Suggestions for Ethically Fading Out ABA Services

While ABA is generally a long term commitment that a client and his or her caregiver makes, oftentimes before the child reached his or her third birthday, it is still important to have a fade-out policy in place in for when the client reaches their treatment goals or the provider is no longer able to provide services. Unlike many professions, behavior analysts want our clients to reach a point where they no longer need our services! Here are some tips for developing an effective fade out policy that is supportive of your client’s transition out of services.

1. Clearly outline eligibility, timeline and fade out procedure

The fade-out policy should explicitly state the conditions that qualify a client for fade out of services (e.g. client is no longer benefitting, client no longer requires the services, client requests discontinuation, client violates terms of client-services agreement, etc.). In addition, a fade-out should provide the family with a transition plan detailing when caregivers will be notified of anticipated discharge date, rate of fade out (e.g. Decreasing frequency of sessions from once per week to once every two weeks) and resources provided for addressing remaining areas of deficit. Having a clear plan takes the guesswork out of the process of transitioning out of services for both clinicians and caregivers.

2. Communicate your fade-out policy to caregivers at the onset of treatment

Include your fade-out policy as part of the initial intake process. This informs caregiver expectations and prevents them from assuming the myth that formal ABA therapy is going to be part of the rest of their child’s life.

3. Planning ahead for at least 6 months prior to termination of services

Structure treatment plans to account for and support transition out of services to ensure that fade out does not feel sudden or disruptive. Treatment should always maximize opportunities to utilize natural teaching strategies and caregiver training and support. It is recommended that the provider adequately train caregivers to support generalization of mastered programs as well as provide training so they have the necessary skills to know how to prompt, reinforce, and adjust the environment when necessary. In addition, work with any new provider who will be supporting the client to ensure a smooth transition and continuity of services.

4. Support client independence and teach functional skills

The long-term goal of ABA therapy is to help clients learn functional skills that can help them integrate into an inclusive environment. Thus, treatment plans should address functional skills first in order to ensure that the client can achieve maximum independence if services are no longer available.

5. Develop a network of professionals and community partners to assist in transition of care beyond scope of practice

Collaborate with ABA-friendly providers to provide resources for clients after they transition out of formal ABA services to maximize skill maintenance and continuity of care. Some BHCOEs partner with adult transitional programs that assist in job-placement into sites that utilize ABA-strategies to ensure success.

6. Include an aftercare plan with follow-up consultations when possible

Schedule follow-up consultations with caregivers after transition out of services to troubleshoot issues that may have arisen.


This piece was written by the Behavioral Health Center of Excellence and has been shared with their permission. For more information, please visit www.bhcoe.org.

Posted in ABA

Considerations for Parents on Grounding Kids

Many parents choose to “ground” their kids when they make poor decisions. Maybe they lose access to video games for a week, or can’t watch TV for a month. Grounding in and of itself is not necessarily a bad thing. Here are a few considerations:

  • If you keep grounding your kid for the same behavior, then grounding is not changing the behavior. Sometimes grounding your child is a default response, but if it’s not working, you might want to consider some other options. You can take a look back at our series on differential reinforcement or our post on noncontingent reinforcement.
  • When possible, the consequence should be connected to the behavior. If your child throws a controller, then not having access to video games makes great sense. However, if video games are taken away for any infraction, it may not be the most logical punishment and over time, it may even backfire. If the child is losing video games for everything, then he/she might stop trying to earn video games at all.
  • Longer durations of grounding may make you miss out on opportunities for reinforcing appropriate behaviors. Remember that reinforcement is simply any consequence that increases the future likelihood of the behavior. If you have set a rule that your child is grounded from using video games for one year, then you are missing many, many opportunities to teach the appropriate behavior. The same can be said for one month or even for one week. Especially when considering children with autism, they may require multiple trials of the appropriate behavior before you see an increase in the appropriate behavior. In that case, grounding may just not be the best option.
  • Longer durations of grounding may backfire if you experience fatigue. Often our kids are experts at asking the same question repeatedly until you finally give in. The last thing you want to do is set a standard that when you say your child is grounded for a week, they are really only grounded until they wear you down.
  • Consider a different tactic. This isn’t possible for all behaviors, but if you are seeking a specific appropriate behavior, set a standard that if a certain duration or a certain number of appropriate behaviors results in more access to preferred items and activities. This is sort of the inversion of grounding and may be more successful.

WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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

Posted in ABA

Common Mistakes In Implementing Reinforcement

Over the years, I’ve seen several behavior intervention plans written and implemented. Typically, these plans include reinforcement for the desirable behavior, but I see the same mistakes crop up again and again. Here are a few common mistakes in implementing reinforcement to look out for:

Fail to identify individual reinforcers. Hands down, the most common error I see is identifying specific activities or items as reinforcing. For instance, many people love gummy bears, but they make me want to puke. Presenting me with a gummy bear would not increase my future likelihood of engaging in the appropriate behavior! You must account for individual differences and conduct a preference assessment of your learner, then make a plan based on his or her preferences.

