Archive for July 2017

Monthly Archive

Ask Dr. Emily – Understanding Behavior and Bilingual Children with Autism

Welcome to the July edition of Ask Dr. Emily!

We often receive questions that we want to share with all our readers. To help with this, Dr. Emily Rastall, a clinical psychologist at Seattle Children’s Autism Center, will share insights in a question and answer format.

We welcome you to send us your questions and Dr. Rastall will do her best to answer them each month. Send your questions to

Q: I am a student and I recently started interning at a child development center. We care for a child who is on the autism spectrum who deliberately burps during his tasks. I’m assuming that this is one of his repetitive, stereotypical behaviors. Is this correct? Would you suggest some ways to reduce or stop the behavior?

A: Thank you for your work and for your question. Before we call this behavior “deliberate,” we will want to determine the function that this behavior is serving. Behaviors can be categorized into serving one or more of the following three purposes: Getting something (like attention or the iPad), avoiding something (like an unpleasant task), and/or self-stimulation (a repetitive, non-functional behavior that serves to stimulate a sensory response). You will also want to consider whether the behavior is a safety risk and/or whether it significantly impacts an individual’s daily functioning. Your intervention (or lack thereof) will vary based on what function the behavior is serving and how impactful it is on the child’s life.

In summary, it sounds like a functional behavior assessment (FBA) is in order. An FBA can help you determine what purpose a behavior is serving, which will determine the intervention you will choose to use. You will want to consult with your team of supervisors regarding how best to go about scheduling an FBA with a trained professional.

Q: I am a father of a child with autism who just turned five. My child’s mother and I do not live in the same home. My daughter speaks only Spanish in her mother’s home. I speak only English with her in my home, and her educators and therapists speak English with her as well. Historically, I have been against her learning Spanish, as I was concerned that her language development would suffer as a result of being bilingual. Although my daughter’s language development has grown dramatically over the last year, I have heard mixed opinions about the impact of being bilingual on language development in children with autism. Given that she is bilingual (whether I like it or not), I wonder if I should make an effort to seek out a bilingual teacher and/or speech therapist. Should I be concerned that my child with autism is being raised bilingual?

A: Thank you for writing in. Rest assured, the research is telling us that there are no ill effects for kids with autism who are exposed to two languages. In fact, the research even points to benefits of being bilingual for children with ASD; for example, bilingual children with ASD have been observed to vocalize more and use gestures more frequently. Seeking out a bilingual speech therapist might help your daughter advance in both languages and could be helpful in coaching you and your daughter’s mother to foster her bilingual growth.


Parent Perspective on Transitioning to Adult Care

When you have a child with special needs or complex medical issues, it takes a long time to learn about the care they need, and put together their team of doctors and other providers.

After my daughter got her multiple diagnoses, between ages two and three, it was years before I felt like we had her full team of experts in place. It was really hard work, where I had so much to learn about what my daughter needed – and so did her care team.

We’ve been developing our relationships with these providers over the many years since then. We’re comfortable with each other. I trust them to know and understand my daughter and our family. When we talk about her care, we have a shared understanding of our experience, a shared history of knowing what works for us and what doesn’t. On an even more basic level, I’m familiar with the processes for making appointments, and how billing works. I know where to park and how to navigate the buildings to the clinics we need. I even have the phone numbers of her most frequent providers memorized, simply from having dialed them so often!

My daughter turned 18 last year, and I know that our time with our familiar team is running out. This is a really hard thing to think about, because I don’t want to have to do all this work over again – finding and getting to know and learning to trust and work with a whole new set of providers. What makes this even more complicated is that every clinic or specialist we see seems to have a different approach. One of her specialists has laid out a plan that includes a recommendation of the doctor to switch to, starting next year. Another has told us when we have to leave, but not where to go. Her pediatrician says she’ll keep seeing her “as long as no one tells me I have to stop.” Several clinics have never brought up the subject at all, and I’ve found it comfortable to avoid it myself as long as I can.

And at the same time that we’re figuring out this big transition, my daughter’s going through all kinds of other “transitions to adulthood.” There’s so much to learn and figure out all at once, it seems. It’s scary and confusing for me and for her.

What I’ve come to realize, a little later than I wish I had, is that planning ahead for this change is important. Just like in the early days when she was first diagnosed, it’s going to take some hard work and effort to pull together all the resources she needs now, as an adult, to keep her healthy and thriving. I’ve discovered that there are some helpful tools out there. And we don’t have to do this alone – we can ask her current providers for support and assistance in figuring out how to move forward in the safest, smoothest way possible.

Here are some resource that you might find helpful:

Checklist for Transitioning to Adult Health Care – PE2643

Adolescent Health Transition Project

Autism Speaks Adult Transition Tool Kit

Disabilities, Opportunities, Internetworking and Technology – University of Washington DO-IT Program


Friendship Adventures – Recreational, Educational, and Leisure Opportunities for Adults with Developmental Disabilities

Giving Your Child an Active Role in His or Her Healthcare

Preparing for Transition From School to Supported Employment

Transition to Adulthood for Youth With Intellectual and Developmental Disabilities



Mindful Monday – Cultivating Humility

What does humility have to do with mindfulness? In a word – acceptance. In this case, acceptance that we’re all human with our foibles and limitations. No one is perfect.


Being humble doesn’t mean being meek or weak. We have all met someone who demonstrates a humble confidence, taking ownership of mistakes and sharing successes.  And we’ve all met someone who demonstrates an insecure arrogance, blaming others for mistakes and taking credit for successes. Whom would you prefer to work with? Live with? Be?

Here are a few tips from Donald Altman in one minute mindfulness to help think about humility:

Reflect on:

  • What mistakes have I made and what lessons in humility do they hold?
  • How can I demonstrate to others that we’re all in this together?
  • How can I remind myself that humility is a strength?



Autism 200 Announcement – Now Available At Home

Autism 200 now available to be viewed at home!

We are pleased to announce that Autism 200, our monthly lecture series that provides information related to autism spectrum disorder is now available to be viewed at home through a PC or mobile device.  You can sign up for the live stream and view the current class schedule through the Autism 200 website.

After you fill out the form you will receive instructions regarding how to set up streaming using Blue Jeans technology from your personal computer or device.

This summer we will again be offering lectures on the transition to adulthood and will focus on vocational opportunities including classes on “Finding a Job” and “Keeping a Job”.  Of note is our September lecture on screening for ASD with a focus on educating community providers.

As always, lectures can be viewed after they are posted on our website and YouTube page.  See below to access these channels.

Thank you for watching!


The Autism Blogcast – July Edition

News Flash: The July edition of The Autism Blogcast, featuring autism experts Raphael Bernier, PhD and James Mancini, MS, CCC-SLP.

In an effort to keep you up to date on the latest news in research and community happenings, we welcome two of our favorite providers best known as Jim and Raphe, the autism news guys.

These two have too much energy to be contained in written format so our plan is to capture them in 2-5 minute videos that we’ll post the first week of each month. We welcome your questions and comments. Tell us what you think of our dynamic duo!

In this edition of the blogcast, our reporters discuss The Welcome Inclusion Symposium and promoting inclusion in the community.