search on nutritional supplements will reveal over 25,000,000 hits. Everyone is talking about the use of nutritional supplements. I am certainly not qualified to talk about which nutritional supplements are right for your child. I can, however, share what I have learned about nutritional supplementation. Then you can take that information with you when you meet with a qualified health care practitioner who is trained to help you and your child.

Nutritional Deficiencies

Second, we know that some people, including children with autism, may have nutritional deficiencies. Speaking personally, I was anemic from the first time I tried to donate blood (early 20s) until 2 years ago. Because of this, an iron supplement seemed like the appropriate treatment. Additionally, I was on the path to osteoporosis. Again, taking Vitamin D and Calcium seemed like an obvious treatment. Thus, it seems likely that nutritional supplementation is actually required in some instances.

Underlying Medical Conditions

Third, we know that some medical conditions can prevent certain individuals from absorbing the nutritional supplements they take. Conditions such as Celiac can cause inflammation in the GI tract. This inflammation can prevent the supplements (and nutrition from food) from being absorbed properly. Thus, treating the underlying medical condition should be a first goal.

Supplements Improve Behavior

Fourth, we know that some nutritional supplements can actually improve behavior. For example, the research on melatonin has been shown to improve the sleep of individuals with autism. Zinc supplementation can also result in improved taste and other sensations. Join us later this week as we review a study on the effects of fish oil on behavior.

Research on Supplements

Finally, a number of studies have been conducted, or are being conducted regarding the use of other supplements for children, including children on the spectrum. This includes the use of Vitamin C, Vitamin D, magnesium, zinc, omega fatty acids (fish oil), and Vitamin Bs.

So, my advice to you is to meet with an appropriately trained health care practitioner so that he/she can help you identify any underlying medical conditions or nutritional deficiencies in order to determine what your child may need as part of a regularly balanced diet.

Good luck and please keep us posted on the progress and findings.

Readers, please share! Do you take nutritional supplements? Do you give them to your children? Does it help?

If you have a behavior question for Missy, email askmissy at applied behavioral strategies dot com.

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Check out the cartoon below! Funny, right? Be sure to come back next week. On Monday, an anonymous reader “asks Missy” about nutritional supplements, see what Missy has to say. On Thursday, we will be reviewing a study on the effects of fish oil as a treatment. Thanks to Close to Home cartoonist, John McPherson, for such a great laugh!

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Here at Applied Behavioral Strategies, our mission is to improve the quality of life through effective intervention. One way we hope to do that is by reviewing research articles for our readers. Today’s article is titled, “Meta-analysis of Grade Retention Research:Implications for Practice in the 21st Century”. Shane Jimerson authored the article and School Psychology Review published it in 2001 (Volume 30, No. 3 pages 420-437). You may read the entire article yourself here.

Purpose of the Study

Researchers have been studying grade retention for many years. However, recently, the quality of studies has improved (e.g., more rigorous experimental designs, comparison groups). So, the purpose of the study was to review all the studies on grade retention between 1990 and 1999. The author completed a meta-analysis of the studies to better inform educators and parents about the effects of grade retention.

Research Questions

The author asked a number of research questions including:

(a) In what grade were the students retained and at what age/grade were the outcomes examined?

(b) What were the academic achievement outcomes of retained children versus promoted children?

(c) What were the social-emotional and behavioral outcomes of retained students versus promoted children?

Methodology (How the Study was Completed)

The author searched for research studies on the effects and outcomes of grade retention. Over 400 studies were found. The author identified studies that met the following inclusionary criteria:

(a) research must have been presented in a professional publication;

(b) study results must have addressed the efficacy of grade retention (i.e., achievement, social-emotional, or other);

(c) study must have included a comparison group of promoted students;

(d) research must have been published between 1990 and 1999

Twenty studies met the criteria and were analyzed for the meta-analysis.

The author and two research assistants coded the studies. Meta analyses were completed using the effect sizes reported by study authors. For our readers with little experience and training in research, this means that the author and research assistants read the previously published studies and entered information into a spreadsheet. They also took the results from the previous studies and combined them with all the other study results to get an average outcome across studies.


Groups Studied

The retained students and the promoted students were matched on several variables including academic achievement, IQ, gender, SES, and social-emotional adjustment). Essentially, all the studies made sure that both groups were equal except for one variable: retention or promotion.

Grade of Retention and Grade of Outcome

The majority of the studies (N=14 out of 20) included students that were retained in kindergarten, 1st, 2nd, or 3rd grade. The remaining six studies included students retained K through 8th grade. Many studies (14 out of 20) reported outcomes over a series of years. Only 6 studies reported outcomes in just one year.