Fade reinforcement too quickly. Let’s say you’re working with a child named Harold who draws on the walls with crayon. You implement a reinforcement plan in which he earns praise and attention from his parent each time he draws on paper. The first few days it’s implemented, Harold’s rate of drawing on the wall greatly decreases. Everyone claims that his behavior is “fixed” and suddenly the plan for reinforcement is removed… and Harold begins drawing on the wall once more. I see this sort of pattern frequently (and have even caught myself doing it from time to time). After all, it can be easy to forget to reinforce positive behavior. To address this issue, make a clear plan for fading reinforcement, and use tools such as the MotivAider to help remind you to provide reinforcement for appropriate behavior.

Inconsistent with reinforcement plan. Harriet is writing consistently in a notebook, to the detriment of her interactions with peers. Her teachers implement a DRO, deciding to provide reinforcement for behavior other than the writing. However, the teachers didn’t notify all the adults working with her of the new plan, so Harriet’s behavior persists in certain environments, such as at recess, allowing her to miss multiple opportunities for more appropriate social interaction. To address this issue, make a clear outline of the environments in which the behavior is occurring and what adults are working in those environments. Ensure that all of the adults on that list are fully aware of the plan and kept abreast of any changes.

Don’t reinforce quickly enough. This one can be quite challenging, depending on the behavior and the environment. Let’s saying you’re working with a boy named Huck who curses often. You and your team devise a plan to reinforce appropriate language. You decide to offer him tokens that add up to free time at the end of the school day. However, sometimes as you are handing him a token for appropriate language, he curses again right before the token lands in his hand. Though it was unintentional, the cursing was actually reinforced here. Remember that reinforcement should be delivered as close to the desired behavior as possible. To address this issue, consider your environment and materials and make a plan to increase the speed of delivery.

Fail to make a plan to transfer to natural reinforcers. Ultimately, you don’t want any of these behaviors to change based solely on contrived reinforcement. Making a plan for reinforcement of appropriate behavior is essential, but your ultimate goal is to have the behavior be maintained by naturally occurring reinforcement. To address this issue, the first thing you need to do is identify what that naturally occurring reinforcement might be. For Harold, it might be having his artwork put up in a special place or sharing it with a show and tell. For Harriet it might be the interactions she has with peers on the playground. Once you have identified those reinforcers, you can create a plan for ensuring that the learner contacts those reinforcers over time. This might include pairing the naturally occurring reinforcers with the contrived reinforcers, then fading out the latter.

Ultimately, it’s important to remember that reinforcement is not as simple as it seems. Taking the time to plan on the front end will help with long-term outcomes.


WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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

Posted in ABA

“I hear that BCBAs don’t believe in sensory issues. What gives?”

This month’s ASAT feature comes to us from Carl Sundberg, PhD, BCBA-D
Behavior Analysis Center for Autism and David Celiberti, PhD, BCBA-D
Association for Science in Autism Treatment. 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!

Some people believe behavior analysts are “anti-sensory” — opposed to offering any sensory-based experience for individuals with autism spectrum disorder (ASD).  The term “sensory” can be problematic and ambiguous because it does not specify whether an individual is showing a sensory preference or sensory aversion, nor whether the sensory experience is a “like” or a “need.” It may also minimize or disregard other explanations for why a behavior is occurring. These distinctions are significant when developing a treatment plan. In this brief article, we clarify how behavior analysts approach sensory issues.

Not every behavior problem should be assumed to have a sensory basis.

It would be beneficial to discuss the many faces of motivation. Each of us, not just children with autism, may be highly motivated by sensory experiences that vary in modality, intensity, and duration. Ever catch yourself tapping your pencil, twiddling your thumbs, biting your nails, or popping bubble wrap. If so, would you say you have “sensory issues”?  We are all highly motivated by other experiences as well such as attention, a smile, a knowing look, or laughter. Other times, it is something tangible and specific, such as a new pair of sneakers or a piece of artwork. We all engage in a wide array of behaviors to access these experiences. On the flip side, sometimes we are motivated to avoid or escape certain forms of attention (e.g., closing our office door or ignoring telemarketer calls) or other specific things (e.g., a traffic ticket or non-preferred vegetables).  Why is this important?

First, assessment of challenging behavior must carefully assess the function for that behavior (i.e., underlying motivation) in order for it to have the greatest likelihood of leading to effective intervention. We intentionally referenced the same behavior (biting) in a few different examples to help make the distinction between form (e.g., biting) and function (e.g., to escape a demand of gain sensory input).

  • Tommy bites his teacher when she attempts to help him put on his snow boots.
  • Lisa bites her father as soon as he stops playing with her and attempts to leave the room to take a phone call.
  • Sudhir bites his babysitter when she asks him to put away his iPad.
  • Melanie bites classmates when the fire alarm sounds or her older sister plays music loudly.
  • Jennica bites her father’s arm when he wears long sleeve dress shirts.
  • Mitchell’s teeth are coming in and he has been seen biting a plastic hanger.

