Curriculum Guides For Older Learners

This month’s ASAT feature comes to us from Dr. Kirsten Wirth, C.Psych., BCBA-D. 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 child is older now and the early years curriculum guides we have used (e.g., the Assessment of Basic Language and Learning Skills-Revised (ABLLS-R) and Verbal Behavior Milestones and Placement Program (VB-MAPP)) are no longer appropriate. How should we plan for his future and current goals?

Answered by

Kirsten Wirth, C.Psych., BCBA-D

Wirth Behavioural Health Services

There may be some good curricula that can be used at an older age (e.g., Partington’s Assessment of Functional Living Skills (AFLS)).  Curricula like the AFLS include measuring basic living skills, vocational skills, home skills, community participation, and independent living skills.  That said, there are several reports that highlight areas to consider in programming for any individual.  Peter Gerhardt (2009) developed a paper that covers what services are available for adults with autism spectrum disorder (ASD) and considerations that should be made. The Drexel Autism Institute put out a report discussing transitions into adulthood (Roux, Shattuck, Rast, Rava, & Anderson, 2015). This question will be answered using information from both reports as well as clinical experience working with children and adults with ASD over the past 18 years.

Both reports highlight the importance of starting early.  For example, on average, transition planning and working towards future goals should begin by 14 years of age, although in some states this may happen earlier.  In many high schools and programs this type of planning happens much later, but the reason 14 years is recommended is because it can take several years to teach job or recreational skills, as well as any skills that need to be taught well before the ultimate desired outcome.  Also, more time allows for assessing and incorporating changing and developing interests over time. It is ideal that all these skills are incorporated into the students’ school program.  Skill areas may include planning for a vocation, post-secondary education, recreation and leisure, community safety, transportation, vacationing, health and wellness, sexuality instruction, handling crisis and interacting with first responders, daily living, and communication.

Where to start? Start by thinking and talking with the individual, family, and staff involved that know the individual best. Think about each area and explore what the individual might be interested in 5-10 years down the road as a team. Once all the ideas are jotted down, start discussing what should be chosen to target or to explore further. Keeping in mind you should weed out things that are not realistic but keep things that may be a stretch.  How do you know if it is realistic or not?  Having a detailed and current assessment of the individual’s abilities and skills is helpful.  For example, if an individual has intellectual and adaptive scores at or near the average range, a traditional college education may make sense and they may not need goals set in post-secondary education.  However, making friends and enjoying leisure and recreation may be an area of weakness so goals should be set in those areas.  As another example, if an individual has very low intellectual and adaptive scores, a college education may not make sense, but a part time job and skills around that job may need to be learned. Most importantly, goals should be set incorporating the individual’s existing skills, preferences, and interests.

Vocational goals: Is the individual able or interested in part-time or full-time work?  If he is still in school, can he work part-time?  What kind of work can he do independently right now?  What kind of work is he realistically capable of gaining skills in during the next 5-10 years?  Sometimes exploring different types of work through volunteer experience can be set up either with a one-on-one support person, or just on his own.  If skills need to be taught, how much should they be broken down for the individual to perform all skills independently?  Can all skills be taught at the same time or one at a time?  For example, if he is going to do custodial work at a local small hotel, this might include vacuuming the hallways; sorting, putting laundry through the washers, and folding; sweeping up the breakfast area; and making small talk or hanging out during breaks.  Each skill may need to be taught explicitly or not, dependent on the individual. Sorting laundry may include teaching matching skills and sorting skills before applying to daily life; or, many of these tasks could be taught by practicing in the school or leisure program on a regular basis.  Making small talk or engaging in conversation during break may require setting goals in social skills and communication areas as well. Taking direction from supervisors or others in authority and learning how to ask appropriate questions might be another area of consideration.  How will the individual get to work? Is he able to learn to drive a car to get himself there? Should a bus route and taking the bus be taught?  Driving or even using transportation might have multiple steps to learn, especially if there are construction detours, or changes to timing that would have to be checked regularly.  Do the vocational goals require further education?  Do money concepts have to be taught? Counting out change? Entering an order into a computer system?

Post-secondary Education goals: Does the individual have any special skills or strengths that should be considered?  Is the individual interested in a trade?  Business?  Graduate school?  If the individual could realistically perform a job in their area of interest down the road, do goals need to be set for pre-requisite subjects at the high school level – even if it may take longer to meet them – such that entry requirements can be met?

