Monthly Archives: February 2018

Being Realistic about Changing the Environment

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Recently I visited the home of one of my clients. I asked the RBT working there if our client was still throwing materials. She said he hadn’t thrown anything all week. I was excited to hear this news, until I heard her next sentence. “I realized he always throws the materials when he asks to be all done and I say ‘not yet.’ So now, whenever he says he’s all done, we just clean it up.”

While it is true that behavior analysts make changes to the environment to improve behaviors, that doesn’t mean we change the environment at the expense of teaching new skills. Our ultimate goal for any client is that they lead as independent a life as possible. For this particular client, I hope that one day he will be employed. This means that we need to start teaching him now that sometimes he will have to complete a task, even when he doesn’t feel like it.

So how do you know when you’re being realistic about changing the environment?  Here are a few questions you should ask yourself:

Is the environmental change I’m suggesting something that will be implemented in the natural environment? If no, then you should think about how to shape appropriate behaviors rather than simply avoid the problematic behavior. For this client, refusing to work further would not be acceptable in a school or in future work environments. It could also potentially result in more restrictive learning environments for the client.

In what future circumstances might this behavior cause problems for my client? If you can envision scenarios in employment, social situations, or in public, then you need to focus on teaching an appropriate behavior rather than simply avoiding the problematic behavior. Furthermore, thinking about these circumstances may help you identify potential replacement behaviors that you can teach.

How can I shape an appropriate behavior? Think about the steps you can plan for shaping a replacement behavior. For instance, with the example of my client, we could start by requiring him to complete one more simple instruction before putting the activity away (such as placing one more puzzle piece, responding to one more question, or imitating one more action.) After he’s mastered that step, we could increase the requirement to completing two more simple instructions, then to working for one more minute, then two more minutes, etc. We can implement a systematic plan for teaching an appropriate response and completing the work even if he doesn’t want to anymore.

Is what I’m asking reasonable? In another case, one of my clients’ goals was to pull her hair back into a ponytail independently. The intention behind this goal was to do it in situ, when she would naturally be pulling her hair back. However, the implementation of the goal resulted in her practicing pulling her hair back and taking it down multiple times. Her hair would often tangle and she would feel pain while taking her hair out of the ponytail. It’s fair to say that asking a client to put up and take down her hair several times is an unreasonable request. If your request isn’t reasonable, think about how to change it so the client still learns the skill without it becoming aversive.

Ultimately, we should not change the environment in order to avoid behaviors, unless there is something unreasonable or unnecessary about what we are requesting the client to do. It is our job to teach the client how to communicate effectively, as well as to teach and reinforce appropriate behaviors to promote independence.

WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

Sam is an ABA provider for students ages 3-15 in NYC. Working in education for twelve years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. She is also an assistant professor in the ABA program at The Sage Colleges.

Sharing and Cooperation

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by Dana Reinecke, PhD, BCBA-D

Sharing and cooperative play are among the most difficult skills for children to learn, whether or not they have a diagnosed disability. Why is sharing so hard? Because it necessarily involves giving something up, and usually it’s something highly preferred that is being forfeited. Cooperative play is similarly challenging because there’s often an element of compromise required. Play isn’t cooperative if one partner is getting his or her way the whole time; what makes it cooperative is the give and take. Taking is usually easier for some children than giving, and most children struggle when asked to share their toys or their parents’ attention, but there are ways to make it easier to learn these important social skills.

First, most simply, reinforce sharing and cooperation as you would reinforce any behavior that you want to see more of. Often when a child is asked to share or to compromise, the immediate and only consequence for that behavior is losing something that he or she was enjoying. This is not going to be effective for increasing sharing and cooperating in the long run, but we can add reinforcers that make it more motivating to engage in these responses again in the future. If a child shares his toys and receives lavish praise and maybe access to even better toys as a reward, he may be more likely to want to share in the future. Similarly, being willing to take turns or let someone else “go first” in a game might be more likely to happen in the future if that behavior is followed by some other reinforcer like getting an extra turn or the option of picking the game next time.

Second, approach sharing and cooperation as skills to be built up gradually. This might mean stacking the deck for success initially. Sharing and cooperation can be easier to teach when the target peers are likely to be cooperative and patient. Both areas of social skills may be modeled from peers, perhaps slightly older children, who are willing to demonstrate how to share and cooperate. Peers who are willing to take “short turns” and quickly return shared items, or to accept small concessions at first, are also going to be better partners for the learner who is only just developing these social skills, rather than peers who might be trying to learn the same lessons at the same time.
It can also be a lot easier to encourage sharing and cooperation if the games and activities where they are being practiced are not competitive. It may be harder to recruit cooperation or sharing when there is a clear “loser” and “winner” as an outcome, resulting in extra motivation to do the opposite of sharing and cooperating. Poker players don’t cooperate or share with each other, because they want to win. But, sharing and cooperating are less costly and in fact often enjoyable when applied in creative, productive situations. Having children practice cooperation and sharing when doing a craft together, for example, may be more effective than during a competitive activity.

