The transition back to school and back to a new routine is always an exciting, yet bittersweet time for students and educators. Carefree summer days are in the past, and getting back into a structured daily routine can be an overwhelming process. However, new teachers, new friends, and new settings provide the opportunity to make progress with academic, behavior, and social goals. Even while students and their families should enjoy every precious moment of summer fun, it is also important to set aside some time to prepare for the transition in the new school year.
Getting Proactive
Most school-based BCBAs can attest that the most important aspect of school consultation is assisting educators and other stakeholders to be proactive about behavior instead of reactive. This advice is especially valuable while preparing for a new school year. Teachers and families can begin to discuss and implement proactive strategies in the days prior to the first day of school.
For teachers and school based BCBAs, summer preparation days can be used to discuss simple environmental manipulations that can be made within the classroom. For instance, before students even step foot in the classroom, the teacher and other support staff can arrange seating that is limited from distraction and enhances engagement. A common suggestion from BCBAs is usually to seat students with a history of elopement behavior far away from the exit doors. Some consultants may even suggest preparing some visual supports and schedules ahead of time in order to prepare staff and students. Students thrive with structure and organization, so if the classroom has established expectations the students will find it easier to decide which behaviors lead to rewards and desired activities.
Building Rapport
Antecedent interventions do not only apply to teacher prep days. Chances are, not all students will engage in challenging behaviors on the first day of school. Hence, those first days of school are crucial because they are the opportune times for pairing. Classroom staff should prioritize gaining trust and rapport with students. This process can begin the moment the students arrive at school on the first day. Teachers and staff can begin pairing with students simply by greeting students with a smile and limiting demands. Students should be given the chance to feel happy and relaxed while adjusting to a new environment.
The more the students feel comfortable in the environment, the more likely they are to view the adults in the environment as a reinforcer, or a signal for access to preferred items and activities. When trust and rapport is established, it will also be easier for teachers and staff to engage in activities that may not be highly preferred. Of course the primary focus of the teachers should not be to place increasingly difficult demands on the students. However, establishing themselves as a person that will provide rewards and other motivators, allows the adults in the classroom to assist the students in developing pivotal behaviors that will provide access to a whole world full of reinforcing items and activities.
While students are adapting to the new enrichment, teachers and staff can use the opportunity to informally assess the students’ preferences. Enriching the enrichment with items high on the students’ preference list will not only assist in the pairing process, but can also be used as potential motivators for instances of positive reinforcement scenarios.
Embracing Collaboration
Lastly, the most important aspect of the transition back to school and adjustment to a new environment and routine is collaboration with all key stakeholders. Parents and caretakers, as well as teachers, should be involved and have input on any strategies and goals put in place. The more the students’ parents and caretakers feel involved in the decisions being made for their children, the more likely they are to carry out plans with fidelity. Also, establishing effective collaboration and communication assists with overhaul generalization of behaviors and makes the students’ support system stronger and more successful.
About the Author
Alicia Marshall, MAT, BCBA LBS, started out as a Special Education teacher and made the switch over to full-time BCBA 5 years ago. Alicia received her BCBA coursework at Rutgers and currently works as a Director of Behavioral Health in the Greater Philadelphia area. Alicia is passionate about making learning fun for all stakeholders and to encourage educators to focus on socially significant goals and compassionate care.
When Alicia is not disseminating the science of ABA, she can be found on the beaches of the Jersey Shore (and occasionally Hawaii) with her husband and two dogs.
ABA often gets a bad rap due to misunderstandings about reinforcement. In my career alone, I’ve had people tell me that people are not like rats and pigeons, that reinforcement harms intrinsic motivation, and that when I do produce behavior change, it has nothing to do with ABA but with my abilities as a teacher. Today, I’d like to clear up some misconceptions about reinforcement.
Reinforcement is not equivalent to rewards.
Reinforcement is anything that occurs immediately following a behavior that increases the future likelihood of that behavior. For instance, I am more likely to say hello to my neighbor down the street because in the past he has responded by saying “hello” back to me. However, I do not say hello to my next-door neighbor because she has never responded to my greeting. My history of reinforcement with the neighbor down the street increases the likelihood that I will greet him upon seeing him.
Reinforcement occurs in the natural environment all the time, whether we are conscious of it or not.