Recreation & Leisure goals: What kinds of interests does the individual already have during downtime?  Are interests limited?  Developing new preferences might be required. This might include providing repeated exposure to new places or activities to see if the individual enjoys them, or providing additional reinforcement for participating in them.  Do any barriers exist to participating in the new experiences?  Does any desensitization (e.g., exposure to certain sounds or experiences in the environment while preventing problem behaviour) have to occur before going on outings?  Are there refusals or problem behaviours to be decreased?  If so, goals should be set in those areas as well.  Does he or she need help with setting goals to earn a specific amount of money to go on a desired vacation or attend an event?  Does the individual have a regular group of friends to attend events or hang out with?  Do friendships need to be established?  Are social and communication skills related to making friends required to be learned first or during?  Should the individual get a ride with friends?  Take the bus?  Drive and offer to pick up friends?  Establish a meeting place at the event with friends?

As you may have noticed, many of the areas described above overlap with social and communication areas, transportation, and others. Goals naturally should be set in each area to appropriately encompass all skills needed in one’s day-to-day life. Remember the other areas as well; i.e., health and wellness (e.g., exercise, healthy eating, good hygiene), sexuality instruction (e.g., how to have sex, when to have sex, protection from disease and pregnancy), daily living skills (e.g., laundry, cooking, shopping), and so on. Happy planning!

References

 

Gerhardt, P.F. (2009). The current state of services for adults with autism. Arlington, VA: Organization for Autism Research.

Roux, A.M., Shattuck, P.T., Rast, J.E., Rava, J.A., & Anderson, K.A. (2015). National Autism Indicator Report: Transition into young adulthood, Philadelphia, PA: Life Course Outcomes Research Program, A.J. Drexel Autism Institute, Drexel University.


About The Author 

Dr. Kirsten Wirth (C.Pysch., BCBA-D) is a licensed psychologist and board certified behavior analyst-doctoral with a PhD in Psychology – Applied Behaviour Analysis (ABA) from the University of Manitoba. She is an Advisory Committee Member, Founder, and a Past President of the Manitoba Association for Behaviour Analysis (www.maba.ca). Dr. Wirth is the Co-Coordinator of Clinical Corner for the international organization, the Association for Science in Autism Treatment (www.asatonline.org). She is also the author of “How to get your child to go to sleep and stay asleep: A practical guide for parents to sleep train young children.” Dr. Wirth has 18 years experience working with children, adolescents, and adults, with or without developmental disabilities and autism using, teaching, and training others to use ABA. She provides screening and diagnostic assessment for children with autism, early intensive behavioural intervention (EIBI/ABA) programming to children with autism and their parents, or intensive behavioural intervention (IBI) for older children or adults with autism or developmental disabilities. Dr. Wirth also conducts assessment and treatment of severe problem behaviour, child behaviour management, parent coaching, sleep assessment and coaching, toilet training, social skills training, skill building, school or daycare consultation, and more, for children with or without psychiatric diagnoses. Dr. Wirth has been an invited speaker and presenter at local and international conferences and is a co-investigator of a number of research projects including comparison of comprehensive early intervention programs for children with autism and comparison of prevalence rates and factors related to delayed diagnosis.

Preparing For The Holidays

While the holidays can be a very fun and exciting time, they often tend to disrupt regular routines. A disruption in routines can frequently lead to added stress, anxiety, and behavioral difficulties for individuals with autism and their families. So how can you maintain the fun in holidays but also manage the major changes in routine? Here are a few ideas that may be helpful:

Use and/or modify tools your child already utilizes well. If your child uses an activity schedule, calendar, or some kind of app to prepare for transitions and upcoming events; be sure to include new icons, symbols, or preparation for the events related to holidays.
Practice the event. It may be possible for you to role play an event such as a larger family dinner, loud music, or the arrival of a someone dressed up as a character (such as Santa Claus.)
Take the time to list out what may be unique or new. While you cannot prepare for everything, it’s valuable to consider what your child may not have encountered in the past. For example, will there be lit candles within reach? Will there be appealing items your child is required to leave alone? Once you’ve brainstormed a bit, you’ll be better able to respond appropriately.
Enlist some help. If there is a family member or friend who will be present and can help if you need it, ask for their help beforehand and be specific. This might be asking them to engage your child in an activity for a short period of time, or running interference for you when your distant aunt approaches with a litany of rude questions about autism.
Make sure your child has an appropriate way to request a break. Whether your child is verbal or nonverbal, it’s helpful to teach them an appropriate way to exit a situation that is uncomfortable. This is a skill you can practice at home and use in other environments as well.
Recognize your successes. The holidays can be a stressful time, but they can also be a great indicator of just how far your child has come. Relatives you haven’t seen in a year are far more likely to see the difference in your child’s growth than you are, since you’ve seen that steady growth from day to day. It can be a wonderful time to step back and acknowledge just how hard you have all worked in previous months.

