Differential Reinforcement of Incompatible Behavior

Today, we are going to take a closer look at Differential Reinforcement of Incompatible behavior (DRI). DRI is defined as “a procedure for decreasing problem behavior in which reinforcement is delivered for a behavior that is topographically incompatible with the behavior targeted for reduction and withheld following instances of the problem behavior (e.g., sitting in seat is incompatible with walking around the room) (Cooper, Heron, & Heward, 2007).

Let’s look at a few examples of DRI in action:

  1. Mrs. Clark is teaching a classroom with six students with autism. One of her students has recently begun to pinch his arms. She takes data on the behavior and discovers that it functions for attention. (When he pinches his arms, she or a teacher’s aid comes over and tells him “no pinching.”) She decided to implement an intervention that utilizes DRI. She teaches him how to sit with his hands intertwined on his desk. This is an incompatible behavior with pinching because he is not able to pinch while his hands are intertwined. She and the teacher’s aid reinforce him for intertwining his hands (come over and tell him, “great job” or “I like how you’re sitting”) and do not provide attention when he engages in arm pinching.
  2. Carly has a 9-year-old daughter. When her daughter wants a break from doing homework, she reaches over and hits Carly’s arm. Carly typically says, “Do you need a break now?” Then, she allows her to take a five-minute break. Carly recognized that her daughter’s intensity with hitting seemed to be increasing, and she was worried she might get hurt. She decided to implement an intervention that utilized DRI. She put a timer on the table within her daughter’s reach, and taught her daughter to touch the timer when she wanted a break. This is an incompatible behavior because her daughter cannot simultaneously touch the timer and hit Carly. When Carly’s daughter touched the timer, she immediately received a break. When she hit Carly, she did not receive a break. This was an especially useful intervention because, over time, Carly taught her daughter to set the timer on her own and become more independent with managing break times.
  3. Mr. Holley teaches a preschool class. During circle time, many of his students become very excited and can be quite loud. Sometimes it seems as though all of his students are yelling at the same time. Once they become too loud, it is very challenging to regain their attention. He decides to implement an intervention utilizing DRI. He uses a decibel meter on his tablet (such as the app Too Noisy). He teaches the students that when the noise level is below a certain number or threshold they all earn stickers. This is differential reinforcement of an incompatible behavior because the children cannot possibly speak loudly and softly simultaneously.

DRI is not always the best option. For example, it may be very challenging to come up with an incompatible behavior. Or, in the case of self-injurious or aggressive behavior, it may be dangerous to use such an intervention.

If you do use DRI, you may consider explicitly telling your learner(s) that you are implementing this new plan, such as Mr. Holley did in the third example above. And remember, this is only one form of differential reinforcement. If DRI is not appropriate for your situation, there are definitely still options for reinforcing appropriate behavior in an effective and efficient manner.

REFERENCES

Cooper, J.O., Heron, T.E., & Heward, W.L. (2007). Applied Behavior Analysis – 2nd ed. Englewood Cliffs, NJ: Prentice-Hall.

Sam Blanco, PhD, LBA, BCBA is an ABA provider for students ages 3-15 in NYC. Working in education for sixteen 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 she is the Senior Clinical Strategist at Chorus Software Solutions

Posted in ABA

Resources for Promoting Dental Hygiene and Success at the Dentist

David Celiberti, PhD, BCBA-D, Maithri Sivaraman, MSc, BCBA, and Yash Gupta
Association for Science in Autism Treatment

Resistance associated with dental visits is an all-too-common challenge for many individuals with (and without) autism spectrum disorder (ASD).  Such resistance can lead to the use of restraint or pharmacological management, and sadly in some instances can be associated with inadequate preventative dental care or delays to access treatment which can lead to more serious health complications. More specifically, individuals with autism requiring special needs such as anesthesia dentistry, can face long waits for service (Bai, 2020). Furthermore, interventions that rely heavily on exposure training require a clinical setting able to make that investment which is often hampered by billing constraints, limited insurance reimbursement, and other logistical barriers.

This list of annotated resources has been created to serve as a helpful reference for families, clinicians, and educators alike. We have incorporated resources for dental providers as well, since there is some research suggesting that the majority of dentists feel anxious or uncomfortable treating patients with special needs (e.g., Dao et al., 2005).  We showcase online resources that highlight strategies and information to address the myriad of obstacles surrounding dental care. We hope that this information shared below will support your efforts, promote cooperation, and help improve dental outcomes. This piece was initially published a few years ago and is now expanded and updated.

Resources for Families (Video/Audio):

Child Preparation- Bergen Pediatric Dentistry. On this very helpful page, Dr. Purnima Hernandez shares several video models and narratives for parents, providers, and children. The videos showcase specific tools and their corresponding sounds which may help prepare your child for a cleaning visit. These videos expose the child to some of the more potentially aversive sensory experiences in a brief and non-threatening manner.

Making Going to the Dentist Easier for Kids with Autism. This helpful video blog by Dr. Mary Barbera describes several strategies you can consider to make dental visits and oral care easier. Dr. Barbera discusses the importance of careful reflection on past visits, learning from those experiences, and setting reasonable goals. She models some of these strategies in this 11-minute video.

Autism: Making Tooth Brushing Possible/Fun. This 12-minute 2013 video by Autism Live includes an interview with Dr. Jonathan Tarbox and addresses the role of reinforcement and shaping/exposure procedures.  Specifically, Dr. Tarbox outlines strategies to reduce the motivation to escape, including criteria to guide gradual progression, and careful use of probes to guide toleration efforts. He also discusses the importance of limiting access to high-ticket rewards so that they can only be achieved by completing one certain task, for example tooth brushing.

Dental Toolkit. In recognition that good oral health habits can be challenging for many individuals with autism, Autism Speaks collaborated with Colgate and Philips-Sonicare to create this 10-minute video. It provides tips for families so they can help their loved ones with autism access a suitable dental care provider as well as how to choose the right brush/toothpaste and practice skills at home, including getting ready for the first visit. Two dentists shared their experiences serving patients with autism offering numerous suggestions, such as how to adapt the examination depending on the child’s reactions.

How To Help Your Autistic Child During A Dental Appointment | Autism Tips by Maria Borde.   

This quick, 3-minute video by Maria Borde showcases many strategies to help prepare for the dentist. Some tips mentioned for children with autism at the dentist are: preparing them in advance by showing them the tools and making them comfortable with the tools, bringing a tablet with your child’s favorite shows as a distraction, and using sunglasses and sound cancelling headphones for children who find bright lights or loud sounds aversive.

Resources for Families (Print Materials):

Autism Dental Information Guide for Families and Caregivers. In an effort to create information guides for families of individuals with autism, service providers, and dental professionals, the Southwest Autism Research & Resource Center (SARRC) published this booklet in collaboration with dental experts and academics. This well-organized and consumer friendly booklet contains background information on the importance of good oral hygiene and care. It provides a comprehensive list of suggestions for scheduling the dental appointment, including a sample form for use when calling the dentist to set up the initial appointment. The sections related to preparing for the office visit and carrying out oral care in the home are particularly detailed and helpful. Finally, there is information about the use of fluoride and metal fillings (amalgam) to help parents become more informed about these products.

Taking Your Son/Daughter with an Autism Spectrum Disorder to the Dentist. This resource was prepared by the Indiana Resource Center for Autism. The article contains many helpful tips, such as bringing the child’s toothbrush and toothpaste to the dental visit for familiarity and having the dental chair already in a reclined position for those children who may not like to be moved backward mechanically. A Tell/Show/Do strategy is described for promoting cooperation and participation during dental routines. This strategy first involves verbally describing the forthcoming step, followed by displaying the tool or instrument and allowing the child to see it, and finally, carrying out the step. Appendices include a list of books, a sample social story, and a visual schedule for visiting the dentist.

Healthy Smiles for Autism: Oral Hygiene Tips for Children with Autism Spectrum Disorders. This publication is based on a collaboration of the National Museum of Dentistry, the Kennedy Krieger Institute’s Center for Autism and Related Disorders, and the University of Maryland Dental School. It showcases best practices related to oral health care for children with ASD. This booklet highlights the importance of parental modeling and recommends that parents invest time in choosing a toothbrush, toothpaste, and flossing materials that work best for the child. Guidelines for helping children brush and floss successfully are consistent with well-established behavior analytic principles and are consumer-friendly, as are the suggestions surrounding how to access dental care (e.g., finding a dental provider, getting ready for the initial visit). This booklet includes well-designed visual sequencing cards, social stories, and a picture dictionary.

Helping Your Child Overcome Fear of the Dentist and Develop Lifelong Oral Hygiene Habits. In this resource shared by Solving Autism, readers will find a brief overview of the common challenges observed in children with autism, tips for finding the right dentist including helpful questions to ask, and proactive strategies in preparation for the visit. There is also a user-friendly set of suggestions for developing sound oral hygiene habits.

Autism and Dental Care: A Guide for Their Oral Treatment. In this resource, Drs. Greg Grillo and David Hudnall offer many helpful strategies in preparing for upcoming dental visits, as well as tips and techniques to promote the development of proper oral health habits. They discuss sedation as well as the benefits of splitting examination components over multiple visits. This resource is available in Spanish (Autismo y el Cuidado Dental) and also refers to a blog in Spanish.

