1 Treatment of Toileting and Feeding Challenges for Children with Autism Spectrum Disorders Nancy Sullivan, Ph.D. and Kim Dunn, MSN/PNP Staff Psychologist and Pediatric Nurse Practitioner, Division of Developmental Medicine
2 No Disclosures 2
3 Goals Understand challenges related to eating and toileting for individuals with autism spectrum disorders. Overview of medical concerns. Learn medical and behavioral steps for achieving toileting and improving feeding. Outline of resources.
4 Overview Toilet Training Toilet training is a common issue in pediatric population Toilet Training is the consolidation of many skills There may be special accommodations or techniques needed when developing a toilet training plan for your child Consider your child s temperament and learning style when developing a plan Constipation is a major obstacle in mastering urine and stool continence for both day and night
5 Goals of Toilet Training Ultimate goal is to get your child to be able to access the bathroom and use the toilet/complete process without assistance First task is to get your child to be comfortable with using the bathroom and toilet Next step is to teach your child to use the toilet for elimination Next step is to have your child become accustom to the entire process (flushing, handwashing,etc.)
6 Toilet Training Readiness Multiple developmental skills needed to successfully toilet train No existing medical problems such as constipation regular bowel patterns Helpful if child and parent are both ready Signs of readiness: Dry at naptime, hiding to have BM s, wants to change wet diaper, etc Common age recommended is cognitive age of 2 years or older
7 Language/Communication Skills Expressive Communication Ability to communicate that diaper is wet or need to use the bathroom (or access bathroom) Verbally, sign language or picture system Receptive Language Ability to understand multi-step directions Verbally Picture system (reinforce each step) Sign Language
8 Motor Skills Ability to: Get self to the bathroom Remove clothing (buttons can be difficult) Sit on toilet (on own vs. being placed) Stay balanced (not fall in ) Push (Use balloon, glove, stepstool, etc..) Wipe have child count out squares if obsessive over paper Get down from toilet.. For Children with physical handicaps there is adaptive equipment available
9 Cognitive Skills How long can child stay dry (can depend on cognitive level) Understand the process of what is going on First: Potty is a chair and practice sitting Second: Potty is used to eliminate Making this connection can take time for some children Attention Span: Attention is needed to perceive signal, get to bathroom, relax and release urine or stool Sequencing of skills can be difficult
10 Social/Emotional Imitation, PECs, Apps, social stories Considerations: Outside Pressures/Change in routine New sibling, new school, change in schedule Pressures may interfere with the toilet training process Resistance can lead to withholding and constipation
11 Social Story Sometimes I have to pee. I go to the bathroom when I have to pee. Sometimes I have to poop. I go to the bathroom when I have to poop. When I go in the bathroom, I pull my pants down. I sit on the toilet. Sometimes I pee in the toilet. Sometimes I poop in the toilet. When I finish going pee or poop I wipe. After I wipe I flush. After I flush I wash my hands.
12 Toilet Training Process Program must take into account your child s temperament Change tends to be gradual Stepwise approach All caretakers should be on the same page during the process (including school if necessary) Include in Individual Education Plan (IEP) at school
13 Huge leaps may increase anxiety and resistance
14 Positive Tactics Reinforce each step of toilet training Reward picture system should include task and reward Verbal praise/singing Reward system instant reinforcement Stay positive (easier said than done) Accidents will happen Too much praise can backfire (too much pressure)
15 Behavioral Treatment Sample jobs and goals for resistant children (shaping) Stand in the bathroom to make a bowel movement (no pressure to sit on the toilet) Sit on the potty with pants Sit on the potty without clothes
16 Strong Preference for Routine Build on your child s preference for routine Teach using toilet training as a new routine rather than a change in routine Breaking patterns can be difficult and change takes time (passing stool in a certain position or place) Allow child to watch a video or play with desired game/toy during sitting times Use PECS to demonstrate entire routine
17 Habit Training Typically older than 6 with cognitive functioning <3 years Assess how long child can stay dry Use tracking system / collect data Child sits every hour for example: Dry or wet when they sit +/- eliminates Goal is to have child learn to stay dry until sitting time Include in IEP Self-initiation takes time
18 Inattention/Hyperactivity Child May need reminders to use the bathroom Watches with vibrating alarms can be helpful (Amazon.com, bedwettingstore.com, pottymd.com) Longer sitting times after meals help with bowel patterns Handheld games during sitting times can be helpful Instant positive reinforcement
19 Sensory Sensory overload in the bathroom earplugs Motor coordination breaking down the process of getting pants down, sitting on the toilet, relaxing, releasing, etc.. Pressure of urine or stool filled diaper may be tactilely soothing Transitioning from diapers to pull-ups to underwear can be very difficult splashing of water when eliminating into toilet Idea of urine/stool getting on the skin
20 Pathology Ensure no pain before toilet training (Constipation/UTI s) Frequent UTI s/pain can lead to withholding Constipation can lead to withholding Coordination difficulties can lead to withholding Toilet refusal can lead to withholding Withholding > constipation > increased withholding > chronic constipation > Encopresis> Many months of behavioral and medical treatment
22 Nighttime Training Separate set of skills Genetic Typical accommodations: Decrease fluids before bed (sips of water following dinner) Urinate frequently throughout the day Urinate before bed Get up to urinate when one awakens at night Medications vs. Nocturnal Enuresis Alarms
24 General Subtypes of Feeding Difficulties: Individuals who do not eat enough/show little interest in feeding Individuals who only accept a limited diet in relation to sensory features or ritualized routine. Individuals whose food refusal is related to aversive experience.