These are simple steps that may be helpful in reducing stress during the holidays. Do you have special tips for how you prepare?


WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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

Self-Management Interventions: Who, What, When, Where, Why, and HOW?

One of the most difficult tasks educators face is managing classroom behaviors and implementing effective behavior management systems.  There is nothing wrong with teachers applying positive reinforcement contingencies (such as implementing token boards, marble jars, or using teacher delivered point sheets) to achieve classroom order but it is desirable that students eventually learn to manage their own behavior.  John Dewey, arguably America’s most famous and important educator, suggested that the ideal aim of education is to give children a sense of ownership over their own behavior.  This process does not occur mysteriously, but through a series of systematic steps.  When a student learns to manage her or his own behavior, the outcome is a win – win. The student has learned an important life skill, becomes more independent, and increases their quality of life while the teacher is provided the opportunity to focus more on academic instruction and adaptive behavior skills.

Let’s dig deeper into the benefits of self-management interventions:

WHAT is self-management & WHO can self-monitor?

In its simplest terms, self-management involves the personal/self-application of behavior change procedures that supports goal achievement.

Self-management is not limited to use with children and/or to individuals with special needs. In fact, self-management interventions are all around us! You’ll find that some of the most popular weight loss programs, fitness monitoring, and budget tracking tools have embedded the foundational elements of effective self-management procedures. Development of self-regulation and self-management is possible from a very young age and virtually every individual has the ability to learn to self-monitor their behavior.

Self-management comes in many forms and an umbrella phrase that encompasses:

• Self-monitoring
• Self-assessment
• Self-observation
• Self-recording
• Self-charting
• Self-graphing

Most commonly, self-management is described as a series of steps where a person:

• Identifies a goal behavior
• Determines if a specific behavior has occurred
• Records the occurrence of behavior
• Obtains reinforcement

WHERE can you engage in self-management?

ANYWHERE! Self-management is an amazingly versatile intervention in that it can be used at home, in schools (Pre-K thru college), in the community, clinics, camps, and even on the job. The opportunities are endless!  Since using self-management places responsibility on the individual instead of an external source, research has shown that self-management promotes generalization to other settings even after the interventions have been faded out.        

WHEN can you engage in self-management?

ANYTIME! There are no time parameters around when you can or cannot self-monitor.  It’s flexible and can work with your schedule. You can self-monitor all day long, but if you only have 1 hour a day to work on a goal start there – it’s about progress not perfection!

WHY are self-management interventions effective?

Researchers have been specifically studying self-management since the 1960’s.  More recent evidence of self-management interventions has been synthesized in the National Autism Center’s National Standards Report, Research Synthesis on Effective Intervention Procedures from the University of South Florida Center for Evidence-based Practice, and National Professional Development Center- Evidence Based Practices. (Just to name of few) (1)  

While there are countless benefits of self-management interventions, here are the 6 most common themes that are highlighted in the research.

1. Self-management promotes independence & self-determination
2. Self-management places responsibility on the individual instead of an external source
3. Self-management interventions can be implemented with individuals with various levels of intellectual functioning
4. Self-management interventions can successfully increase behavioral and classroom performance
5. There is high acceptability for use of Self-management interventions
6. Self-management interventions can be incredibly individualized (2)

Further, self-management using a social accountability check-in (match component) is highly effective in teaching individuals how to self-monitor and in sustaining the success of meeting your goals through the intervention.  This has been outlined in the research since the 1970s.  You may have noticed the use of a social accountability check within self-management programs such as in popular step-counting apps, food tracking apps, and weight loss programs.  

WHAT IS THE SELF & MATCH SYSTEM &

HOW CAN I SET-UP A SELF-MANAGEMENT INTERVENTION?

The key to setting up any effective self-management system is pre-planning; working smarter, not harder.  Take time to think through the specifics of the self-management system before beginning to implement.  There are many variables to consider prior to implementing a self-management intervention.  Here are some of the logistics that you will want to consider:

• Target behaviors
• Procedures and schedule for monitoring the behaviors
• How the monitoring will be recorded
• Reinforcement procedures to implement when the goal is met
• Plans to fade the intervention as mastery is achieved

Systematic planning before beginning an intervention makes a world of difference and is a fundamental element of the Self & Match system. The Self & Match System is a self-management and motivational system firmly grounded in principles of Applied Behavior Analysis (ABA). This manualized behavioral intervention encourages a collaborative approach to promoting systematic behavioral success for children and young adults using self-monitoring with a match component. Each system is individually developed using a comprehensive considerations guide that is included in the Self & Match manual.

