It Takes a Team: 4 Steps to Building a Stronger Therapy Team

For students on the Autism spectrum, having a strong and reliable therapy team to support individual needs can be an important factor in student success. When members of a therapy team are collaborating seamlessly, a student is more likely to have high quality support across all areas of development (communication, social, cognitive, play, motor, and adaptive skills).

mixed working group looking at laptopThe pervasive nature of ASD across these areas means that multiple disciplines are necessarily involved in effective intervention (Donaldson and Stahmer, 2014). When we work together and have a narrow focus, we can help our students make a great deal of progress. Gone are the days of a Speech Language Pathologist, Physical Therapist or Occupational Therapist taking a student away for traditional pull out therapy and leaving no time for debriefing with the classroom team.

Who comprises the therapy team is determined on a case-by-case basis. You may be wondering where to start with this sometimes daunting task of building a strong and supportive team. Below I will discuss some strategies that are evidenced-based and the ways that I incorporate them into my busy life as a speech language pathologist.

Pairing
One of the first things that I always try to do is build rapport with staff, which is known as a behavioral principle called pairing. It is important to build rapport and/or pair with team members, especially if you are new to the team or if other new members have joined. It may sound like very basic advice, but as clinicians we are very busy and sometimes we feel that we do not have time for this piece. I am urging you to put this time with staff on the top of your priority list. Once you have a good rapport with team members, it allows you to share ideas and collaborate more easily and more effectively.

Sharing
The next tip I have is to share the goals your student is working on. If you are the teacher, share the student’s IEP goals with the paraprofessionals and explain why you are teaching particular tasks. Knowledge is power! If you are the occupational therapist, please share your student’s therapy goals with the team. Therapy takes place all day, across settings and across instructors. If the team does not know what the goals are, they will have no idea how to address them across the school day.

Reinforcement
Students and professionals benefit from reinforcement! People feel good about the work at hand when they receive positive reinforcement. Let the paraprofessional know that they are doing a great job with their student(s). Everyone likes to get praise for a job well done!

Data
Another way that we can assure that our collaboration is helping the student is by collecting daily data on skills from all domains (i.e. behavior, academic, communication). When we, as a team, create a data sheet that captures the skills and specific targets we are addressing, we can use this across the student’s day. When we take this data and analyze the progress, we can all make informed decisions about a student’s programming needs. I have included a free team-based daily data sheet from Stages Learning. You can use this data sheet to track a variety of skills.

In my 14 years practicing in the field, the majority of people that I encounter are driven by a desire to see their students. However, even with the best intentions, we may face barriers in collaborating with other staff members. Follow the tips mentioned above and reach out to colleagues who seem to need additional support. I try to continually assess the needs of the teams I work with throughout the year. Maybe the team needs a refresher on a certain skill area – see if you can work this into your yearly professional development time. When we work together as a team, we can help so many students achieve their goals!


ABOUT THE AUTHOR

rosemarie-griffin-headshotRosemarie Griffin, MA, CCC-SLP, BCBA is a licensed speech language pathologist and board certified behavior analyst. Currently she splits her time between a public school system and a private school for students with autism. She is passionate about lecturing on effective communication services for students with autism and has done so at the local and national level. Rosemarie also enjoys spending time with her family, playing the harp and shopping.

Article originally posted on Stages Learning Materials Blog.

Pick of the Week: Save 20% on 2D to 3D Learning Tools!

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We’ve got all the tools you need to develop imaginative play skills with our favorite hands-on learning storybooks and games!

This week only, save 20% on your purchase of these select 2D to 3D learning tools by using promo code 3D2017 at checkout!

*Promotion is valid until March 27, 2016 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code 3D2017 at checkout.

 

Tip of the Week: Teaching Language—Focus on the Stage, Not the Age

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

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

Brown_Grammatical_Structures_ChartFrom aacinstitute.org

 

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

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

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

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

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

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

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

WRITTEN BY SAM BLANCO, MSED, BCBA
Sam is an ABA provider for students ages 3-15 in NYC. Working in education for twelve years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently a PhD candidate in Applied Behavior Analysis at Endicott College. She is also a lecturer in the ABA program at The Sage Colleges.

