Cultural Competency in ABA Practice

The Behavior Analyst Certification Board (BACB) on their website lists credentialed behavior analysts from 99 countries spanning across 6 continents. Behavior analysts and consumers of behavior analysis are now establishing footprints across the globe. Each of these countries comes with its own set of cultural practices and norms. Leon Megginson, author of Small Business Management said, “it is not the strongest, or the most intelligent who survives, but the one most responsive to change”. Considering the high rates of global migration and the international dissemination that our field desires, practitioners find themselves serving an increasingly diverse population. A recent article in Behavior Analysis in Practice by Andrea Dennison and colleagues highlights the variations in cultural norms, caregiver and practitioner linguistic competencies that a culturally competent ABA therapist must consider when designing a home program.

What are the barriers?

The Professional and Ethical Compliance Code for Behavior Analysts from the Behavior Analyst Certification Board requires that behavior analysts consider the role of culture in service delivery (BACB code 1.05c), involve clients and families in treatment process (BACB code 4.02), and individualize the treatment plan to meet client needs (BACB code 4.03). Yet the BACB Fourth Edition Task List and the upcoming Fifth Edition Task List which define the scope of practice of a credentialed behavior analyst do not make much mention of culture – which means that training programs do not typically include cultural competence. Dennison and colleagues (2019) identified several barriers in ABA treatment for culturally and linguistically diverse families and highlighted ways to overcome them.

Do we hold stereotypes?

With the influence of the media or the people around us, we tend to categorize people into social groups and create a simplified conception of the group based on some assumptions – we create stereotypes and hold prejudices. Implicit biases held by a practitioner towards certain cultural sub-groups may result in a subtle, yet observable bias towards the client, and adversely impact treatment outcomes. Dennison et al (2019) suggest that a practitioner’s “self-reflection and introspection regarding cultural attitudes and practices towards clients” may be a first step towards undoing these biases.

Are we aware of cultural norms?

Practitioners often find themselves in a variety of contexts and situations with varying contingencies. Each culture comes with its own set of learned behaviors, beliefs, and norms. Dennison and colleagues add that some cultures might prefer a warm, informal discussion with a service provider prior to a formal meeting to discuss goals. A violation of this might seem off-putting to the client, and conversely, such an expectation for an informal discussion might catch the analyst unaware. In some cultures even a simple handshake for greeting might be offensive They recommend that practitioners monitor clients for signs of discomfort or displeasure during the course of the treatment to identify whether a cultural norm has been violated.

What to do when a practitioner doesn’t speak the home language of the client?

A language mismatch between the practitioner’s language and the home language of the client might lead to information loss. A client might not be able to completely express their priorities in terms of the services they need. Dennison urges practitioners to make every attempt to invite a bilingual practitioner or interpreter either in-person or online, to future family meetings. Providing the family with access to ABA textbooks written in their home language might be a good way to introduce ABA terminology and lead to better acceptability of services delivered. The authors caution against using loosely translated words; online tools might not be ideal for activities that require precise definitions.

Cultural analysis

“A cultural analysis involves an individual analysis of the cultural factors affecting an individual’s environment and the resulting contingency”, the authors add. A re-assessment of priorities in goals might be warranted, and a cultural analysis might inform what behaviors are identified as the primary targets for intervention. Dennison refers to the importance of social etiquette and the value placed on conflict avoidance in Latin cultures as an example. Measuring social validity might give the analyst information about whether the family sees the behavior change as meaningful.

Empathy grows as we learn

Try not to stigmatize immigrant families as “uncaring” for not seeking services earlier. Several socioeconomic stressors such as lack of housing and transportation availability likely play a role in their decision. The authors urge practitioners to empathize with these families and add that attempts to empathize can be made even if the practitioner and family do not share a common home language.

Finally, the lack of diversity in research with the omission of demographic details such as language and ethnicity of participants in scientific publications overlooks the critical value of such information. This calls for a shift in the field towards intentionally inclusive subject recruitment and the reporting of such information.

A culturally competent behavior analyst is not one who knows everything there is to know about every culture. This would be impossible. It is someone who can acknowledge that patterns of cultural difference may be present, and are then able to view a situation from a different cultural perspective than one’s own. Maintaining a curiosity about each client’s culture, and having an open dialogue with them about their background, ethnicity, and belief system can result in a positive outcome for the client and the analyst.

