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.

Medication Considerations

What do you do when your doctor recommends medication? In this month’s ASAT feature, Megan Atthowe, RN, MSN, BCBA, offers insight on a variety of approaches parents can take when medication is recommended for children exhibiting aggressive behaviors. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!


My son with autism has developed aggressive behavior, and his doctor is considering whether medication could help. What can I do to prepare for this conversation?
Answered by Megan Atthowe, RN, MSN, BCBA

doctor-563428_960_720First, you should know that there is no medication that specifically treats autism. Medications approved by the United States Food and Drug Administration (FDA) for other conditions can be useful only to lessen symptoms. That said, off-label use of pharmaceuticals is by no means unique to autism and is common practice for many health conditions. So while research on the use of particular psychotropic medications in the autistic population is growing, our body of knowledge is still limited. In addition, medications can and do affect every individual differently, and children can respond differently as they develop, so it is likely to take time to find the best medication at the appropriate dose. Medication management, in other words, is a complex and an ongoing process and one that is highly individualized. It is a good idea, then, to be prepared with the right information before every visit to your health care provider.

Do you know how often the aggression actually occurs? Bringing data like this to the visit can be very helpful. You may want to ask your son’s teachers to share any information they have about the aggression with your health care provider, too. (They would need your consent to talk with him/her or to share any confidential information such as behavior data.) If you have not been keeping track of the aggression, now is a good time to start, even if there are only a few days until your visit. An easy way to do this is to use a calendar. Record specifics about when the aggression happens, what the behavior is like, how long it lasts, and whether you have noticed any recent changes. It is difficult for anyone to recall these details accurately, especially if the behaviors happen frequently, so writing them down will help you to share the most meaningful information you can with your health care provider. If your son’s school team is not already collecting data, perhaps they should start as well.

In addition to information about the current levels of the behavior, be prepared to describe how the school and your family are addressing the behavior and how long that plan has been in place. Has your son’s team considered or tried Applied Behavior Analysis (ABA) to treat the behavior? Research supports ABA as an effective intervention for decreasing problem behaviors such as aggression as well as for teaching children with autism new skills. It is important to be sure that a qualified behavior analyst is supervising any ABA interventions, as they must be implemented correctly to be effective. Your health care provider may be able to refer you to a local ABA provider, or you can find a list of board certified behavior analysts at the Behavior Analysis Certification Board’s website.

Before your visit, prepare a list of the names and doses of any medications your son takes, as well as any over-the-counter medications, vitamins, or other supplements. If your son receives other therapies, share what they are with your health care provider. He or she will want to ensure that any new medication is safe to take and will not interact with other medications.

If you and your health care provider decide to start your son on a medication, decide what the goal is. How will you know when the medication has been effective? How will you know if it is ineffective? Be specific and write the goal down. Schedule a date when you will check in with your health care provider on your son’s progress. He or she may have specific suggestions about what type of data to keep.
Finally, there are some important questions that you should have the answers to before you leave. Make sure that you ask any questions you have—a responsible health care provider will want to know that you understand how to use the new medication correctly. If you think of questions later, do not hesitate to call and ask your physician, nurse, or pharmacist.

Key Questions:

  • What is the name of the medication?
  • What is the medication used for?
  • When and how should I give it to my son, and how much do I give?
  • Should I give this medication with food?
  • What effects should I expect to see?
  • What are common side effects?
  • How long will it be until I notice the desired effects and side effects
  • What side effects are serious, and what should I do if I notice them?
  • Will side effects lessen over time?
  • Is there anything I should avoid giving my son while he is on this medication?
  • If I decide that I would like to stop giving him the medication, what should I do?
  • What should I do if I miss a dose?

Please note that there is information about research related to medications elsewhere on the ASAT website.

ABOUT THE AUTHOR

Megan Atthowe, MSN, RN, BCBA, LBA, is a registered nurse and behavior analyst who has worked with people with autism and other special needs in educational, home, and healthcare settings for over 15 years. Currently she consults to educational teams who serve students with autism in public schools.

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.

 

 

Thinking Ahead: Self-Determination in the Elementary Years

Though I typically work with elementary-aged children, I’m consistently thinking about what skills the child needs in order to be independent and ready to transition out of the school setting as an adult.  Sometimes, it may seem that it is too early to be thinking about adulthood when the child is only 8 or 9, but there are things we can, and should, be doing to prepare our students from an early age.