 

 

Focus on Generalization and Maintenance

On more than one occasion, I’ve been in the situation that a student will only demonstrate a skill in my presence. And I’ve heard from other colleagues that they have had similar experiences. This is highly problematic. When it happens with one of my students, there is only one person I can blame: myself.  A skill that a student can only demonstrate in my presence is a pretty useless skill and does nothing to promote independence.

TeacherSo what do you do when you find yourself in this situation? You reteach, with a focus on generalization. This means that, from the very beginning, you are teaching with a wide variety of materials, varying your instructions, asking other adults to help teach the skill, and demonstrating its use in a variety of environments. Preparing activities takes more time on the front-end for the teacher, but saves a ton of time later because your student is more likely to actually master the skill. (Generalization, after all, does show true mastery.)

Hopefully, you don’t have to do this, though. Hopefully, you’ve focused on generalization from the first time you taught the skill. You may see generalization built into materials you already use, such as 300-Noun List at AVB press.

Another commonly cited issue teachers of children with autism encounter is failure to maintain a skill. In my mind, generalization and maintenance go hand-in-hand, in that they require you to plan ahead and consider how, when, and where you will practice acquired skills. Here are a few tips that may help you with maintenance of skills:

  • Create notecards of all mastered skills. During the course of a session, go through the notecards and set aside any missed questions or activities. You might need to do booster sessions on these. (This can also be an opportunity for extending generalization by presenting the questions with different materials, phrases, environments, or people.)
  • Set an alert on your phone to remind you to do a maintenance test two weeks, four weeks, and eight weeks after the student has mastered the skill.
  • Create a space on your data sheets for maintenance tasks to help you remember not only to build maintenance into your programs, but also to take data on maintenance.

Considering generalization and maintenance from the outset of any teaching procedure is incredibly important. Often, when working with students with special needs, we are working with students who are already one or more grade levels behind their typically developing peers. Failing to teach generalization and maintenance, then having to reteach, is a waste of your students’ time.

WRITTEN BY SAM BLANCO, MSED, BCBA

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

 

 

Why All Parents Should Use Token Economies

Why All Parents Should Use Token Economies

As parents, we want our kids to want to have good behavior. They should want to behave because it’s the right thing to do, right? Yeah right. This is why all parents should use token economies.

Have you met a 3 year old with an innate desire to good for this world? It’s in there somewhere but at age 3, it’s more like threenager-ville. Little humans do what gets them what they want. They behavior in a certain way to achieve a certain outcome.

A threenager is likely to tantrum to get access to their favorite toy, TV show, candy, a left shoe they can see on the other side of the room — you name it. They are acting a certain way (tantrum) to achieve a certain outcome (getting whatever they want).

What can we do about this? Is there any way to teach them to behave?! Well, we can make sure they get what they want not by having a tantrum, but by engaging in desired behaviors.

We can use positive reinforcement in a more structured and specific way than just handing out praise and rewards willy-nilly.

The definition of a token economy is: a behavior change system consisting of three major components: (a) a specified list of target behaviors; (b) tokens or points that participants receive for emitting the target behaviors; and (c) a menu of backup reinforcer items.

Token economies can possibly take the form of sticker charts, chore charts, marble jars, etc. You need a physical token that your child can earn when they engage in the desired behavior. You do NOT need to go out and spend $50 at the nearest school supply store making a big fancy chart. You can draw 5 circles on a piece of paper. When they do the desired behavior, draw a check mark in the circle. Done. Grab that piece of junk mail off the kitchen counter and a half-eaten, I mean half-broken, crayon.