26 Medical Considerations Constipation: food refusal, poor weight gain and behavioral problems Reflux: vomiting and food refusal. May lead to poor weight gain and food refusal Allergies: May result in poor intake and food refusal Other Medical: Celiac Disease: Treatment may include a Gluten-free diet Other gastroenterological conditions
27 Gluten and Casein Free Diets Diet and Nutrition in Children with Autism Spectrum Disorders: An Autism Treatment Network Collaborative Study Susan Hyman Review: Gluten-free and casein-free diets in the treatment of autism spectrum disorders: A systematic review. Austin Mulloy, Russell Lang, Mark O Reilly, Jeff Sigafoos, Giulio Lancioni, Mandy Rispoli
28 Nutrition Deficits Deficiencies often found: Iron: immunity & energy level B Vitamins: immunity & energy level Fiber: constipation Calcium: needed for growth in children under 5. Vitamin D: bone health High Quality Protein
29 Fiber Needs of Children GENDER/AGE 1 3 y y Female 25 Male y Female 26 Male y Female 29 Male 38 Fiber, g a Adapted from 2005 Dietary Guideline Advisory Committee. Nutrition and your health: dietary guidelines for Americans. Available at: a Total fiber preferred minimum 14 g/1000 kcal. Read labels to determine amounts on all packaged foods
30 Too slow to grow? Calculating expected growth based upon mean parental height Using appropriate growth curve World Health Organization curve until 2 years Genetic conditions with known growth curves Extreme prematurity
31 Sensory Restrictive Eating My child will only eat three foods and they are all brown! Selectivity falls along the sensory experience of the food: Visual appearance Texture Smell Taste If non-preferred foods are not presented, child typically will not eat
32 Ritualized Restrictive Eating My child will only drink out of a certain sippy cup. I changed the cup and he stopped drinking. I was afraid he would become dehydrated. Child insists that food or drink presented in a particular manner/form. Deviation from routine results in distress and refusal. Child may only eat foods out of certain containers or select foods according to brand.
33 Ritualized Restrictive Eating
34 Food Refusal Related to Averse Experience Food Phobia Phobia is the intense FEAR and AVOIDANCE of something. May occur with a punishing event or repeated conditioning with negative stimulus. Use cognitive-behavioral techniques to treat Systematic Desensitization Correct cognitive distortions
35 Treating Feeding Disorders
36 Treating Feeding Problems: General Approaches Fluid Management Solid food choices Control grazing: stimulating hunger Focus on mealtime behavior, rather than food intake. Sit at the table Length of meal Remove behavioral component in ending mealtimes Address maladaptive or disruptive mealtime behaviors
37 Behavioral Treatment Approaches Reinforcement of Specific Behaviors: Reinforce behaviors that promote good food intake. Desensitization: (Food Game) overcoming aversions, fears and over-selectivity. Applied Behavioral Analysis or Discrete Trial Training (used in children with autism and developmental delay).