Dental Health Guidance for Parents and Caregivers of Children with Autism Spectrum Disorder. This fact sheet put together by the Washington State Department of Health and University of Washington’s DECOD (Dental Education in the Care of Persons with Disabilities) Program provides a very helpful list of questions to guide initial conversations with the dentist. It includes an array of tips and strategies to prepare for the visit, as well as some action items for the day of the visit.

Resources for Dental Professionals:

Autism Dental Information Guide for Professionals. This guide has been created by SARRC for dental professionals. Besides information on relevant dental issues associated with ASD, and what to expect with a patient with ASD, the guide offers valuable input on specific items to include in a welcome package. An important strategy for an individual with ASD to have a successful visit to a dental clinic is the preparedness of the professional and the patient for the experience. The guide offers suggestions such as sending pictures of the dental team and the office prior to the visit and providing pamphlets (when appropriate) and parent questionnaires to learn about existing behavioral challenges and sensory preferences towards preparedness.

Autism Speaks Dental Toolkit. The dental toolkit by Autism Speaks is aimed at both parents and professionals. Specifically, the 10-minute video has advice from dental experts with experience treating patients with ASD and highlights the importance of rapport-building for a successful experience. The toolkit also offers a visual schedule that dental professionals can adapt to help their patients anticipate and tolerate the different steps and activities that will occur during their visit to the clinic. Autism Speaks also offers a detailed task analysis for toothbrushing. As is the case with every task analysis, this should be individually tailored to target the child’s needs, skills, and deficits.

University of Washington’s Fact Sheet for Professionals.  This fact sheet put together by the Washington State Department of Health, and University of Washington’s DECOD outlines the symptoms of ASD, commonly associated comorbid conditions, and strategies for dental professionals to manage patients with autism. This resource offers guidance for promoting cooperation in the dental chair and specific tips on techniques to use before and during the appointment. In addition, seizure management during treatment, and ways to handle visible signs of trauma are briefly summarized. This is important given that many individuals with autism develop seizure activity. An analogous Fact Sheet for Dental Professionals has also been developed for ADHDDown Syndrome and cerebral palsy.

National Institute of Child Health and Human Development Resource Center (NICHD)’s Practical Oral Care for People with Autism. This is a handbook for oral care physicians created by the NICHD in collaboration with the National Association of Dental and Craniofacial Research. The booklet is one in a series on providing oral care for people with developmental disabilities including ASD, Cerebral Palsy, Downs Syndrome, and intellectual disability. The autism handbook lists the issues and oral health challenges common in individuals with ASD and provides care strategies for them. Specific ways to prepare for patients who present with “unusual and unpredictable body movements” and sensitivity to sensory stimuli are offered.

Dental Care – Continuing Education course. Dental Care offers a free continuing education course for dental professionals, with an aim to promote understanding of ASD and prepare learners to serve patients with this diagnosis. The course content is extensive and provides modules on creating a sensory friendly office, developing an office protocol for patients with ASD, utilizing a visual schedule, and behavior management strategies to increase appropriate behavior. The course is intended for all types of dental professionals as well as dental students, and is self-instructional.

Dental Exam Tolerance with Dr. Kelly McConnell — ABA Inside Track. This 1 hour and 22-minute podcast with Dr. Kelly McConnell by ABA Inside Track showcases recent behavior analytic research to help children with autism better tolerate dental appointments. It mentions strategies that could be considered when children with autism meet with their dentists, as well as things to avoid. A distinction is made between desensitization and graduated exposure as the latter may be a more accurate description of the procedures typically used.  As shared throughout many of the resources described in this article, it was discussed that adjustments and increased demands should be made gradually.

We hope you will find these resources beneficial whether you are an individual with autism, a family member to someone with autism, an education or behavioral professional, or a dental care professional. We will continue to update this annotated list and reshare with our readers as new resources become available. Together, we can help to make dental visits successful for people with autism. Please consider sharing this article with clients, friends, and colleagues.

References:

Bai, N. (2020, February 24). For patients with special needs, any dentist is hard to find.    https://www.ucsf.edu/news/2020/02/416726/patients-special-needs-any-dentist-hard-find

Dao L. P., Zwetchkenbaum S., & Inglehart M. R. (2005) General dentists and special needs patients: Does dental education matter? Journal of Dental Education, 69(10), 1107-15. PMID: 16204676.

Citation for this article:

Celiberti, D., Sivaraman, M., & Gupta, Y. (2021). Consumer Corner: An updated and annotated list of online resources for promoting dental hygiene and success with dental care. Science in Autism Treatment, 18(5)

Please also see other related ASAT articles:

A Non-exhaustive list of recent research in the area:

Allen, K. D., & Wallace, D. P. (2013). Effectiveness of using noncontingent escape for general behavior management in a pediatric dental clinic. Journal of Applied Behavior Analysis, 46, 723-737. https://doi.org/10.1002/jaba.82   

Altabet, S. (2002). Decreasing dental resistance among individuals with severe and profound mental retardation. Journal of Developmental and Physical Disabilities, 14, 297-305. https://doi.org/10.1023/A:1016032623478  

Appukuttan, D. P. (2016). Strategies to manage patients with dental anxiety and dental phobia: Literature review. Clinical, Cosmetic and Investigational Dentistry, 8, 35-50. https://doi.org/10.2147/CCIDE.S63626   

Blitz, M., & Britton, K. C. (2010). Management of the uncooperative child. Oral and Maxillofacial Surgery Clinics of North America, 22(4), 461-469. https://doi.org/10.1016/j.coms.2010.08.002   

Carter, L., Harper, J. M., & Luiselli, J. K. (2019). Dental desensitization for students with autism spectrum disorder through graduated exposure, reinforcement, and reinforcement fading. Journal of Developmental and Physical Disabilities, 31, 161-170. https://doi.org/10.1007/s10882-018-9635-8   

Chandrashekhar, S., & Bommangoudar, J. S. (2018). Management of Autistic Patients in Dental Office: A Clinical Update. International Journal of Clinical Pediatric Dentistry11(3), 219–227. https://doi.org/10.5005/jp-journals-10005-1515

Cuvo, A. J., Godard, A., Huckfeldt, R., & Demattei, R. (2010). Training children with autism spectrum disorders to be compliant with an oral assessment. Research in Autism Spectrum Disorders, 4, 681-696.

Delli, K., Reichart, P. A., Bornstein, M. M., & Livas, C. (2013). Management of children with autism spectrum disorder in the dental setting: concerns, behavioural approaches and recommendations. Medicina Oral, Patologia Oral y Cirugia Bucal18(6), e862–e868. https://doi.org/10.4317/medoral.19084

Du, R. Y., Yiu, C. K., & King, N. M. (2019). Oral health behaviours of preschool children with autism spectrum disorders and their barriers to dental care. Journal of Autism and Developmental Disorders, 49(2):453-459. https://doi.org/10.1007/s10803-018-3708-5.  

Fakhruddin, K. S., Yehia, H., & Batawi, E. (2017). Effectiveness of audiovisual distraction in behavior modification during dental caries assessments and sealant placement in children with autism spectrum disorder. Dental Research Journal, 14(3), 177-182.

Ferrazzano, G. F., Salerno, C., Bravaccio, C., Ingenito, A., Sangianantoni, G., Cantile, T.  (2020). Autism spectrum disorders and oral health status: Review of the literature. European Journal of Paediatric Dentistry, 21(1):9-12. https://doi.org/10.23804/ejpd.2020.21.01.02.

Friedlander, A. H., Yagiela, J. A., Paterno, V. I., & Mahler, M. E. (2006) The neuropathology, medical management and dental implications of autism. Journal of the American Dental Association, 137(11): 1517-1527. https://doi.org/10.14219/jada.archive.2006.0086  

Hernandez, P., & Ikkanda, Z. (2011). Applied behavior analysis: behavior management of children with autism spectrum disorders in dental environments. Journal of the American Dental Association,142(3):281-7. https://doi.org/10.14219/jada.archive.2011.0167

Jaber M. A. (2011). Dental caries experience, oral health status and treatment needs of dental patients with autism. Journal of Applied Oral Science: Revista FOB, 19(3), 212–217. https://doi.org/10.1590/s1678-77572011000300006  

Loo, C., Graham, R., Hughes, C. (2008) The caries experience and behavior of dental patients with autism spectrum disorder. Journal of the American Dental Association, 139, 1518-1524. https://doi.org/10.14219/jada.archive.2008.0078.

Marion I. W., Nelson T. M., Sheller B., McKinney C. M., & Scott J. M. (2016). Dental stories for children with autism. Special Care in Dentistry, 36(4):181-6. https://doi.org/10.1111/scd.12167.