Self & Match has been implemented internationally across a variety of settings including: special & general education classrooms; home; camps; clinics; public, private, and parochial schools; post-secondary education; sports programs; and a soon to be launched pilot peer support project.  Self & Match can be incorporated into individualized behavior systems, class-wide, and school-wide management procedures as a part of SWPBIS.

The 6th edition of The Self & Match System: Systematic Use of Self-Monitoring as a Behavior Intervention, with a lay-flat spiral binding, is comprised of all the materials necessary to guide practitioners and/or parents in the development and implementation of creating individualized Self & Match Systems. Included in the manual is an introduction that provides a review of the literature supporting self-monitoring, Considerations Prior to Implementation Guide, 20 sample Self & Match forms, 5 reproducible Self & Match forms, and an assortment of supplemental materials.  The manual now also includes access to an online portal of customizable digital forms.

Our ultimate goal is to provide you with a tool to help students monitor and reflect on their own behavior so that they can become more independent and self-determined, resulting in an improved quality of life!


About The Authors 

Jamie Salter, Ed.S., BCBA

In her role as Program Specialist, Jamie trains educators on writing effective and legally-defensible Behavior Intervention Plans, provides leadership and guidance to special educators, consults with teams utilizing the Self & Match system, and supports students, families, and IEP teams in determining appropriate programs for students in their least restrictive environment.  Jamie received her Educational Specialist degree, Masters of Education, Nationally Certified School Psychologist status, and BCBA certification through Lehigh University.  Jamie has been actively involved in supporting children with autism for over 15 years.  She has served as Supervisor of an U.S. Department of Education Training Grant (focused on inclusion of students with low incidence disabilities), operated a school-based clinic that provided an emphasis on Intensive Behavioral Interventions, led social skills groups, sibling support groups, and provided in-home behavioral intervention.

 

Katharine Croce, Ed.D., BCBA

Dr. Katie Croce is a Board Certified Behavior Analyst.  Katie received her Doctorate in Educational Leadership and also holds a MS. Ed., in Applied Behavior Analysis, and an Autism Certificate.  Katie is currently the Director of an autism collaborative that is been designed to bring together autism resources locally, regionally, and statewide to improve access to quality services and information, provide support to individuals with autism and caregivers, train professionals in best practices and facilitate the connection between individuals, families, professionals and providers. Katie has worked as a behavior analyst in public/private schools and home settings for children with autism spectrum disorders (ASD) and other developmental disabilities.  Katie has also worked in a clinic setting developing programs for individuals with ASD a support program for college students with ASD, and training undergraduate and graduate education and psychology majors who wanted to work in the field of ASD.  Additionally, Katie has also worked in higher education developing and teaching undergraduate and graduate course work in autism spectrum disorders and applied behavior analysis.  

Contact Jamie or Katie at selfandmatch@gmail.com

  1. In 2009, the groundbreaking National Standards Project report reviewed 775 studies in applied autism treatments and identified the level of scientific evidence available for each treatment.  Self-management was one of the 11 established treatments identified in the investigation; indicating that is has a substantial research base that supports the effective use of self-management for treating individuals.  This was further strengthened by similar findings in the National Standards Project, Phase 2, which was released in 2015.  You can download the report for free at: www.nationalautismcenter.org/nsp/
  2. Details & supporting research can be found in the Self & Match manual

 

Double Up!

Learn all about our newest game Double Up from creator Rosemarie Griffin, CCC/SLP, BCBA! 

If you are working with older students, I know that you have probably struggled with finding materials that were age appropriate. I am a school based speech language pathologist and board certified analyst. I created Double Up to help my students strengthen their vocabulary and leisure skills.  

If you are a special education teacher, speech language pathologist, board certified behavior analyst or parent – you will love Double Up. This product can be used with students who are non-verbal and by students who are conversational. A no prep social skills activity for mixed groups!!

Double Up includes 4 different games and 144 vocabulary cards. It can be played with as few as one person or as many as 4 people. Vocabulary terms focus on the areas of leisure and hygiene. The first person to fill up their board- yells “Double Up” and they are the winner.  Read below for skills that you can work on when playing Double Up.

Matching – If you have students who would benefit from matching identical pictures, you can do that easily with double up! Just pass out the game boards of the same color. Get the matching vocabulary cards and you are ready to go. Each student picks a card and matches to their board. If they don’t have the card they pick – they can pass it to the person who does have it. If students are able to ask they can ask who has the card. For example, “who has the picture of reading?”

Associations – Students can work on matching items by association. If you pass out the purple leisure noun boards, get out the red leisure action vocabulary cards. You will turn over a leisure action ( i.e. reading), if you have the picture of the book on your board – you match it! If someone else has the book – you can pass it to them or ask “who has the book?” A great way to play for students who understand word associations.

