It is not uncommon for parents or practitioners to implement a new intervention that appears to be working well, then after a few weeks or months report that the intervention has stopped working. Often, the change in behavior in feels like a mystery and leaves people scrambling for a new intervention. But before searching for a new intervention, you should consider the possibility of problems with procedural fidelity, which “refers to the accuracy with which the intervention or treatment is implemented” (Mayer, Sulzer-Azaroff, & Wallace, 2014).
Problems with procedural fidelity in ABA are common, and you will experience more success with your interventions if you take steps to address fidelity at the outset. Here are a few suggestions:
Post the steps in a visible spot. Clearly list the steps of the procedure and put them in a spot where you will see them often. This might be on the actual data collection sheet or on the wall. One parent I worked with had a Post-it® note with the steps for our intervention attached to her computer screen. Another parent kept the steps inside the ID part of his wallet, where they were protected and visible each time he opened his wallet.
Plan meetings to go over the steps. As part of your intervention, set brief monthly or quarterly meetings to go over the steps of the intervention and be sure everyone is maintaining procedural fidelity.
Assess for procedural fidelity. Schedule observations to ensure that each step of the intervention is implemented as described. If you do not have someone who can supervise you, take video of yourself implementing the intervention, watch it and compare your actions to the steps outlined in the intervention plan.
Outline steps for systematic fading of the intervention. When implementing an intervention, the goal is to have the learner eventually exhibiting the desirable behavior without prompts or planned reinforcement. Sometimes when a parent or practitioner sees the learner’s behavior improving, they begin to remove the prompts or planned reinforcement before the learner is quite ready for it. By writing a plan for fading the intervention into the plan, you make it clear to everyone involved what the requirements are for each step towards mastery.
REFERENCES
Mayer, G.R., Sulzer-Azaroff, B., & Wallace, M. (2014). Behavior analysis for lasting change (3rd ed.). Cornwall-on-Hudson, NY: Sloan Publishing.
About The Author
Sam is an ABA provider for school-aged students in Brooklyn, New York. Working in education for over 15 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 and the Senior Clinical Strategist at Encore Support Services.
One of the tenets of ABA is to provide evidence-based practice. The best way to help us do this is to keep up with the literature! Each month, Sam Blanco, PhD, LBA, BCBA will select one journal article and provide discussion questions for professionals working within the ABA community. The following week another ABA professional will respond to Sam’s questions and provide further insight and a different perspective on the piece.
When I was first starting out in behavior analysis, I was
amazed at the simplicity and accuracy of functional analysis. Behaviors that
had seemed complex and impossible to change suddenly made sense. I felt ready
to create interventions to address those behaviors, and started to see more
success in my behavior change procedures. Functional analysis remains one of my
favorite topics to teach, and one of the questions I get most often from my
graduate students is about ethical concerns in relation to completing a
functional analysis for potentially dangerous behaviors.
This has been a concern in the field, and there is a strong evidence base that identifying, assessing, and treating precursor behaviors is effective in reducing the target problem behavior. For this month, I have selected a paper on this topic.
What is the purpose of the current study? How is it relevant to your current work?
The researchers used both indirect and descriptive methods for identifying precursor responses. What were these methods?
Describe each of the probability measures the researchers used. How were these related to each other? Could these be used in your current setting?
What did the authors find was most probable to occur prior to head-hitting behavior? Why is this information important?
When the researchers conducted the functional analysis on the precursor behavior, was the head-hitting behavior eliminated? Why is this important to recognize? What implications does it have for practitioners?
Identifying the precursor behavior can decrease risk resulting from problem behaviors such as self-injurious behavior or aggression. Can you identify a current problem behavior for one of your clients and create a plan for determining precursor behaviors?
Please note that this particular study has only one participant. Sometimes, behavior analysis as a field is criticized for the use of single-subject studies. You can read this previous post for more on the topic of single-subject studies.