“If we are going to live with our deepest differences then we must learn about one another.”  ― Deborah J. Levine

References

Dennison, A., Lund, E., Brodhead, M., Mejia, L., Armenta, A., & Leal, J. (2019). Delivering Home-Supported Applied Behavior Analysis Therapies to Culturally and Linguistically Diverse Families. Behavior Analysis in Practice, OnlineFirst, 1-12.


About The Author

Maithri Sivaraman is a BCBA with a Masters in Psychology from the University of Madras and holds a Graduate Certificate in ABA from the University of North Texas. She is currently a doctoral student in Psychology at Ghent University, Belgium. Prior to this position, Maithri provided behavior analytic services to children with autism and other developmental disabilities in Chennai, India. She is the recipient of a dissemination grant from the Behavior Analysis Certification Board (BACB) to train caregivers in function-based assessments and intervention for problem behavior in India. She has presented papers at international conferences, published articles in peer-reviewed journals and has authored a column for the ‘Autism Network’, India’s quarterly autism journal. She is the International Dissemination Coordinator of the Association for Science in Autism Treatment (ASAT) and a member of the Distinguished Scholars Group of the Cambridge Center for Behavioral Studies.

Focus on Reinforcement

Teaching can be incredibly overwhelming, especially in a special education classroom. Between paperwork, lesson planning, updating bulletin boards, and actually teaching, the day can get pretty hairy. Sometimes, that stress leads to a short temper, which can lead to a punitive classroom environment.

If things seem to be going in the wrong direction in your classroom, the first thing you should do is focus on reinforcement. Here are a few steps to consider:

  1. Identify 1-3 behaviors you would like to see your students exhibiting. For instance, maybe you’d like to see an increase in hand-raising (as opposed to calling out.) Clearly define the behaviors you want to see.
  2. Set up a contingency for increasing those behaviors. Maybe you’ll wear a MotivAider to give yourself a reminder throughout the day to provide verbal praise to students exhibiting the target behavior. Maybe you’ll have students earn points that they can exchange for other things, such as a homework pass or lunch with the teacher. Maybe you’ll encourage students to recognize each other when they engage in the target behavior.
  3. Teach the students about the target behavior(s). Introduce the goals to the students. It’s helpful to create a sign or other visual to remind students about the new goals.

While these are simple steps, providing more verbal praise and other reinforcement can turn around a classroom with too much time spent on reprimands and punishments.

It’s also helpful to remember (especially for new teachers) that you can make changes at any time. One of my mentors in my first year of teaching told me to tell my class we had gotten off track, so we were having a brand new first day of school. (I was teaching fourth and fifth grade students with emotional behavioral disorders.) It was shocking how well that new first day of school went over. The students were excited about the idea of a “fresh start” in the middle of the school year, and it helped me get back on track with creating a more positive learning environment.

Ultimately, the goal is to teach students about appropriate behavior by spending more time showing them what they’re doing right than focusing on what they’re doing wrong.


Written by Sam Blanco, PhD, LBA, BCBA

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.

Posted in ABA

Six Tips For A Successful Halloween

Holidays can be challenging for everyone in the family. Your to-do lists get longer, your routines are switched around, and all the little stresses can be especially difficult for your child with autism. Here are a few tips to ease the difficulties related to Halloween.

For Preschool & Elementary Children

  • Practice – Invite your neighbors to have a “rehearsal” for Halloween so your learner can practice the steps. If this isn’t a possibility for you, it may be helpful to watch youtube videos of trick-or-treating.
  • Prepare – Let your child know the trick-or-treating route in advance. In the days leading up to Halloween, make yourself aware of houses to avoid based on decorations that are gory, include excessive lighting, have strobes, or any other aspects that you know will make your learner uncomfortable.

For Teenagers

  • Consider alternatives – You may want to join with other parents to throw a Halloween party that is autism-friendly based on the needs of your learner and the needs of other party guests. Another suggestion would be to celebrate with a themed activity, such as Halloween activities at local museums or art institutions.
  • Give a task – Let your child have a job such as giving out the treats at the door, managing an activity for younger children, or helping with decorating your home.

For All Children

  • Be flexible – Think about what is necessary for your learner, what your learner is interested in, and what success looks like in terms of Halloween. Maybe success means you visit three houses, or maybe success means your learner chose a costume. The idea is to keep it fun.
  • Remember it’s okay to stay at home! – You can create your own Halloween tradition that fits your family’s needs. This could include a special movie night, creating Halloween-inspired foods together, or anything that is fun for the whole family.