We are reinforced by paychecks for going to work, by our favorite dessert for visiting a restaurant 30 minutes out of our way, by compliments when we get a new haircut and more. ABA utilizes reinforcement when an individual is not acquiring skills in order to help them learn. And when ABA is implemented correctly, reinforcement should be as close to naturally occurring reinforcers as possible and should be reduced systematically over time to levels that would naturally occur in their environment.
Reinforcement works for dogs and for humans.
The previous two points illustrate that humans do respond to reinforcement, and decades of scientific research back that up. Comparing the work behavior analysts do with humans to the work behavior analysts do with other animals is not far off base. What is off base is using such a comparison to imply that behavior analysts treat people with disabilities like dogs. As with other professionals who work with individuals with disabilities, (such as speech therapists, physical therapists, nurses, etc.) most behavior analysts are professionals who put a lot of time, care, and love into their work.
Reinforcement is individualized.
Everything we do in ABA is individualized because human beings are wonderfully complex creatures that cannot be characterized by statistics, averages, or norms. One of my students may find stickers reinforcing; another may show no interest. One student may find listening to music reinforcing; another may cover his ears and ask me to turn it off. In ABA, we seek to find the items and activities that are motivating for individuals; then use those as tools not only for reinforcement but for increasing skills and broadening interests and opportunities. In an ideal ABA session, my students spend a lot of time engaging with items and activities that they enjoy while also learning and growing.
It’s easy to fall prey to misconceptions about reinforcement, but such misconceptions can make it impossible for us to understand how to alter the environment in order to provide the best possible outcomes for our students. As Skinner put it, “The ideal of behaviorism is to eliminate coercion: to apply controls by changing the environment in such a way as to reinforce the kind of behavior that benefits everyone.”
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. You can read more of Sam’s posts for DRTL here!
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.
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.
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.
Get a preview of the helpful tips found in ABA Tools of the Trade by Sam Blanco, PHD, LBA, BCBA.
From the beginning of my career, I have loved data collection. Not only does it help me track what interventions are working and how quickly my students are learning, it also provides excellent structure and organization of what needs to be done on a daily basis. Much of this love of data collection was influenced by my colleague Val Demiri. While Val and I both looked at data as a way to make our lives easier, for many of our colleagues, data appeared to be more of an obstacle than a useful tool. So we set out to change that.
We’re both so thrilled about the release of ABA Tools of the Trade: Easy Data Collection for the Classroom. Our goal is to make data collection easier, more useful, and possible considering the many tasks a teacher is already doing on a daily basis in their classroom. Here are few things we’re really excited to have in the book:
An overview of some of our favorite tools for data collection, including why we love them and when they might be useful for you
An easy-to-use guide based on the specific behavior challenges you are currently facing, with suggestions for data collection and recommended readings
A task analysis of the data collection process that breaks down each step for pre-data collection phase, data collection phase, and post-data collection phase
A wealth of strategies to use to address problem behavior before they occur
An entire section devoted to BCBA Supervision that not only aligns with Task List 5 but also contains lesson plans and rubrics for assessing supervisees
We hope that by making data collection methods more accessible, we can motivate you to appreciate tools for data collection as much as we do!
About the Author
Sam Blanco, PhD, LBA, BCBA, is an ABA provider for students ages 3-15 in NYC. Working in education for twelve years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. She is also an assistant professor in the ABA program at The Sage Colleges.
This ASAT feature comes to us from Niall Toner, MA, BCBA of the New York State Institute for Basic Research in Developmental Disabilities. 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 special education teacher working with students with autism. At times I find it difficult to figure out what motivates my students and what they’re interested in. Can you make some suggestions about the best way to do this?
This is an excellent question and one that highlights a challenge often experienced not only by teachers but also by family members of individuals with autism. We know that the interests and preferences of individuals with and without autism vary significantly over time. Also, we know that effective teaching of skills and behavior change are predicated upon the timely use of powerful reinforcement (i.e., positive consequences of skilled behavior that motivate and strengthen that behavior). As discussed below, identifying an individual’s preferences is a critical first step in teaching new skills because these preferences often lead to the identification of powerful reinforcers; but how we do this can be easier said than done, especially when the learner has a limited communication repertoire or very individualized interests. The best way to identify preferences is through ongoing preference assessments.