As you can see, the same behavior (biting) occurs in very different contexts and likely serves very different functions. In some instances, the motivation may be to get or keep a preferred item or activity, whereas in other instances, the child is trying to avoid or escape something he or she does not like. A “sensory” explanation based on the fact that they are biting would miss the mark in most of the examples illustrated above. If we mislabel certain behaviors as “sensory,” the recommended sensory intervention will not address the targeted behavior properly and may prevent access to more effective intervention.

Not every sensory-seeking behavior reflects a “need.”

Let’s examine the misuse of the term “sensory need” and differentiate between a sensory need and a sensory preference. Some individuals with autism enjoy swinging, may be willing to work hard to earn it and show pleasure while swinging. Whereas other children may start off agitated and appear calmer following swinging, but it is not necessarily an experience they would choose (children experiencing pain relief from taking aspirin may also benefit from it but not necessarily choose it).

Activities stimulating the senses can serve multiple behavioral functions, depending on the motivation. Jumping on a trampoline is likely to be repeated because of its reinforcing vestibular effects — it is fun. This leads to the question, “Does the student jump on the trampoline because he or she needs to jump on the trampoline, or because it’s enjoyable?” Again, the responses one engages in depend on the learning history, communication skills, social contingencies, and the strength of the motivation.      

“Sensory” concerns have profound implications for the teaching of new skills that can be targeted through behavior analytic strategies.

Any discussion on “sensory issues” would be remiss without some mention of sensory hypersensitivity. We have also observed some individuals with autism who have extreme reactions to sensory input (e.g., loud noises, bright lights) and there are those who are extra sensitive to textures or certain clothing (e.g., the tag in the back of a shirt or particular food). These children/adults learn to engage in behaviors that reduce the aversive nature of such stimulation. But this isn’t exclusive to autism – there are also people without autism who are sensitive to certain stimuli as well.

There are individuals who experience extreme discomfort when exposed to situations which would be considered typical to most of us (e.g., loud music). Some will engage in behaviors that relieve the anxiety, such as escape behaviors (leaving the situation), avoidance behaviors (skipping the situation entirely), or engaging in some incompatible behaviors (practicing relaxation techniques). In these cases, sophisticated skills and strategies are in place.

It is unfortunate that many people with autism do not have the skills to engage in the socially accepted methods that relieve anxiety or discomfort. However, many other non-socially accepted behaviors have been shaped and have proven to be effective in removing the aversive stimulation. If we were in a room where the music is too loud, we would leave or ask for it to be turned down. If those behaviors are not possible, we may have to tolerate the situation. We have learned that behaviors such as biting will result in undesired social consequences. But what if:

  • We did not have the language to ask for the music to be turned down?
  • We did not know that leaving was an option, or did not know how to ask, or were forced to stay?
  • We didn’t value the social consequences as others so? That is, we didn’t currently care how others perceive us or if we get invited back.

If all those were true, we might engage in biting to get the music turned off or get removed from the room once we see that this is an effective behavior.

Now, suppose we do have those skills, and we can always find a way to get out of situations that cause stress or sensory overload; or we tough it out because of the social contingencies that have been learned over our lifetime. Chances are, no one would suggest we had sensory issues and put us on a sensory diet or prescribe sensory integration therapy. However, a person with autism who may have the same level of discomfort and escapes the situation in the only way he or she knows how, is often said to have “sensory issues” when perhaps it would be more helpful to say he or she has skill deficits.

In summary, to develop the most appropriate and effective treatment, one must analyze the function, evaluate whether the behavior has a sensory basis (and whether it reflects a “need” or a “like”) or other underlying motivations. It is then important to identify skills (e.g., requesting) that may either compete with and potentially replace the behavior or provide the individual with coping skills to better negotiate his or her environment.

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Carl Sundberg, PhD, BCBA-D, is the chief clinician and founder of the Behavior Analysis Center for Autism. He received his doctorate degree in ABA from Western Michigan University under the direction of Dr. Jack Michael. While a graduate student, he taught behavior analysis at WMU for seven years. Dr. Sundberg has publications in The Analysis of Verbal Behavior (TAVB), A Collection of Reprints on Verbal Behavior, and the Journal for the Experimental Analysis of Behavior (JEAB). Dr. Sundberg has over 30 years of experience using behavioral interventions to teach individuals with autism and other developmental disabilities. He oversees the training of all the staff at BACA and consistently spends time with the clients. Eighty percent of his time is spent contributing to the training of staff and addressing specific client programs.

David Celiberti, PhD, BCBA-D, is the part time Executive Director of ASAT and Past-President, a role he served from 2006 and 2012. He is the Co-Editor of ASAT’s newsletter, Science in Autism Treatment. He received his PhD in clinical psychology from Rutgers University in 1993. Dr. Celiberti has served on a number of advisory boards and special interest groups in the field of autism, applied behavior analysis, 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 applied behavior analysis (ABA) at both the undergraduate and graduate levels, supervised individuals pursuing BCBA certifications, and conducted research in the areas of ABA, family intervention, and autism.