Turn Taking – Double Up allows for practice with turn taking. Picking a card and taking your card is a functional leisure skill. The format of this game, allows for many opportunities to take your turn and wait while others take their turn.

Waiting – If you play Double Up as a 4 person game- your students will have to wait for their peers to take a turn. This is a natural way to work on the skill of waiting. Waiting can be so very difficult for our students and this is a great way to embed work on this skill. 

Independent Work. Double Up also makes a functional independent work task. A student could take one board from the double up game and the matching cards. They would match the identical cards for an independent work task. The pictures are functional and age appropriate, so not only are students work on increasing their duration with an independent task, they are being exposed to words that are important to them!

Conversation Skills – The pictures in double up lend themselves to conversation. You can discuss the vocabulary terms with the students. “Have you lifted weights before?” “Have you been camping?” The conversation opportunities are endless! 


About the Author

Rosemarie Griffin, MA, CCC/SLP BCBA, is an ASHA certified Speech-Language Pathologist and a Board Certified Behavior Analyst. She divides her time between a public school and a private school for students with autism in Ohio. She’s presented at the national, state and local level about systematic and collaborative language instruction for students with autism. Her professional mission is to help all students expand their communication step by step. She can be reached at www.abaspeech.org, on Facebook or Instagram. 

3 Ways To Fade Prompts

Prompts are ways we help our learners demonstrate new skills. We use prompts to get our students to greet a peer, flush the toilet, name the color blue, and clap their hands. Prompts are something we add to the situation because the natural or teaching cue was not enough to cause the student to respond. The natural cue of being finished using the toilet was not a strong enough reminder to flush the toilet so we added the verbal prompt, “flush the toilet” and the student now responds. Prompts are important but fading them is just as important.  Prompt fading in ABA needs to be planned from the start and is an integral and essential component to the plan. Unless you are committing to following that child around for the rest of his life and tell him to flush the toilet – prompt fading is essential.

Some rules for prompt fading in ABA:

* Plan it out from the start.
* Train your staff.
* Do it gradually.
* If incorrect responding begins, return to last prompt level.

1. Least to Most Prompt Fading

Like we discussed in Monday’s post, least to most prompting involves starting with the least intrusive prompts and moving up in the prompting hierarchy. This can be beneficial because it gives students to the opportunity to be independent and you are only providing as much prompting as needed. This is a strategy we tend to use naturally. When you meet a your friend’s toddler you put out your hand to give a high five. If she doesn’t respond you say, “give high five.” If she still doesn’t respond you move her hand to your hand to give a high five. This is a natural method of prompting. When using this prompt fading technique, ideally the prompts will be somewhat self fading. If you are always starting at the least intrusive prompt, your students will have the opportunity to demonstrate independence. As the student begins to learn the task, he will need less and less prompts to perform it correctly.

Some key tips for using this prompt fading in ABA procedure:

  • allow wait time; if you do not provide wait time you may be providing more prompts than needed and taking away the opportunity for the student to respond correctly
  • take data; data is key to track progress. Every time you utilize this prompting method – note the level of prompt you used. You want to see that your student is requiring less intrusive prompts as time goes on. This will help avoid prompt dependence.
  • use high powered reinforcers; use an item that is actually a reinforcer that your student wants to work for. The sooner he demonstrates the skills, the sooner he gets the reinforcer.

2. Most to Least Prompt Fading

Most to Least prompt fading is another effective method of using prompts. With this method you start the most intrusive prompts and gradually fade to less intrusive prompts. The prompt fading is build right in. However, sometimes people forget that and in their head rename this most to most prompting. The key to errorless learning and using the most intrusive prompts first is that you fade the prompts out. The idea behind most to least prompting is that students will contact reinforcement right away and you will avoid errors and the students developing any incorrect habits.

How to fade prompts in Most to Least Prompting:

  • set criteria for changing prompts; once your student hits a particular number of days or sessions or trials at a particular prompt level, fade to the next level; take data to track progress
  • once you hit the criteria move to the next type of prompt; refer to our prompt hierarchy or order that is in Monday’s post. Move up the list to less and less intrusive prompts.
  • fade magnitude than switch prompt type; before you switch from a gestural to a verbal prompt adjust the magnitude of the prompt. A dramatic point to an object is different that a nod of your head.

Data is critically important for avoiding prompt dependence. You want to set a criteria ahead of time and take data to make sure you are sticking with the criteria. The criteria you set will depend on the student and the task. Maybe you want 3 consecutive days with each prompt level. If you are taking data you can ensure that you are sticking to that schedule. If errors begin occurring, go back a prompt level. The data will guide your implementation of this procedure. If you are fading too quickly, your data will tell you!