McConnell, K. L., Sassi, J. L., Carr, L., Szalwinski. J., Courtemanch, A., Njie-Jallow, F., & Cheney, W. R. (2020). Functional analysis and generalized treatment of disruptive behavior during dental exams. Journal of Applied Behavior Analysis 53(4), 2233-2249. https://doi.org/10.1002/jaba.747   

Ming, X., Brimacombe, M., Chaaban, J., Zimmerman,-Bier, B., Wagner, G. C. (2008). Autism Spectrum Disorders: Concurrent Clinical Disorders. Journal of Child Neurology, 23, 6-13. https://doi.org/10.1177/0883073807307102

Nelson, T., Chim, A., Sheller, B. L., McKinney, C. M., & Scott, J. M. (2017). Predicting successful dental examinations for children with autism spectrum disorder in the context of a dental desensitization program. The Journal of the American Dental Association, 148(7), 485-492. https://doi.org/10.1016/j.adaj.2017.03.015  

Nelson, T. M., Sheller, B., Friedman, C. S., & Bernier, R. (2015). Educational and therapeutic behavioral approaches to providing dental care for patients with Autism Spectrum Disorder. Special Care in Dentistry, 35(3). 105-113. https://doi.org/10.1111/scd.12101

O’Callaghan, P. M., Allen, K. D., Powell, S., & Salama, F. (2006). The efficacy of noncontingent escape for decreasing children’s disruptive behavior during restorative dental treatment. Journal of Applied Behavior Analysis, 39(2), 161-171

Stark, L. J., Allen, K. D., Hurst, M., Nash, D. A., Rigney, B., & Stokes, T. F. (1989). Distraction: its utilization and efficacy with children undergoing dental treatment. Journal of Applied Behavior Analysis22(3), 297–307. https://doi.org/10.1901/jaba.1989.22-297

Virdi, M. S. (2011). Application of contingency management in pediatric dentistry practice. Journal of Innovative Dentistry, 1(1), 1-4.

About The Authors

David Celiberti, PhD, BCBA-D, is the Executive Director of ASAT and Past-President, a role he served from 2006 to 2012. He is the Editor of ASAT’s monthly publication, Science in Autism Treatment. He received his PhD in clinical psychology from Rutgers University in 1993 and his certification in behavior analysis in 2000. Dr. Celiberti has served on a number of advisory boards and special interest groups in the field of autism, applied behavior analysis (ABA), and early childhood education. He works in private practice and provides consultation to public and private schools and agencies in underserved areas. He has authored several articles in professional journals and presents frequently at regional, national, and international conferences. In prior positions, Dr. Celiberti taught courses related to ABA at both undergraduate and graduate levels, supervised individuals pursuing BCBA certifications, and conducted research in the areas of ABA, family intervention, and autism. 

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). 

Yash Gupta is a 9th grader attending high school in California. Yash has a family member with autism and has been volunteering for the Association for Science in Autism Treatment on a variety of projects. In his spare time, he enjoys playing tennis and drawing and partakes in the Boy Scouts and debate. He is working to broaden his experience with autism research and aspires to pursue a career in the medical field. His goal is to spread awareness about ASD, so that people with autism are better treated and represented in society. 

Posted in ABA

Returning To School After Virtual Learning

On my first day returning to the office after over a year of working from home and Zoom, I felt as if I had lost all of my leaving-the-house skills. What shoes did I wear? What could I pack for lunch? Did I have time to drink my coffee at home or would I need to bring a travel mug? Where I used to be able to make it out the door 45 minutes after waking up, I suddenly was running 20 minutes late. What had been years of routine was now completely unfamiliar.

Many of us will probably be feeling the same way, including our students with Autism. How do we possibly ease this transition? Below are a few suggestions, and we’d love to hear any you may have as well. 

  1. Offer choice whenever possible. Access to choice is motivating for many kids, and can be a balm in instances where so much is out of their control. You can provide choices with what they pack for lunch, what outfits they wear, or what fun activity they can do when they return home from their first day back to school.
  2. Create alerts and schedules. Have your kid participate in creating a basic schedule, setting alarms, or putting alerts in your smartphone for new activities added to the schedule. Another benefit of creating a schedule is that you can add fun events/activities in with the new required activities.
  3. Identify supports within the school. Many schools and teachers are creating their own plans to ease the transition. Find out what your school and/or your child’s classroom teacher are doing, and see what you can do to support that plan or carry it over into your home.
  4. Practice the new transitions. Role-play the new routine as much as possible. This could be as simple as setting the alarm for the new wake-up time; or it can be more complex in that you wake up, go through the morning routine, and practice the drive to school. Practice will help your child adjust to the new routine, but will also alert you to any potential problems without the added stress of having to complete the routine in its entirety.
  5. Prep what you can in advance. Set out clothing the night before, prep lunches in advance with your child, or set a time with a fellow parent for children to meet prior to walking into the school.
  6. Use tools that have been successful in the past. Reflect on transitions that have been challenging in the past for your child. What strategies worked in those instances? How could those strategies be implemented now to ease this transition?
  7. Prepare your child for additional changes. There are many changes that will be outside of your control. It’s possible the school will change (or has already changed) its re-open date, or that it will close again after re-opening. It can be helpful to state this possibility for your child, and tell them what you’ll do if plans change.
  8. Check in. Set aside time to check in with your child. One game that can be fun for check-ins is “high, low, buffalo.” Here, you and your child each share a high point of your day (high,) a low point of our day (low,) and a something else funny or fun or interesting about your day (buffalo.) Providing this structure can be a great way to normalize check-ins and ensure that you are addressing any issues that may arise during the transition.

Sam Blanco, PhD, LBA, BCBA is an ABA provider for students ages 3-15 in NYC. Working in education for sixteen 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 she is the Senior Clinical Strategist at Chorus Software Solutions. 

Posted in ABA

Social and Job Skills for Independence: Smile & Succeed for Teens Online Course

According to Harvard University social skills are the top factor in getting a job. Is your teen or young adult prepared? Social skills are especially difficult for individuals on the autism spectrum, however many of these skills can be learned, and with practice, can become habit. Social skills are critically important to make friends, get and keep a job, get along with co-workers, and live a fulfilling, independent (or as independent as possible) life.

I created the Smile & Succeed for Teens Online Course as an engaging, easy and fun way for teens and young adults to learn and master valuable social and job skills. The content is quick and easy to learn with no wasted words, perfect for short attention spans.

“Smile & Succeed for Teens is a fantastic resource to help teens be successful at work.” Temple Grandin, One of Time Magazine’s 100 most influential people in the world, leading autism advocate, author, Thinking in PicturesThe Autistic Brain

At-Home Learning
The pandemic has negatively affected many teens and young adults’ social skills. Smile & Succeed for Teens Online Course is perfect for at-home, in-class or remote learning, self-paced or instructor led. This flexible course provides an ideal resource for all young people, including those in transition and autism support programs, to gain the social and job skills necessary for success. The course is mobile friendly and can be viewed on a cell phone, tablet, laptop, or desktop computer.

Now is a perfect time for your son or daughter to learn or refresh vital social and job skills. The online course mirrors the content in my Teachers’ Choice Award and Mom’s Choice Gold Award-winning book, Smile & Succeed for Teens: Must Know People Skills for Today’s Wired World. The seven modules in the online course correspond to the seven chapters in my book. Your young adult will learn the same life-changing skills.

KEY TAKEAWAYS FOR TEENS:

  • How to interview effectively, land a job and keep it!
  • How to make friends.
  • Electronic etiquette.
  • The important life skills your first job can teach you.
  • Customer service, sales and fundraising skills to excel.
  • The many benefits of volunteering.
  • How to handle stress.
  • Job skills that make you stand out.
  • Improved confidence and self-esteem.
  • What colleges are looking for in applicants, and a lot more.

    The online course is perfect for middle, high school and college students and all young adults.

Course Benefits

  • Quick and easy to implement. Simply log in and begin using!
  • Straightforward, simple and extremely user-friendly.
  • Bookmarks and highlights. Users can bookmark, make notes and highlight key points.
  • Search function to refresh skills and for quick and easy reference.
  • Interactive questions and answers make learning fun.
  • Curated videos reinforce concepts.
  • Mobile friendly.
  • “Wired Tips” remind students of the benefits of face-to-face communication and electronic etiquette.
  • ADA (Americans with Disabilities Act) compliant.
  • Compatible with free Read&Write extension for Google Chrome.
  • Lexile: 720L (4th grade reading level)

A Solution for Schools and Students
Many students are struggling with “soft skills” (social skills). This online course provides instructors with an easy way to teach students these powerful skills. There are opportunities for comprehension testing along the way.

For school purchases with multiple users (instructor(s) and students), the instructor(s) will receive the instructor version of this online course that includes an embedded teaching guide with differentiated activities and lesson plans that make it easy to teach the content and provide additional learning opportunities.

Prep time is very minimal. A teacher can purchase and implement the same or next day. Results from quizzes automatically populate into the gradebook with the gradebook export feature.

The specific curriculum for customer service skills in this online course meets Customer Service Standards as outlined by the Ohio Department of Education.

Note: This course is a content delivery system. It can stand alone or fit inside your Learning Management System (LMS). It can even integrate with your video conferencing tools such as Zoom or Microsoft Teams.

Course Benefits

  • User-friendly common-sense approach to people skills.
  • Written in an upbeat manner that holds the interest of young people.
  • Entertaining graphics with educational captions enhance the content.
  • Reaches a wide variety of teen and young adult abilities.
  • Allows for independent use.

Excerpt from the Online Course

Once you land a job you will want to work hard to keep it.

HERE’S HOW

  • Follow directions
  • Communicate clearly
  • Be on time
  • Be enthusiastic
  • Practice self-control 
  • Take responsibility for assigned tasks
  • Be able to work without supervision
  • Be respectful
  • Accept instruction eagerly

Why do most young people lose a job?

  • Being late or being absent
  • Not making an effort to get along with others
  • Slow to learn good work habits

Whether they are looking for a job, already working, starting their own business, volunteering, or applying to college, Smile and Succeed for Teens Online Course is ideal for young adults. Packed with indispensable tips, proven techniques, and “must-do-now” strategies, this course generates results.