38 Systematic Desensitization Maintain fun, playful atmosphere- not at meals Introduce foods in a desensitization chain Introduce a small number of foods at a time After food is mastered, then focus on generalization Treatment is slow and gradual Keep anxiety at a manageable level Use play and rewards to increase motivation Always end on a positive note
39 Sensory Food Aversions Description: Refuses specific food textures, tastes or smells, eats preferred foods without difficulty. Treatment: Introduce foods early in life but back off with severe aversion- Don t force feed Modeling of parents and peers effective Occupational Therapy Give small amount of the food and make them ask for more. Parents goal: stay emotionally neutral Behavioral Feeding Therapy
40 Ritualized Restrictive Eating Behaviorally reinforce deviations from the routine Use pictures and visuals to introduce new foods Introduce new before getting rid of the old Avoid Cold Turkey approaches Use behavioral and desensitization therapies Use cognitive strategies when appropriate
41 Using the Applied Behavioral Analysis or Discrete Trial approach: Breaking down the steps: baby steps. Using rewards. Making a high frequency behavior (e.g., perseverative behavior or access to object) contingent on a low frequency behavior (trying a new food). Frequency of trials. Generalization of gains.
42 Discrete Trial Training Prompt 1: Do this (hold food/kiss/lick/bite) Response 1: Child responds as prompted. Principles: Reinforcer assessment. Errorless learning: prompt correct response Use multiple trials, regularly practiced each day Use ABA sessions AND caregiver directed sessions.
43 Naturalistic Behavioral Approach Touching: incorporate into play as barrier or touch to different parts of face Tasting: taking turns, you pick/child picks Using first/then with preferred before nonpreferred.
44 Treating Children with Autism Spectrum Disorders: Visual Supports Spell out contingencies: Managing behavioral problems related to feeding difficulties. Menu Board: Help child make choices and increase variety Reward Token Boards: clearly defines how much a child has to do. Helps with motivation and compliance.
45 Video example:
46 Feeding Resources: Treating Eating Problems of Children with Autism Spectrum Disorders and Developmental Disabilities: Interventions for Professionals and Parents by Keith E. William Food Chaining: The Proven 6-Step Plan to Stop Picky Eating, Solve Feeding Problems, and Expand Your Child s Diet by Cheri Fraker, et al. How to Get Your Child to Eat but Not Too Much by Ellyn Satter
47 References American Academy of Pediatrics, Toilet Training. Guidelines for Parents. AAP Schonwald A, Sherritt L, Stadtler A, Bridgemohan C. Factors Associated with Difficult Toilet Training. Pediatrics Vol. 113 No. 6 June 2004 pp Stadtler AC, Gorski PA, Brazelton TB. Toilet Training Guidelines Clinicians The Role of the Clinician in Toilet Training. Pediatrics. 1999; 403 (suppl)
Toilet Training Children with Special Needs Toilet training can be challenging for parents and children, but especially so if the child has a developmental disability. Unique circumstances and characteristics
Successful Toilet Training and Beyond Anna Edwards, Ph.D., Clinical Child Psychologist Kristen Michener, Ph.D., Clinical Child Psychologist Made For Kids, Inc. www.made4kids.org Intro Most children have
COMPASS Information Series: Toilet Training Parents look forward to the time their young child is toilet trained. Parents expect their child to learn to use the toilet as part of the growing up process.