Written by Sam Blanco, PhD, LBA, BCBA

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.

Posted in ABA

Building Variability Into The Routine

Several years ago, I was working with a 6-year-old boy we’ll call Terrence. Terrence was diagnosed with autism. He was a very playful child who was generally good-tempered, enjoyed playing with trains and watching TV, and posed few difficult behavior issues for his parents…until the day there was construction on their walk from the grocery store to their apartment and they decided to take a different route home. What happened next is what most people would call a full-blown meltdown: Terrence dropped to the ground, screaming and crying, and refused to move.

Many of the parents I work with have a similar story when it comes to their child with autism and an unexpected change in the routine. The change varies: the favorite flavor of fruit snacks is out of stock at the store or the babysitter greeted the child at the bus instead of the parent or they grew out of the coat they wore the past two winters… In fact, it can be difficult to anticipate exactly what specific routine may be a trigger for your learner. This is precisely why building variability into the routine can be helpful.

Here are a few things to consider:

First, think about the routines that are the most likely to be interrupted. Make a list of these so you can begin thinking about how to address those issues.
Second, work with your team (whether that means family or practitioners that work with your learner) to select 2-3 routines to focus on first.

Discuss how those routines would most likely be interrupted. For instance, a favorite TV show may be interrupted during election season or you may have a family function when the TV show is aired. In teaching your learner to be flexible with changes in routine, you will contrive changes that are likely to occur to give your learner quality practice.

Plan to vary the routine. Essentially, you are setting up the change in routine, but you will be prepared in advance to help your learner behave appropriately. (You’re much more likely to experience some success in this scenario than you would be if a change in routine occurs unexpectedly and/or last minute.)

Give your learner a vocabulary for what is happening. I teach many of my students the term “flexible.” I might say, “I appreciate how you’re being flexible right now” or “Sometimes when plans change we have to be flexible. This means…”

Reinforce appropriate behaviors related to flexibility! You want to be clear when they’ve made an appropriate, flexible response. In the planning phase, you can discuss what appropriate reinforcers might be for the routines you are targeting.

If you build in variations in routine and teach your learner some strategies for being flexible, you and your learner are much more likely to be successful in navigating unexpected changes.


Written by Sam Blanco, PhD, LBA, BCBA

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.

Posted in ABA

Teaching Language—Focus on the Stage, Not the Age

Teaching language skills is one of the most frequent needs for children with autism, but also one of the most misunderstood skillsets amongst both parents and practitioners. The desire to hear your learner speak in full sentences can be overwhelming, making it especially difficult to take a step back and consider what it means to communicate and how communication skills develop in neurotypical children. Many times we get hung up on what a child should be capable of communicating at a certain age, rather than focusing on what they are capable of communicating at this stage of development.

Many practitioners and curricula utilize Brown’s Stages of Language Development.* Brown described the first five stages of language development in terms of the child’s “mean length of utterance” (or MLU) as well as the structure of their utterances.

Brown_Grammatical_Structures_Chart

From aacinstitute.org

Sometimes it is necessary to compare a child to his or her same-age peers in order to receive services or measure progress, but it can be detrimental to focus on what a child should be doing at a specific age instead of supporting them and reinforcing them for progress within their current stage.

Research has suggested that teaching beyond the child’s current stage results in errors, lack of comprehension, and difficulty with retention. Here are some common errors you may have witnessed:

  • The child learns the phrase “I want _____ please.” This phrase is fine for “I want juice, please” or “I want Brobee, please,” but it loses meaning when overgeneralized to “I want jump, please” or “I want play, please.” It’s better to allow your learner to acquire hundreds of 1-2 word mands (or requests) before expecting them to speak in simple noun+verb mands.
  • The child learns to imitate only when the word “say” is used. Then the child makes statements such as “say how are you today,” as a greeting or “say I’m sorry,” when they bump into someone accidentally. Here, the child clearly has some understanding of when the phrases should be used without understanding the meanings of the individual words within each phrase.
  • The child learns easily overgeneralized words such as “more.” This is useful at times, but the child can start using it for everything. Instead of saying “cookie” he’ll say “more.” Instead of saying “train,” he’ll say “more.” And he may say “more” when the desired item is not present, leaving the caregiver frustrated as he/she tries to guess what the child is requesting. Moreover, as language begins to develop, he may misuse it by saying things such as “more up, please.”
  • The child learns to say “Hello, how are you today?” upon seeing a person entering a room. A child comes into the classroom and the learner looks up, says “Hello, how are you today?” The child responds, “Great! Look at the cool sticker I got!” Your learner then doesn’t respond at all, or may say “fine,” as he has practiced conversations of greeting.