One of my favorite articles addressing this issue is a 2015 article from Teaching Exceptional Children by Papay, Unger, Williams-Diehm, and Mitchell.  (The entire issue is about transition and is a fantastic read. You can view that issue here: http://journals.sagepub.com/toc/tcxa/47/6.) While the Individuals with Disabilities Education Act requires transition planning to begin at age 16, and some states require it to begin at age 14, if we want to provide more successful outcomes for individuals with special needs, we must begin thinking about the transition into adulthood at a younger age.

Papay et al., suggest focusing on self-determination. “Individuals who are self-determined have better knowledge of their own interests, strengths, and needs, and they carry out their own desires. Self-determined individuals make decisions, set goals, and carry out the necessary steps to ensure their goals are accomplished” (Papay, et al., p. 311, 2016). The authors then go on to suggest activities for incorporating self-determination at the elementary level, such as understanding grades, using responsibility charts, making choices, and problem solving. In the push to get students up to speed with academic skills, we may be leaving out these core skills that provide success in adulthood. And these skills, such as goal-setting and problem-solving are skills that typically developing children need years of practice to develop.

            So, how do you get started? Here are a few suggestions:

  • First, read the full article here: http://journals.sagepub.com/doi/pdf/10.1177/0040059915587901
  • Call a meeting of the adults in the child’s life and the child to talk about appropriate goals around these specific skill sets.
  • Write down the ways in which you can incorporate self-determination activities in your student’s daily life.
  • Identify short-term outcomes you would like to see in relation to the activities you’ve identified.
  • Share with your colleagues and other students what you are doing in relation to self-determination to help normalize this conversation on the elementary level.

In recent decades, we have come a long way in providing services for youth with special needs. At this point in time, it is becoming more and more clear that we need to be doing more for adults with special needs, but we can’t wait until the individual is well into their teenage years to begin thinking about it.

Papay, C., Unger, D. D., Williams-Diehm, K., & Mitchell, V. (2015). Begin With the End in Mind Infusing Transition Planning and Instruction Into Elementary Classrooms. Teaching Exceptional Children, 47(6), 310-318.

Autism and the Peer Review Process

Autism peer review process

If one wanted to market a scientifically-unproven intervention, device, or pill as a valid autism treatment to families affected by autism, how would one go about it? Glossy pictures? Glowing testimonials? Miracle claims? Hyped social media pitches? Charming infomercials? Answer: All of the above.

And, here’s another marketing strategy: portraying one’s product as having scientific validation when, in fact, such validation does not exist. To do this, one might make references to “scientific evidence” in material that, upon systematic inspection, is less than convincing.

I was reminded of this when I recently reviewed a web page that boldly claims, “SCIENTIFIC RESEARCH Verifies The Son-Rise Program® WORKS!” Findings support the efficacy of parent-delivered SRP intervention for promoting social-communicative behavior in children with autism spectrum disorders.”

What are these findings? On the website, the Son-Rise marketers provide a link to a key source of their “verification” – a paper entitled “Training Parents to Promote Communication and Social Behavior in Children with Autism: The Son-Rise Program”. This paper, written by a trio of Northwestern University researchers, presents a study of the purported benefits of intervention delivered by 35 parents of children with autism who participated in a five-day parent-training course on Son-Rise Program methods, as well as an advanced follow-up course 3-12 months later. Parents completed The Autism Treatment Evaluation Checklist (ATEC), a rating scale that contains items on communication, sociability, cognition, physical status and behavior.

The authors divided the 35 parents into three groups based on how many hours of intervention the parents reported giving their child each week during the interval between their first and second Son-Rise trainings (i.e., no intervention [11 parents], 1–19 hours [13 parents], 20 or more hours [11 parents]). The authors present results reflecting statistically significant higher ATEC scores at second ATEC completion relative to the first, and they suggest that these higher scores reflect real improvements in communication, social skills, and sensory and cognitive awareness. They go on to point out that children with greater gains were more likely to have had more hours of parent-administered SRP.