WRITTEN BY SAM BLANCO, PhD, LBA, BCBA
The founder of ABA Journal Club, 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.
This month’s ASAT feature comes to us from Megan McCarron, MS, BCBA. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!
I am a BCBA working in an ABA Teaching Home. I am adept with teaching play skills to younger children but would like some guidance on assessing interests and helping young adults develop hobbies that they can pursue in an independent and meaningful manner.
This is a very important question. There is an abundance of research on how to teach leisure activities using instructional methods such as modeling, video modeling, and activity schedules, moreover, it is vital that careful thought and planning be put into selecting and individualizing leisure activities.
Typically, one’s interests are developed over
time via exposure to and interaction with new and varied people, places, and
activities. Exposure usually occurs over the course of life without much
forethought, resulting in interests that shift and change. Unfortunately, this
is often not the case for individuals with autism spectrum disorder (ASD).
There are two key deficits within the
diagnostic criteria for ASD that are likely to impact individuals’ exposure to
and interaction within varied leisure activities. First, persistent limitations
in social communication and social interaction can hinder an individual’s
ability to request access to items and activities, and/or to express one’s
level of interest. Second, the presence of restricted, repetitive patterns of
behavior, interests, or activities may prevent an individual from exploring
novel items or activities.
Individuals’ difficulty making or expressing choice limit exposure to new and varied items and activities. Limited interests or those that are markedly different from those of same-aged peers make it that much more difficult to determine ways to expand and develop interests. As a result, careful thought and planning are required to help individuals with autism engage in meaningful leisure activities.
Finding Leisure
Activities
Given that there is an unending number of items or leisure activities that could be assessed, it is important to narrow down the field to things that are likely to be of interest before conducting your assessments. A few of these approaches are as follows:
Expand upon current interests. Ask caregivers, teachers, siblings, or others who spend time with the individual to complete an interview, checklist or other type of survey. Create your own questions or use published materials such as the Reinforcer Assessment for Individual with Severe Disabilities (RAISD). Do not immediately discount unusual or idiosyncratic interests. Look to see if there are groups in the community or online that share that interest. If necessary, teach when and where it is okay to engage in preferences that may be annoying to others or are socially stigmatizing. Examples:
Select novel activities that contain components of already preferred activities. Identify common features of known preferences, and then identify novel items or activities that contain the same or similar features. Examples:
Make modifications to existing activities to incorporate the preferred feature of other preferred activities. Examples:
Pair a known interest with a compatible novel activity. Examples:
Identify shared interests. In addition to identifying activities by exploring and expanding upon current interests of the individual, it can be worthwhile to identify interests of the people the individual spends a lot of time with and activities available in the individual’s school, home, and local community. These activities will offer up the opportunity for social interaction with others.
Assessing Activities
Once potential activities are selected, assessments can be conducted to determine how preferred the activities are. While preference assessments are commonly used and talked about in terms of finding reinforcers, they are equally useful for assessing preference levels for potential leisure activities. Initially, free operant assessments are very helpful in terms of assessing potential leisure activities. These can be conducted in the natural environment or a contrived and enriched setting.
Free operant preference assessments can be conducted through direct observation by providing free access to activities without demands, time limits or requirements to use items in a predetermined manner (unless it is a safety issue). Assessments can be conducted in either a natural or contrived setting, as described below (Toner, 2014; Chazin & Ledford, 2016).
Collect data on:
Which items/activities the individual interacts with
Duration of each interaction
Can be helpful to note the individual’s observable signs of positive affect during interactions, such as smiles or laughter
If the individual interacts with an item in an unexpected or unusual manner, make note of what he or she did.
Once the free operant assessment data have been collected and ranked in order of which activities were engaged with the most (e.g., by calculating a percentage of time of the observation in which the student engaged in each activity), subsequent paired choice preference assessments or MSWO assessments could be conducted to better assess the individual’s relative preference for activities. With this information, you can make an informed choice about what activities are likely to provide “enjoyment” and thus fit the definition of leisure.