HELP My Child Won t Eat! HELP My Child Won t Eat! Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone: (830) 237-2886 Fax: (866) 855-8301 Email: ASDpuzzle@aol.com Website: www.asdpuzzle.com
Potty Training: A Different Perspective Esther Weisz, MS, OTR/L You are ready to ditch those diapers and move into big kid underwear. There are many tried and true tips available to help families and their
Toilet Training Readiness When do I start? Bowel and bladder control is a necessary skill. Teaching your child to use the toilet takes time, understanding, and patience. The important thing to remember
Teaching Functional Skills to Individuals with Autism and other Developmental Disabilities Dr. Barry D. Morgenstern Institute of Professional Practice 1 2 Why Focus on Functional Skills? Functional skills
Toilet Training A workshop for Parents Jenny Tsagalas Behaviour Support Specialist Autism Service AIM OF WORKSHOP To give you practical information regarding toilet training techniques for you and your
Continence issues in children and young people with autism Suzie Franklin Family Liaison and Support Worker Inscape House School Anna Turner Paediatric Continence Advisor PromoCon Aims for today: To develop
This pack provides hints and tips to help you facilitate independence in toileting with the children you work with. Please use the advice and strategies contained in this pack before you make a referral
Benefits of Toilet Training Tamara S. Kasper MS/CCC-SLP, BCBA Alisa Morrison-Armata, BA WISABA 2011 The benefits of toilet training are obvious and important. Your child will learn an important life skill,
My child and toilet training What I need to know Information for parents and carers Community Paediatric Continence Service Incorporating hospital and community health services, teaching and research This
A Psychological Guide for Families: Feeding & Eating Child & Family Psychology Introduction This booklet is part of a series that has been written by Clinical Child Psychologists from the Child and Family
TOILET TRAINING: Background, approach & practical advise Background: Biologically all species bring their own internal characteristic structures which are in interplay with the conditions of the environment
Exploring Feeding Behavior in Autism A Parent s Guide These materials are the product of on-going activities of the Autism Speaks Autism Treatment Network, a funded program of Autism Speaks. It is supported
Your guide to Toilet training your child Contents Toilet training your child 4 Getting started 5 Developing a routine 6 Hand washing 8 Habit training 9 The environment 10 Night time 11 Further information
Understanding getting ready for toilet training: A Guide for Parents 1 Toilet / potty training can be hard for families - and is even harder when a child has special needs. However, having special needs
Behaviour Potty/toilet training Information for parents of disabled children in England, Northern Ireland, Scotland and Wales Contents Introduction 3 What do we mean by toilet training 4 When should you
ACT-NOW Fact Sheet 17 p. 1 Dietary Issues and Autism Information for parents by Prof. Bruce Tonge & Dr Avril Brereton Many parents report that their child with autism is a fussy eater or has food fads.
TARGETING THE BIG THREE TOILET TRAINING CAREGIVER MANUAL SUMMARY This training offers hands-on instruction for parents, caregivers, and direct care staff to address the most frequent and problematic areas
Behaviour Support for Children with Autism Spectrum Disorders Parent Training Welcome Social Interaction Anxiety/emotional outbursts due to unpredictable nature of social interaction. Can lead to low self
Staying Dry: Good bladder habits for your child Developed by the health care professionals of Urology Department with assistance from the Department of Learning and Development. All rights reserved. No
Today s Date: MULTIDISCIPLINARY PEDIATRIC FEEDING PROGRAM BACKGROUND INFORMATION 1. Child s 2. Date of Birth: / / 3. Gender: Male Female 4. Parent/Guardian(s) Name(s): 5. Marital Status: Married Single
1 TREATMENTS FOR AUTISM Guideline for Evidence Levels: Established. Sufficient evidence is available to confidently determine that a treatment produces beneficial treatment effects for individuals on the
Example Outcomes The following examples are taken from real Routines-Based Interviews, which produced the informal goals below. The format for the observable goals, which is used interchangeably with outcomes,
Toilet Learning at SLC At SLC, we work with parents to potty train their children. Children should remain in pull-ups or in plastic pants over underwear at school until arrangements have been made between
Services Learn about Intensive Behavioral Intervention (IBI) The IBI program is a comprehensive treatment for children with autism using applied behavior analysis (ABA). This autism treatment is evidence-based
Toilet Training page 1 Toilet Training Are you and your toddler just about ready to say goodbye to nappies for good? If you are, then it s time to learn more on the subject of toilet training. At first,
4.9 Specialist Health Expertise Guidelines 4.5.9 Faecal incontinence (Encopresis) Background Encopresis may be defined as the voluntary or involuntary passage of formed, semiformed, or liquid stool into
Avoidant / Restrictive Food Intake Disorder (AFRID) Tweet Chat Transcript Hosted by Dr. Kaye and Dr. Menzel January 29, 2015 EDH: Welcome to today s #EDHchat! We are excited to have you all with us! We
Toilet training A guide for parents of children and young people with learning disabilities Introduction Teaching your child to use the toilet correctly can be a difficult task, whether they have disabilities
Family Style Meals: 101 Nutrition Education in the Classroom Agenda Definition and benefits of family style meals Specific roles in family style meal service Strategies to support family style meals Nutrition
CHILD S FACE SHEET/ENROLLMENT FORM INFANT/TODDLER CHILD INFORMATION: Child s Name: Date of Birth Home Address: Place of Birth:(city/town) Telephone: Primary Language: Child s Identifying Information (required