The value of preference assessments
Since many individuals with autism may have difficulty identifying and communicating their preferences directly, we must consider alternative methods of obtaining this information. At the onset, it is important to keep in mind that what may be rewarding or reinforcing for one individual may not be for another. For example, one child may enjoy bubble play, crackers or a particular cause-and-effect toy while a classmate may find one or more of these uninteresting or even unpleasant. Furthermore, an individual’s preferences change across time. For example, an individual may have demonstrated little use for music at age 11, but she may demonstrate a keen interest in music at age 13.
Preference assessments provide a systematic, data-based approach to evaluating a host of potential interests (e.g., food, toys, activities) for an individual. Although preference assessments do require time and effort up front, their use can decrease the time and energy, required to change behavior in the long run. Research indicates that when caregivers use a presumed preference that, in fact, is not the learner’s actual preference, valuable time, energy and resources are lost (Cooper, Heron, & Heward, 2006).
Types of Preference Assessments
Preference assessment can be conducted in three distinct ways: (1) Interviews and Formal Surveys; (2) Direct observation; and (3) Systematic assessment.
Interviews are a straightforward technique that can be used to gather information quickly. They involve obtaining information from the individual’s parents, siblings, friends, and teachers (and from the individual, if communicative) by asking both open-ended and comparison questions. Examples of open-ended questions include: “What does he like to do?” “What are his favorite foods?” and “Where does he like to go when he has free time?” Comparison questions might include: “Which does he like better, cookies or crackers?” and “What would he rather do, go for a walk or eat chips?” Resultant information is then compiled in a list and identified items and activities can be piloted out as possible reinforcers.
Formal surveys can also be used to guide these discussions. One widely used survey is the Reinforcement Assessment for Individuals with Severe Disabilities (RAISD; Fisher, Piazza, Bowman, & Amari, 1996). This interview-based survey gathers information about potential reinforcers across a variety of domains (e.g., leisure, food, sounds, smells), and ranks them in order of preference. It should be noted that, although simple and time-efficient, using interviews alone can result in incomplete or inaccurate information. In fact, some studies have shown that, for the same individual, staff interviews did not reveal the same information as using a survey (Parsons & Reid, 1990; Winsor, Piche, & Locke, 1994).
Direct observation involves giving the individual free access to items and/or activities that he or she may like (presumed preferences) and recording the amount of time the individual engages with them. The more time spent with an item or activity, the stronger the presumed preference. In addition, positive affect while engaged with these items and activities could be noted (e.g., smiling, laughing). During these observations, no demands or restrictions are placed on the individual, and the items are never removed. These direct observations can be conducted in an environment enriched with many of the person’s preferred items or in a naturalistic environment such as the person’s classroom or home. Data are recorded over multiple days, and the total time spent on each object or activity will reveal the presumed strongest preferences. Direct observation usually results in more accurate information than interviews but also requires more time and effort.
Systematic assessment involves presenting objects and activities to the individual in a preplanned order to reveal a hierarchy or ranking of preferences. This method requires the most effort, but it is the most accurate. There are many different preference assessments methods, all of which fall into one of the following formats: single item, paired items, and multiple items (Cooper, Heron, & Heward, 2006).
Single item preference assessment (also known as “successive choice”) is the quickest, easiest method. Objects and activities are presented one at a time and each item is presented several times in a random order. After each presentation, data are recorded on duration of engagement with each object or activity.
Paired method or “forced-choice” (Fisher et al., 1992) involves the simultaneous presentation of two items or activities at the same time. All items are paired systematically with every other item in a random order. For each pair of items, the individual is asked to choose one. Since all objects and activities have to be paired together, this method takes significantly longer than the single-item method but will rank in order the strongest to weakest preferences. Researchers found that the paired method was more accurate than the single item method (Pace, Ivancic, Edwards, Iwata & Page, 1985; Paclawskyj & Vollmer, 1995).
The multiple-choice method is an extension of the paired method (DeLeon & Iwata, 1996). Instead of having two items to choose from, there are three or more choices presented at the same time. There are two variations to this method: with and without replacement. In the multiple choice with replacement method, when an object is selected, all other objects are replaced in the next trial. For example, if the individual is given a choice of cookies, crackers, and chips, and he chooses cookies, the cookies will be available for the next trial, but the crackers and chips are replaced with new items. In the without replacement method, the cookies would not be replaced and the choice would only be between the crackers and chips. No new items would be available.