Selecting Teaching
Targets for the IEP
It is important to help an individual build a repertoire of activities that can be used to fill the various functions of leisure. Therefore, the activities chosen as a focus of teaching should cover a variety of leisure situations.
Social Activities (any activity done with another person).
Individual Activity (any activity that can be done alone).
Health and Fitness.
Longer duration activities.
Short duration activities that can be done while waiting (looking at books, magazines, music on phone, etc.)
Some activities may be adaptable enough to be
used across several leisure functions. For example, listening to music can be a
social or individual activity; it can easily be paired with a variety of health
and fitness activities and can be used for short or long durations.
In addition to selecting specific activities/skills for leisure, it is advisable to include an objective in a student’s IEP that targets the individual’s exposure to leisure activities. The goal of this objective would be to have the student continue to try out new activities over three to four opportunities to further expose them to new activities. During the sampling sessions, staff should collect data on duration of engagement, observable signs of affect, and any skill deficits that inhibit engagement.
Considerations for Increasing Functional Independence in Leisure While identifying preferred activities is a major part of building a leisure repertoire, there are a whole host of skills that can increase an individual’s ability to access and engage in leisure activities as independently as possible.
Ensure the individual has an effective means of communication. An essential skill, regardless of the individual’s vocal verbal ability, is teaching an appropriate way to request access to activities, especially those that are not readily available in the current environment such as requesting to go to the mall or to a specific store (Schneiter & Devine, 2001). Equally important is the ability for an individual to appropriately decline participation and/or end an activity when the activity is not preferred.
Teach prerequisite skills. If a student shows interest in an activity but is not able to fully engage in the activity, it may be necessary to teach the individual specific prerequisite skills. Examples:
If a Sampling Leisure Activities objective has been included in the IEP, the sampling period can be used to help identify what types of prerequisite skills may need to be taught.
The individual may need to be taught skills related to any materials or equipment required for an activity. For example, gathering equipment / materials prior to starting the activity; caring for the equipment / materials putting equipment away when finished, and problem solving (e.g., what to do if materials are missing, broken, or need to be replenished).
Time management skills, such as identifying when it is time to engage in a leisure activity, selecting an activity that fits the amount of time for leisure, identifying when activities are essential components of increasing independence. Using schedules and calendars can be helpful to structure and prompt leisure activities but may require specific teaching. For example, using a calendar app on a phone can be very useful, but it may be necessary to start off with teaching the student to respond to an alert to engage in an activity and build up to having them enter information into the calendar.
Final Thoughts
Every individual has different interests, abilities, and obstacles to work through in establishing leisure skills. However, building on and expanding from high preference, high availability activities and using evidence-based assessment and teaching strategies to establish independence in leisure activities provides a strong foundation from which to start.
References
Blum-Dimaya, A.,
Reeve, S. A., Reeve, K. F., & Hoch, H. (2010). Teaching children with
autism to play a video game using activity schedules and game-embedded
simultaneous video modeling. Education & Treatment of Children, 33(3),
351-370.
Carlile, K. A., Reeve,
S. A., Reeve, K. F., & DeBar, R. M. (2013). Using activity schedules on the
iPod touch to teach leisure skills to children with autism. Education
& Treatment of Children, 36(2), 33-57.
Carr, J. E., Nicolson,
A. C., & Higbee, T. S. (2000). Evaluation of a brief multiple-stimulus
preference assessment in a naturalistic context. Journal of Applied
Behavior Analysis, 33(3), 353-357.
Chan, J. M., Lambdin,
L., Van Laarhoven, T., & Johnson J. W. (2013). Teaching leisure skills to
an adult with developmental disabilities using a video prompting intervention
package. Education and Training in Autism and Developmental
Disabilities, 48(3), 412-420.