These are only a few of the common language errors you may see. While you may want your learner to speak in longer sentences, your goal should be to have them communicate effectively. With this goal in mind, it becomes essential to support them at their current stage, which means it’s essential to assess them and understand how to help them make progress.

This is why I always use the VB-MAPP to assess each child and make decisions about language instruction. I need to have a full understanding of how the learner is using language, and then move them through each stage in a clear progression. I may want the child to say “Hello, how are you today?” But when I teach them that, do they understand those individual words? Do they comprehend what today means as opposed to yesterday or tomorrow? Do they generalize the use of “how” to other questions?

As you make treatment decisions for your learner, think about their current stage and talk about how to support your child with both a Speech Language Pathologist and an ABA therapist.

*Brown, R. (1973). A first language: The early stages. London: George Allen & Unwin Ltd.


Written by Sam Blanco, PhD, LBA, BCBA

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.

Posted in ABA

Consider Behavioral Momentum in Improving Compliance

If I were to ask you right now, what types of activities does your learner like to do, and what types of activities is your learner resistant to, you’d probably be able to respond pretty quickly to both questions. For instance, you might say, my son loves to practice addition facts, but he is resistant to working on spelling homework. Or you might say, my student enjoys passing out papers in class but is resistant to lining up with the rest of the class when it’s time to go to lunch.

You can use this information to increase the likelihood of compliance for those tasks your learner does not like. First, let’s call the tasks your learner enjoys high-p tasks (or high probability tasks) and the tasks your learner does not enjoy the low-p tasks (or low probability tasks). Once you have identified high-p and low-p tasks, you can use this information to produce behavioral momentum.

So what might this look like? Let’s take our first example of the learner who liked to practice addition facts, but is resistant to spelling. The conversation might look like this:

Parent: 2 + 4
Son: 6
Parent: 3 + 5
Son: 8
Parent: 4 + 3
Son: 7
Parent: Spell “apple.”
Son: A-P-P-L-E

Behavioral momentum is quite a broad topic. The conversation above is an example of just one element of behavioral momentum: a high-probability (or high-p) request sequence. This is “an antecedent intervention in which two to five easy tasks with a known history of learner compliance (high-p request) are presented in quick succession immediately before requesting the target task, the low-p request” (Cooper, Heron, & Heward, 2007, p. 492).

By providing several sequences such as the one above, you can practice all of the spelling words without fighting him to sit down at the table and practice only spelling for ten to fifteen minutes.

With the example of the young girl who likes to hand out papers but doesn’t like lining up before lunch, it might look something like this:

Teacher: Can you take this paper to Lucy?
Student takes paper to Lucy.
Teacher: Can you give this one to Marcos?
Student takes paper to Marcos.
Teacher: Nice work. Can you stand behind Henry?
Student gets in line behind Henry.

It should be noted that the goal is to move the low-p tasks to high-p tasks. We don’t want the learner to always require two to five high-p tasks before they engage in the low-p task! You can do this by decreasing the number of high-p tasks before giving a low-p task, or by increasing the number of low-p tasks. For instance, maybe the first learner is responding quickly each time his parent gives him a spelling word, so the parent can start giving two spelling words after the series of high-p tasks, then systematically increase the number of spelling words over time.

Overall, the high-p request sequence is an easy-to-implement strategy that can improve compliance and reduce stress for all parties involved.

REFERENCES

Cooper J.O, Heron T.E, & Heward W.L. Applied behavior analysis (2nd ed.) Upper Saddle River, NJ: Pearson, 2007.


Written by Sam Blanco, PhD, LBA, BCBA

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.

Posted in ABA

Encouraging Parent Participation in Home-Based Intervention

This month’s ASAT feature comes to us from Alice Walkup, 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! You can read more of our ASAT featured posts here.

How does a behavior consultant who is invested in the child’s best outcome encourage parents to actively participate in home-based intervention?