Parts taken from “Smile & Succeed for Teens: Must-Know People Skills for Today’s Wired World” Copyright © 2014-2021 by Kirt Manecke. Kirt Manecke is the award-winning author of “Smile & Succeed for Teens: Must-Know People Skills for Today’s Wired World” online course and book, and “The Teaching Guide for Smile & Succeed for Teens”.

Posted in ABA

Parenting For Joy

Editor’s note:  Autism Awareness month is becoming a call to action from the autism and neurodivergent communities for change from the rest of society. In this edited excerpt from their upcoming book with Different Roads, co-authors Shahla Ala’i-Rosales and Peggy Heinkel-Wolfe offer a specific call to action to both parents and professionals—to seek and maintain joy’s radiating energy in our relationships with our children.

Parents have the responsibility of raising their children with autism the best they can. This journey is part of how we all develop as humans—nurturing children in ways that honor their humanity and invite full, rich lives. Ala’i-Rosales and Heinkel-Wolfe’s upcoming book offers a roadmap for a joyful and sustainable parenting journey. The heart of this journey relies on learning, connecting, and loving. Each power informs the other and each amplifies the other. And each power is essential for meaningful and courageous parenting.

Ala’i-Rosales is a researcher, clinician, and associate professor of applied behavior analysis at the University of North Texas. Heinkel-Wolfe is a journalist and parent of an adult son with autism.

Joy gives us wings! ― Abdul-Baha

“Up, up and awaaay!” all three family members said at once, laughing. A young boy’s mother bent over and pulled her toddler close to her feet, tucking her hands under his arms and around his torso. She looked up toward her husband and the camera, broke into a grin, and turned back to look at her son. “Ready?” she said, smiling eagerly. The boy looked up at her, saying “Up . . .” Then he, too, looked up at the camera toward his father before looking back up at his mother to say his version of “away.” She squealed with satisfaction at his words and his gaze, swinging him back and forth under the protection of her long legs and out into the space of the family kitchen. The little boy had the lopsided grin kids often get when they are proud of something they did and know everyone else is, too. The father cheered from behind the camera. As his mother set him back on the floor to start another round, the little boy clapped his hands. This was a fun game.

One might think that the important thing about this moment was the boy’s talking (it was), or him engaging in shared attention with both his mom and dad (it was), or his mom learning when to help him with prompts and how to fade and let him fly on his own (it was), or his parents learning how to break up activities so they will be reinforcing and encourage happy progress (it was) or his parents taking video clips so that they could analyze them to see how they could do things better (it was) or that his family was in such a sweet and collaborative relationship with his intervention team that they wanted to share their progress (it was). Each one of those things is important and together, synergistically, they achieved the ultimate importance: they were happy together.

Shahla has seen many short, joyful home videos from the families she’s worked with over the years. On first viewing, these happy moments look almost magical. And they are, but that joyful magic comes with planning and purpose. Parents and professionals can learn how to approach relationships with their autistic child with intention. Children should, and can, make happy progress across all the places they live, learn, and play–home, school, and clinic. It is often helpful for families and professionals to make short videos of such moments and interactions across places. Back in the clinic or at home, they watch the clips together to talk about what the videos show and discuss what they mean and how the information can give direction. Joyful moments go by fast. Video clips can help us observe all the little things that are happening so we can find ways to expand the moments and the joy.

Let’s imagine another moment. A father and his preschooler are roughhousing on the floor with an oversized pillow. The father raises the pillow high above his head and says “Pop!” To the boy’s laughter and delight, his father drops the pillow on top of him and gently wiggles it as the little boy rolls from side to side. After a few rounds, father raises the pillow and looks at his son expectantly. The boy looks up at his father to say “Pop!” Down comes the wiggly pillow. They continue the game until the father gets a little winded. After all, it is a big pillow. He sits back on his knees for a moment, breathing heavily, but smiling and laughing. He asks his son if he is getting tired. But the boy rolls back over to look up at his dad again, still smiling and points to the pillow with eyebrows raised. Father recovers his energy as quickly as he can. The son has learned new sounds, and the father has learned a game that has motivated his child and how to time the learning. They are both having fun.

The father learned that this game not only encourages his child’s vocal speech but it was also one of the first times his child persisted to keep their interaction going. Their time together was becoming emotionally valuable. The father was learning how to arrange happy activities so that the two of them could move together in harmony. He learned the principles of responding to him with help from the team. He knew how to approach his son with kindness and how to encourage his son’s approach to him and how to keep that momentum going. He understood the importance of his son’s assent in whatever activity they did together. He also recognized his son’s agency—his ability to act independently and make his own choices freely—as well as his own agency as they learned to move together in the world.

In creating the game of pillow pop, parent and child found their own dance. Each moved with their own tune in time and space, and their tunes came together in harmony. When joy guides our choices, each person can be themselves, be together with others, and make progress. We can recognize that individuals have different reinforcers in a joint activity and that there is the potential to also develop and share reinforcers in these joint activities. And with strengthening bonds, this might simply come to mean enjoying being in each other’s company.

In another composite example, we consider a mother gently approaching her toddler with a sock puppet. The little boy is sitting on his knees on top of a bed, looking out the window, and flicking his fingers in his peripheral vision. The mother is oblivious to all of that, the boy is two years old and, although the movements are a little different, he’s doing what toddlers do. She begins to sing a children’s song that incorporates different animal sounds, sounds she discovered that her son loves to explore. After a moment, he joins her in making the animal sounds in the song. Then, he turns toward her and gently places his hands on her face. She’s singing for him. He reciprocates with his gaze and his caress, both actions full of appreciation and tenderness.

Family members might dream of the activities that they will enjoy together with their children as they learn and grow. Mothers and fathers and siblings may not have imagined singing sock puppets, playing pillow pop, or organizing kitchen swing games. But these examples here show the possibilities when we open up to one another and enjoy each other’s company. Our joy in our child and our family helps us rethink what is easy, what is hard, and what is progress. 

All children can learn about the way into joyful relationships and, with grace, the dance continues as they grow up. This dance of human relationships is one that we all compose, first among members of our family, and then our schoolmates and, finally, out in the community. Shahla will always remember a film from the Anne Sullivan School in in Peru. The team knew they could help a young autistic boy at their school, but he would have to learn to ride the city bus across town by himself, including making several transfers along the way. The team worked out a training program for the boy to learn the way on the city buses, but the training program didn’t formally include anyone in the community at large. Still, the drivers and other passengers got to know the boy, this newest traveling member of their community, and they prompted him through the transfers from time to time. Through that shared dance, they amplified the community’s caring relationships. 

When joy is present, we recognize the caring approach of others toward us and the need for kindness in our own approach toward others. We recognize the mutual assent within our togetherness, and the agency each of us enjoys in that togetherness. Joy isn’t a material good, but an energy found in curiosity, truth, affection, and insight. Once we recognize the radiating energy that joy brings, we will notice when it is missing and seek it out. Joy occupies those spaces where we are present and looking for the good. Like hope and love, joy is sacred.

“When there is so much hate and so much resistance to truth and justice, joy is itself is an act of resistance.” ― Nicolas O’Rourke

Photo Credit: Bruno Nascimento c/o Unsplash

Compassionate ABA

Compassion requires three actions: listening, understanding, and acting. ABA is a compassionate practice by definition, because behavior analysts are trained to do each of these actions in very specific ways.

Listening is necessary for consent. Behavior analysts are required by ethical and professional guidelines to ensure informed consent prior to implementing assessment or intervention. Informed consent includes demonstrating that you understand what you are agreeing to, so behavior analysts should be listening to clients and their parents/guardians to determine if this understanding exists. If they are really consenting, clients or their parents/guardians will always be in control of the goals targeted and strategies of intervention.

Understanding occurs through the functional perspective taken by behavior analysts, which means that they take the time to learn and understand why behavior is happening or not happening. After listening to what is important to and for the client, the next step is to assess behavior. Put simply, the behavior analyst endeavors to get into their client’s shoes and figure out why they are acting the way they are acting. The assumption is always that the individual has good reasons for their behavior, and if those actions are going to change, we need to figure out how to replace them or make them less necessary, more efficient, or easier. We assume that people are right about their interactions with the world. If anything needs to change, it is the world, and not the person.

Acting is done through the development of interventions designed to improve the client’s situation and experience, based on the priorities established by the client through listening and consent. Behavior analysts hold social validity to be a very important value, in that not only should behavior change be meaningful and helpful to the individual who is changing their behavior, but the ways in which behavior is changed must also be acceptable. Behavioral interventions are not done to people, but with them, to help them meet their own goals in ways that they find reasonable.

Consent, assessment, and intervention meet the three requirements for compassion – listening to someone to hear what is concerning them, attempting to understand or feel their distress, and then doing something to alleviate their problems. Failure to take steps to listen to concerns and understand behavior takes the “analysis” out of the practice and reduces it to a collection of tricks that sometimes work but often don’t, and sometimes even make things worse. Unfortunately, sometimes poor training or supervision, or simple unethical practice, results in behavior analysis that is not compassionate and that reflects badly on the whole field.

Consider two scenarios that could happen when a well-meaning behavior analyst meets a new client for the first time, and finds that the client engages in high rates of stereotypy:

● Behavior analyst A draws upon her experience and determines that the levels of stereotypy that the client engages in will likely be disruptive in school and other community environments. She informs the family that stereotypy is inappropriate and teaches the parents to implement a comprehensive plan that includes environmental enrichment, positive reinforcement for periods of time when stereotypy does not occur, and asks them to collect data throughout the day on levels of stereotypy. Then she leaves with a promise to return in a week to evaluate their progress. The parents call the agency and say that they don’t think ABA is for them.