Compliments of Autism Asperger s Digest January-February 2004 issue Examining the Structure of your ABA Program William Frea, Ph.D. & Ronit Molko, Ph.D. One of the most difficult, if not painful processes
Why does my child have a sleep difficulty? Research suggests that at least two thirds of children and young people with developmental difficulties have a sleep problem at some point. Your child developing
Bathroom Toolkit More students with hygiene goals are being educated in their neighborhood schools. This requires staff to increase their skill sets to include instruction in toileting and hygiene. Our
Talk about getting ready for potty training -A Guide for Parents June RogersMBE Director Promocon Disabled Living, North West June 2007 Toilet/potty training can often seem a challenge for some families
The ABC s of ABA Claire Benson Kimberly Snyder Sarah Kroll Judy Aldridge ABA Overview Applied Behavior Analysis is NOT one set of procedures that can be applied to everyone. Applied Behavior Analysis is
Alberta Aids to Daily Living P R O G R A M Pediatric Incontinence PROGRAM MANDATE: The Alberta Aids to Daily Living (AADL) program helps Albertans with a long-term disability, chronic illness or terminal
Constipation in Children and Young People Information for Parents Children s Ward 01625 66101080 Leaflet Ref: 10167 Published: 01/16 Review: 01/19 Page 1 Constipation Your child has been diagnosed with
Children s Records must be maintained for at least five (5) years after a child has left the program FAMILY CHILD CARE ENROLLMENT PACKET F A C E S H E E T Please fill out these forms completely. If a question
with Inflammatory Bowel Disease of Inflammatory Bowel Disease () is a term that describes several different conditions that cause inflammation (pain, swelling, irritation and ulcers) in the small or large
Diagnostic Center, Southern California California Department of Education Toilet Training Procedures For Individuals With Developmental Disabilities Diana Browning Wright To achieve toilet training success
Task Analysis: Steps for Implementation Franzone, E. (2009). Task analysis: Steps for implementation. Madison, WI: The National Professional Development Center on, Waisman Center, University of Wisconsin.
Recovery After Stroke: Bladder & Bowel Function Problems with bladder and bowel function are common but distressing for stroke survivors. Going to the bathroom after suffering a stroke may be complicated
Quick Facts About Potty Training By Elizabeth Pantley, Author of The No-Cry Potty Training Solution Potty training can be natural, easy, and peaceful. The first step is to know the facts. The perfect age
Beating the Toilet Monster Introduction I was toilet trained at 18months He is doing it to wind me up Two comments that many parents of special needs children have either heard or have said themselves.
Development of taste and food preferences in children. Dr Gillian Harris School of Psychology, University of Birmingham The Children s Hospital, Birmingham Developmental agenda for feeding In utero Some
Autism Spectrum Disorder Series: Introduction to Applied Behavior Analysis (ABA) Sylvia J. Acosta, PhD May 23, 2016 Introductions and Disclosure Sylvia J. Acosta, PhD, Assistant Professor, Postdoctoral
0 3 Months Sensory Motor Checklist Enjoys playful face-to-face interaction with people Coos in response to playful interaction Notices and responds to sounds Moves legs and arms off of surface when excited
Toilet Training Page 1 of 11 Toilet Training 1. Why?...3 2. Are we ready? 4 3. Preparation 6 4. Trip Training 7 5. Self Initiation 8 6. Nighttime 9 7. Resources 11 Prepared by: Hanna Nagtegaal, MOT Page
These articles were originally published in The Callosal Connection, Fall 2007. The Callosal Connection is a publication of the ACC Network The Role of Occupational Therapy for Children with ACC By Erin
Picky Eating in Children with Autism Spectrum Disorders By Sharon A. Cermak, EdD, OTR/L, FAOTA, Professor of Occupational Science and Occupational Therapy, and Professor of Pediatrics, at the University
CNA Workbook WHAT IS INCONTINENCE? Incontinence is the inability to control the flow of urine or feces from your body. Approximately 26 million Americans are incontinent. Many people don t report it because
Presented to: Kentucky Autism Training Center Myra Beth Bundy, Ph.D. Department of Psychology Eastern Kentucky University Acknowledgements to Dr. Linda Kunce, Dr. Tony Attwood } Characteristic symptoms
PBO 930022142 NPO 049-191 Incontinence Incontinence can be upsetting and humiliating for the person with dementia as well as stressful for the carer. However, there are many ways in which the situation
Refrigerator Notes & Handouts Effective Praise and Encouragement Effective Ways to Praise and Encourage Your Child Bringing out the Best in Your Child HOME ACTIVITIES FOR THE WEEK CONTINUE PLAYING with
The Commonwealth of Massachusetts Department of Early Education and Care Child s Enrollment Form Child Information Child s Name: Date of Birth: Age at Admission: Date of Admission: Child s Home Address:
Autism Conversations: The sensory entry point Marilyn J. Monteiro, PhD Adapted from Autism Conversations: Evaluating Children on the Autism Spectrum through Authentic Conversations (2010). Los Angeles:
Adoption: Adoption is the legal process by which a person becomes a lawful member of a family different from their birth family. Adoption is a permanent lifelong commitment to a child. Becoming a parent
Feeding History Questionnaire This form must be completed prior to your child s visit. Please mail, email, or fax it to The Clubhouse at least 3 business days before your first visit. Fax: (602) 368-8605
Teaching Functional Life Skills Created by: Staff of Society for Treatment of Autism Overview Identifying functional goals Developing a teaching plan Specific examples: Independent activity Toilet training
ABOUT YOUR SCHOOL NURSING SERVICE Welcome to Your School Nursing Service Now Your Child is at School When your child starts school the School Nursing Service takes over their care from the Health Visitor.