A few final recommendations
When conducting preference assessments, consider testing leisure items/activities and food assessments separately because food tends to motivate individuals more than toys and other leisure items (Bojak & Carr, 1999; DeLeon, Iwata, & Roscoe, 1997). Also, be sure to assess preferences early and often. Preference assessments should be conducted prior to starting any new intervention or behavior change program. And remember that preferences change over time and require continuous exploration. Therefore, assessments should be updated monthly or whenever an individual appears tired of or bored with the preferred items. Keep in mind too, that the identification of one type of preference may provide ideas for other potential reinforcers. For example, if an individual loves a certain type of crunchy cereal, he/she may like other cereals or crunchy snacks. Or if an individual enjoys coloring with crayons, consider exploring whether he/she may enjoy coloring with markers or using finger paints.
Finally, when selecting a preference assessment method, a practitioner or parent should consider the individual’s communication level, the amount of time available for the assessment, and the types of preferred items that will be available. Taken together, these preference assessment methods can provide the valuable information necessary to help motivate and promote behavior change in individuals with autism.
References
Bojak, S. L., & Carr, J. E. (1999). On the displacement of leisure items by food during multiple stimulus preference assessments. Journal of Applied Behavior Analysis, 32, 515-518.
Cooper, J. O., Heron, T. E., & Heward W. L. (2006). Applied Behavior Analysis (2nd ed.). Upper Saddle River, New Jersey: Prentice Hall.
DeLeon, I. G., & Iwata, B. A. (1996). Evaluation of multiple-stimulus presentation format for assessing reinforcer preferences.Journal of Applied Behavior Analysis, 29, 519-533.
DeLeon, I. G., Iwata, B. A., & Roscoe, E. M. (1997). Displacement of leisure reinforcers by food during preference assessments. Journal of Applied Behavior Analysis, 30, 475-484.
Fisher, W. W., Piazza, C. C., Bowman, L. G., & Amari, A. (1996). Integrating caregiver report with a systematic choice assessment. American Journal on Mental Retardation, 101, 15-25.
Fisher, W. W., Piazza, C. C., Bowman, L. G., Hagopian, L. P., Owens, J. C., & Slevin, I. (1992). A comparison of two approaches for identifying reinforcers for persons with severe to profound disabilities. Journal of Applied Behavior Analysis, 25, 491-498.
Pace, G. M., Ivancic, M. T., Edwards, G. L., Iwata, B. A., & Page, T. J. (1985). Assessment of stimulus preference and reinforcer value with profoundly retarded individuals. Journal of Applied Behavior Analysis, 18, 249-255.
Paclawskyj, T. R., & Vollmer, T. R. (1995). Reinforcer assessment for children with developmental disabilities and visual impairments. Journal of Applied Behavior Analysis, 28, 219-224.
Parsons, M. B., & Reid, D. H. (1990). Assessing food preferences among persons with profound mental retardation: Providing opportunities to make choices. Journal of Applied Behavior Analysis, 23, 183-195.
Windsor, J., Piche, L. M., & Locke, P. A. (1994). Preference testing: A comparison of two presentation methods. Research in Developmental Disabilities, 15, 439-455.
About The Author
Niall Toner MA, BCBA, LBA is a licensed behavior analyst and board certified behavior analyst with over 10 years experience working in the fields of applied behavior analysis and developmental disabilities. Niall is currently the Clinical Director for Lifestyles for the Disabled. Prior to the position he served as a consultant to various organizations including the New York City Department of Education. He also held the position of Assistant Director at the Eden II Programs. Niall has presented locally, nationally and internationally. His interests are Preference Assessments and Functional Analysis, which he presents and publishes.
Originally reposted to Different Roads to Learning on September 28, 2017
Back to school is an exciting time for students and teachers, but those with learning differences might find it stressful to start a new school year with new faces, rules, and expectations. Fortunately, there are behavioral support strategies that can help to smooth the way for a fun, productive year of learning. Following are some research-based methods to consider.
Choice
One of the easiest ways to help students to succeed in school is to offer choices! Dunlap at el. (1994) found that students were more engaged in tasks and less disruptive when offered choices of activities. Giving students choices of activities that all achieve the same learning objective is a great way to facilitate engagement and ownership of task outcomes. Students who can pick how they learn something may be more enthusiastic about learning overall.