Finally, don’t jump to complex social skills like sharing and cooperating until the child has the basic skills in place for the target activities. It would be a lot to expect someone to learn how to do something else while also learning to share and cooperate. To return to the idea of working on sharing and cooperating during a craft activity, make sure that craft is something that isn’t entirely new to the learner and that he or she has the basic skills to do the activity. This will take some of the pressure off and make sure that the focus of learning can be on the more complex social skills.

About The Author 

Dana Reinecke is a doctoral level Board-Certified Behavior Analyst (BCBA-D) and a New York State Licensed Behavior Analyst (LBA).   Dana is an Assistant Professor and Department Chair of the Department of Special Education and Literacy at Long Island University Post.  Dana provides training and consultation to school districts, private schools, agencies, and families for individuals with disabilities.  She has presented original research and workshops on the treatment of autism and applications of ABA at regional, national, and international conferences.  She has published her research in peer-reviewed journals, written chapters in published books, and co-edited books on ABA and autism.  Current areas of research include use of technology to support students with and without disabilities, self-management training of college students with disabilities, and online teaching strategies for effective college and graduate education.  Dana is actively involved in the New York State Association for Behavior Analysis (NYSABA), and is currently serving as President (2017-2018).

Ethics Part Four: Considerations On Punishment

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Punishment procedures are, with reason, very controversial. Today, I’d like to clear up a few concerns and issues about punishment procedures, especially in regards to the ethical obligations of behavior analysts.

First, it’s important to define the terms we’re discussing. In behavior analysis, when we refer to punishment, we mean any response to a behavior that decreases the future likelihood of that behavior. This means that we won’t categorize a particular intervention as punishment unless we have actual proof that it decreases the behavior. When I was a classroom teacher, I had a student who at the beginning of math class would break his pencil and begin cursing. My immediate response to this behavior was to send him out of the room. But this wasn’t actually punishment because it did not decrease the behavior. Instead, his ability to escape the math class actually maintained the pencil-breaking and cursing behavior. If I wanted to punish, or decrease, that behavior, then I needed to change my response.

Often, when we’re talking about interventions, we lump several responses into the punishment category (such as time out, verbal reprimands, or detention) without any evidence that they are actually decreasing the target behavior. So the question becomes, what is an aversive stimulus for the individual you’re working with?

While this distinction is important in order to create effective interventions, it is also important to reference the Professional and Ethical Compliance Code for Behavior Analysts. Item 4.08 details the responsibilities of behavior analysts in regards to punishment. First, it states “behavior analysts recommend reinforcement rather than punishment whenever possible.” If behavior analysts have exhausted all possibilities and must use a punishment procedure, access to reinforcement must be a part of the intervention. This can be as part of reinforcing replacement behaviors that should be taught and reinforced in lieu of any problematic behavior.

Another important aspect of our ethical code is that when punishment procedures are being utilized, there is an increase in training, supervision, and oversight. A BCBA should not come in, explain a punishment procedure, and then not show up again for three months while teachers or practitioners are implementing the punishment procedure. Instead, there should be ongoing support and supervision and a plan to discontinue aversive procedures when they are no longer needed.

Ultimately, behavior analysts should be focused on reinforcement procedures. But when it becomes necessary to use aversive procedures to address dangerous behaviors, behavior analysts are required to be aware of and follow this compliance code.

WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

Sam is an ABA provider for students ages 3-15 in NYC. Working in education for twelve years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. She is also an assistant professor in the ABA program at The Sage Colleges.

“Touch Your Head” Or “Make Your Bed”? Staying True To The Applied Dimension Of ABA When Creating Program Goals For Students With Profound Cognitive Impairment

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This article originally appeared at www.bsci21.org. 

Nearly six months had gone by since we began Lily’s home-based ABA program, and she had not mastered a single target of a single program. Not one. I stared blankly at my own furrowed reflection through the graph on my computer screen. What was I doing wrong? Why couldn’t I get her to learn? Why was ABA failing me?

Prior to taking on Lily’s case, I had worked almost exclusively with early intervention and preschool children; kids who came to me with limited or nonexistent foundational skills, but who responded to ABA like a dream and whose graphs were magnificent; a baseline of 0% with a quick and steady climb to mastery. Over and over again, like behavioral clockwork. My work with early intervention kids is what got me hooked on ABA and convinced me that it could work for everything and everyone. “It’s a science!” I once exclaimed over-zealously to the thrilled parents of a toddler who was finally talking after only 30 days of treatment. I had become superbly confident in my niche.