Academic Outcomes

All of the data from the 20 studies resulted in 175 different academic outcomes for students. Of those 175 outcomes, only 9 favored retained students while 82 outcomes favored promoted students. 84 outcomes showed no difference between retained and promoted students.

More specifically, the promoted group of students performed higher than retained students in areas of language arts, reading, math, composite scores, and grade point average.

Social-Emotional Adjustment

All of the data from the 16 studies that examined social-emotional adjustment resulted in 148 outcomes. Of those, 8 favored the retained students and 13 favored the promoted students. 127 of those showed no differences between groups.

Author Recommendations

The authors of the 20 studies favored either retention or promotion and these results were analyzed. Authors from 4 studies recommended grade retention while authors from 16 studies recommended against grade retention.

Authors from the 4 studies recommending retention emphasized that remedial strategies in addition to grade retention is necessary. Grade retention alone is not enough.


The author of the meta analysis concludes with a few recommendations for educators and school psychologists.

  1. First, he stressed the importance of utilizing remedial strategies to support children who are struggling.
  2. Second, he encouraged educators and educational researchers to study the long-term effects of grade retention, particularly in light of other research linking grade retention to higher rates of high school drop out.
  3. Third, he encouraged school psychologists to explore educational alternatives and to disseminate research to parents and teachers to that teams make informed decisions regarding grade retention.
  4. Finally, he recommended that educators consider using interventions that have been proven effective through special education research. These include: mnemonic strategies, enhancing reading comprehension, behavior modification, direct instruction, cognitive behavior modification, formative evaluation, and early intervention.

What are things that you considered when deciding to retain or promote your child? Teachers, behavior analysts, what variables did you consider? What interventions did you try first?

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If you have stopped by because the title sounded enticing and you were really looking forward to some hearty discussion about evidence-based practices, you will have to come back another day. You know as readers that we are die-hard evidence-based girls. None the less, today’s topic is actually about parental responsibility of keeping teachers up to date on family matters.

Besides us, as parents, teachers spend more time with our children than any other person in our children’s life. Wow. That is a lot of time. Because of this, teachers may be the first to notice subtle changes in our children’s behaviors, emotions, learning, and friendships.

We, as parents, need to keep teachers informed about events in our children’s lives that may impact their performance at school. We are not suggesting that you air your dirty laundry with your child’s teacher. Instead, we are suggesting that you keep her apprised of serious events.

As adults, we process information differently than children. We have a series of life events, education, and experiences that have formed the way we process information. What may seem like an everyday activity, may be a source of stress for a young child who is still figuring out the world. Factor in hormonal changes that occur with adolescence and your child could have a serious case of the blues at school.

Serious Illness in the Family or Friendship Circle

Illnesses such as cancer are scary for all of us but it is especially scary for children. If you have a friend or family member who is fighting cancer, your child may fear that he/she will catch it. They may begin thinking about death and have questions about the future. Hopefully, you have held those discussions at home. Either way, your child is probably thinking about it.

Change of Living Conditions

As parents, we are good about telling school staff when we move. However, what if the conditions in the home change? What if a relative is moving in for an extended period of time due to a loss of a job? What if the children changed rooms? What if a parent is out of the home to go care for a sick family member? All of these things sound simple for us as adults, but children may not handle the change so easily.

Loss of a Relative

The loss of a cousin, great-aunt, or other distant relative may not result in a cross-country trip to the funeral. Thus, your child’s teacher is most likely unaware of the incident. However, your child is. With the invention of cell phones, many of us have adult conversations all day long when our children are within an earshot of us. They know when these events happen, even if we don’t directly share the information with them.

Loss of a Pet

You know that goldfish that you have been secretly wishing would die? Well even though your child hasn’t fed it, spoken to it, or even looked at it in months, she will fall apart when it’s gone. Endearment for pets is not just limited to living pets. Some children form close bonds with stuffed animals. If one gets a “boo-boo”, it could cause stress for your little one.

New Pregnancy

We get that you were not planning a pregnancy or that you don’t want the world to know until it is a safer time. However, your little one has probably already picked up on the vibes or even overheard conversations. Nothing is more confusing for children than the age-old question “where do babies come from?” So, while you may want to keep it a secret, it is probably best that your child’s teacher know that you are pregnant. That is far better than her assuming that you are “sick” from too many cocktails the previous night.