Momentum
Another great way to get compliance with task demands is to use the strategy of momentum. This involves asking the student to do tasks that he is likely to comply with, before asking him to do things that are harder. For example, a teacher might present a coloring activity to a student who likes to color, and then praise him for completing that activity. The next activity could then be something a little harder and less preferred, like spelling, but now the student has a history of reinforcement for compliance and so is more likely to continue to comply. Lipshultz and Wilder (2017) offer a review of the recent research in this area.
Task Distribution
Sometimes stretching learning out over multiple sessions and across days can be helpful. Some research shows that distributed learning, where students are given instruction on the same skill for several days, is more efficient and effective than massed learning, where students are given lengthy instruction on the same skill all at once (e.g., Haq et al., 2015). For students who struggle in a particular area, consider shorter, more frequent opportunities to practice and learn.
Given thoughtful supports and reasonable, meaningful accommodations, students with learning challenges can be successful and happy in school. Adding some strategies like the ones described here can make for a fun and productive year!
References
Dunlap, G., DePerczel, M., Clarke, S., Wilson, D., Wright,S., White, R., & Gomez, A. (1994). Choice making to promote adaptive behavior for students with emotional and behavioral challenges. Journal of Applied Behavior Analysis, 27, 505–518.
Haq, S. S., Kodak, T., Kurtz-Nelson, E., Porritt, M., Rush, K., & Cariveau, T. (2015). Comparing the effects of massed and distributed practice on skill acquisition for children with autism. Journal of Applied Behavior Analysis, 48, 454–459.
Lipschultz, J. & Wilder, D. A. (2017). Recent research on the high-probability instructional sequence: A brief review. Journal of Applied Behavior Analysis, 50, 424–428.
About The Author
Dana Reinecke, Ph.D., BCBA-D is a New York State Licensed Psychologist and Licensed Behavior Analyst (LBA). Dana is an Assistant Program Director in the Applied Behavior Analysis department at Capella University, overseeing the PhD in Behavior Analysis program and mentoring doctoral learners. She is also co-owner of SupervisorABA, an online platform for BACB supervision curriculum and documentation. Dana has provided training and consultation to school districts, private schools, agencies, and families for individuals with disabilities. She has published her research in peer-reviewed journals, written chapters in published books, and co-edited books on ABA and autism. Current areas of research include use of technology to support students with and without disabilities, self-management training of college students with disabilities, and online teaching strategies for effective college and graduate education. Dana is a Past President of the New York State Association for Behavior Analysis (NYSABA).
Originally published by Different Roads to Learning on September 21, 2017.
When a child is diagnosed with autism, there are a number of resources, therapies, and programs recommended to parents. They are told all about ABA, ST, OT, PT, and FT, among others, receiving an alphabet soup of therapies. We explain the importance of early intervention. For parents of older children or teens, they learn how to navigate the school system with BIPs, IEPs, ARDs, and more. They begin to understand the behaviors of their children in a new light, and may even gain a few new fears from behaviors of other children. They learn the proper term for eloping and steps to take to help prevent sensory overload. And while many behaviors are explained, it also becomes obvious that there is not an immediate fix for many of them.
One service that professionals may not tell parents about at the time of diagnosis is their local police department’s registry program for individuals on the Autism Spectrum (along with other disorders or special needs). However, if this is a service is available to them, it could help alleviate many of the concerns that come along with an autism diagnosis. This free and essential service is often not openly advertised to the public, but rather, lives on a corner of their local webpage. Some don’t even have an obvious link on the homepage, requiring citizens to use the search function in order to get their child included on the list. This service can have a variety of names, including but not limited to: “Safe Return Program,” “[Autism and] Special Needs Registry,” “C.A.R.E.S,” and “Voluntary Registry Program for Vulnerable Populations.”
Registering your ASD Child for this program will create a note associated with your home address in the local police’s internal system. This can help participants in multiple ways. First, if there is ever an officer dispatched to your home, they will be alerted that an ASD individual lives in the home and be prepared to accommodate that person’s needs. Additionally, if a child was to elope, many programs have the option to upload a recent photo. This will make it easier for law enforcement to distribute the child’s picture quickly. For some cities, , this information could also be shared with the any firefighters or paramedics sent to the home by the dispatch team.
The method for finding if your local police department offers this program will differ depending on your city. The best start is to try searching “[CITY NAME] Special Needs Registry” on a search engine such as Google. If this doesn’t work, you may have to do some detective work on the local police website. When trying to find this program locally, I had to find the “Community Programs” tab on the menu bar of the police website.