Answered by Alice Walkup, MS, BCBA

For many parents of children with autism, participation in a home-based behavioral intervention program may seem overwhelming. In addition to managing and advocating for the child’s various services, parents may find it difficult to attend to the needs of other family members, their spouses, and their jobs. Participating in their child’s home-based program can certainly seem like one more responsibility for which there simply is not enough time. It is important to appreciate that other commonly-endorsed autism therapies, such as occupational or speech therapy, do not usually require the same level of time, energy and parental involvement that an intensive behavioral intervention program does.

Understanding And Assessing Barriers To Participation

When you conduct the intake interview (and likely throughout the consultative relationship), it is important to take note of any potential barriers to the parents’ participation. Education level, socio-economic status, competing responsibilities, other family members in the home, cultural beliefs, and beliefs about autism and autism treatments are just a few factors to consider. It is also important to keep in mind that parents may be unaware that the skills of children with autism (e.g., communication, compliance) do not automatically generalize from therapists to parents. As such, it is important for consultants to gauge the willingness and motivation of family members to be active participants in their child’s intervention program (Taylor & Fisher, 2010).

From the outset, it is important to explain to parents that they will be a critical part of their child’s learning and will be shown how they can help the child practice what they’ve been taught during therapy sessions. Parents may also hold misconceptions regarding behavioral intervention, such as a belief that behavioral techniques are based exclusively on punishment. Explaining the intervention process at the outset will help eliminate such concerns. A final point to consider is that many parents of children with autism experience their own psychological challenges, such as depression and anxiety. Some research suggests that mothers with depressive characteristics do not acquire as much information and skills during parent training as mothers without depressive characteristics (Gelfand, Teti, Seiner, & Jameson, 1996; Cicchett, Rogosch, & Toth, 2000). Such issues may present challenges for consultants but once identified can be taken into consideration when individualizing consultation and the scope of the home-based intervention. It may also become clear during the intake process that referral to other services or resources are warranted.

Setting The Stage For Success

When working with a new family, there are many strategies you can employ to build a collaborative, open relationship from the outset. These include:

  • asking questions that will help you better understand the parents’ experiences as they relate to supporting their child with autism. Such questions may include asking what other services/therapies the child has received (or is still receiving), what supports (community, family and individual) are available to the parents, and what they see as their biggest challenges related to parenting a child with autism
  • being an attentive and compassionate listener
  • minimizing “behaviorspeak,” including clinical terms and acronyms with which the parent is unfamiliar. When explaining behavioral principles, it may help to use simpler, every-day examples to illustrate the concepts
  • explaining the intervention process and what a typical session may look like
  • using language that fosters a cooperative spirit; for example, saying, “we as a team” instead of “you” when discussing the home-based intervention

Goal Selection

When meeting with parents for the first time, encourage them to identify the hopes and fears they have for their child as doing so will help guide intervention planning and goals. It is equally important to identify goals that are most relevant to the family such as eating, sleeping, and community-based goals (Taylor & Fisher, 2010). This conversation should address both short- and long-term goals for the child, such as playing with friends, sitting appropriately in church, or attending college. With this knowledge, the consultant can assist parents in identifying their top three most important goals. One strategy for longer-term goals is to give each a name, such as “Project Friendship” for a socialization goal, as it will serve as a reminder to focus on the big picture. Once these are identified, the shorter-term goals and associated skills to be taught can be more easily defined, and the parents can see how they are supporting the longer-term goal. After selecting initial teaching targets and determining appropriate instructional strategies, the behavioral team will begin implementation. Keep in mind that some parents may challenge your typical approaches to behavior change, such as finding it difficult to tolerate extinction bursts, appreciating the need for direct teaching of desired skills, or using edible reinforcers. This again highlights the critical importance of discussing the intervention process and teaching strategies with parents at the outset. You can also explain their potential roles as teachers and that they will be included in their child’s teaching at the appropriate time. Doing so will help foster a more collaborative relationship and help parents better anticipate and understand their roles in the behavioral intervention process.

Promoting Enduring Participation

Once parents agree to be involved in their child’s home-based intervention, many factors can potentially influence their adherence to behavioral programs and their participation. Continued parent participation can be impacted by parental perceptions of themselves as effective in behavior change, confidence in the treatment approach, and by the degree to which the child is accepted in the family and community, among other variables (Moore & Symons, 2011). When engaging parents in the teaching process, the key is setting them up to be successful. Start with a smaller goal that the child has already mastered with the in-home therapists so that parents leave the teaching interaction feeling effective in promoting behavior change in their child. Utilizing best practices for training that incorporate modeling, rehearsal, and feedback will provide parents with valuable opportunities to both observe and practice teaching the targeted skill to their child. Tracking and graphing their progress in addition to the child’s, then taking the time to review it with them regularly, is a good strategy to provide encouragement throughout the intervention process.