Prompt fading in ABA isn’t scary. Plan ahead and make sure you train your staff. This is a group endeavor!

3. Time Delay

One effective way we can fade prompts is using a time delay. A time delay inserts a set amount of time between the natural or teaching cue and our prompt. When utilizing a time delay, start with a zero second (i.e. no) time delay – so it will basically be like errorless teaching. For the first few trials, give the prompt right away so the student knows how to respond. Then after several trials, increase the time delay. For example, you may start with 2 seconds. If the student does not respond within 2 seconds – provide the prompt. If the student responds before the 2 seconds, provide loads of reinforcement. Once the student is successful and responding under the 2 seconds for several trials, increase the time delay. Now wait until 4 seconds to provide the prompt. Continue on. If the student does not respond with the 4 second time delay, move back to the 2 second time delay.

The key to time delay is planning and data. Set the criterion ahead of time. Plan how many sessions you will do at 0 seconds before moving to the first time delay. Determine what the mastery criteria is – how many times do you want the student to respond within the time delay before increasing the time delay length? Take data on this. It can easily and quickly get confusing if you don’t have a data sheet to track what you are doing. Write the plan in simple terms at the top of your data sheet. I like to track prompted correct (PC), prompted incorrect (PI), unprompted correct (UC), and unprompted incorrect (UI) using those abbreviations on my data sheet. If the student responds before the prompt it is counted as unprompted and if it’s after the prompt it is prompted!

There is no magic number of trials or days you should stay within the 0 second or 2 second time delay. It depends on the student’s level of functioning and the difficulty of the task. This is where data majorly comes in to play. If you’ve moved along too quickly, you will know and you can scale back.

Time delay works really well with verbal prompts. Another key component to time delay working successfully is making sure the reinforcement you give for the unprompted responses is better than the reinforcement for prompted responses. So if Johnny responds before the time delay and says the color blue on his own – give him 3 m&ms and praise but if you are using a 2 second time delay and he doesn’t respond and you provide the verbal prompt “bl…” and then he says blue only provide praise. You want the independent responses to be getting more reinforcement so your student is motivated to engage in those responses more!


About The Author

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

Normalization

So much to say on this topic, far more than anyone would actually want to read.

Does ABA therapy require/demand/force individuals into a narrow and specific box titled “NORMAL”? No.

(Well, it shouldn’t anyway)

But the myth persists.

I mean this in the best way, but many of the children I work with just are not going to fit into that “normal” box, no matter how much someone tries to push or squeeze them into it… it ain’t happening.

And that’s a cause for celebration!

The very thing I love about working with such a diverse group of kids, is that they are all different, yet all interesting. I work with some super fascinating small people, who constantly show me how dumb I am. And I thank them for it, because how can you grow if you already think you know everything? You can’t.

As a provider, of course I know the research on the effectiveness of ABA therapy. I also know the many success stories I have seen with my own eyes, of children I directly worked with. But success story does not equal “…and then the child was totally normal!”.

A couple of reasons why my job is not to drive families in my car to a fantasy location called “normal”:

1) Each client/family I work with usually has their own idea of what “normal” means. If you have been in this field more than 10 minutes, you know this to be true. This client over here may live in a home where no one really cares what time they go to bed, as long as they stay in their room and are quiet. But that client over there, may live in a home where all the parents want most in the world is for that child to get their 7.5 hours of sleep every night.

2) Even when a family can explain to me what “normal” means for them, it quickly changes! Again, if you have been in this field more than 10 minutes you know this is true. Sometimes parents tell me they want desperately for their child to talk, but what they really mean is they want their child to communicate. Or, a parent may tell me they want desperately for their child to go to “normal” school with their big sister, but next thing you know that parent has decided to homeschool. Expectations change, as perspective changes.

 

So if ABA therapy is not about hitting a child over the head with your magical “normal” baseball bat, then how exactly is it decided what the goals of treatment will be? I’m so glad you asked.

If you are working with a quality ABA provider, the goal selection process will look something like this:

“I need to evaluate/assess your child to collect baseline data” – This just means data is collected at the onset of services to create a starting point. Over time, that starting point data will be reviewed again and again to make sure the child is progressing. If therapy has been happening week after week after week, but the child has not progressed past that starting point, then something is seriously wrong. This is why it’s important to collect that initial data, so over time you can compare the child’s current learning to their previous learning.”

“What are your goals for therapy? Tell me the reasons why you initiated services.” – The people who asked the ABA team to show up clearly had reasons for doing so, and we need to know what those reasons are. We cannot fully help if we don’t know what issues are happening. Treatment planning should always be a team effort, with the family/client working together with the BCBA to create goals.”