Each program will require different information to register. At a base, caregivers should expect to provide name, address, diagnosis, and physical description of the registrant as well as the contact information for all caregivers. If the registrant is able to drive, information about their primary vehicle will also be required. Any additional required information will vary depending on the local program. Some require a doctor’s letter proving diagnosis, others ask for a recent picture, and other ask for communication methods and support items.
If you find that your local police department doesn’t have a program, consider approaching them about implementing one. With the updated CDC estimate of 1 in 44 children getting diagnosed with autism, it is almost guaranteed that this program will be useful to more than just you. Additionally, these programs can be utilized for individuals with Alzheimer’s, Dementia, Down Syndrome, and many other special needs. BCBAs and Educators are the perfect individuals to partner with police on program parameters. Additionally, it’s a great opportunity to broach your local police department about training for interacting with ASD individuals.
Cassie Hauschildt received her autism diagnosis at 32 years of age and is the mother of an ASD son, who was diagnosed at 20 months old. Since his diagnosis, she has become an advocate for ASD children. She dedicates her time to mentoring parents of ASD kids through the tough first few months post-diagnosis. She also is trying to get rid of the negativity surrounding ABA therapy. She does this through humor, while using real talk, on her TikTok @AnotherAutismMom. She also runs the “Dino and Nuggets Corner” Facebook Group.
Autism spectrum disorder occurs in individuals from many different cultures and backgrounds. Therefore, cultural competency and sensitivity is imperative for effective delivery of services. To work with autistic learners, is to respect that they are the product of many environments that have shaped them and will continue to shape them throughout their life.
As stated in the most updated ethical code from the BACB, behavior analysts are responsible for incorporating and addressing diversity in practice. For example, the BACB ethical code states that behavior analysts must practice within our scope of competence, maintain competence including cultural responsiveness and diversity. Specifically, providers must “evaluate their own biases and ability to address the needs of individuals with diverse needs/backgrounds” (Ethical Code, 2022, 1.07).
However, what are the practical implementations to culturally sensitive treatment? What does this actually look like in practice? As providers, we are obligated to offer exceptional service delivery with individualized treatment goals. Considering our learner’s cultural background and the impact of their community’s beliefs and attitudes is essential to effective treatment. The following will provide guidance on how providers can apply cultural sensitivity to their clinical decisions in treatment.
Priorities in Treatment Goals
Overlooking the cultural impact can also create conflict and disparity within the stakeholders’ involvement and commitment to treatment. In contrast, “when these values and expectations align with those of the family receiving the intervention, positive outcomes are likely, including high levels of participation and response to treatment” (Dubay, Watson, & Zhang, 2018). Thus, we must also consider how we prioritize goals for culturally sensitive treatment.
For instance, I recently worked on a sleep intervention to desensitize my client to sleeping in his own bed. When discussing the intervention, and more importantly, when to introduce the treatment goal, the cultural sleeping norms had a significant impact. In some urban and minority cultures, co-sleeping is common. Yet, if a provider may think it is significant for the client to start sleeping in their own bed by the age of six, but it is common in the culture to continue co-sleeping even until the child is ten, culturally sensitive conversations can play an important role.
In another example, Filipino cultures find it respectful for younger family members to “bless” elder members by bowing towards the hand of the elder family member and placing their forehead on their hand. Thus, although the provider may find it significant for the client to learn to wave to greet others, by prioritizing cultural norms, it may have a greater influence on the client receiving natural reinforcers by working on blessing their family members, first.
The contradiction between parents following therapy targets that will be supported by their community compared to the skills that might benefit their child in the long term may prove to be challenging and demanding on the family (Dubay, Watson, & Zhang, 2018). Thus, culturally sensitive treatment is prioritizing treatment goals with the best outcome and secures family commitment.
Interdisciplinary Collaboration
By creating culturally sensitive treatments, providers will build better relationships with stakeholders and in turn, reduce the social stress that may come from raising and teaching an autistic child within various cultures. This idea does not only apply to parents, but even extends to the interdisciplinary team that could be influenced by the learner’s culture.
Within Russian communities, it is common to eat soup for lunch. When I provided services in a primarily Russian daycare, I had to consider my client’s aversion to eating these traditional meals as well as the importance of this target behavior to the daycare providers. Rather than dismiss this potential goal, despite my own perspective on the client’s needs, I modified my treatment goals to effectively collaborate with the daycare providers. By understanding the cultural impact and importance of certain behaviors to any stakeholder, the provider can often address unmet needs, gain support for treatment, and keep open communication if other issues arise (Fong et. al, 2017). We must be culturally sensitive towards the beliefs and attitudes that are different than those in the US, and not assume that the learner’s culture does not affect how they or their community respond to treatment.