The next step is to define the behaviors. Again, you don’t need a big fancy dictionary. Just pick one to three behaviors that will earn the tokens. You need your Little to understand this so it can’t be a big grown up idea like ‘being responsible’ or ‘showing respect’. What does that mean to a Little? Be specific. You earn a token for: (1) following instructions without yelling; (2) eating 5 bites of every food Mom puts in front of you; and (3) putting on your shoes when instructed to.

Pick your battles. You may have a list of 20+ things your Little could stand to improve. I’m pretty sure I have a list of 20+ things to put myself on a token economy. Let’s prioritize and make it understandable by the kiddo.

Lastly — what can they earn with these tokens? You can give choices before earning and they can decide at the beginning or at the end. You can make a fancy menu of reinforcers — Chuck E Cheese is the perfect example of this. This many tickets = this super awesome toy.

Or, you can just say: get all the stickers, get 5 check marks, get 10 marbles and earn a fun activity. You can pick from: extra screen time, trip to the library, a new toy from the dollar spot, etc.

All of that in short form:

  1. Pick 1-3 behaviors and make sure your Little understands what they are.
  2. Have an actual token they can earn and set a goal.
  3. Provide the reward when they reach that goal. Make it a big deal!

Tips:

  • When you first start out, set the goal low. If it’s too hard to achieve, that won’t motivate anyone, especially a Little who is struggling with those behaviors to begin with.
  • Over time, raise the goal. Make the reward bigger for a bigger goal, smaller for a smaller goal. Play with it to see what is successful for your Little and doable for you in your busy day.
  • Make every token earned a big deal — lots of praise and excitement.
  • Don’t spend a lot of time and money setting up a fancy system. Like all things we do as parents — as soon as we get a good system down, our Little changes things up on us and we have to be flexible. My own daughter sees a strip of printer paper and thinks I’ve made her a new sticker chart. That’s how fancy sticker charts are at my house!
  • Be creative!
    • My aunt gave this idea from her life: She had a picture of a poodle and her daughter glued cotton balls on it. When she filled the picture, they actually got the poodle!
    • My sister let her oldest pick out his marbles for a marble jar on a special shopping trip to the craft store (less than $5 — don’t go overboard, folks!). That helped him buy into the process form the get go.
    • Cut up a picture of the prize like a puzzle. They get a puzzle piece as a token. The finished puzzle earns the prize!
    • Look in the app store. Seriously — there are many apps for reward charts.
    • Google ‘behavior chart’. You’ll find a gazillion cute templates if that’s what you’re into — cutesy.
    • I once made a necklace for a student who was really into jewelry. It was a laminated sticker chart necklace and she loved it.

One last thought: Someday you will find that things are going well and the token economy goes by the wayside. Remember it when a new problem behavior crops up and you are once again at your wit’s end. Start over. Pick new behaviors, new rewards, same system.

Don’t take my word for it — this is just the tip of the iceberg in behavior analytic research supporting token economies.

If you’re not a crafty person, you can always check out our reward chart here

Citations:
Cooper, J., Heron, T., & Heward, W. (2007). Basic Concepts. In Applied Behavior Analysis(2nd ed., pp 560-567). Columbus: Pearson.

Kazdin, A. E. (Ed.). (1977). The token economy: A review and evaluation. Plenum Publishing Corporation.

Kazdin, A. E. (1982). The token economy: A decade later. Journal of Applied Behavior Analysis15(3), 431-445.

Skinner, B. F., Ferster, C. B., & Ferster, C. B. (1997). Schedules of reinforcement. Massachusetts: Copley Publishing Group.

Reitman, D., Murphy, M. A., Hupp, S. D., & O’Callaghan, P. M. (2004). Behavior change and perceptions of change: Evaluating the effectiveness of a token economy. Child & Family Behavior Therapy26(2), 17-36.


Leanne Page, M.Ed, BCBA
 has worked with kids with disabilities and their parents in a variety of settings for over 10 years. She has taught special education classes from kindergarden-grade 12, from self-contained to inclusion. Leanne has also 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. Since becoming a mom, Leanne has a new mission to share behavior analytic practices with a population she knows needs it- all moms of littles! Leanne does through her site parentingwithaba.org and through her book ‘Parenting with Science: Behavior Analysis Saves Mom’s Sanity”.  You can contact her at lpagebcba@gmail.com.