Pending Divorce or Separation

No parent wants the neighborhood that things on the home front have fallen apart. However, your child’s teacher needs to know that a separation or divorce is on the horizon. Your child may handle the news when you present it but she may show her feelings differently at school.

These topics are just a few of the things you should share with your child’s teacher. School staff, including your child’s teacher, have received training on how to handle confidential information. Privacy laws prevent your family’s issues from becoming fodder for school gossip. Additionally, schools have a number of different staff available who can assist your child in times of need (e.g., school psychologist, school social worker, and school counselor). However, these trained personnel cannot help if they do not know.

Thus, be sure to keep your child’s teacher in the know so he/she can help your child adjust to life events.

This post will be linked up over at Yeah Write. Go check out all the other posts that have linked up.

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Hi and welcome to Ask Missy Mondays where I respond to email questions from readers who have questions about their child’s behavior.Today’s question comes from Karen who asks,

“My son with autism is in 2nd grade and struggling with academics along with his social challenges. I am wondering if we should hold him back and keep him in 2nd grade next year. What are the things we should consider to help us with this decision?”

All parents ask this question from time to time–regardless of whether their child has a disability. Some parents hold children back so they will be older when they graduate. Others hold their children back so they will have a greater likelihood of excelling in sports. So, the good news is that you are not alone in thinking about this.

I think there are several issues to consider. Personally, I am opposed to holding a child back once they start school. Thus, if you intentionally start them a year later than their similar aged peers, I don’t believe the consequences are as severe as when you hold a child back once they have started school.

Peer Relationships are Formed

Children begin forming their peer groups on the first day of school. Yes, children begin forming relationships as early as preschool. Friendships formed at that age, can potentially last a lifetime. Once your child develops relationships, it will be detrimental to him/her to lose those relationships. Sometimes the mere separation from teacher to teacher can be enough to interfere with friendships. However, if the children remain in the same grade with different teachers, they will continue to share lunch time, recess, and some specials.

Holding your child back to repeat a grade separates him/her from friends. They must learn to fit in with social groups that have already been formed. They must eat lunch and play outside with a whole new crop of friends. If your child has issues socially, this could be an even more difficult time for him/her.

Child’s Self-Esteem

A child’s self-esteem may take a blow when they are asked to repeat a grade. Children know when their friends move on. Children know when they have to say “I’m in first grade again”. Even if you think your child is unaware, chances are he/she is fully aware, she just may lack the verbal skills to tell you.

Fitting In Size Wise

Depending on the month of your child’s birthday, when you first enrolled him/her in school, and general family genetics, your child’s height and weight (and subsequent puberty) may be an issue if you choose to hold them back. For example, if your child holds an August birthday and you choose to start 1st grade at age 7 rather than age 6 but then a couple of years later, your child repeats a grade, your child is now almost 2 years older than her classmates. Your child could be hitting puberty much sooner than her peers and she could be the victim of negative social attention for it. Moreover, the last thing you want is for your daughter to be the tallest girl in the grade (unless of course Basketball is in her future).

Research Shows Retention is Ineffective

A number of studies have been conducted on the long-term effects of grade retention, including social effects as well as academic effects. The research shows that grade retention does not result in the intended outcomes. In fact, some negative long-term effects include a greater risk of high school drop out as well as poor academic achievement.

Children Know and Remember

Finally, your child’s peers will know and remember that your child was held back. They will carry it with them over the years, “Oh yes, that’s Suzie, she was in 2nd grade with me and she had to repeat 2nd grade”. Children have so many other issues to over come, it seems odd that we would purposefully add another source of stress for them.


Here are some other resources you may find helpful:

Center for Development and Learning

National Association for School Psychologists (NASP)

A second post by NASP

Weigh In

I would love to hear from our readers on this one. Have you held your child back? How did it go or how is it going? Did your friends? Teachers and behavior analysts, what have your experiences been?

If you have a behavior question for Missy, email askmissy at applied behavioral strategies dot com.

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In the social media world, you can make many friends. Our list of Tweeps, Facebook friends, and LinkedIn folks is growing every day. Recently, we met a blogger who is a great resource for families in the special education world. Her website is The Special Education Advisor and her name is Dennise Goldberg. You can follow her on Twitter @SpecialEdAdvice. (If all of the social media is confusing to you, we wrote about how Twitter can help you.You can read it here.)

Dennise asked us to write something for her website and, well, since it is IEP season, we thought a great piece on IEP minutes would be helpful for readers.

So, instead of reading our post on our site, hop on over to hers to read it there. Look around her website and check out the resources she has available.