● Behavior analyst B has a lengthy conversation with the family about their preferred activities as a family. She asks them what they love to do with their child, and finds that they all enjoy going to the playground but that they usually reserve that activity for chilly days or early evenings and that they have been going less and less. When this is explored a bit further, they share somewhat reluctantly that both parents are uncomfortable when other parents and children stare when their child engages in stereotypy. The behavior analyst asks what they would like to do about this, if anything, or if they feel that their current strategy is working for them. The parents ask if they can think about it, and the behavior analyst agrees to discuss at next week’s meeting. In the meantime, she leaves them with some websites about functional assessment to look over. At the following week’s meeting, the parents say that they would like to prioritize other issues over stereotypy at this time, but they would like to learn more about functional assessment to see if it could help them to understand stereotypy a bit better.

In these scenarios, behavior analyst A provided a set of interventions that are not aversive and potentially not difficult for a trained professional to implement, but perhaps overwhelming to a family newly introduced to ABA. She prioritized the goals for intervention based on her experience rather than the family’s needs and preferences, without taking the time to listen to them and ensure consent. She also did not assess or attempt to understand the behavior and instead attempted to swiftly take action to reduce it. In addition, she did not attempt to determine if the interventions were acceptable to the parents or the child. If the family did choose to continue with her plan, it is possible that stereotypy might have decreased, but it is also possible that her plan would fail to meet the function of the behavior, resulting in unnecessary stress and a poor experience for the child. Ultimately, the family decided that this approach did not fit with their needs and they lost out on all of the potential benefits of well-implemented ABA for other areas of their child’s life, such as improving communication and independence.

By contrast, behavior analyst B moved slowly. She did not start by trying to identify problems, but by listening to the family by exploring their strengths and reinforcers, providing her with knowledge about how to connect with the child and parents and how to create a fun, warm, and enjoyable experience for everyone. She allowed them to share what makes it difficult for them to enjoy those reinforcers, and she opened the door to helping them with this issue if that is what they want. She did not provide a solution without consent or assessment, however. She left them with information and time to think, and the family was comfortable to have her return and continue to explore what would be best for their child in the context of their family. Ultimately, by listening and assessing, this behavior analyst has a chance of eventually acting and providing truly compassionate service and care to this client and family.

Both behavior analysts mean well. Both want what is best for their client. Neither behavior analyst wants to frighten families, make children cry, or take away what they enjoy. Both have rich resources at their disposal, but only one will likely be able to share those resources and meet her goals and the goals of the family. Practicing with compassion keeps communication open, but failure to demonstrate compassion by not listening and not understanding can result in a closed door and a great loss for the family and the field.

When practiced correctly and compassionately, ABA includes several features. First and foremost, there is a continuous emphasis on client and family input. Goals, strategies, and outcome measures are determined in consultation with the individuals who will be affected by the intervention. This includes not only the individual person receiving services, but those who love that person as well. Taking a broad viewpoint that includes the whole family is an important part of compassion.

Next, not only should behavior analysts obtain consent as mentioned earlier, but they should also be sure to get assent from clients who are not able to legally consent. Assent is a less formal version of consent that can be given by children or individuals who have cognitive differences that make it impossible for them to truly consent. Due to the extreme nature of the behavior of some individuals who receive behavior analysis services, at times assent is not obtained for safety reasons. This should only occur during times of crisis when the individual and/or those around them is in true danger. Any such occurrence should be immediately followed by obtaining consent and then conducting assessment and analysis of ways to prevent crises from occurring in the future. Interventions should be acceptable to all parties, including the individual receiving services. Again, many individuals who receive ABA services cannot verbally express assent, but the behavior analyst should be skilled enough to recognize behavioral indicators of assent or lack of assent, and adjust their actions accordingly.

Compassionate behavior analysts are also flexible. They recognize that there are changing circumstances in clients’ and their families’ lives, and that sometimes even effective plans need to be adjusted. They also recognize when sometimes despite their own best intentions, their efforts are not working well and they are willing to step back, reevaluate, and adjust approaches as needed. Behavior analysts should also be honest about what they can offer, their competence and comfort level with what is being asked of them, and how clients and families can best participate in their own services. Finally, it is crucial for behavior analysts to make human connections with the families they serve. Many behavior analysts find it easy to connect with their clients through their reinforcers and successes, but it is also important to maintain a connection with the rest of the people in their clients’ lives by showing interest and concern for them.

One final thought is that compassion can be a two-way street. Behavior analysts can most successfully connect with the client and family when the effort to connect is reciprocated. Although it is up to the behavior analyst to attempt to make the family comfortable in sharing their needs and preferences, sometimes we don’t know what we don’t know. Even the most compassionate and skilled professional might miss something, so families and if possible, clients, should speak up and let them know if that is the case. It is also important to be clear about whether or not consent and assent are being given. If the behavior analyst is not asking for consent, it is perfectly acceptable for the client or family member to pause the interaction and discuss what the limits of implied consent may be in any individual situation. Finally, families who demonstrate flexibility, connection, and honesty in return and who are open about any reservations or discomforts are allowing for the maintenance of a longer-term and more productive relationship, which will only help their loved one more.

References Consulted

Behavior Analyst Certification Board. (2014). Professional and ethical compliance code for
behavior analysts. Author.

Callahan, K., Foxx, R. M., Swierczynski, A., Aerts, X., Mehta, S., McComb, M. E., Nichols, S. M., Segal, G., Donald, A., & Sharma, R. (2019). Behavioral artistry: Examining the relationship between the interpersonal skills and effective practice repertoires of applied behavior analysis practitioners. Journal of Autism and Developmental Disorders, 49(9), 3557-3570.

LeBlanc, L. A., Taylor, B. A., & Marchese, N. V. (2019). The training experiences of behavior analysts: Compassionate care and therapeutic relationships with caregivers. Behavior Analysis in Practice, 13, 1-7.

Taylor, B. A., LeBlanc, L. A., & Nosik, M. R. (2018). Compassionate care in behavior analytic treatment: Can outcomes be enhanced by attending to relationships with caregivers? Behavior Analysis in Practice, 12(3), 654–666.

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 a Core Faculty member and Associate Chair in the Applied Behavior Analysis department at Capella University. She is also co-owner of SupervisorABA, an online platform for BACB supervision curriculum and documentation. 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 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 Past President (2019-2020).

The Joy of Genuine Progress: Remote Teaching and Flashcards

This week’s blog comes to us from Kate Connell, the creator of the Picture My Picture flashcard collection. Visit our site to learn more! 

Having three boys at home for three months in 2020 I understand the challenge of remote learning. There were certainly moments of chaos and times that felt overwhelming. But in the mix were also many great moments where I observed genuine progress. Those “ah ha” times, when something previously unclear or unknown was understood, were deeply satisfying. To all the parents and carers out there that are remote teaching right now, all power to you. A key lesson that I learnt was that dedicated learning time is more effective when it is fun. Enter – flashcards. 

Why use flashcards at home?

Flashcards are an ideal tool for teaching kids at home because they are visual. Using visuals can increase the rate at which your child learns  as well as their ability to comprehend, remember and retrieve information. You don’t need to be a qualified therapist or teacher to use flashcards.  

What can flashcards teach?

Flashcards can assist with your child’s learning in many ways. They support language development and can also assist with emotional regulation, critical thinking and memory.  

How do I use flashcards at home?

Flashcards are a very flexible teaching tool. A wide range of activities can be applied to the one set.  They are suitable for pre-school children right through to more advanced learners. The types of activities you can use flashcards for include pairing, sorting, naming, describing and performing. 

Pairing activities

The act of pairing, grouping two or more associated things, assists your child’s ability to reason because to successfully make a pair they need to use systematic steps to arrive at a conclusion. 

A set of ‘Go Togethers’ flashcards is a great resource for learning about pairing. It typically consists of pairs of associated images, such as shoe/sock and bowl/spoon. A fun activity is placing four cards on a table and then having your child match the card handed to them (such as the bucket) with the one on the table (such as the spade). You can talk about the cards as you’re playing “Yes! The stamp goes with the envelope.”

Sorting

Sorting things by type (such as color, shape or purpose) is a skill that develops your child’s language and maths abilities. It is crucial for being able to relate, store and recall words. A set of Categories flashcards is ideal for learning how to sort. It typically consists of a range of categories (e.g. transport, furniture, clothes), with a number of cards per category (e.g. bus, plane, motorbike, ferry and car). 

There are many learning activities you can try with Categories. One is placing five cards on a table from five different categories (eg animals, instruments, transport, food and clothes). Then passing your child the remaining cards from these categories, one by one, and asking them to place the card they are holding on top of the card on the table to which it belongs. So the horse goes on top of the dog and the piano goes on top of the violin etc. 

Naming

Enhancing your child’s vocabulary supports their ability to grasp and express ideas clearly. It also enhances their capacity for abstract thinking. A large set of Nouns flashcards is ideally suited to vocabulary building. It typically consists of many different types of nouns such as animals, occupations and locations.

A very simple activity you can do with the Nouns set is to have your child name the image on the card they are shown, such as “Cat” or “Blender”. Once successful, encourage them to create a sentence relating to the image they are shown (eg “The milk is white”). A Nouns Set can also act as a spring-board for discussing topics in detail such as a swimming pool. You might ask “What do you like about going to the swimming pool?” or “What do we need to take to the swimming pool?”