Parents and consultants should also consider whether or not the funding source for child’s in-home services requires parent participation (and to what degree). Currently, some funding sources place a significant emphasis on training the parents to be effective at-home therapists and require behavior consultants to teach parents therapeutic skills to a level of mastery that they can do so. Parents can be asked to implement programs and collect data, and the consultant must report the level of parent involvement to the funding source. In extreme cases, in-home services have actually been terminated due to a lack of parent participation. While it is often more effective to appeal to parents on a more personal level when encouraging their involvement, this requirement and the potential loss of services should be discussed.

Behavior consultants providing in-home services are tasked with addressing a child’s needs within an existing, and sometimes challenging, family dynamic. The ideal in-home behavioral intervention program would include extensive and high-quality parent participation during therapy sessions; however, this may not always be possible. As such, we must individualize the type and extent of parent involvement on a case-by-case basis and employ our skills as consultants to encourage and maintain active parent participation, where possible. Despite the challenges that may accompany our efforts, it’s important to remember that, at the end of the day, we are all working towards the same goal: ensuring the best possible outcomes for the child.

References

Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2000). The efficacy of toddler–parent psychotherapy for fostering cognitive development of offspring in depressed mothers. Journal of Abnormal Child Psychology, 28, 135-148.

Gelfand, D. M., Teti, D. M., Seiner, S. A., & Jameson, P. B. (1996). Helping mothers fight depression: evaluation of a home-based intervention program for depressed mothers and their infants. Journal of Clinical Child Psychology, 25, 406-422.

Moore, T. R., & Symons, F. J. (2011). Adherence to treatment in a behavioral intervention curriculum for parents of children with autism spectrum disorder. Behavior Modification, 35, 570-594.

Taylor, B. A., & Fisher, J. (2010). Three important things to consider when starting intervention for a child diagnosed with autism. Behavior Analysis in Practice, 3, 52-53.

Citation for this article:

Walkup, A. (2012). How does a behavior consultant who is invested in the child’s best outcome encourage parents to actively participate in home-based intervention? Science in Autism Treatment, 9(4), 4-6.


About The Author

Alice M Walkup, MS, BCBA currently resides in Los Angeles, CA where she practices behavior analysis with clinical populations. 

Posted in ABA

ABA Journal Club: A Response from Dana Reinecke

A quote from this week's ABA Journal Club response from Dana Renecke

Welcome back to ABA Journal Club! 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.

Check out last week’s discussion questions here!

Behavior analysts engage in many different professional activities, many of which are more or less likely given specific clinical or research settings. For example, some behavior analysts who work with individuals with disabilities are likely to conduct preference assessments and use token economies, while those who work with organizations are less likely to use these technologies. One part of the behavior analyst’s repertoire that is always important, however, is the careful and accurate collection of data. This skill set is necessary for understanding and assessing behavior, as well as for ongoing monitoring of the effectiveness of behavioral interventions. 

It is important to understand not just how to measure behavior, but when to use each type of measure.  LeBlanc, Raetz, Sellers, and Carr (2016) describe some of the critical questions that should be considered when choosing a measurement procedure and offer a clinical decision-making model to guide behavior analysts in making these choices.  This article is useful for helping trainees to practice choosing measurement procedures, and reminding more experienced behavior analysts about the considerations involved in measurement. 

LeBlanc, L. A., Raetz, P. B., Sellers, T. P., & Carr, J. E. (2016). A proposed model for selecting measurement procedures for the assessment and treatment of problem behavior. Behavior analysis in practice9(1), 77-83.

Why is this article important for practitioners to read?

Measurement of behavior is one of the most important activities that a behavior analyst engages in.  Without accurate, meaningful measurement, assessment of both behavior and intervention effectiveness is impossible.  Trainees should read this article to learn about the important variables involved in choosing appropriate measurement systems, and more seasoned behavior analysts should read it to remind themselves about those variables.  Even though the article is focused on the measurement of problem behavior, the same principles can be applied to the measurement of behavior targeted for increase.

The model proposed by the authors incorporates several variables (such as observability of behavior and personnel resources.) Are there any other variables you might consider when selecting a measurement procedure?