Educate Ourselves. Stay Cultured. It is not required to culturally match your clients to provide adequate care and treatment. However, providers should strive to acquire knowledge and skills related to cultural responsiveness and diversity. Although we may be the experts in our particular discipline, remember that the parents are the experts on your learner. Culturally sensitive providers should strive to learn about the cultural norms of their diverse clientele. Constant dialogue, keeping an open perspective, and asking questions about cultural norms can make all the difference.
About the Author:
Nicole Gorden, M.S., BCBA, LBA has over 14 years of experience implementing Applied Behavior Analysis principles with the Autism Population. She currently works for Comprehensive Behavior Supports in Brooklyn, NY.
DuBay, M., Watson, L. R., & Zhang, W. (2018). In Search of Culturally Appropriate Autism Interventions: Perspectives of Latino Caregivers. Journal of autism and developmental disorders, 48(5), 1623–1639.
Fong, E. H., Catagnus, R. M., Brodhead, M. T., Quigley, S., & Field, S. (2016). Developing the Cultural Awareness Skills of Behavior Analysts. Behavior analysis in practice, 9(1), 84–94.
Fong, E. H., Ficklin, S., & Lee, H. Y. (2017). Increasing cultural understanding and diversity in applied behavior analysis. Behavior Analysis: Research and Practice, 17(2), 103-113.
Patton, S. (2017, April). Corporal punishment in black communities: Not an intrinsic cultural tradition but racial trauma. CYF News. http://www.apa.org/pi/families/resources/newsletter/2017/04/racial-trauma
Working on the front lines of Autism care in a residential facility is both rewarding and, at times, challenging. Although our residents depend on us in many ways to teach them how to complete day-to-day tasks, it is important for all staff to recognize and respect that our residents each have their own preferences and interests. Therefore, we always strive to let our residents make as many choices as possible (provided they are healthy choices that do not cause harm to anyone). Just because we as staff might complete a particular task a certain way does not mean it is the “right” or only way to do so. Recognizing and respecting residents’ choices can help avoid negative behaviors or frustration for our residents. Our goal is always to teach and foster independence and self-direction.
It is always important to build good rapport with our residents so we are in tune with their wants and needs, while also enabling them to better trust us, work with us, and learn from us. Unfortunately, with current staffing crises and funding cuts in residential care settings, one challenge we face is securing long-term, seasoned staff. This type of setting often suffers from a high turnover rate, which this is a matter that needs more global attention, as hardworking, dedicated, and experienced/trained staff are crucial for our population.
One of the biggest considerations we have on a daily basis, particularly during the global COVID-19 pandemic, is finding creative and entertaining recreational and leisure activities to keep our residents happy and actively engaged. Anyone can become restless and bored with nothing to do, and those with Autism are no different, which is why active engagement is one of our top priorities in a group home setting. When selecting activities, we strive to ensure that each resident’s preferences are considered and incorporated. This includes a combination of both community outings and in-house events/activities. Going into the community on outings can be challenging at times when unpredictable factors (e.g. noise, crowds, etc.) may trigger negative behaviors. However, we do our best to avoid triggering situations by researching and/or visiting the activity or location before our residents experience it in order to help determine if there are any barriers that will prevent it from being an enjoyable and successful outing for all. We also do our best to go prepared on each community outing with preferred items that can be used as a source of redirection and comfort if needed. For example, headphones to drown out noise if it gets too noisy, as well as preferred snacks or drinks if our residents get hungry or thirsty. In the residence, we also strive to think of creative leisure activities, such as dance or karaoke parties, Bingo nights, movie nights, baking, and arts and crafts. Having an enthusiastic and supportive approach, as well as using preferred reinforcers, helps to engage our residents in these activities and increase their interest level.