Performing

The act of performing fosters creative self-expression in your child. Performers have to be critical thinkers, problems solvers and good listeners. Performing is particularly helpful when teaching your child how to regulate their emotions so that they’re calmer and better able to navigate relationships. 

Emotions flashcards can be used to encourage performing. You might ask your child to perform the emotion shown on the card or to enact a brief scenario relating to the emotion such as licking an ice cream then dropping it and feeling sad. Or you might enact a scenario yourself such as opening a present and have your child choose the relevant emotion card from a range of cards. 

Flashcards provide a valuable and accessible resource when teaching your child remotely. They can assist with learning in many ways and each set has a multitude of different uses. By keeping it playful and fun you keep your child engaged and with that engagement comes the learning. 

About The Author

Kate is the owner of Picture My Picture, an international business which specializes in educational flashcards. She is the mother of three boys, Christopher, Louis and Tom. Christopher is on the spectrum of Autism. The flashcard based teaching program she oversaw in the early years of his life was the inspiration for the business she owns today. 

A Perspective on Today’s ABA

This piece was originally posted on Dr. Greg Hanley’s website and has been shared with permission. Visit his website for more information as well as free resources on ABA for educators and parents: https://practicalfunctionalassessment.com

This is today’s ABA when starting therapy with an autistic person, especially one who routinely engages in problem behavior. 

Today’s ABA (applied behavior analysis) is about continually learning about the predilections of the autistic person being served so that preferred learning contexts can be developed en route to developing skills that can be appreciated by the autistic person as well as others. What follows is a guide for those implementing today’s ABA but written for those who are curious about what today’s ABA involves.

Learn by listening.

Ask the autistic person and/or ask people who know and love the autistic person about what he/she/they loves and hates. Be sure to review the love, aversion, and indifference towards activities, objects, furniture, contexts, and especially social interactions. Ask that person about the autistic person’s voice. How do they routinely communicate? And, especially, what are they communicating with their problem behavior? In other words, today’s ABA starts with asking questions, listening, and learning about the autistic person by people who know and love the autistic person.

Learn by creating joy.

From that conversation, put together a context in which the autistic person will be happy, relaxed, and engaged, one in which they will feel safe and in control. Enrich this space with all of the objects and activities that they love. Don’t be stingy with the stuff–more is better. Be sure to include all the things that they have lost in the past because they could not handle their removal or because they engaged with them in unique, stigmatizing, or disruptive ways.

Do not restrict in any way their freedom to do or move. Keep the door open. Follow their lead, physically and conversationally. Let the autistic person bring other materials to this context, remove materials from this context, reposition objects and people in this context, and essentially redesign it with either their actions or words.

Be sure to create clear signals of your submission (i.e., remove all signals of dominance—hovering too close or standing above them). During this time, avoid all acts of redirection, prompting, teaching, questioning, and language expansion. Be 100% available to the autistic person but do not add your “two-cents” to the situation unless asked. Reserve even praise unless the autistic person initiates by sharing what they are doing or just did with you and you are authentically impressed. Do not supervise the experience; share in it without taking it over in any way.

Respond to all attempts to communicate–this will happen the sooner you stop trying to lead the situation. Help them, for instance, not when they struggle, but when they indicate they would like assistance. Be earnest in your attempts to help even when you are not sure how to do so. Do not let any behavior towards you be ignored; react to their behavior in normal ways, just do not attempt inspire the next interaction—let them lead.

Continue revising the context and your manner of interaction until the autistic person does not want to be anywhere but there. Let them “vote with their feet.” Besides being dignifying and avoiding regrettable physical management, allowing them to leave the space provides good information. Leaving means something important is missing or something aversive is present. Keep working on building and refining the context until the autistic person is happy, relaxed, and engaged for an extended period. Recognize that happy, relaxed, and engaged looks very different for different autistic persons, which is why it is essential that someone who knows and loves the autistic person is present at this and the next step of the process.

In sum, teach the autistic person that you know them, you see them, you hear them, and you are there for them. This is the first and crucial step in today’s ABA.

Learn by empowering.

After you are confident that you can create a safe and engaging context and there is zero probability of any severe problem behavior in this context, it is time to empower the autistic person further and establish trust between you and the autistic person. It starts by clearly signaling that the prevailing conditions are about to change, and for the worse, but be clear and kind about it. Through normal actions and words, make it clear to the autistic person that you would like them to stop what they are doing, set aside their materials, move in a different direction, inhibit any self-stimulatory behavior, and transition to an area in which developmentally appropriate instruction/expectations will commence. Be sure this area of high expectations is set aside to some extent and populated with all the challenging activities and expectations reported by those who know and love this autistic person as important for his/her/their development.

If the autistic person shows any explicit sign of distress, discomfort, or protest in the form of either minor or severe problem behavior while transitioning from essentially their way to your way, acknowledge it immediately and relent. Let the autistic person return to their way and resume following their lead until he/she/they gets back to their version of happy, relaxed, and engaged for a short period.

Repeat this process until it is obvious that the autistic person is empowered and understands that they do not need to comply against their will and they do not need to escalate to escape or avoid the things they don’t want or obtain the things they do want. Teach them that you see them, hear them, and understand them even more now, despite the sometimes lack of precision or general acceptability of their communication.  Teach them to trust you.  In this period, be clear, be alert, be quick, and be consistent. From this resetting of the relationship, you will eventually restore balance and be able reintroduce the ambiguity and challenges of life without problem behavior returning.

Learn while teaching.

The path to a joyous lifestyle for families with autistic persons is paved with skills. The big pavers are play/leisure skills, communication, toleration, and cooperation. Once these are set, the branching paths are endless. Today’s ABA process continues by replacing the behavior revealed in the empowerment phase with an easier one that will be better received by others. The process involves gradually introducing ambiguity as to whether the new communication skill will work and by stretching the periods of cooperation. The pace and aims of this treatment process are continually informed by feedback provided by the autistic person, both in terms of what they say and do. Gone are the days of working through problem behavior and negative emotional responses—those are indictors that the treatment process needs to be adjusted, and not at the team meeting, but at that moment.

This treatment process is one in which the starting point is a happy, relaxed, and engaged autistic person. The themes of I see you, I hear you, I understand you, and I am here for you persist throughout the entire process. It bears repeating that there is no obligation to teach while children are upset in any way or under any duress. Hasty efforts at promoting compliance or assessing the developmental status of an autistic person are not championed in this process. That which is championed is establishing trust, engagement, authenticity, and agency. Cooperation in shared experiences follows. Acknowledged in this process is that skills will be learned both during therapist-, teacher-, and parent-led times as well as during times in which the autistic person is leading. Also recognized is the understanding that developmental assessment is best undertaken once trust and persistence in difficult tasks has been established.

Today’s ABA is trauma-informed. It is to be assumed that any person in the care of a behavior analyst for problem behavior has experienced multiple adverse events, with many exceeding the criteria for acknowledging that trauma has been experienced. By learning through listening; by enriching therapeutic contexts; by building and maintaining trust; by following one’s lead; by relying on personalized contexts in which people are happy, relaxed, and engaged; by listening to communication bids; by not working people through noncompliance or emotional duress; by allowing people to walk away; by making decisions based on performance; and by teaching from joy; today’s ABA is trauma-informed.

Final Reflections

Our world, our country, and yes, our little field of ABA are at all at their own crossroads. The time to reconsider the status quo is now, whether it be as mundane as how to work in an office and socialize in restaurants or as profound as dismantling systemic racism. Our issues in ABA are somewhere in between but I daresay that our issues share challenges associated with getting back to work in the midst of the coronavirus and addressing injustices for people of color, especially black people in America.  Let’s learn from others, especially those expert in public health policy, human rights, and criminal justice as we make our way. But let us not wait any longer to get on the right side of history.

Ours is not to dominate but to de-escalate or better yet prevent escalation in the first place. Ours is not to coerce (thank you Murray Sidman!) but to listen, learn, guide, and coach. Ours is not to redirect, restrain, or merely manage and modify. Ours is to understand, share, and shape. Ours is to prioritize safety, rapport, and the televisibility of what we do above all else. We have proven that meaningful outcomes can follow when we prioritize these things (see www.practicalfunctionalassessment.com ).

To those who do not know this as ABA or who downright despise ABA: I hear you and I understand where the confusion or hatred comes from. I acknowledge that our field has been associated with wrongs on its journey of helping autistic people and members of underserved populations (i.e., those with intellectual disabilities). Our collective attempts at helping are better now than they were, and both research and practice reveal to me that behavior analysts doing better is continuing. I also recognize that improvement is not inevitable just because we embrace a form of scientific method. Values-based movements have been displaced from ABA in the name of science for as long as ABA has been in existence. This is a sad and uncomfortable truth, but one within our power to address if we listen to the voices of dissent that have been marginalized for too long.

ABA has the potential to inflict trauma, and it has the potential to alleviate trauma. I don’t want to wait for some horrific incident being recorded for fundamental change to take place. I have been attempting to correct my mistakes and improve the way I do ABA through research, authentic practice, consulting, and especially listening to other voices outside my choir for many years. I won’t make excuses for my behavior or that of other BCBAs. I simply apologize. I apologize for not doing more, saying more, pushing more, or disrupting more. Consider this a step in the direction towards self-awareness, improvement, transparency, accountability, and an obvious commitment to protecting the rights of those we serve. I hope you will join me on this quickening walk towards a more perfect ABA to help families of autistic persons whose lives are negatively impacted by problem behavior.