Length of observation period might be a relevant factor in choosing a measurement procedure.  Consideration of the availability of resources may be influenced by the goal for how much observation is desired.  To use the case example provided by the authors, Joey’s teacher and aide might not be able to continuously record his work engagement throughout the day, but one of them might be able to do so for a limited sample of each day.  They could choose to conduct continuous measurement during a sample interval, and compare it to the longer period of discontinuous measurement to ensure that the discontinuous measure does not result in an over- or under-estimate of behavior. 

Table 1 clearly outlines each form of measurement along with strengths and limitations. Discuss the forms of measurement you frequently use and the limitations to incorporating other forms into your current practice.

As a consultant, I need to measure behavior based on limited samples when I can observe, and I also need to design data collection plans for the staff who are there for the rest of the week.  Staff are often responsible for more than one student, and may not have the resources to conduct continuous event recording.  Behavior is also often not discrete (e.g., crying) or occurs too frequently to count (e.g., stereotypy).  I often use partial-interval recording when I consult in school programs.  This allows for a very easy, non-intrusive overview of the pattern of behavior across the school day.  Another common measure is duration of behavior, because it is also relatively easy to start a timer when behavior begins, and stop it when it ends.  Frequency data are pretty rare in my practice, and reserved for low-frequency behavior that only occurs under specific circumstances.

In Figure 1, the authors provide a flow chart for easily selecting the most appropriate form of measurement. Many of the questions are directly related to observer resources. In this article, the term “resources” relates directly to the ability of personnel to continuously monitor the behavior. Are there any other factors you would consider in relation to personnel? If yes, how do you typically address those factors?

When training staff to collect data, it’s important to acknowledge any unintended bias.  Depending on the staff member’s level of experience, I will conduct more or less frequent IOA to reduce the risk of observer drift, and will also regularly review behavioral definitions to ensure that we are still talking about the same thing.

In discussing the behavior being measured, the authors write: “If the behavior can occur at any time, consider all dimensions of the response and select the ones that are most critically important to fully capture the important features of the behavior and the potential change in the behavior that may occur due to intervention” (p. 81).  How do you determine which dimensions of the response are the most critically important? Can you think of an example?

The importance of each dimension of the behavior will depend on the situation, the behavior, and the target or goal for the behavior.  For example, if a student is able to answer social questions but only does so after a delay, we would want to target, and therefore measure, latency to respond instead of frequency.  Or, a learner might engage in several very brief tantrums throughout the day.  In that case, I would expect that duration would be less important, and frequency a more meaningful measure.  By contrast, if a learner engages in one or two very long tantrums per week, we would want to measure duration and possibly intensity, rather than highlighting frequency.

One of the limitations of this paper is that the model it presents has not been empirically tested. What might such an empirical study look like?

One possible way to validate this model would be to provide several experienced behavior analysts with some case studies, and ask them to use the model to recommend measurement procedures for each case study.  High levels of agreement between the behavior analysts might indicate some validity for the model.  Further validity could be achieved by using the model to select measures, and then conducting those measures and comparing them to true values (e.g., permanent products or continuously-collected event recording).


About The Author

Dana Reinecke, Ph.D., BCBA-D is a doctoral level Board-Certified Behavior Analyst (BCBA-D) and a New York State Licensed Behavior Analyst (LBA).   Dana is a Core Faculty member in the Applied Behavior Analysis department at Capella University.  She is also co-owner of SupervisorABA, an online platform for BACB supervision curriculum, forms, and hours tracking.  Dana provides training and consultation to school districts, private schools, agencies, and families for individuals with disabilities. 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).

ABA Journal Club: Clinical Decision Making

Welcome back to ABA Journal Club! 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. Next week, another ABA professional will respond to Sam’s questions and provide further insight and a different perspective on the piece.

One of my favorite parts of my job is training people who are working to become BCBAs. There is an immense amount of content for my supervisees to learn, and one of the key aspects of this is to understand how to implement all of the new concepts they’re learning within the context of an actual case. This is often far more challenging than it might appear at first blush. I frequently supervise students pursuing their BCBA, and I require each one of them to read LeBlanc, Raetz, Sellers, & Carr (2016) because it provides a clear model for clinical decision-making.