“What are the highest priority areas of concern in the home? At school? In the community?” – What this question is really getting at is “where do you want to start?”. It isn’t unusual that families want to work on…oh, 85 behaviors or so when you first meet them. Unless I can get a good idea of the priority level of those 85 things, the treatment plan will be a chaotic mess. Prioritizing treatment helps focus in on the areas of deficit that are impacting the client the most.

“Describe your household: rules, routine, disciplinary procedures commonly used, etc.” – This question gets at Culture. Households form a sort of culture, or a way things are done. Stepping into a household/family dynamic and imposing completely opposing culture onto it, is not a great idea. It will likely lead to aggressive resistance. What is more helpful, is to teach the family strategies and techniques that line up with the way their household functions.

“Can you finish this sentence: In 5 years, I want my child to be able to…..” – This question is really getting at long-term goals. Professionals need to know long-term goals, because every long-term goal is really made up of hundreds of baby steps. Gradually introducing those baby steps leaves less work to do down the road and increases the likelihood of successful skill acquisition.

“Your child scored low on (insert skill domain here). Do you care about that??” – One of my fave questions to ask. I have learned to ask this, because I used to do quite a bit of assuming. Things like “Of course, you guys want him to write his name, right?” or “Of course, you guys want her to stop eating with her hands, right?”. Maybe not. If I see an area of concern, I will bring it up. If the parent isn’t as concerned as I am or wants to stick a pin in that issue until a later time, then it’s really important that I know that.

My normal is not your normal, and vice versa. What’s considered “normal” in your household might not fly in my household, and what’s “normal” in your marriage could be unbearable for another couple. That’s why normal is such a useless word to throw around, because it has too many meanings to actually mean anything significant.

One of my pet peeves is when a parent says to me during an intake, “I just want him/her to be normal!”. Ummm, and that means what?? 🙂 Seriously, I need details over here. I do not have an intervention for “normal” behavior, nor do I know how to program for that.

Does ABA therapy seek to change individuals? Yes! Behavior change is the entire point of this therapy, either increasing appropriate behaviors or decreasing inappropriate behaviors. But if you think that the only change ABA therapy values is when a child can be fully “normal”, you are:
100%,
absolutely,
wrong.


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

Implementing the Intervention…Even When Things are Going Well

Recently I was working with a parent who was using a TimeTimer with her son to help him recognize when it was time to get ready for bed. Our plan was to start the timer every night while he was engaged in an activity, show him the timer and have him repeat how many minutes left, then have him tell his mom when the timer went off. For the first couple of weeks, this plan worked beautifully. The boy could see the time elapsing, brought the timer to his mother when it went off, and then started the process to get ready for bed without engaging in tantrum behaviors.

I went in for a parent training session after a month of the intervention and the boy’s mother informed me the timer just wasn’t working any more. As we started talking, I realized that the mother had drifted from our original plan in a way that is quite common. As her son experienced success, she used the timer less frequently. Then, if he was struggling, she would introduce the timer. In effect, she started only using the timer when he was misbehaving, instead of using it as a consistent tool to help him with the bedtime routine.

This type of procedural drift (when there is an unintentional or unplanned change in the procedure outlined for the intervention) is very common for parents, teachers, and ABA therapists. It’s important to understand this type of drift so it can be corrected when it occurs.

Here are a few things to remember when implementing an intervention:

• First, any intervention should include a clear plan for fading the intervention. In the example above, the TimeTimer was an appropriate tool for this particular child, who was only four years old. But we don’t want him to rely on the timer for the duration of childhood! A plan should include how to fade the intervention with specific steps and specific requirements for mastery.

• The use of the TimeTimer is considered an antecedent intervention. This means that we are implementing a change in the environment prior to any problem behaviors to help the child contact reinforcement and experience success. Antecedent interventions should be implemented consistently as part of a routine, not ONLY when a problem behavior occurs. If it is only implemented when the problem behavior occurs, it is no longer an antecedent intervention.

• If we implement a tool (like the TimeTimer) only when problem behavior occurs, it’s possible the tool will become aversive to the child and possibly result in an increased magnitude of the problem behavior.

• Consider using tools for the people implementing to intervention to remind them of the specific steps. For example, you might create a video model and instruct the parent (or other adult implementing the intervention) to watch it every couple days. Or you might post the steps in a clear space to be reviewed regularly.

• Finally, we have to remember that a couple of good days in a row without any instances of problem behavior does not mean that the problem is solved. This is why the first step outlined above is so important. We want to teach the child replacement behaviors and give them lots of opportunities to be successful with it.

 

Ultimately, we were able to re-implement the procedure with this parent and see more continued success with this particular case. We also decided to post the steps to the intervention on the back of the TimeTimer for easy review on a daily basis.