Constipation in the older child Definition Constipation in children is a common problem. Constipation in children is often characterized by infrequent bowl movements or hard, dry stools. Various factors
Behavior & Sensory Strategies for Individuals with ASD Kathleen Mo Taylor, OTR/L The Autism Programs Center for Development and Disability University of New Mexico This presentation is made possible, in
The contents of this app were developed under a grant from the Department of Education, NIDRR grant number H133S120002. However, those contents do not necessarily represent the policy of the Department
Potty Training When is the right time to start toilet training? There is no set age at which toilet training should begin. The right time depends on your child's physical and psychological development.
ABA & Teaching Methods C H A P T E R 7 E A S T E R S E A L S S O U T H E A S T W I S C O N S I N S T A R T E A R L Y, S T A R T S T R O N G P R O G R A M ABA ABA = Applied Behavior Analysis Science devoted
Childhood Wetting and Soiling: information for parents and carers Contents Introduction Introduction 1 What is ERIC? 2 At what age do most children become clean or dry? 3 Why does my child still wet or
Benefit Coverage Rehabilitative services, (PT, OT,) are covered for members with neurodevelopmental disorders when recommended by a medical provider to address a specific condition, deficit, or dysfunction,
Handbook for Teachers of Students with Autism Spectrum Disorder Dear Teacher Our Child Needs Help A Handbook for helping children with Autism Spectrum Disorder including Pervasive Developmental Delay Not
Mrs. M. Care Plan (Post Significant Change) Mrs. Cynthia M is a 90-year-old, Caucasian female, born June 22, 1920 in Germany and immigrated to the United States when she was seven years old. Mrs. M speaks
Minutes: North Tidewater Community of Practice in Autism (NT CoPA) Topic: Pivotal Response Training Date: October 13, 2009 Location: Healthy Families Partnership Building, Hampton Participants: 6 Pivotal
Parallel Issues, Behavioral Issues and Care Provider Struggles C L A I R E B R A N N A N M O B I L E C L A S S E S A N D C O N S U L T I N G A P R I L 1 0 T H, 2 0 1 5 An Aging Population The number of
Behavior 141 142 BEHAVIOR What is Behavior? A behavior is the way a person acts in response to a particular situation. Why is Behavior Important? For children who have experienced trauma, keeping themselves
A to Z of Potty Training Tips Age There is no right age to potty train, as natural readiness varies from child to child. Children gain bowel and bladder control at their own pace, but most are potty trained
TODDLERS Learning Objectives Alignment with MN Early Learning Guidelines Birth to Three PLAYBOOK Toddlers Learning Objectives Social and Emotional Development Form and Maintain Relationships Toddlers develop
Promising Practices for Students with Autism Dr. Heather Duncan Agenda Autism: An Overview & Diagnostic Criteria A Comprehensive Approach to Intervention Environmental Structure Goal Development FBA Plan
Terms to know When should toilet training be started? Benefits of toilet training Goals of independent toileting Potty chair or toilet? To sit or to stand? What should the child wear? Home or school? Data
The American College of Obstetricians and Gynecologists f AQ FREQUENTLY ASKED QUESTIONS FAQ120 WOMEN S HEALTH Problems of the Digestive System What are some common digestive problems? What is constipation?