Chazin, K. T., &
Ledford, J. R. (2016). Free operant observation. In Evidence-based
instructional practices for young children with autism and other disabilities. Retrieved
from http://vkc.mc.vanderbilt.edu/ebip/free-operant
Fisher, W. W., Piazza,
C. C., Bowman, L. G., & Amari, A. (1996). Integrating caregiver report with
a systematic choice assessment. American Journal on Mental Retardation,
101(1), 15-25.
Graff, R. B., &
Karsten, A. M. (2012). Assessing preferences of individuals with developmental
disabilities: A survey of current practices. Behavior Analysis in
Practice, 5(2), 37-48.
MacDuff, G. S.,
Krantz, P. J., & McClannahan, L. E. (1993). Teaching children with autism
to use photographic activity schedules: Maintenance and generalization of
complex response chains. Journal of Applied Behavior Analysis, 26(1),
89-97.
Schneiter, R., &
Devine, M. A. (2001). Reduction of self-injurious behaviors of an individual
with autism: Use of a leisure communication book. Therapeutic
Recreation Journal, 35(3), 207-219.
Toner, N. (2014). How
do you figure out what motivates your students? Science in Autism
Treatment, 11(1), 12-14.
Please use the
following format to cite this article:
Megan McCarron M.S., BCBA, LBA (CT) holds a Master of Science Degree in Child Development, is a Board Certified Behavior Analyst, and Licensed Behavior Analyst in the state of Connecticut. She has been in the field of autism treatment since 1992. Megan has experience providing services for children with autism in school, home and community settings. She has worked at Milestones Behavioral Services (formerly, The Connecticut Center for Child Development, Inc.) since 1999. During her time at Milestones, she has served in various capacities. She started out as an instructor and is now a Clinical Director. In addition to her responsibilities in and around Milestones, Megan presents lectures and workshops on autism and Behavior Analysis at local and national conferences.
When I first came across this study, “Behavioral Training for Siblings of Autistic Children,” I was immediately hesitant. There’s something about the idea of sibling-as-therapist that makes me cringe a little bit. When I work with the families of children with autism, the hope is that the siblings of the child with autism still have a childhood without being pushed into the role of caregiver. And I also want the child with autism to have independence and feel like an individual who is heard, which may be more challenging if their siblings are issuing demands just as a parent or teacher would. But as I read the study, I realized that the work they completed had incredible social significance.
In the study, there were three pairs of siblings. The ages of the children with autism ranged from 5 years old to 8 years old. The ages of the siblings ranged from 8 years old to 13 years old. The researchers trained each sibling of a child with autism how to teach basic skills, such as discriminating between different coins, identifying common objects, and spelling short words. As part of this training, the researchers showed videos of one-on-one sessions in which these skills were taught, utilizing techniques such as reinforcement, shaping, and chaining. What the researchers did next was the part that really stood out to me: they discussed with the siblings how to use these techniques in other environments. Finally, the researchers observed the sibling working with their brother/sister with autism and provided coaching on the techniques.
It should be noted here that the goal of the study was not to have the siblings become the teacher of basic skills. Instead, it was to provide a foundation of skills in behavioral techniques for the sibling to use in other settings with the hope of overall improvement in the behaviors of the child with autism. The researchers demonstrated that, after training, the siblings were able to effectively use prompts, reinforcement, and discrete trials to effectively teach new skills. But, perhaps the most meaningful aspects of the study were the changes reported by both siblings and parents. The researchers provide a table showing comments about the sibling with autism before and after the training. One of the most striking comments after the training was, “He gets along better if I know how to ask him” (p. 136). Parents reported that they were pleased with the results and found the training beneficial.
This study provides excellent evidence that structured training for siblings has real potential for making life a little easier for the whole family. The idea isn’t that they become the therapist, but instead that knowledge truly is power.
REFERENCES
Schriebman, L., O’Neill, R.E. & Koegel, R.L. (1983). Behavioral training for siblings of autistic children. Journal of Applied Behavior Analysis. 16(2), 129-138.
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