About The Author

Dr. Hanley has been applying the principles of learning to improve socially important behaviors of children and adults with and without disabilities for 29 years. He started in direct care and management roles in ICFs/MR (1990-1994), worked on the Neurobehavioral Unit at the Kennedy Krieger Institute (1994-1997), was degreed at the University of Florida (2001), was tenured at the University of Kansas (2006), and developed and directed the Behavior Analysis Doctoral Program and Life Skills Clinic at Western New England University (WNEU; 2007-2019).

Dr. Hanley is a Fellow of the American Psychological Association (Div. 25), past Associate Editor of The Behavior Analyst, and past Editor of Behavior Analysis in Practice and of the Journal of Applied Behavior Analysis. He has published over 100 articles in peer-reviewed journals and book chapters primarily focused on the assessment, treatment, and prevention of problem behavior and sleep problems, teaching strategies for developing life skills, and empirically-derived values for practitioners.

Dr. Hanley currently advises doctoral candidates as a Research Professor at WNEU, serves as an Adjunct Professor of Psychiatry at the University of Massachusetts Medical School, and leads FTF Behavioral, the international training and consulting group based in Worcester, Massachusetts.

Posted in ABA

How can I teach telephone skills at home?

This month’s ASAT feature is from Chante Glick, MEd, BCBA, LBA and David Celiberti, PhD, BCBA-D. 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!

My child can no longer attend school or therapies due to COVID-19, and we are staying home to avoid transmission of the virus. I’d like my child to remain connected to her grandparents and other family members during this uncertain time, but she isn’t great at talking on the phone. Her grandparents would be so happy to be able to talk with her. Is there anything I can do to help her learn to have phone conversations?

Answered by Chante Glick, MEd, BCBA, LBA and David Celiberti, PhD, BCBA-D
Association for Science in Autism Treatment

Yes! Maintaining social relationships while keeping physical distance is both incredibly important yet difficult. But by working on telephone skills with your child, you can both help her maintain important social and conversational skills and also help deepen her relationship with her grandparents and other family members. Since we don’t know your child, we can’t give specific advice, but we’ll share examples of skills that could be taught and a variety of teaching strategies you could use. Finally, we’ll share detailed examples of how you could put it all together.

Many social and pragmatic language skills go into a telephone conversation. You might know exactly which ones your daughter needs to work on based on your observations of her existing phone conversations. If not, you could watch for this during your next few phone calls to identify strengths and deficits.  You can also reach out to your child’s teacher, speech therapist, or behavior analyst, and get their input. Generally, consider starting with some emerging skills (ones that your child can already do to some extent but not really well or not consistently) instead of brand new and difficult skills. This may allow faster progress and more enjoyable phone conversations. Here are some skills that would lend themselves to phone practice. Some of them are skills in using the phone itself; others are general conversation skills that can be practiced on the phone. These examples cover skills for a range of ages and skill levels.

Specific Phone Skills

SkillExamples
Dialing the phone●     Dialing a number
●     Finding and tapping a name
●     Finding and tapping a picture
●     Hanging up if there is no answer (see below for messages)
Beginning a conversation●     Saying “hello” via voice or communication system (consider a video chat if your child uses sign or gestures)
●     Learning a sequence of identifying self, asking for conversation partner, checking if it’s a good time to talk, asking how they are
Answering a call●     Picking up a ringing phone
●     Responding to partner’s questions (e.g., “Is this Annie?”)
●     Passing phone to requested person
Messages●     Writing down a message
●     After hearing a message, walking to a parent and relaying the message
●     Leaving a message on a voicemail
Making calls for specific purposes●     Ordering food
●     Asking for information (e.g., “Do you have any eggs?” or “What time do you close?”)
Ending a phone conversation●     Saying goodbye
●     Explaining why you need to go (e.g., “My mom’s calling me for dinner…”)
●     Reciprocating expressions of affection (e.g., “I love you too.” “Me too.”)
●     Hanging up the phone/Disconnecting call
Safety Skills●     Answering calls when other family members aren’t home (should she answer the phone, only answer calls from people she knows, or only answer calls from parents)?
●     Checking in with family members at designated times
●     Calling 911 or other emergency numbers
●     Responding to inappropriate questions (e.g., “Are you home alone?”) or marketing and spam calls

General Conversation Skills

SkillExamples
Answering questions●     Answering yes/no questions “Did you go to school today?”
●     Answering WH questions about a tangible item shared via video conference “What did Grandma send you?” (while opening a gift)
●     Answering WH questions about past events “What did you have for breakfast?”
●     Answering WH questions about future events “What are you going to have for lunch?”
Trading Statements and Questions●     Saying, “I’m having pizza” when a partner says, “I’m having spaghetti for dinner.”
●     When a partner says “What did you do today?”, answering “I played outside… What did you do today?
Asking Follow Up Questions●     Asking “What?” when the partner says, “Guess what.”
●     Asking “What’s wrong?” when a partner says, “I am not feeling well.”
●     Asking “What did you have?” when the partner says, “I made a delicious breakfast.”
●     Asking “What did you watch?  when a partner says, “I watched a very funny thing on TV.”
Changing Topics●     Introducing a new topic (e.g., “I want to tell you about what I saw outside.”)
●     Discussing the new topic that the conversational partner brings up.
●     Waiting for a break in conversation and politely changing the topic.
Repairing Conversations●     Repeating self when asked “What did you say?”
●     Increasing volume when told “I can’t hear you.”
●     Asking a partner to repeat themself “What did you say? I couldn’t hear you…”
●     Asking clarifying questions “Did you say you are mad?…. Oh, sad.”
Reading Between the Lines●     Identifying conversation partners’ emotion from their tone of voice.
●     Identifying meaning of indirect statements (e.g., responding to “Well, I’m kinda busy…” as meaning “I can’t talk right now”).

Once you’ve identified a skill or two, plan out how to practice it. Consider the format and timing of the calls, how you can prepare up front for success, and how to actually teach the skill before and during the call. Since your child will be practicing with a familiar family member, you might even consider redoing the call immediately so that prompted skills can be practiced independently. Here are some ideas in each of those categories. As stated above, keep in mind that since we don’t know your child and can’t give specific advice, it’s up to you and your team to choose which strategies you believe will work best.

Format & Timing

Conversation Partner●     Start with someone your child knows well and enjoys spending time with.
●     Start with someone who communicates easily with your child.
●     Only after a few successful conversations, move onto other people.
●     If your child has been receiving ABA or SLP services, check if they are providing telehealth services. Calling with them would be a great way to practice the first couple calls.
Length and Time●     Set up regular, ongoing scheduled calls, so you don’t have to plan each one separately. The calls are more likely to happen this way with less effort.
●     Call frequently! This is both good for skill building and for keeping social relationships close.
●     Keep the calls short initially. End on a positive note, leaving both parties looking forward to the next call.
●     If desired, increase the duration of the call over time. One strategy to increase the length of the call is to have you or the conversation partner ask “What are some things you might want to talk about right now?”  These can even be written down initially.
Format of Call●     Use a speaker phone. By hearing both sides of the conversation, you’ll be better able to help your child be successful.
●     For some learners, a video chat may be more effective than an audio-only call. It’s also more personal and family members may appreciate the face to face interaction. Try Facetime on an iPhone, Duo on Android, or Skype on a computer.
●     If getting a family member set up with an app or account is daunting, there are web-based alternatives such as Linkello that don’t require any sign up or downloads.
●     Check out Marco Polo. It’s a video chat app that can be used asynchronously. Whenever you are available, you record a video call. When your conversation partner is available, they watch the video and reply. This has the benefit of not having to schedule specific times for phone calls. It has an added educational benefit of being able to listen to the video message multiple times and have your child practice their reply before recording it. There are some special features with which you child can experiment such as filters, voice effect, and doodles which can be accessed to make the practice more reinforcing (more fun!).

Planning & Preparation

Break Down the Skill●     Before starting, break down the skill into the details of exactly what you want your child to do, how well, and when.
●     Write down the steps of the skill in as much detail as you can. For example, if you want to teach your child to “not end the conversation abruptly” you might decide that means they should do the following steps: 1. Say, “I need to go now”, 2. Wait for a reply, 3. Say “goodbye”, 4. Wait for a reply, 5. Hang up the phone.
●     Write down “how well” you expect it to be done. For example, if you want your child to have longer conversations, decide how long of a conversation you expect. If you want your child to answer questions that grandma asks, decide whether you expect complete sentences or single word answers, and correct answers or just their best attempt.
●     Write down when the skill should be done, being as specific as possible. If the skill is changing the topic of conversation, you might decide that the child should change the topic when there has been a lull of 3-5 seconds in the conversation.
Make a Visual Cue●     Put the key information from your break down of the skill, and create a visual for your child. This can be used to prompt them during a call or to review how they did afterwards.
●     If the skill is a long series of steps, the visual could be a list of steps to follow, either in words or images.
●     If the skill should be repeated throughout the conversation, the visual could be a reminder of what to do, and check boxes to mark each time it is done.
Plan Some Content●     Think of a number of interesting conversation topics you can introduce if needed to keep the call going. Better yet, let your child help make this list.
●     If your child’s conversation skills are just beginning or if they dislike the phone, find some preferred activities that could be done over the phone or video chat. If your child and a grandparent like to read books or sing songs together, consider doing that for a portion of the call.
Enlist the Conversation Partner’s Help●     Let the person you’ll be calling know what skills the child will be working on
●     Tell them how they can help provide opportunities for practice such as asking a lot of questions, giving the child adequate time to answer.
●     Tell them how they can reward the child for using their new skills such as praising their efforts.