Posted in ABA

Creating Daily Routines to Eliminate Downtime and Increase Productivity

Imagine telling your students to sit down at the table for math. You finally get 4 students seated, but then you turn your back for two seconds to grab the materials for your lesson, and in the meantime, two kids pop up and run back to their preferred activities. Scenarios like these make me want to pull my hair out…I hate downtime…my students struggle with it, which makes my life as a teacher so much harder. So one way I have found to eliminate as much downtime as possible (besides packing my day full of activities) is to create routines in every part of my day. This way, students know what is expected and can independently get going with an activity even when I have to run and grab some materials, deal with a challenging behavior, etc. It makes my students (and me) more productive! In today’s post, I want to share some helpful tips and activities I have found to reduce downtime in the classroom.

Visual Schedules. One helpful way to do this is to post a visual schedule of your routine. In the beginning, you will need to teach this to your students on a very consistent basis. Over time, they will get into the swing of things and they’ll be ready to get started without you! For my morning group, by the end of the year, I put each kid in charge of a different activity (their names were written on a clothespin and clipped onto the activity) which gave me time to do attendance, get the lunch count, check backpacks, etc. while still monitoring the group as needed.

Binders. Binders can be another helpful way to create routines. Students can grab their binders and begin working on activities in order. If you need students to stop and pause between activities for more instruction, use dividers to split the binder into sections along with a “stop and wait” visual. (Check out this post for more info on my morning work binders or this post for 8 ways to use binders in your classroom).

I often find it is the beginning of the lesson that is the hardest…like I said before, teachers need time to get set up, materials gathered, smart board turned on, etc. In general ed, teachers often have a “do now” or “warm up” activity where their students do a review activity, practice problem, or introduction activity for the lesson that will follow. I find this extremely helpful in my classroom as well. Here are a couple activities I have used to fill the downtime in the beginning of a lesson.

Correcting Sentences. To start my advanced morning group, I had my students start with a daily correcting sentence worksheet. We would review as a group, then move onto other literacy activities (click here to see a blog post detailing what we did in this group).

Fluency Timings. I have utilized a few different versions of fluency timings in my classroom and they can be extremely helpful as a beginning “warm up” activity. [My little soapbox on fluency….fluency is speed + accuracy. Our students can sometimes learn skills, but they are too slow with that skill to make it actually functional. Fluency activities help students practice a skill and increase their speed.] With my beginner students, we use these fluency timings where students label as many pictures/numbers/letters/etc. out loud in one minute. With my advanced students, we did written fluency timings. We had kids assigned to be in charge of these as well (yellow cards were student initials who were in charge). These helped my kiddos increase their ability to generate ideas when given a topic, speed of writing, and made writing into a fun activity. And of course, including some visual directions for the activity increased student independence!

Check-in/out. I helped a teacher create this check-in for students who came into her room when they needed a break from their general ed classroom. To help them not disrupt her other groups and get to their break as quickly/independently as possible, she came up with the idea to have them check-in, select their break activity, set a timer, and check out when they were finished. I have also seen some great social skills groups start and end with a check-in/out worksheet. Here is a sample from do2learn which provides these FREE.

Predictable Worksheets.  I like these worksheets for practicing letters/numbers as they involve minimal writing, but more coloring, tracing, and circling.  Most of my kiddos could complete these with minimal assistance, and with so many worksheets, we could use them throughout the year to begin a group.

File folders, puzzles, or adapted books.  Have a bin of these at the ready to either set at each student’s spot or have them make a choice from the bin as the beginning activity before starting your lesson. I love using my “All About Me” books which each student has to practice targeting personal information.


About The Author

This piece was originally published on Autism Tank.

My name is Hailey and I have been a special education teacher for students with autism for over 10 years.  I taught students in 1-8th grade.  My class size has ranged from 4-13 students over my career and I have had between 1-4 paraprofessionals full time in my classroom. I currently work in a school district as an autism specialist and help teachers in all disability areas to implement evidence-based interventions for their students. I have had several family members with disabilities, which initially made me interested in the special education field.  I took an intro to special education course in college, where I absolutely fell in love.  As a course requirement, we had to volunteer every week in a classroom, and it became the highlight of my week!  

Posted in ABA

How to Take Family Conversations from Painful to Pleasant

A parent writes:  “Dear Behavior BFF, My son likes to talk about the Octonauts (Cartoon). If I hear one more thing about Kwazii the cat, I may stab myself in the ear. Help!”

I think so many parents can make this exact statement, just change out Octonauts for whatever your kid is into right now: Santa, trains, Frozen, the weather, a book, the number four, whatever! But please refrain from injuring your own eardrums. There are positive behavior supports to employ before resorting to anything extreme! 