As linked on the Son Rise web-site, this study is typeset like a published research article, prompting me to try to determine which peer-reviewed journal had published it. Through email correspondence, the third author, Cynthia K. Thompson, reported that the study had not been published because the team had decided to collect additional data prior to submission for peer review. In other words, this study is a “work in progress” and certainly not a verification of treatment effectiveness. In fact, this practice of repeatedly analyzing results prior to the close of data collection is, in itself, problematic from a scientific standpoint, as the process involves conducting many analyses that often yield varying results but are never reported (see Simmons, Nelson, & Simonsohn, 2011).

One of the mechanisms that make science such a powerful engine for progress is the reliance on the peer review process. The scientific method requires that, when a scientist makes an assertion (e.g., “This treatment works!”), (s)he knows that there exists a responsibility to show other scientists how they arrived at their conclusions with enough specificity that others can replicate the study. It is through this process of peer review that faulty assertions about the data are challenged and, hopefully, rejected in short order.

Typically, in the peer review process, an editor reviews a manuscript and, if deemed appropriate, shares the manuscript with a team of reviewers with demonstrated expertise in the relevant subject area. In many cases, these reviewers are “blind” to the identity of the authors and vice-versa, so as to minimize personal biases (e.g., affiliations, personal grudges). The reviewers are charged with the task of evaluating the contents of the manuscript on the basis of scientific merit, including the methodology, statistical analyses of the data and logic of the authors’ conclusions. The reviewers then describe, in writing, their opinions regarding the strengths and weaknesses of the study and make a recommendation regarding publication. The editor synthesizes this feedback and provides a summary to the author(s). In many cases, the editor will reject the manuscript for publication altogether. In other cases, he or she may require revisions, acknowledge limitations, temper conclusions or make other substantive changes prior to publication.

In the case of the manuscript written by Thompson and her colleagues, I suspect that, if it were submitted to a journal with a legitimate peer review process, a multitude of questions would be raised about it, including:

  • participant recruitment (35 self-selected parents out of a pool of 430 parents, many of whom participated in the first training but apparently did not return for more)
  • group distribution (non-random group assignment)
  • the outcome measure (one brief checklist completed by parents)
  • treatment fidelity (no way of verifying the quality or quantity of actual treatment), and
  • control for placebo effect, expectancy bias or any number of potential threats to the validity of responses.

And, despite some effort on the part of the authors to control for this, there is no real way of knowing what other interventions the child was engaged in during the interval between their parents’ first and second Son Rise training.

Of course, scientists who make up peer review committees are vulnerable to the same kinds of human frailties as the rest of humanity (i.e., jealousy, ego, bias, profit motive); however, the communal nature of the process, as well as another scientific safeguard- replication of results by others- helps to minimize the degree to which these frailties impact decisions regarding the quality of a study and our confidence in the results. The scientific method is far from perfect, but it is probably the best game in town for vetting new interventions.

Parents and other consumers of product pitches can watch for treatment claims that look like they have been established through the scientific process but in actuality fall short. Discuss potential treatment options with licensed and/or board certified experts whom you trust. Practice skepticism, especially when fantastical claims are made. Use resources, such as ASAT’s Treatment Summaries for quick reference. Families affected by autism deserve honest, direct communication about the state of the science for treatment options. Accept nothing less.

References

Simmons, J. P., Nelson, L. D., & Simonsohn, U. (2011). False positive psychology: Undisclosed flexibility in data collection and analysis allows presenting anything as significant. Psychological Science, 22, 1359–1366.

Cite This:

Mruzek, D. W. (2012). Focus on science: “Verification” and the peer review process. Science in Autism Treatment, 9(3), 18-19.

About The Author

Daniel W. Mruzek, Ph.D., BCBA-D is an Associate Professor at the University of Rochester Medical Center (URMC), Division of Neurodevelopmental and Behavioral Pediatrics in western New York. He received his doctoral training in Psychology at the Ohio State University and is a former Program Director at the Groden Center in Providence, Rhode Island. Currently, he is an associate professor and serves as a clinician and consultant, training school teams and supporting families of children with autism and other developmental disabilities.

Mruzek coordinates his division’s psychology postdoctoral fellowship program in developmental disabilities and is an adjunct faculty member in the University of Rochester Warner School of Education. He is actively involved as a researcher on several externally funded autism intervention research studies and has authored and co-authored more than 20 peer-reviewed articles and book chapters on autism and other developmental disabilities. Dr. Mruzek is on the editorial board for the journals Focus on Autism and Other Developmental Disabilities, Behavior Analysis in Practice, Journal of Mental Health Research in Developmental Disabilities, and Intellectual and Developmental Disabilities. Dr. Mruzek is a former member of the Board of Directors of the Association for Science in Autism Treatment.