Pick of the Week: Sensory Tools for Staying Calm And Focused

Maintaining calm and focus can be a challenge in a busy classroom. Our solution? Help reduce fidgeting and reward good behaviors with these sensory tools for staying calm and focused: the Fidgets Kit and Reinforcer Kit. For this week’s Pick Of The Week, save 20% on these items by using promo code FOCUS20 at checkout.

DRK_315_Fidgets_Kit

Fidget toys can be a great and socially acceptable management tool for stereotypical or repetitive behavior in the classroom or community that may be distracting to classmates. While there are many reasons for fidgeting, including sensory overload, boredom, frustration, or anything in between, the good thing is that it can be easily managed. Some students find the repetitive action of “fidgeting” to be calming; thus, they are then better able to focus on the task at hand. Created in conjunction with our behavioral consultant Stacy Asay, LMSW, our Fidgets Kit includes an array of tools that provide a variety of sensory experiences: stretchy, chewy, spiky, twisty, bumpy, twisty, clicky, bouncy and smooshy!

DRP_575_Reinforcer_Kit

Our Reinforcer Kit provides a selection of products that many children diagnosed with autism would not only want to play with but would be willing to “work for” during their one-on-one intervention. Although teachers can always use praise, food, candy and other toys, we think this bright and colorful kit of tools will help our families get a head-start on what to use for children wanting a favored object. The kit includes:

Spectra Spinner (battery operated)

Wooden Slide Whistle

Magic Mic (an Echo Microphone)

Magic Spring

Squishy Flashing Ball

Jelly Ring

Bubbles and more!

 

*Promotion is valid for one-time use through September 20,  2016. Offer cannot be applied to previous purchases, combined with any other others, transferred, refunded, or redeemed and/or exchanged or cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code FOCUS20 at checkout.

Pick of the Week: The NEW ABA Program Companion — Take 20% Off!

New ABA Program Companion Cover.inddJ. Tyler Fovel, MA, BCBA’s essential manual for creating professional and effective ABA programs blends clear explanations of scientifically-based concepts and methodology, clinical examples and advice, and suggested implementation strategies. This revised edition presents information on:

  • qualities of an effective ABA program
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TAKE 20% OFF The NEW ABA Program Companion this week with our promo code NEWABA at check-out, and get a head start on designing an efficient ABA program for your students this year.

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Tip of the Week: Ideas for Interactive Play For Learning

Creating opportunities for interactions is key when working with any child, but it is especially important when working with children with autism. ABA often gets a bad rap for being staid or leaving a kid stuck at a table doing discrete trials for hours on end. In reality, it should be neither! While I do discrete trials in my practice, my biggest priority is always focused on increasing learning opportunities by taking advantage of the child’s natural motivations. This typically means leaving the table, so I alternate between discrete trials and lots of teaching through games and activities. Here are a few of my favorites:

Toss & Talk
For this activity, I usually use a large ball, a soft ring, or something else the child can toss. I name a category, and we take turns tossing the ball (or other item) and naming an item from that category. The game can be easily modified for whatever you’re working on: counting, skip counting, or even vocal imitation. I like the game because it’s simple, it provide a back-and-forth that is similar to a conversation, and it can easily be modified to include peers, siblings, or parents. This is particularly great if your learner likes throwing balls, but I’ve also modified it to push a train back and forth or take turns hopping towards one another.