Let’s get technical for a minute. Have you ever heard of DRL: Differential Reinforcement of Low Rates? If you are an ABA nerd like me, the answer had better be yes. If you are a mom (also like me), the answer is probably now. With DRL, you provide reinforcement for responses that are lower than a criterion you set.

How many times a day does your child talk about (insert preferred and rather annoying subject here)? Let’s say 20. Set a number lower than 20. Your child can talk about that subject 15 times tomorrow to earn positive reinforcement.

You set a number that is acceptable to us and achievable to the child. You can’t go from 20 times a day to 5 times a day. That may be acceptable to you, but will your child ever get to earn that positive reinforcement? Doubtful.

A structured way you can set this up in your family is to create a behavior contract (aka contingency contract). This is a physical document that outlines the exact behavior that must be completed to earn a specified reward. It also includes a place to keep track of that behavior & reward. It needs to be specific.

Write down the exact task to complete. The task in this situation would be talk about ___subject____   no more than __number___ times. 

Specify the reward. If this contract is going to last all day, the reward had better be pretty good — what is the reward, when will it be received, how much of it — be precise!

And finally, include a task record. This means you write down whether or not they achieved it that day. You could put some tally marks down to show the number of times your child talked about that subject. Or you could just put a check mark or happy face on days when the reward was earned.

What’s the purpose of documenting this? So you can review it again with your child and show them the progress they are making!

What if the contract isn’t working? If they aren’t making progress, then revisit your criteria. Do you need to raise the number of times they talk about Octonauts a little? Is the reward not awesome enough? Do you need more options? Is a whole day too long? Do you need to do a reward opportunity for the morning and the evening? There are options here! Step away from the silverware — do not stab yourself in the eardrum!

The physical visibility of the contract can be a helpful cue or response prompt to remind your child how many times they have left to talk about Octonauts or it may be a visual reminder of that potential reinforcer coming their way. Hang it on the fridge or some other prominent spot to serve as a helpful tool in and of itself!

Over time, you should be able to lower that daily goal. From 20 times a day, to 18 times a day, to 15 times a day, to 12 times a day, etc. Don’t go too fast. Let your child be successful at each level a few times before lowering that number of allowed times they can talk about their favorite thing. And don’t go too low. I don’t want my daughter to think I never ever want to hear about what she is into. I do, however, want her to learn some balance and variety when it comes to conversation topics.

If your son’s conversations about Octonauts are decreasing, does he know what else to talk about? You need to teach him some other replacement topics that are appropriate and interesting to him. We aren’t going to jump from Octonauts to the Blacklist or Grey’s Anatomy, but maybe he can talk about books instead of just his favorite TV show. How about talking about experiences he’s had? Making plans for the future? Give him some choices of topics and model those conversations. Encourage and provide positive reinforcement when he uses any different appropriate topic of conversation.

Here it is in a nutshell:

Set a reasonable & doable number of times your child can engage in that behavior (talking about Octonauts). Provide positive reinforcement when he stays at or under that level. This is called DRL: Differential reinforcement of low rates of responding.

Formalize it with a behavior contract. Be specific. Hang it where it can be seen. Document progress. Revise as needed.

Teach your child a replacement behavior. What CAN he talk about instead? Make it appropriate for your child, for the situation, but make it something he is interested in. Maybe he doesn’t love these other topics as much as Octonauts, but pick some interesting topics to keep him engaged.

And most importantly, don’t stab yourself in the ear!  Find a way to make pleasant conversations in your home possible.  No, more than just a possibility, make pleasant family conversations a regular occurrence. You can do it!


Leanne Page, MEd, BCBA, is the author of Parenting with Science: Behavior Analysis Saves Mom’s Sanity. As a Behavior Analyst and a mom of two little girls, she wanted to share behavior analysis with a population who could really use it- parents!

Leanne’s writing can be found in Parenting with Science and Parenting with ABA as well as a few other sites. She is a monthly contributor to bSci21.com, guest host for the Dr. Kim Live show, and has contributed to other websites as well.

Leanne has worked with children with disabilities for over 10 years. She earned both her Bachelor’s and Master’s degrees from Texas A&M University. She also completed ABA coursework through the University of North Texas before earning her BCBA certification in 2011. Leanne has worked as a special educator of both elementary and high school self-contained, inclusion, general education, and resource settings.

Leanne also has managed a center providing ABA services to children in 1:1 and small group settings. She has extensive experience in school and teacher training, therapist training, parent training, and providing direct services to children and families in a center-based or in-home therapy setting.

Leanne is now located in Dallas, Texas and is available for: distance BCBA and BCaBA supervision, parent training, speaking opportunities, and consultation. She can be reached via Facebook or at Lpagebcba@gmail.com.