To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

Who’s Most Qualified To Work With Your Child.txt

Parents of children with autism are faced with a wide range of choices when it comes to the education and support of their children. The most important question of all is who’s most qualified to work with your child? Although a great deal of research supports Applied Behavior Analysis (ABA) as the only effective treatment for autism, there are still many other interventions that are touted as potentially helpful. Research shows that combining ABA with other interventions is less effective than implementing it alone, with high fidelity and intensity (Howard, 2005).

Who's Most Qualified To Work With Your Child? Not all behavioral professionals are created equal. There is little control over the use of terms like “behavior specialist,” “behavior therapist,” and “behaviorist.” Just about anyone can claim to be one of these, often on the basis of very limited training and virtually no on-going supervision.  Consumers are often not aware that these are uncontrolled titles, and may put their trust in untrained, unsupervised practitioners. 

The problem of lack of quality control in behavior analysis was addressed by the development of state certifications for behavior analysts, and eventually the Behavior Analyst Certification Board (BACB) was formed. 

BACB credentials allow consumers some degree of confidence in the education, training, and supervision of the professionals they entrust their children to.  If someone claims to have one of these credentials, consumers should be able to find them on the BACB registries, easily accessed online at www.bacb.com

What does the BACB mean for consumers?  Those seeking behavioral interventions for themselves or others can look for professionals who have met the standards of the Behavior Analyst Certification Board with the confidence that that they have a minimum level of education, experience, and supervision and that they are obligated to follow an ethical and professional code.  Whether looking for a school program, privately hiring a professional, or seeking insurance coverage of services, the BACB designations can help consumers to determine if professionals and staff members providing services are well-qualified. They are also not at all easy to accomplish, so it is safe to say that someone with one of these credentials has achieved a high level of understanding of the science of behavior and the practice of behavior analysis.

Some states now license and certify behavioral professionals, and the standards for state licensure and/or certification may be more or less than those required by the BACB.  Having a BACB credential in addition to state licensure ensures that the professional also meets the BACB’s high standards. 

Credential Minimum education requirement Type of work Supervision
Registered Behavior Technician (RBT) High school diploma or equivalent Direct implementation of behavioral interventions (paraprofessionals) Ongoing by a BCaBA, BCBA, or BCBA-D
BCaBA Bachelor’s degree Practice under supervision, supervise RBTs Ongoing by a BCBA or BCBA-D
BCBA Master’s degree Independent practice, supervision of BCaBAs and RBTs None
BCBA-D Doctoral degree Independent practice, supervision of BCaBAs and RBTs None

 

Guest post written by Dana Reinecke, PhD, BCBA-D.

 

References

www.bacb.com, retrieved January 28, 2017

Howard, J. S., Sparkman, C. R., Cohen, H. G., Green, G., & Stanislaw, H.  (2005).  A comparison of intensive behavior analytic and eclectic treatments for young children with autism.  Research in Developmental Disabilities, 26, 359-383.

National Autism Center.  (2015). Findings and conclusions: National standards project, phase 2. Randolph, MA: Author.

Overcoming 3 Barriers To Earning Your BCBA

Working toward a BCBA or BCaBA is hard work – attending classes, getting experience hours and, working, often full time, and for many, doing all this while raising a family. The good news is that all of this hard work will someday pay off. After all, the ultimate goal of this is to be qualified to provide help to individuals who desperately need it. Working in the field as a BCBA is a noble cause and many families will be grateful for your support.

But along this path there are many details to manage, details which can easily slow, or derail your path, if not properly managed. You know the details I’m referring to – direct supervision hours, indirect supervision hours, correct ratios of experience to supervision, weekly forms to be signed, tracking hours for each of these and sorting through the multiple supervisors who have provided fractions of the needed hours to you this month. This can get confusing and quickly create barriers – but it doesn’t have to.

Overcoming 3 Barriers To Earning Your BCBA

Learn more about overcoming 3 big barriers to earning your BCBA, and read along for our tips on how to maneuver past them.

Barrier #1 – Lack of a plan.