Thanks for having us Dennise!

Also, we linked our blog from Monday up with Bruna over at Bees with Honey. Hop on over there and see what all of her friends have to say. It is another way to meet other bloggers and blog readers.

Bees With Honey

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We read an interesting post on one of our list serves reminding us that even when we use words that “we” believe are commonly understood, we may be assuming too much.The post we saw today referred to rewards as bad things because they lead to, among other things, “satiation.”

The post was published on Edutopia on March 6, 2012 (http://www.edutopia.org/blog/reward-fraud-richard-curwin). Dr. Curwin noted that

Satiation means that more of something is required to get the same effect. Examples are pain medication or hot water in a bath. I love a hot bath, but eventually it starts to feel cooler, and I add more hot water. Rewards are like that. Children never say, “That’s way too much. Please give me less.” They often say, “Is that all? I want more.” Eventually, rewards like stickers, food, parties, toys or candy become expected, and their effect is greatly reduced.”

Now, we know that Dr. Curwin’s interpretation of satiation does not align with the text-book definitions of satiation. In fact, the definition of satiation is almost the exact opposite of what Dr. Curwin described. Satiation, according to the Oxford English Dictionary, is “point at which satisfaction of a need or familiarity with a stimulus reduces or ends an organism’s responsiveness or motivation.” Dictionary.com, offers a much more user-friendly definition, “the point at which one is satisfied or more than satisfied“.

In our behavioral framework, we say that a person becomes satiated when overexposed to an item that previously was needed or wanted. Take thirst, for example. In a 4-term contingency that includes motivating operations (MO, also understood as internal motivations), “thirst” serves as an MO. That is, in the presence of water (Sd), given “thirst” as a precondition (MO), a person will drink the water (response) because the value of slaking his thirst is pretty high (Sr+). On the other hand, if I’m feeling pretty hydrated, I likely won’t drink water (‘response’) even when it is present (‘Sd’) because the value to me (Sr+) is diminished at that time.

Dr. Curwin is right when he says that satiation is not a good thing when working with kids, but he is not correct from a behaviorally analytical framework. When folks get too much of something (even if it’s awesome at first), they will want less of it in the future!

We think that sometimes folks just get confused with all these terms and their relationship to one another. So, next time you think you’ve explained everything clearly, check to see that you all share the same understanding. What you find may just surprise you!

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Hi and welcome to What Works Wednesdays where we share a success story from one of our clinical cases. All names have been changed to preserve the privacy of the child and family. Our intent is to show readers how successful ABA can be. Today’s story is about a young man we call Boost (you will see why a bit later in this post).

Boost came to us with a long history of feeding difficulties and he was only 7. He was diagnosed with autism and he was also non-verbal. Boost had previously eaten food but only in wet ground form. By the time he got to us, he consumed only Boost and apple juice. Both liquids were consumed from a bottle with the top of the nipple cut off so the liquid would literally pour into his mouth.

Prior to any behavioral feeding therapy, we require a thorough record review and assessment to assess for any possible underlying issues. (Honestly, all intervention programs should be preceded by a thorough assessment to help with program planning. We have written about that previously here.) For Boost, we completed a record review to determine if any assessments were needed prior to therapy. Boost had a long history of gastrointestinal (GI) issues so we referred his family to a gastroenterologist for a thorough work up.

The gastroenterologist completed an endoscopy during which the gastroenterologist inserted a pill camera to complete an assessment of the entire small bowel. He discovered that Boost had serious inflammation in his GI tract. Specifically, Boost’s pylorus was so inflamed that even the pill camera would not pass. You heard us correctly. A tiny pill camera would not pass through his pylorus. And we all wondered why he had limited his calorie consumption to a pure liquid diet.

You see, Boost was non-verbal. He could not tell us that he had GI pain. He could not tell us that it hurt to eat. Had we started therapy without the GI Assessment, we could have caused Boost a great deal of pain. This case is an excellent example for demonstrating the importance of assessment prior to treatment.

The GI Doctor placed Boost on an elemental formula and anti-inflammatory medication so that Boost could obtain appropriate nutrition while allowing his GI tract to heal, a process that took 6 months.

Parents, if you have a picky eater, please make sure that you obtain assessment in all areas to rule out underlying issues. Behavior analysts, do due diligence in the assessment process to ensure that you do no harm in your behavioral feeding therapy.

We would love to hear from readers. Please share what types of information you have gained from the assessment process prior to behavioral feeding therapy.

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