Posted in ABA

Tips For Handling A Crisis

Take A Deep Breath

This advice seems so absolutely silly and obvious. I used to hate when people would tell me to take a deep breath. “Got it. I’m breathing. I’m not going to suffocate myself. Chill.” But then I realized that sometimes in a crisis I jump in split-second too early. Yes, when there is a safety risk we want to act as quickly as possible. But the 3 seconds of taking a deep breath before acting usually resulted in me responding not reacting. A reaction is based off of emotion, it’s impulsive, and it’s more likely to be wrong. A response is planned and thought. A deep breath is the difference.

Have A Crisis Plan

Sick of hearing me talk about crisis plans? Too bad! They are still THAT important. This is your insurance policy. Hopefully, you’ll never have to use it but you sure as heck better have one. Check out my mini video training series on Developing a Crisis Plan. You can also download my simple and visual crisis plan here

Keep Other Students Safe And On Task

What’s worse that one crisis? More than one crisis. Keep your other students safe but also try to keep them on their schedule and engaged in an activity. I always recommend keeping bins of puzzles, file folders, and other independent work in every area of the classroom so you always have something to give other students. If students are getting distracted, give headphones and an iPad to keep them occupied during this time. 

Gather Information

Every major behavioral incident is a chance to learn about your student. What are his triggers? What helps him deescalate? Even though you are working on keeping your student and others safe, be gathering valuable information while doing so. Write it down as soon as you can. This information may help prevent this issue in the future. 


About The Author 

Sasha Long, BCBA, M.A., is the founder and president of The Autism Helper, Inc. She is a board-certified behavior analyst and a certified special education teacher. After ten years of teaching in a self-contained special education classroom, Sasha now works full time as a consultant, writer, and behavior analyst. Sasha manages and writes The Autism Helper Blog, as a way to share easy to use and ready to implement strategies and ideas. Sasha also travels internationally as a speaker and consultant providing individualized training and feedback to parents, educators, therapists, and administrators in the world of autism. She is currently an adjunct professor in the school of Applied Behavior Analysis at The Chicago School of Professional Psychology. Sasha received her undergraduate degree in Special Education from Miami University and has a Masters Degree in Applied Behavior Analysis from The Chicago School of Professional Psychology. Contact Sasha at sasha.theautismhelper@gmail.com.

Posted in ABA

Build Desirable Behaviors

One of my favorite textbooks about ABA is Focus on Behavior Analysis in Education: Achievements, Challenges, and Opportunities. And one of my favorite chapters in that book is called “Building Behaviors versus Suppressing Behaviors,” which focuses on school-wide positive behavior change This is an often-overlooked key concept in behavior analysis that can have a huge impact on the school environment. Furthermore, when we think of ABA, we often think about individual interventions, but the principles of ABA can be highly effective when applied to large environments, such as an entire school.

The chapter references several studies about school-wide behavior change and offers evidence-based practices for achieving such change. It also outlines social behaviors that should be taught, such as how to apologize or how to make a request, then discusses strategies for rewarding the desirable behaviors. I appreciate that it focuses on getting students involved in making such changes.

Teaching these desirable behaviors can often feel challenging with the additional stresses of a special education classroom. One curriculum I have found effective in addressing this problem is Skillstreaming. I often use Skillstreaming in Early Childhood with young learners, and love that it clearly defines desirable behaviors, such as how to listen or how to offer help (see image below), but provides those definitions in simple terms with visual prompts that help our young learners. It also incorporates positive reinforcement for learners who are engaging in those desirable behaviors.

Listening Skill

In summary, there is lots of evidence out there that focusing on what kids should be rather than what they should not be doing is beneficial for the learner and the general culture of the classroom. Providing clearly defined desirable behavior and building instruction in those behaviors throughout the day is essential. And that instruction may need to be more frequent and more detailed for our learners with developmental disabilities.

REFERENCES

Heron, T. E., Neef, N. A., Peterson, S. M., Sainato, D. M., Cartledge, G., Gardner, R., … & Dardig, J. C. (2005). Focus on behavior analysis in education: Achievements, challenges, and opportunities. Pearson/Merrill/Prentice Hall.


Written by Sam Blanco, PhD, LBA, BCBA

Sam is an ABA provider for school-aged students in Brooklyn, New York. Working in education for over 15 years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. She is also an assistant professor in the ABA program at The Sage Colleges and the Senior Clinical Strategist at Encore Support Services.

First Responders Educators In Autism

This month’s ASAT feature comes to us from Karen Parenti, MS, PsyD. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

I am a parent of a young man with autism. I also work in the area of law enforcement. What are some important considerations when teaching first responders and law enforcement personnel how to interact with individuals with an autism spectrum disorder?