But Lily’s graphs were a nightmare. Like the jagged teeth of an orthodontically-challenged dinosaur, and always below the 50% line. Identifying Body Parts, Matching Identical Pictures, Sorting Objects by Color, Requesting – the quintessential programs that I had come to rely on as instantaneously acquired were just not working. I had tried everything – switching back and forth from errorless teaching, using prompting strategies up the wazoo, working in different environments and at different times of the day; every new approach led to the same low, variable results. She couldn’t label. She couldn’t identify. She couldn’t imitate. She had one self-created sign that she used to universally indicate that she wanted something, but it was up to us to figure out what that something was. Her data book was a nasty, inflamed pimple on the otherwise flawless complexion of my career as a behavior analyst.

I considered talking to my supervisor and requesting that another BCBA take over the case. Someone with more experience, someone who knew more about non-verbal kids, someone who had tricks up their sleeve that I clearly didn’t. Before I made that call, I went back through her file one last time. She was 10-years-old and entirely nonverbal. She was not reliably toilet trained. A recent medical report indicated that her cognitive functioning level was similar to that of a 6-month-old child, and likely always would be. And then it hit me.

She didn’t need my programs. She didn’t need Imitating Actions with Objects. She didn’t need to meet criteria on “Answering ‘Who’ Questions or “Identifying Parts of a Picture.” Sure, those skills would be great to have, but they weren’t her most pressing needs. This child needed to learn to bathe herself. She needed to learn how to make a snack. She needed to brush her teeth and make her bed and use the bathroom independently. These were the skills that might one day mean the difference between a group home and an institution – not whether she could identify 15 exemplars of a school-bus from a larger array. I suddenly felt silly and almost angry at myself that I had spent so many months trying to jam the concept of pronoun-specific body part identification down her throat when there had been such an obvious deficit in actual living. I understood for a moment why we as behavior analysts sometimes get flak from the general population for being hard-headed and data-obsessed.

I scratched her entire program. I bought a copy of the AFLS (Assessment of Functional Living Skills) and started probing that week. Her scores were low, but we had a starting point. We implemented 10 functional programs and began fully prompting backward-chains of each. Her therapists relied on muscle memory and consistency, since she could not comprehend visual cues or task analysis pictures. We worked untiringly after school and on weekends to commit these sequences to memory and reach independence. And 30 data points later, she had mastered her first program: Making a Snack. She could find the cabinet where the cheese puffs were, twist off the top, pour some into a bowl, replace the top, replace the puffs, walk to the table, sit down and eat them. Without a single prompt. When the therapist called me to tell me, I welled up.

In the end, it wasn’t ABA that failed me. It was my own limited application of ABA, and the fact that I lost sight of perhaps the most important dimension of our science –that it’s meant to be applied.After working with Lily, I threw out my grand idea that I held the secret recipe for the “Fix-all Cookie Cutter ABA Program for Children Everywhere.” Now, every time I begin an initial assessment for a new client, I start the recipe from scratch. The first question I ask myself is, “What is the most significant, functional, real-life challenge for them?” instead of asking whether or not they can tell me the functions of 10 community helpers within 60 seconds over 3 consecutive sessions.

The content of this article is not based on any specific person. Certain incidents, characters, and timelines have been changed for creative purposes and may be composites or entirely fictitious.

Katherine DeCotiis Wiedemann, M.A., BCBA had her very own behavior intervention plan as a kindergartner in 1989. She had to earn five smurf stickers every morning in order to go to recess. Katherine eventually graduated from kindergarten and beyond, and after a false start as a comedic actress (she dropped out of NYU’s Tisch School of the Arts) she found herself very at home in special education and behavior analysis.

After 10 years in the field, she founded Every Child Behavior Solutions, a NJ-based consulting practice that provides behavior-analytic services to school districts, families and anyone else who asks. She loves public speaking, and has done countless school in-service presentations about ABA, as well as for pediatric groups and medical students at the top hospitals in the state.

Although the first chapter of her career focused mostly on children with autism spectrum disorders, she has also spent a good deal of time in general education and specializes in the school-based treatment of ODD, ADHD, OCD and anxiety disorders. One of her short-term goals is to convince the world that ABA is not just a teaching tool for autism (although it does that well), and that behavior analysts are not all condescending blockheads (although some may be). You can learn more at Katherine’s website, or contact her at katherine@everychildnj.com. 

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