It is easy to get carried away with the busyness of your life and forget to take some time to create a plan for meeting your requirements. 2 years often gets tossed around as the time it takes to earn your BCBA. This is a fine time frame to aim for, but without a concrete 2-year plan, it is easy for life to get in the way, and fall short on that goal.

Taking an hour to plan your course of action now can save you months later. Identify some concrete, measurable goals and create a plan. The BACB website has the information you need to get started. Find the requirements – course sequence, experience hours, supervision hours, etc., and create your goals based on those. For example, if you are doing supervised independent fieldwork to reach your experience hours, you will need to accumulate 1,500 total hours to qualify for the exam. This can now be your basis for your experience plan.

Once you have figured out how many experience hours you need, grab that 2 year time frame and calculate how many hours per week you need to acquire in order to reach your goal in time. If we use our 1,500 number, and you are able to work 50 weeks a year, that comes out to 15 hours per week. This weekly goal of 15 experience hours is much more manageable and accomplishable than a goal of 1,500 in 2 years. With this weekly goal too you can begin to plan how you will get your 15 hours per week.

Barrier #2 – No control over experience and supervision.

This is a barrier that is a little bit harder to overcome, depending on how you are acquiring your hours. If you have set your weekly goal at 15 hours of experience per week, but you don’t currently receive 15 hours of work per week, then something needs to change. Either lower your hours to a number you do currently receive on the regular, and adjust your timeframe accordingly, or talk to your practicum site to see if you can arrange for more hours.

Be cautious about tightly planning around the number of hours you are promised to work each week, especially if you don’t already work this much. It is more difficult to provide those hours than some practicum sites would like to admit. One strategy is to request 10% to 20% more hours than you need, to account for cancellations. After you agree on a weekly goal of experience hours with your practicum site, add that number along with the corresponding supervision hours required into your supervision contract. While you have responsibilities as a supervisee, your supervisor also has responsibilities to provide you with the training you need. Both of these contingencies should be in writing in your signed contract.

Barrier #3 – Disorganization.

Now that you have overcome the first 2 barriers to earning your BCBA it is time to actually accumulate those hours. This is where the responsibility truly falls on your shoulders. Make sure you stay organized from the start.

A great way to keep yourself organized is to write down your your goals for experience and supervision and track your progress each week. You can track this information in any form that is easy for you. Some people use Excel, others use Google Calendar, but I like to use my Self Management Planner for things like this, because it incorporates an appointment book with a place to write weekly goals and track progress toward that goal every day of the week. Whatever you use, make sure your tracking system is easy to use and portable. Write down your progress every day, and include the number of experience hours and the number of supervision hours you logged.

Write down your supervisor name next to your hours too. This way you won’t forget who provided supervision and when. The experience forms you need to fill out from the BACB have a section to write in your experience hours for the supervision period along with the supervision you acquired during that period. But if you wait to write down your supervision when you are filling out these forms every week or two, it will be very difficult to remember all the hours you got. This is especially hard when your experience is broken up over 5 different clients at 6 different locations and 2 different supervisors. Logging this daily in your planner, or whatever system you use will help immensely. Staying up to date with this will pay off 2 years from now when you are filling out your forms to take your exam.

Earning your BCBA is hard enough, with the challenging courses, rigorous exam, and complex nature of learning about behavior analysis. But planning for and tracking experience hours does not have to add to these difficulties. By removing these three barriers, you will remove a big stressor, and get yourself one step closer to successfully earning your BCBA in the time you want.

Daniel Sundberg is the founder of Self Management Solutions, an organization that operates on the idea of helping people better manage their time. Towards this end, he created the Self Management Planner, which is based on an earlier edition created by Mark Sundberg in the 1970s. Daniel received his PhD from Western Michigan University and currently consults with organizations on performance improvement.

Lisa Sickman supports Self Management Solutions with ongoing content and product development. She received her Masters degree in behavior analysis from Western Michigan University, and then worked for several years as a BCBA at an autism center. Lisa currently teaches future BCBAs and BCaBAs as a co-instructor for ABA Technologies.