Practice & Call

Practice Prior to the Call●     Practice the skill in person without a phone.
●     Practice it on the phone with a family member in a different room.
●     Practice it in a role play, taking turns in different roles.
●     During practice, use the visual you created to prepare the child for what to do before starting, remind the child of what to do during the practice, and review how they did after the practice.
Prompt During the Call●     Place initial calls on speaker phone so you can prompt (assist your child in trying the new skill).
●     Model the exact thing you want your child to do and let them imitate it.  (e.g., “Say, ‘Are you busy?’”. Modeling is most helpful in the early stages of learning a skill.
●     Use the visual cue you created and/or, for children who read, write out prompts on the fly (e.g., point to card that says “Ask what Grandpa is doing”).
●     For a child with more advanced language skills, try a low level verbal cue, or hint (e.g. you say, “I wonder if the snow melted at Grandma’s house.” to prompt your child to ask Grandma if it melted.).
Provide Feedback●     During the call, find a way to celebrate when your child uses a skill successfully that doesn’t completely interrupt the call. This might be a gesture (thumbs up), a physical interaction (a high five) or a star on a chart or token board.
●     After the call, provide your child feedback. Provide praise for skills done correctly, and additional practice where mistakes were made.
●     Consider whether your child is adequately motivated to do their best on the call. If not, you might add an extra incentive in addition to the praise.

Putting it Together – Early Language Skills

Here’s an example of how you could put a number of these recommendations together. Let’s imagine that your child is an early learner and you want her to learn to dial the phone, and ask and answer some easy questions.

Format & Timing: She usually sees her grandfather a few times a week and she loves making silly faces with him, so you start by calling him. Since seeing her face is important to her, you choose to use Skype on a table for a bi-weekly call that is scheduled right after dinner on Mondays and Thursdays.

Planning & Preparation: For the skill of dialing, you add pictures of people in her life to your Skype account, so she can tap on the picture of the person she wants to call. For the skill of answering questions, you know that she sometimes, but not always, answers “who” and “what” questions about things and people in her immediate environment like answering, “Who is that?” when a sibling walks in or “What is it?” when she has something interesting. You decide to practice these questions on the phone. You aren’t sure how to teach her to ask questions, so you reach out to her teacher, who suggests that her grandfather put some fun items in a box, and you prompt her to ask, “What’s that?”, so her grandfather will answer and pull the surprise item from the box. Then you talk to her grandfather, and set up a plan for him to have a box with several interesting items in it to talk about.

Practice & Call: During the call, grandfather occasionally brings the box on screen and makes a leading statement like, “Ohh… look what I have!” and waits for her to ask “what is it?” before pulling out the item dramatically. You also ask him to engage in silly faces with her during the call, especially right after she asks or answers a question, in order to reinforce it. You’ve arranged for other household members to walk through the room or make funny noises occasionally, to provide her grandfather the opportunity to ask questions like “Who is that?”.

Putting it Together – Advanced Social Skills

Here’s another example for an older child learning more advanced social skills.

Format & Timing: When she makes a call, she typically starts talking about her interests immediately, so you decide to teach her to start a conversation using the following steps: identify self (e.g., “Hi this is Sarah”), check if it’s a good time to talk (e.g., “Do you have time to chat?”), and ask the conversational partner a small talk question (e.g., “How are you?” or “What are you doing?”). You also have observed that she doesn’t respond to indirect statements or someone’s tone of voice. You noticed this last week, when she asked her brother if he wanted to play a game, and after he sighed heavily and said “oh, fine”, she seemed unaware of his disinterest and started the game enthusiastically.

Planning & Preparation: You sit down with her to develop visual cues for both skills. For the first one of starting a call, you make a list of the steps, and let her write in the examples. You also put a checkbox next to each step so you can mark it off as she does it. For the second skill, you and she make a list together of examples of what someone might say/do in response to an idea or request, what it really means, and how to respond.

Practice & Call: Then you decide to role play together. With the visuals right in front of her, you take turns pretending to be different family members and friends on a call. When the opportunities to use the skills come up, you pause the call immediately after each one to give her feedback on what she did well and what she could do differently. Before the first call with a family member, you share with them the fact that she’s working on reading between the lines, and coach them on providing opportunities for her to practice. You have her put the conversation partner on speakerphone, so that you can prompt by pointing the appropriate part of the visual cue as needed.

As shown above, telephone skills are complex and multifaceted so there are plenty of opportunities for new skill development. As you consider new skills to teach, revisit the suggestions above and think about what types of teaching strategies are best suited for that new target. If your child struggles, consider whether there are perquisite skills that should be targeted first. As always, reach out to the relevant providers on your team for guidance. We hope that, while remaining physically distant, these ideas will help to continue to build your child’s social communication skills and help the family stay socially connected.

Citation for this article:

Glick, C., & Celiberti, D. (2020).  Clinical Corner: How can I teach telephone skills at home?  Science in Autism Treatment, 17(4).

About The Authors

Chante Glick, MEd, BCBA is currently a full time student at Endicott College and a mother to an eighteen-month-old. Throughout her career, she has taught in special education and general education in both public and private schools, run a summer camp for at risk youth and adults with developmental disabilities, provided behavior analytic services to children and adults in a variety of settings, volunteered with the Association for Science in Autism Treatment (ASAT) and WA-GROW (providing training for special education teachers in Mexico) and directed an ABA organization that specialized in in-home programs and school consultation. When not writing papers for her doctoral program, she can be found reading non-fiction, playing with her daughter, or rewatching The West Wing for the billionth time.

David Celiberti, PhD, BCBA-D,is the Executive Director of ASAT and Past-President, a role he served from 2006 to 2012. He is the Editor of ASAT’s monthly publication, Science in Autism Treatment. He received his PhD in clinical psychology from Rutgers University in 1993 and his certification in behavior analysis in 2000. Dr. Celiberti has served on a number of advisory boards and special interest groups in the field of autism, applied behavior analysis (ABA), and early childhood education. He works in private practice and provides consultation to public and private schools and agencies in underserved areas. He has authored several articles in professional journals and presents frequently at regional, national, and international conferences. In prior positions, Dr. Celiberti taught courses related to ABA at both undergraduate and graduate levels, supervised individuals pursuing BCBA certifications, and conducted research in the areas of ABA, family intervention, and autism.

Posted in ABA

Teach For Generalization With The R.E.A.L. Model!

Do you want to just teach skills or teach meaningful responses?

Many ABA practitioners and parents struggle to generalize learned skills, whether to parents or other people, to school, community or natural environments. Sometimes they question — will this child ever really learn this behavior? I mean, REALLY do this behavior. Like when it actually counts?!?!

One of the first clients I have ever worked with transferred from another provider. He had received intensive ABA programming for 2 years. He had already acquired a number of skills — colors, numbers, letters, matching, categorization, even self-help skills. Yet, nothing was functional. If the question wasn’t given in the same format (e.g., touch this, where’s red, wash hands) he would not demonstrate the skill. He lacked the ability to generalize to the natural environment…where it actually counted! It led me to ask myself….

  • Does ABA just create robots? Am I creating a robot? Are all of the responses just rote? When should the behavior occur? Does it?
  • Will this individual’s ABA program result in being able to join a typical classroom?
  • Will this child recognize his hands are dirty and wash them with complete independence?
  • Will this child respond to greetings when in the community with someone she’s never seen before?
  • Will this child interact with their peers when no trainer is present?
  • Will all of these skills being targeted actually result in a meaningful way?

“ABA is not a commodity, but a whole treatment process designed to address all aspects of a child’s life, ultimately improving the overall quality. Generalization should be viewed as an active process of ‘skills learning’ which also requires a systematic approach to teaching.”

Brenda Terzich-Garland, author and creator of The R.E.A.L. Model.

All of these questions can be answered in the new book, The R.E.A.L. Model, Rethinking Generalization: A Practitioner’s Guide to Teach for Generalization in ABA Treatment for Autism and Other Disabilities.

Here are some take home points:

  • We live in an ever changing world, you need to program for this. The R.E.A.L. Model sets up a very practical way to plan for generalization.
  • You must plan for Generalization across trainers, stimuli, environments and to the verbal community. The R.E.A.L. Model gives you a systematic way to plan for generalization in a simple step by step manner, across five unique levels of generalization. Each level has specific guidelines,
  • You must plan for Generalization systematically and from the very start of programming. The R.E.A.L. Model focuses on Case Formulation within the Assessment Process, as well as a unique Real Matrix to plan for generalization throughout ABA programming.


Sometimes we do not know what we are missing, simply because we have not been exposed to something. The R.E.A.L. Model is this exact reference. Pick up a copy today to forever change your programming to be more efficient and create more flexibility and adaptivity across all programs!


WRITTEN BY MARI UEDA-TAO, MA, BCBA

Mari is the Chief Clinical Officer for Applied Behavior Consultants, Inc. (ABC) CA. Working in the field of ABA for almost 20 years with students with Autism Spectrum Disorders and other developmental delays, Mari has worked across ten different countries, spreading Behavior Analysis globally.