This month’s article:

LeBlanc, L. A., Raetz, P. B., Sellers, T. P., & Carr, J. E. (2016). A proposed model for selecting measurement procedures for the assessment and treatment of problem behavior. Behavior analysis in practice9(1), 77-83

This month’s questions:

  • Why is this article important for practitioners to read?
  • The model proposed by the authors incorporates several variables (such as observability of behavior and personnel resources.) Are there any other variables you might consider when selecting a measurement procedure?
  • Table 1 clearly outlines each form of measurement along with strengths and limitations. Discuss the forms of measurement you frequently use and the limitations to incorporating other forms into your current practice.
  • In Figure 1, the authors provide a flow chart for easily selecting the most appropriate form of measurement. Many of the questions are directly related to observer resources. In this article, the term “resources” relates directly to the ability of personnel to continuously monitor the behavior. Are there any other factors you would consider in relation to personnel? If yes, how do you typically address those factors?
  • In discussing the behavior being measured, the authors write: “If the behavior can occur at any time, consider all dimensions of the response and select the ones that are most critically important to fully capture the important features of the behavior and the potential change in the behavior that may occur due to intervention” (p. 81).  How do you determine which dimensions of the response are the most critically important? Can you think of an example?
  • One of the limitations of this paper is that the model it presents has not been empirically tested. What might such an empirical study look like?

Check back next week for our ABA Journal Club response post from Dana Reinecke. Let us know what your thoughts are on Facebook and Instagram!


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.

Posted in ABA

VB-MAPP vs ABLLS-R: Understanding The Differences

Assessment is the cornerstone of creating appropriate and effective interventions. Two common assessments used for youngsters with autism are the Assessment of Basic Language and Learning Skills-Revised (ABLLS-R) and the Verbal Behavior – Milestones Assessment and Placement Program (VB-MAPP). You’ve likely heard of both the ABLLS-R and the VB-MAPP. While these two assessments are similar in many ways, there are also some big differences that might make one more appropriate for you than the other.

ABLLS-R

The ABLLS-R is made up of two components: the ABLLS™-R  Protocol and the ABLLS™-R Guide. The protocol is comprised of a skill-tracking system, assessing items ranging from listening and language skills to academic and ADL skills. The scoring system is simple, in that each specific skill is broken down into 2-4 levels. You simply mark the level that matches your client’s current skill. The simple organization allows for you to easily track your learner’s progress.

It is important to recognize that the ABLLS-R is more than just the protocol. It also includes the ABLLS-R Guide, which provides instructions for scoring as well as strategies for using the information to develop appropriate goals. Over the years, I have seen many practitioners simply using the protocol without referring to the guide. This is an error that should be corrected, as the guide is a useful resource for parents, teachers, and practitioners. Finally, the ABLLS-R assessed skills that typically develop between approximately ages 2-6.

VB-MAPP

The VB-MAPP is composed of five components.

The Milestones Assessment is comprised of 170 measurable milestones, all based in B.F. Skinner’s analysis of verbal behavior. It focuses primarily on language and social skills, but does include some skills related to academics.

The Barriers Assessment provides a way to assess and measure common barriers to learning experienced by children with language delays. These include barriers such as prompt dependence, impaired social skills, and failure to generalize.

The Transition Assessment provides a way to assess and measure progress towards the child’s ability to move to a less restrictive environment. This portion of the VB-MAPP includes items such as the rate of acquisition for new skills, adaptability to change, and ability to learn from the natural environment.

The fourth component of the VB-MAPP is the Task Analysis and Supporting Skills. This portion goes hand-in-hand with the Milestones Assessment. It is comprised of hundreds of skills that are often directly related to the milestones. It shows the skills that should be taught prior to each milestone and can provide additional information into the child’s current skill level.

The final portion is the VB-MAPP Placement and IEP Goals. This is an in-depth guide for developing IEP goals and identifying interventions based on the results of the other portions of the assessments.  As with the ABLLS-R, I’ve seen many practitioners utilizing the VB-MAPP without referring to the Placement and IEP Goals in the VB-MAPP Guide. This is an error that should be corrected to best use the assessment. The VB-MAPP assesses language skills that typically develop by age 48 months.

VB-MAPP vs ABLLS-R?

It is valuable to receive training in both of these assessments. They are important tools for assessment, especially if you are working with young children.

No matter what assessment you choose, we’ve got you covered! Head to our website and check out our full line of ABLLS-R and VB-MAPP supports, including our exclusive full assessment kits!


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. You can read more of Sam’s posts for Different Roads To Learning when you click here!