Ecological Assessment For Successful School Inclusion Settings

School learning communities are dynamic and complex, and meeting the challenge requires a detailed understanding of how such communities work, a task that is ideally suited to Ecological Assessment. Ecological Assessment for successful school inclusion settings can be a vital part of the structure of maintaining scientifically-grounded, evidence-based practices in schools. Like functional assessment, Ecological Assessment uses the tools of Applied Behavior Analysis – behavioral definitions, direct observation and data collection, task analysis, simple statistical analysis, structured interviews – and applies them to the ecosystem of the classroom and other settings in schools.

ecological assessment for successful school inclusion settings

In 2007, Cooper, Heron, & Heward wrote: “An ecological approach to assessment recognizes the complex interrelationships between environment and behavior. In an ecological assessment a great deal of information is gathered about the person and the various environments in which that person lives and works. Among the many factors that can affect a person’s behavior are physiological conditions, physical aspects of the environment (e.g., lighting, seating arrangements, noise level), interactions with others, home environment, and past reinforcement history. Each of these factors represents a potential area for assessment.” (p. 55)

Ecological Assessment has been discussed in behavior analysis for at least the past 45 years. Wallace and Larson (1978) described Ecological Assessment as referring to the analysis of an individual’s learning environment and his/her interactions within and across these settings. In stressing the importance of ecological assessment, Hardin (1978) said that “appropriate and effective intervention cannot occur without an adequate understanding of the child and his or her environment.” Heron and Heward (1988) pointed out that sometimes students’ situations warrant comprehensive study, saying, “…some students’ learning/behavior difficulties are subtle and complex and, thus, necessitate a more global assessment to ensure the most appropriate instructional approach.”  They suggested that Ecological Assessment should be based on various sources of information such as student records, interviews, formal and informal tests, and direct observation, and include an examination of specific influences within a setting such as:

  • Spatial Density
  • Seating Arrangement
  • Noise
  • Student-Student Interaction
  • Classroom Lighting
  • Teacher-Student Interaction
  • Home Environment
  • Reinforcement History

According to Carroll (1974) a model of Ecological Assessment consists of six steps:

  1. “Delineation of the assessment goals (i.e., identify the data to be collected and how they will be used)
  2. Formation of a conceptual framework within which to assess the learner and the environment (i.e., identify the relative importance of learner and environmental factors)
  3. Implementation of the assessment plan (i.e., conduct direct observations, inspect work samples or products)
  4. Evaluation of assessment results
  5. Development of a set of hypotheses (i.e., relationships between student behavior and identified learner characteristics and environmental factors)
  6. Development of a learning plan (i.e., an intervention strategy designed to match learner characteristics with appropriate environmental settings).”

Like functional assessment, Ecological Assessment is part of an analysis involving students and the environment. While functional assessment identifies specific behaviors (usually problem behaviors) exhibited by a student as the target of the assessment, Ecological Assessments have both a setting focus and a student focus. Ecological Assessments study the nature of all behaviors required to be reinforced in a particular setting and the specific circumstances under which those behaviors must occur. It then compares these requirements to the abilities and experiences of the student. The central question in an Ecological Assessment is, “What does the student need to do to succeed?”


Why Conduct an Ecological Assessment?

There are many reasons to conduct an Ecological Assessment:

  • With students making transitions between programs, Ecological Assessments can supplement the typical discussions between sending and receiving teams, providing formal observations, data-taking, setting inventories, and structured interviews that allow for a smoother transition
  • For students who are less-than-engaged in class and exhibit off-task behavior, Ecological Assessments help teachers identify and eliminate the barriers to on-task behavior and, as efforts are made to resolve issues, provide both a baseline and a convenient on-going monitoring vehicle for both the student’s behavior and any continued existence of the barriers
  • When evaluating student readiness, Ecological Assessments identify the key skills actually reinforced in target environments, so that specific, concrete, realistic preparations can be implemented


The Future of Ecological Assessment

Educational teams in schools tackle problems encountered in inclusion settings every day, both from the assessment side and the student preparation side. While Ecological Assessment has been frequently discussed as a valuable tool and would seem to be ideal for gaining a detailed understanding of environmental barriers and challenges in classrooms and other inclusion settings, there is little established structure to guide clinical implementation.

At this point, one Ecological Assessment is very likely to look completely different from another. Like functional assessment, Ecological Assessment in the future must take on recognized and validated structure that is data-based, reliable, and highly descriptive of setting characteristics and related student abilities. Insights into how to provide meaningful student inclusion experiences depend on well-developed tools that synthesize and easily communicate information about complex challenges.

