Build Desirable Behaviors

By Sam Blanco, PhD, LBA, BCBA

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.


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.

Easy Data Collection for the Classroom

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.

Back to School!  Using Behavioral Strategies to Support Academic Success

By Dana Reinecke, Ph.D., BCBA-D

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.

Self Care for Moms

By Leanne Page; originally posted on Parenting with ABA

When you hear the words “self-care”, what is your reaction? A sigh of relief? Rolling your eyes as it feels like just ONE. MORE. THING.?

As a busy mom, we’ve all heard the expression to put your own oxygen mask on first. But when are we supposed to do that?

Self-care doesn’t have to mean bubble baths and beverages. It doesn’t have to mean shopping or pedicures. So what the heck does it mean then?

The World Health Organization defines self-care as “the ability of individuals, families and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a healthcare provider”.

And the American Psychological Association says “Self-care has been defined as providing adequate attention to one’s own physical and psychological wellness. Beyond being an aspirational goal, engaging in self-care has been described as an “ethical imperative”.”

Self care means paying attention to your own wellness- emotional, physical, and psychological. How are YOU doing right now? And the question you’ve heard me encourage you to use before- 6 little magic word: What do you need right now?

Quick and easy ways to improve your physical self-care:

  • Drink more water. Make this easier by using habit stacking. This means take an existing habit and add the step of drinking a glass of water on top of it. In ABA speak, the existing habit becomes the SD for drinking water. When I turn on my coffee maker in the morning, I drink a big glass of water while the coffee machine heats up.
  • Sleep hygiene. Turn off screens earlier in the evening. Go to bed earlier. Remove distractions. Journal before bed. Whatever works for you to promote good sleep!
  • Eat healthy. Instead of focusing on removing certain foods from your diet, just add in one healthy thing a day- like a fruit or vegetable. Habit stack by adding a piece of fruit to your afternoon cup of coffee, tea, or water.

Quick and easy ways to work on your emotional & psychological self-care:

  • Gratitude practice. There is SO much research on the benefits of gratitude practice for your mental health. This doesn’t have to be time consuming or involved. Habit stack by thinking about one thing you are grateful for every time you brush your teeth. Or ask every member of your family what they are grateful for each day (or call it a happy thing or a good thing) every time you all sit down at the kitchen table together.
  • Insert a pause. Just a simple pause throughout your day can help! When you are starting to feel emotionally heightened, pause and take some deep breaths. Insert this pause before you react to your kids or something else. Just giving yourself that moment to breathe and collect your thoughts can be wonderful for your self-care!
  • Schedule alone time. Work with your partner or support system to have a standing date with yourself on the calendar. It may be 20 minutes to sit on the back porch or an hour on the weekend to go to a yoga class. Whatever works for you! Put it on your calendar and treat it like an important appointment. It is important!

If you like bubble baths and wine- feel free to use it for your self-care. But that’s not all that matters! What matters is that you find a way to give yourself a little breather from the mental load of motherhood.

Prioritize yourself- even just in small increments. Learn something new, try a new hobby, read a book, exercise. Find what works for YOU and schedule time for it. Guard that time as an important appointment because you are worth it.

What small ways can you incorporate more self care into your days this week?? Try something and let me know how it goes!

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 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.

Special Needs Registries to Inform First Responders

By: Cassie Hauschildt

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.

By: Nicole Gorden, M.S., BCBA, LBA 

This blog post is part 2 of 2. Read part 1 HERE


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.


References:

Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. Littleton, CO: Author.

DuBay, M., Watson, L. R., & Zhang, W. (2018). In Search of Culturally Appropriate Autism Interventions: Perspectives of Latino Caregivers. Journal of autism and developmental disorders48(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 practice9(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

By: Stephanie Tafone, M.A., P.D., Behavior Intervention Specialist at Eden II Programs 

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., P.D. earned her B.A. in Psychology from St. John’s University before going on to earn her M.A. and Professional Diploma in School Psychology from Kean University. She is currently in the process of completing the requirements to obtain an Advanced Certificate in Applied Behavior Analysis as she pursues national certification. For the past ten years, she has been working with both children and adults with disabilities. She currently works as a behavior intervention specialist at a residential facility serving adults who have been diagnosed with Autism Spectrum Disorder. She also works as a school psychologist serving children with various diagnoses and disabilities, as well as an adjunct professor for courses pertaining to Applied Behavior Analysis, Autism, and Intellectual Disability. 

Whose behavior needed to be fixed? The kids’ or the parents’??

At a recent family meeting, I had put an item on the agenda- listening to mom and dad so we don’t have to repeat ourselves. In the past week, I had noticed that I was having to say things many more items than usual and my husband and I had both raised our voice more often. So I brought this up in a problem solving format with all 4 of us- two kids, my husband, and myself. Everyone was given a chance to propose solutions- no matter how off the wall.