In addition to recreational and leisure activities for entertainment and socialization, day-to-day life in the residence is also a learning experience for our residents, as they work on a variety of individualized goals with their assigned staff. Examples of goals may include activities such as participating in a consistent exercise regimen, learning how to independently cook rice or make tea, learning how to independently count money and make purchases, and learning how to independently vacuum or clean one’s room. The selection of a participant’s goals is a collaborative process that involves input from parents/caregivers, input from the participant(s) if possible, and input from the management team at the residence. We strive to ensure that selected goals not only address a skill deficit, but are also aligned with the participant’s interests and will help the participant become more independent in daily living skills. Similarly, participants learn increased independence by participating in various chores around the house, such as setting the table for lunch and dinner, loading and emptying the dishwasher, and doing one’s laundry. Teaching many of these goals and chores can be accomplished through the use of a visual task analysis that breaks the task down into smaller components (i.e. individual steps), which are each depicted in visual images. Visuals are a very helpful teaching technique for those with Autism, who often struggle significantly with understanding verbal language and oral directions. It is also helpful for learning, especially in the initial stages, to use a preferred reinforcer to reward correct completion of steps. In the beginning of learning a new goal or chore, one step may need to be taught for a number of consecutive days until it is mastered and the next step can be taught.
Overall, working in a residential setting has been a great learning experience and we know that our work has had, and continues to have, a significant influence on our residents’ lives, which is very rewarding for all staff.
About the Author:
Stephanie Tafone, M.A., has over a decade of experience working with individuals with disabilities. She currently works as a behavioral specialist supporting both children and adults who have a range of diagnoses, including Autism Spectrum Disorder.
Children with Autism Spectrum Disorder (ASD) have amazing potential that can and should result in a high quality of life. However, this is highly dependent on the treatment received. Unfortunately, the current standard of care—Conventional Applied Behavior Analysis (ABA)—is quite rigid and formulaic in its approach, yielding treatment that is not tailored to the unique needs of the children and their families. Typically, treatment only addresses limited areas such as behavior and communication deficits. Although children may receive some benefits from Conventional, protocol-based ABA, the results usually do not endure over time, nor do they translate to more natural settings that are essential for self-sufficient adulthood.
Autism Partnership Method is an extremely individualized approach to ASD that yields lifelong benefits. Rather than follow a “one size fits all” treatment recipe. Progressive ABA training is not time based, but performance based — no less rigorous or precise than the training regimens of surgeons or civil engineers. Quality treatment focuses on the entire child, thereby addressing the child’s foundational behaviors, including communication, socialization, play, and independent living skills — as opposed to addressing a more limited set of behavioral or communication needs. Progressive ABA treatment is designed so that children can succeed in mainstream settings, such as regular education classes, and can thrive in extracurricular activities. Children who receive progressive treatment, have been shown to make the progress their parents dream of, such as playing with their sibling and developing meaningful friendships.
In 2011, the journal Education and Treatment of Children published A Program Description of a Community-Based Intensive Behavioral Intervention for Individuals with Autism Spectrum Disorder. This study evaluated the progress of 64 children at Autism Partnership agencies in Seal Beach, California; Hong Kong; Leeds, United Kingdom; and Melbourne, Australia. The results found that 70.3% of children achieved best outcomes when individualized ABA services were provided early (i.e., before the age of 9), and intensively (i.e., 10–40 hours a week), by quality therapists.
At Autism Partnership we are deeply concerned about the expectations regarding the outcomes for children diagnosed with ASD! Simply put, we feel that the expectations are too low. Children with ASD have a far more favorable prognosis than believed achievable decades ago, yet there still seems to be a lack of understanding regarding children’s’ actual potential. Children with ASD have amazing potential! The majority of children can become conversational, achieve success in school, develop meaningful friendships and most importantly, experience a high quality of life! However, achieving this requires high quality intervention with highly trained staff.
Ronald Leaf, Ph.D. is a licensed psychologist who began his career working with Ivar Lovaas in 1973 while receiving his undergraduate degree at UCLA. Subsequently he received his doctorate under the direction of Dr. Lovaas. During his years at UCLA he served as Clinic Supervisor, Research Psychologist, Interim Director of the Autism Project and Lecturer. He was extensively involved in several research investigations, contributed to the Me Book and is a co-author of the Me Book Videotapes, a series of instructional tapes for teaching autistic children. Dr. Leaf has consulted to families, schools, day programs and residential facilities on a national and international basis. Ron is a Director of Autism Partnership. Dr. Leaf has published extensively in research journals. Dr. Leaf is the co-author of: A Work in Progress, Time for School, It Has to Be Said!, Crafting Connections, A Work in Progress Companion Series and Clinical Judgement.