Well-structured Ecological Assessments will provide a vital means of approaching inclusion that, in addition to providing a detailed analysis, will create a structure that can extend well beyond the initial decision-making phase of programming, and, without a doubt, promises to contribute enormously to student program development.

 


For more on Ecological Assessment, check out our newest product by Fovel, the SEAT!

seat

This innovative new protocol and manual provides essential structure to facilitate ecological assessment of inclusion settings that is systematic with ABA principles and straightforward to implement. This assessment tool is a must for practitioners and educational teams at all levels and grades, who need to design, and evaluate student inclusion experiences using evidence-based methodologies.

This week only, get the SEAT for 15% off with promo code SEATNEW.

 

WRITTEN BY J. TYLER FOVEL, M.A., BCBA

Tyler Fovel has worked in the field of Applied Behavior Analysis for over 40 years, with all ages of students and with dozens of educational teams. He has published manuals on educating students with autism and related developmental disabilities: The ABA Program Companion and The New ABA Program Companion (DRL Books). He lives in Massachusetts with his wife, Jan, and their golden retriever, Lucy. 

 

Preventing Bullying of Students with ASD

Did you know that October is National Bullying Prevention Month? In an effort to raise awareness around issues of bullying for students with autism, we’re honored to feature this article on preventing bullying of students with ASD by Lori Ernsperger, PhD, BCBA-D, Executive Director of Behavioral Training Resource Center, on some tips and information for parents on protecting their children from disability-based harassment in school. 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!


We have a nine-year old daughter with ASD who started 3rd grade in a new school. She is coming home every day very upset due to other students calling her names and isolating her from social activities. We wanted her to attend the neighborhood school but how can we protect her from bullying?

Answered by Lori Ernsperger, PhD, BCBA-D

Unfortunately, bullying and disability-based harassment is a common issue for individuals with ASD. As parents, you have a right to insure that the school provides a multitiered framework of protections for your daughter to receive a free appropriate public education (FAPE) in the least restrictive environment and free from disability-based harassment. Start with educating yourself on the current legal requirements and best practices for preventing bullying in schools.

Preventing Bullying of Students with ASD

Recognize
Recognizing the startling prevalence rates of bullying for students with ASD is the first step in developing a comprehensive bullying and disability-based harassment program for your daughter. According to the Interactive Autism Network (IAN, 2012), 63% of students with ASD were bullied in schools. An additional report from the Massachusetts Advocates for Children (Ability Path, 2011) surveyed 400 parents of children with ASD and found that nearly 88% reported their child had been bullied in school. According to Dr. Kowalski, a professor at Clemson University, “because of difficulty with social interactions and the inability to read social cues, children with ASD have higher rates of peer rejection and higher frequencies of verbal and physical attacks” (Ability Path, 2011).

In addition to recognizing the prevalence of bullying of students with ASD in schools, parents must also recognize the complexities and various forms of bullying. Bullying of students with ASD not only includes direct contact or physical assault but as with your daughter’s experience, it can take milder, more indirect forms such as repeated mild teasing, subtle insults, social exclusion, and the spreading of rumors about other students. All adults must recognize that laughter at another person’s expense is a form of bullying and should be immediately addressed.

Finally, recognizing the legal safeguards that protect your daughter is critical in preventing bullying. Bullying and/or disability-based harassment may result in the violation of federal laws including:

  1. Section 504 of the Rehabilitation Act of 1973 (PL 93-112)
  2. Title II of the Americans with Disabilities Act of 2008 (PL 110-325)
  3. The Individuals with Disabilities Education Improvement Act (IDEA) of 2004 (PL 108-446)

The Office of Civil Rights (OCR), along with the Office of Special Education and Rehabilitative Services (OSERS), have written guidance letters to all schools to clarify that educational institutions are held legally accountable to provide an educational environment that ensures equal educational opportunities for all students, free of a hostile environment. Any parent can access and print these Dear Colleague Letters and distribute them to school personnel working with their child.

  • US Department of Education/Office of Civil Rights (October 2014)
  • US Department of Education/Office of Special Education and Rehabilitative Services (August 2013)
  • US Department of Education/Office of Civil Rights (October 2010)
  • US Department of Education (July 2000)

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