I expected the conversation about listening better to go one of two ways when the kids are allowed to make the call: either all about earning rewards, or about getting trouble. One extreme or the other. But I sat quietly and let my little ones (ages 7 and 4) have the floor and share what they thought would fix this issue we were having. Things started to go down the punishment lane- maybe we should lose allowance when we don’t listen- and I shut that down. I told them that allowance is not tied to their behavior and we wouldn’t be making changes to our allowance system. Then things got interesting. My FOUR year old shared that her pre-kindergarten teacher would say “1, 2, 3, eyes on me” and then the kids would listen to her. So my littlest suggested a change to MY behavior to fix the problem. So the 7 year jumps in and says “Remember how you used to do silly poses to get our attention? Maybe you can do that again.” Again – they wanted to change the PARENTS’ behavior, not their own. I was all in on this train of thought. I suggested I use things I used to do consistently when we were in full-on virtual school mode- clapping patterns, hand gestures, silly voices- to get their attention before asking them to do something. That way they are actually listening the first time and we won’t have to repeat ourselves. As a family, we agreed the solution to the problem of the kids not listening was to make a change to Mom & Dad’s behavior- we would do something to make sure we had their attention FIRST and then tell them whatever we needed them to hear.

This is not a new and noteworthy idea. But it is a good idea! I’ve even written about it before here: https://www.parentingwithaba.org/get-my-kids-to-listen-part-1/. Here’s an excerpt from that to help you (and me) remember: Get their attention first. We have to interrupt whatever is currently going on- and somehow win that battle for attention from something they prefer more than listening to mom giving instructions. I mean, what could be more fun than listening to mom giving instructions? Oh- everything? I see.

  1. Be silly. Interrupt with silliness. Make silly faces, silly poses, or use different voices. Get their attention AND a smile on their face before you even start to give instructions.
  2. Start with a joke, then give the instructions.
  3. Say something absurd. Instead of “Go wash your hands” try “Go wash your earlobes”. Let your kids correct you- now they have said the instructions themselves! “Oh silly me. Wash your hands, not your earlobes!”

By letting the kids help come up with this solution, they’ve been all in. If we do anything to get their attention first, they freeze and make big eyes and stare at us. It’s a little overboard with the dramatics, which I find hilarious and awesome. And when I forget, they will say “1, 2, 3, eyes on me” to me as a reminder. So far things are better in my house with no major reward system, no punishments or loss of allowance, no big drama. We just needed to talk through a problem and whose behavior needed a change? Not the kids. It was the parents’ behavior that was changed this time (and most of the time if we’re honest with ourselves here). What things to do you use to get your kids’ attention? What works for you?

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.

Raising Expectations for the Treatment of Children With ASD

On November 6th 2021 in NYC, Dr. Ronald Leaf will describe the Autism Partnership Method (APM) in a free seminar at St Monica’s Church from 2-4pm. Free CEUs will be available! 

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. 

Register for the Autism Partnership seminar here! 

About The Author

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 ProgressTime for SchoolIt Has to Be Said!Crafting ConnectionsA Work in Progress Companion Series and Clinical Judgement.

In The Event Of Crisis

When it comes to the treatment or reduction of challenging, disruptive, dangerous problem behaviors, regardless of the setting or populations served, this will often be referred to as “Crisis Intervention”.

This concept is far broader than ABA, as many institutions and facilities will create, monitor, and implement crisis interventions whether anyone on site has received ABA training, credentialing, or licensure, or not (examples: police, schools, daycares, residential settings, prisons, etc.).

Being such a broad topic, that can look about 10,000 different ways depending on the setting and availability of highly trained specialists, it should come as no surprise that crisis behavior scenarios frequently result in injury or even death. If you do some online searches for news stories related to seclusion and restraint, regardless of the setting, you will see what I mean.

This issue is also larger than disability.

Yes, most of the horror stories we see on the news where someone was seriously injured during a restraint DO involve people with disabilities (whether it was known at the time, or not). But in the absence of disability or mental health issues, crisis management can still lead to serious injury or death. That could be for the person(s) responding to the crisis, or to the person(s) having the crisis.

This is a very weighty and complex topic, and I can’t possibly cover everything anyone should know about crisis intervention. However, due to the seriousness of crisis scenarios and the increased risk of harm (again, for the person intervening, the person or having a crisis, or even both of those people), I very much want to share some resources and information about managing behavioral crises.

First, some terms. Here is my favorite definition of a crisis:

A time of intense difficulty, trouble, or danger; a time when a difficult or important decision must be made.

During a behavioral crisis, the individual is having intense difficulty or trouble. They are having a hard time (not giving you a hard time). Decisions must be made, not just regarding what to do RIGHT NOW, but in the future, in case this happens again. Which, without the proper supports in place, the crisis event is highly likely to happen again.