This is a very important question and one on which many local communities are focused. In addition, treatment of individuals with autism spectrum disorders (ASD) by law enforcement is a common worry for parents. As such, the topic requires training to increase awareness of ASD for first responders and local community members, as well as collaboration between service providers and law enforcement. As in any crisis situation, it is important to focus on positive and preventative approaches, as most behavioral crises with individuals with ASD can be prevented or lessened. To promote awareness on the part of first responders and prevent crises, ASD service providers should proactively prepare individuals with ASD for a possible encounter with emergency personnel and law enforcement using understandable language, pictures, books, or video models about emergencies so they know what to expect and how to respond. Additionally, building rapport and familiarity between individuals with ASD and local police might help ensure the person with ASD perceives the first responder as a helper when a behavioral or medical event occurs. In many cases, situations will arise that require emergency intervention by first responders because of the unique challenges and behavioral escalations that commonly occur with individuals with ASD. Therefore, training for first responders is of the utmost importance.

Police officers expertly respond to a large number and variety of emergency situations on a daily basis. Each emergency situation has its own unique characteristics, and so do the individuals involved in that crisis. First responders and police receive standard and rigorous training on how to respond to emergencies compassionately and effectively. This training, while appropriate and efficient for the vast majority of situations, is not necessarily the best way to respond to a child or adult who is diagnosed with ASD. This can lead to an outcome such as this example of how an unfortunate misunderstanding can result in tragedy.

Whether the emergency is a medical or behavioral crisis, understanding ASD and how someone with ASD might behave is crucial to ensuring a favorable resolution to the incident. Individuals diagnosed with autism may have heightened emotional responses in these volatile and stressful situations. For persons with ASD, emergencies are difficult to comprehend. During these confusing events, a person with ASD may fail to respond to vocal directions, may exhibit a startle response when touched, may run when addressed, or may engage in self-injurious or aggressive behavior.

For emergency responders, interacting with individuals with ASD can be ambiguous and unpredictable. Therefore, it is essential that emergency personnel learn to respond as sensitively and efficiently as possible to individuals diagnosed with ASD, so attempts to speak with or care for the individual does not inadvertently cause the individual’s behavior to escalate. As you may know, this is especially important during a medical crisis because individuals with autism cannot always communicate feelings of pain or discomfort. A person with ASD may already be feeling frustrated and possibly agitated by his or her inability to convey his or her experiences and needs, thus when approached that individual may respond in an unpredictable and unconventional manner. It is important that first responders be prepared for such unusual responses, incongruent emotions, and failure to respond to directives and questions.

In addition to providing police officers and first responders with information about autism symptoms more generally, an important next step is to teach first responders how individuals with ASD might behave in a crisis. In particular, emergency personnel need to understand how individuals with ASD might act when they are agitated, confused, overwhelmed, or in pain.

A Child or an Adult Diagnosed with an Autism Spectrum Disorder May:
• Avoid eye contact.
• Walk away from familial residence or a group home to local pools or other places they enjoy. They may wander into traffic, not understanding environmental dangers.
• Be overstimulated and not comply appropriately to police or first responders’ instructions. For example, they may not respond to directives such as “get out of the street” or “let me see your hands.”
• Become preoccupied with certain objects or interests, such as planes, trains, fire trucks, or movies.
• Repeat or echo phrases, words, or actions.
• Not know how to relate, talk, or play with others.
• Have sensory sensitivity, manifested by stereotypical behaviors which may include covering their ears, flapping their hands, spinning, toe walking, or making unusual noises among others.
• Become agitated due to the disruption in their routine.
• Have unusual reactions to the way things in the environment look, feel, smell, sound, or taste.
• Be nonverbal and unable to communicate effectively.
• If verbal, may have difficulty understanding questions or may respond noncontextually. For example, they may simply script from a movie or speak about their special interests or ask repeated questions about the responder’s personal life.
• Be unable to communicate that they are in pain.

A first responder will be able to interact more appropriately with a person with autism if he or she is able to recognize that the person may have ASD. Once the first responder has learned to make this identification, he or she should become familiar with the following crisis response and intervention safety habits.

Crisis Response and Safety Habits:
• Take 30 seconds to assess the situation and the scene before responding.
• Remain calm.
• Use an even, controlled tone of voice with minimal directives, including simple phrases and visual cues such as pointing or using simple gestures that may be easily understood by minimally verbal individuals.
• Pay close attention to the person’s body language, tone of voice, gestures, and any other signs of potential agitation.
• Practice trauma-informed care and assume that everyone has experienced some type of trauma and is easily startled.
• Respect personal space, except when it is absolutely necessary to approach the person. Remember that getting too close may increase agitation in some individuals with ASD.
• Assess the situation objectively and ask the person or someone familiar with the individual with ASD what he or she wants/needs while maintaining a safe distance.
• Reduce stimulation and allow time and space for the person to process information and requests. For example, it might be helpful to clear the area of additional people, turn off the lights of the emergency vehicles, and eliminate other extraneous noises as possible.
• Be prepared and practice situational awareness. Know your surroundings and the location of the closest exit.
• Deflect aggression and block self-abuse when possible.
• If a physical intervention is necessary because the situation is unsafe, establish control in a safe, non-threatening manner. Remind the person that you are there to help.
• Recruit familiar and trusted persons to assist you in understanding how to approach the individual.