Ideas for Interactive Play For LearningPlay Dough Snake
This game is one I saw a preschool teacher use years ago and have had great success with. In this game, I simply create a snake out of play dough. I make a large opening for the snake’s mouth, then roll up little balls of dough that will be “food.” I tell the child that we are going to pretend the play dough is food. I have a silly snake voice, and I tell the child “I’m so hungry. Do you have something I can eat?” The child picks up a piece of the rolled-up play dough, tells me what kind of food it is, and then feeds it to the snake. I pretend to love it, and the little ball of play dough becomes incorporated into the snake’s play dough body (which is great, because the more “food” the snake eats the bigger it gets.) I can expand the game to have the snake dislike certain foods or tell the child he is too full. On several occasions, the learner has asked if they can be the snake, which is fantastic! This is another great game for peer play, sibling play, and modeling.

Pete’s A Pizza/You’re A Pizza
One of my favorite books for young learners is Pete’s A Pizza by William Steig. In this book, it’s a rainy day and Pete’s parents entertain him by pretending they are making him into a pizza: they roll up the “dough,” toss him in the air, add toppings, etc.
This is another game I saw a preschool teacher using during play time, and one I’ve used with many, many students. Sometimes I read the book beforehand, but if my learner’s level of comprehension or attention span is not appropriate for the book, I can just introduce it as a standalone game. I say, “It’s time to make a pizza!” Then, we get into the fun part of rolling the learner around, tossing him on a couch or mat, etc. This can generate a lot of language, work on sequencing, and provide a lot of opportunity for requesting activities.

Ideas for Interactive Play For LearningAnything with a Parachute
My parachute is one of my best purchases of all time. I use it often and it allows me to play a wide range of games. Besides just having the learner lay on the floor and have the parachute float down onto his/her body, it is a highly motivating toy for a range of activities. Many of my learners love just pulling that large item out of it’s small bag. I’ve already written about three games I frequently play with the parachute. You can see that here.


Songs

Repeating rhymes and songs with motions that your learner loves can provide anticipation of an activity that may increase eye contact and manding. One of my favorites is shown in a video here. While this video is shown with toddlers, I’ve used it with kids up to 6 or 7 years old. Similar activities might include Going on a Bear Hunt; Heads, Shoulders, Knees, and Toes; and Animal Action.

It’s important to note that none of these activities is beloved by every learner I encounter. The idea is to have a range of possible activities to learn which ones are motivating to your learner, then use those to create opportunities for language and interaction.

WRITTEN BY SAM BLANCO, MSED, BCBA

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

Pick of the Week: 15% Off Handwriting Tools

Get a head start on helping your child improve their handwriting skills before the school year begins! This week, take 15% off our handwriting programs and tools with promo code WRITE15 at checkout!

Jumbo triangular pencils are just right for the student who is making the transition from using grips to regular pencils. These pencils are fatter and have a soft dot comfort zone for a non-slip grip. The box comes with 12 pencils, all in black lead.

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We’ve compiled the Writing & Art Kit to support students in their writing and arts & crafts skills. This kit contains: a pair of child-safe scissors, lined paper for upper- and lowercase writing, and a jumbo grip triangular pencil that improves a child’s grip directly on the pencil.

For the arts, we’ve included triangular crayons, triangular glue sticks, both for a better grip, and glossy colored paper for bright, shining artwork.

Sensible Pencil, by Linda C. Becht, is a handwriting program that contains 200 sequential worksheets to help new writers achieve success quickly and pain-free. Children start with simple horizontal and vertical lines that are presented as fun, and then go on to the other basic lines needed for handwriting skills. The program also includes a progress chart and a manual for teachers and parents. Notebook format.

 

 

View our entire sale here.

*Code is valid for one-time use through August 16, 2016 at 11:59pm. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code WRITE15 at checkout.

Pick of the Week: Oops Groups Categories — and more!

Can you find the “oops” to help complete the Oops Groups Express Train? Our new Oops Groups Categories is a unique puzzle game where players use concentration and memory to find same-color Oops Groups Express puzzle pieces. To win, players must sequentially build the train and identify the one item on each puzzle piece that does not belong with the other items. Categories include food, animals, tools, season, and colors.

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Promotion is valid until August 2, 2016 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code OOPS15 at checkout.