Viewing a crisis through this lens takes the responsibility off of the individual having the crisis, and onto the supports in place (or lack thereof). When a crisis event occurs, ask yourself these questions:

     1. Does this individual know how to safely de-escalate during a crisis event?

     2. If yes, then why are they not using that tool?

Truly individualized and effective de-escalation tools are best understood as the means by which an individual in a crisis state can identify they are approaching a crisis state, select a de-escalation method, implement the method, and lastly evaluate how well the method worked once they are calm again.

Depending on the setting, availability of support help, and the understanding of de-escalation (or lack thereof), this “returning to neutral” process can take minutes, hours, days, or may not occur at all. It may involve a team of people, a caregiver or support person, or happen independently. When it doesn’t occur at all, that typically results in emergency room visits or admittance into an inpatient facility.

I do not know your work setting, the populations you serve, or your job title, but if you are reading this post I have to assume you have either experienced a crisis event with a client/student/etc. or want to be equipped if it should happen.

Right here I have to point out a very common myth, that can be quite dangerous when people believe it: In the field of ABA, clients who exhibit (or have a history of exhibiting) highly violent or dangerous problem behaviors may be classified as exhibiting “severe behavior”. It is a myth that only severe behavior clients can have crisis events. That is not true at all. Clients with non-violent or less disruptive problem behaviors, under the right set of combined circumstances, could have a behavioral crisis. For example, what if their home routine is significantly disrupted, they are ill, dealing with a change of medication, and also recently started puberty? These setting events when combined, could trigger a crisis event. For this reason, it is important for professionals and practitioners to be properly trained and equipped for crisis conditions, far before they are needed.

Now I want to speak specifically to ABA implementers (RBT’s, paraprofessionals, etc.) who work directly with clients: If you are working with clients where you are regularly responding to crisis events or working with clients with a known history of crisis events, you should be following the policies of the physical management training you received. If you have not received any physical management training, then you should not be working with those clients. It is dangerous for you, and dangerous for them.

Again, crisis events could potentially happen at any time, with any client/student/etc. It would be unwise to think “Oh I don’t work with severe behavior individuals, so this doesn’t apply to me”. For ANY of us (disabled or not, mental health issues or not) the right set of circumstances could trigger a crisis event.

If you were in the midst of a crisis event, who would you want helping you? Someone reacting on impulse or instinct, or someone who has been thoroughly and properly trained on safe de-escalation?

So what can be done? Glad you asked.

There are many, many crisis intervention and de-escalation resources readily available. If you are not in the position to set policy or choose employee trainings, you can still request additional training from your employer and send them recommendations of evidence-based methodologies. You can also always communicate when you feel ill-equipped or prepared to work with a specific student/client/etc. or feel unsafe.

Research shows that in the absence of individualized, evidence- based crisis interventions, individuals will contact injury to self and others (Burke, Hagan-Burke, & Sugai, 2003), receipt of medications with serious side-effects that rarely correct the causes of the behaviors (Frazier et al, 2011), receipt of intrusive, ineffective interventions that are punishment-led (Brown et al, 2008), and increased negative interactions (Lawson & O’Brien, 1994).

In ‘Effects of Function-Based Crisis Intervention on theSevere Challenging Behavior of Students with Autism ‘, the following procedures are recommended for crisis intervention planning-

Be cognizant of crisis needs and function when designing a behavior plan for students with crisis behaviors, and operationally describe steps to be taken for each phase of escalation. When describing these steps, be aware of the behavioral function. Change the quality of reinforcement delivered between appropriate and inappropriate behavior, and prompt appropriate behavior before providing access to calming activities. Train staff to competence on the intervention strategies (which most often includes role play scenarios during training, not just discussion/lecture). 

*Recommended Resources (please share!):

~Find the number for the mental health crisis/emergency support services in your state, and save it in your cell phone

~For caregivers, if your child is on medication the Physician/Psychiatrist will likely have an after-hours or emergency help desk. Save that number in your cell phone

https://www.pcmasolutions.com/

https://www.marcus.org/autism-training/crisis-prevention-program

Crisis Intervention Strategies

Prevention of Crisis Behavior

Crisis Help in Georgia

ASD & Crisis Behaviors

Handbook of Crisis Intervention and Developmental Disabilities

ASD & De-Escalation 

Crisis Prevention Institute 

ASD & Stages of Behavioral Escalation

Nationally Certified Crisis Training Providers

About The Author: Tameika Meadows, BCBA

“I’ve been providing ABA therapy services to young children with Autism since early 2003. My career in ABA began when I stumbled upon a flyer on my college campus for what I assumed was a babysitting job. The job turned out to be an entry level ABA therapy position working with an adorable little boy with Autism. This would prove to be the unplanned beginning of a passionate career for me.

From those early days in the field, I am now an author, blogger, Consultant/Supervisor, and I regularly lead intensive training sessions for ABA staff and parents. If you are interested in my consultation services, or just have questions about the blog: contact me here.”

This piece originally appeared at www.iloveaba.com