When police officers and first responders receive training in interacting and treating individuals with ASD, incidents in the community may be resolved quicker and more effectively. With quality training, headlines reporting distressing incidents, such as that above, may be a thing of the past. Instead, the type of training discussed here, when offered regularly to our dedicated police officers and first responders, could result in positive approaches similar to this:

Autism awareness is essential for all members of the larger community, but is truly imperative for first responders. In the absence of information, first responders may misinterpret the behavior of a person with ASD, may ascribe hostile intent to agitated behavior, may inadvertently escalate the behavior of the individual, or may fail to safely calm the individual. In cases such as these, there can be dangerous consequences. An opportunity exists for ASD service provider agencies to provide specialized training to local first responders. Providers can contact law enforcement officials and other emergency personnel to offer informational training sessions on a local level. In our experience, the administrators are routinely grateful and accommodating about arranging such training.

First responders need a dual skill set. First, they need accurate information about persons with ASD, including their behavioral characteristics, and secondly, they must use skills to de-escalate the situation when they engage with a person with autism who is in a confused and agitated state. With community outreach, negative outcomes can be averted, bridges can be built, and wider acceptance of persons with ASD can become a reality.

The following resource provides additional information related to first responders:
• Living with Autism – Autism Information for Law Enforcement and other First Responders
• Training for Indiana’s First Responders: Recognizing and Responding Appropriately to Individuals with Autism Spectrum Disorders
• Living with Autism – Autism Information for Law Enforcement and other First Responders
The reader may also be interested in the following ASAT articles:
• Teaching Safety Skills to Adolescents
• Bolting and Neighborhood Safety

Citation for this article:
Parenti, K. (2017). Clinical Corner: First responders’ education in autism. Science in Autism Treatment, 14(4), 6-8.


About The Author

Dr. Karen Parenti serves as the Executive Director of Melmark PA. Karen oversees the development and implementation of programs, as well as the daily operations of Melmark PA. She develops strategic objectives for the Pennsylvania Division, and provides leadership to direct reports in order to assure the achievement of these objectives. Karen also supports the CEO and the Board of Directors through various committees and activities, assuming responsibility for excellence in care and delivery of all services, policy development, quality assurance, risk management, regulatory compliance, and fiscal integrity. Joining Melmark in April 2016, Karen served as Senior Director of Adult Services. In this role, she was responsible for the oversight of all adult day and vocational programs, as well as the adult campus and community residential programs, which include intermediate care facilities that serve individuals with intense medical challenges. She has also served in the role of clinical trainer by teaching crisis prevention and intervention, dual diagnoses, ethics and boundaries, abuse prevention, and behavioral strategies. Karen earned her doctorate degree in clinical psychology, with a concentration in neuropsychology, from Immaculata University. A graduate of York College, Karen also holds a master’s degree in Human Services Administration from Springfield College in Wilmington, Delaware.

Posted in ABA

The Importance of Replacement Behaviors

I’ve written several posts about the importance of reinforcement, but now I want to turn my attention to another important concept: replacement behaviors. It can be very easy to slip into the habit of telling kids what NOT to do. “Don’t touch that! Don’t pick your nose! Don’t run!” However, if we can turn it around and tell kids what to do instead we often see higher rates of compliance.

Here are a few examples of replacement behaviors you can teach:

  • A student refuses to speak when he/she does not understand a question. You can teach the student what to say, such as “I don’t understand” or “Can I get help?” Teach through modeling and role playing in one-to-one settings, then generalize it to the classroom or other environments in which the skill is necessary.
  • When you begin a math lesson, one student frequently attempts to run out of the room. Introduce a signal or symbol (such as a holding up a stop sign) to request a break. Initially, you might give the break each time the student uses the sign correctly, then begin to require more and more math work before a break is received. This allows for appropriate and safe breaks without disrupting the rest of the class.
  • When your learner is done with dinner, he pushes his plate into the middle of the table. Teach your learner to instead put items in the sink. You might start with just placing the fork in the sink, then add more and more items until he/she is clearing the table independently. Another replacement behavior may be to use a symbol or signal as in the previous example to request to leave the table, or to teach the learner to say “May I go?”

Replacement behaviors should be simple to implement, should be taught one-on-one with multiple opportunities to practice and be reinforced, and should, if possible, be functionally equivalent to the undesirable behavior. (For example, if a child is engaging in one behavior to escape, the replacement behavior should teach a more appropriate way to escape.)

Sometimes, simply instructing the learner on a replacement behavior makes a huge change, but often you need to combine teaching a replacement behavior with other strategies (such as differential reinforcement). What I do know is that identifying and teaching a replacement behavior is a necessary part of almost any intervention and should not be overlooked.


About The Author

Sam is an ABA provider for school-aged students in Brooklyn, New York. Working in education for over 15 years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. She is also an assistant professor in the ABA program at The Sage Colleges and the Senior Clinical Strategist at Encore Support Services.