However, in some cases, you might have to create an entirely new intervention using different tools. The goal is to be clear about the steps of the intervention, and to maintain those steps when implementing the intervention.


WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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

Qualifications of Practitioners/Consultants who Practice ABA

This month’s ASAT feature comes to us from Sabrina Freeman, PhD, ASAT’s Consumer Corner Coordinator. 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!

It’s crucial to be a savvy consumer when it comes to one of the most important decisions you will make for your loved one with autism – choosing an ABA treatment provider for your child. Those of us who have already walked in your shoes know that all treatment providers are not the same. To the uninitiated, these professionals all look marvelous. From the slick websites, to the large numbers of associations of which these professionals are members, it is becoming increasingly difficult to differentiate between mediocre and outstanding treatment providers. Furthermore, publication of research in high quality journals is not synonymous with clinical expertise.

Fortunately, in this issue of Consumer Corner, we present a summary of consumer guidelines created by the Autism Special Interest Group (SIG) of the Association of Behavior Analysis International to help you make an informed choice when searching for ABA professionals to design, run and maintain your child’s program. A complete copy of the SIG guidelines are available here: https://3lvvdfmmeol12qpvw2c75ch6-wpengine.netdna-ssl.com/wp-content/uploads/2018/07/Final-Autism-Sig-Guidelines-Parent-Version-May-2018.pdf It is important to remember that your child’s future depends on highly quality consulting. Good luck!

 

  1. Certification:

Treatment professionals must all have advanced degrees, e.g., a Master’s Degree or a Doctorate in a relevant field of study, and be certified either by the Behavior Analyst Certification Board (BACB), or a board that has equal or higher level requirements than the BACB. To look up your consultant, visit: www.bacb.com and click on “Find A Certificant.” If the potential consultant is not on this list, ask where he/she became credentialed, and trained so that you can verify licensure and experience to determine whether it is equal to/or surpasses the standards of the BACB. If this individual responds to your inquiry in a defensive manner, then you may consider looking elsewhere as you are well within your right to seek clarification about certification status.

Find & Contact Certificants

  1. Extensive Hands-On Supervised Training:

Consultants are required to have extensive hands-on training treating children with autism in which they have worked at least one full year (1500 clock independent supervised hours or 1000 hours if taking a university practicum and 750 hours if taking an intensive practicum) under the supervision of a credentialed BCBA Certificant. In addition, they need to prove competency in many areas that cover the design and implementation of both individualized ABA interventions, and comprehensive ABA treatment programs. The partial list below was created by the Autism Special Interest Group (SIG) below. Your consultant should be competent in all the following areas:

  1. a) Design and implement individualized ABA Interventions
  • community living skills
  • functional communication skills (vocal and non-vocal)
  • “learning to learn” skills (e.g., looking, listening, following instructions, imitating)
  • motor skills
  • personal safety skills
  • play and leisure skills
  • pre-academic and academic skills
  • reduction of behaviors that jeopardize health and safety and impede successful functioning (e.g., stereotypic, obsessive, ritualistic, aggressive, self-injurious, disruptive, and other behaviors often described as “challenging”).
  • school readiness skills
  • self-care skills
  • self- management skills
  • social interaction skills
  • vocational
  1. b) Design and implement both comprehensive ABA intervention programs (using multiple ABA procedures to address multiple intervention targets) and focused interventions (using one or more ABA procedures to address a small number of intervention targets).
  2. c) Delivering ABA interventions directly to at least 8 individuals with autism who present with a range of repertoires, levels of functioning, and ages.
  3. d) Implementing the full range of scientifically validated behavior analytic procedures, including but not limited to:
  • reinforcement (including differential reinforcement)
  • extinction
  • discrete-trial procedures
  • modeling (including video modeling)
  • incidental teaching and other “naturalistic” methods
  • activity-embedded intervention
  • task analysis
  • chaining
  • activity schedules
  • scripts and script fading
  • prompting and prompt-fading
  • errorless training
  • error correction
  • motivating operations
  • stimulus control
  • preference assessments
  • choice
  • augmentative and alternative communication training procedures.
  1. Continuing Education:

Not only do behavioral consultants need to be trained as above, in order to maintain their certification, practitioners must also pursue continuing education in a variety of areas that may include, but are not limited to, Applied Behavior Analysis.

Red Flag

These practitioners should not be working collaboratively with professionals who implement an eclectic mix of interventions that are untested, discredited or experimental in nature. If the consultant you use endorses an eclectic approach, understand that this practice is inconsistent with the BACB Guidelines for Responsible Conduct for Behavior Analysis. This red flag is a particularly helpful way to be forewarned about a consultant who is not a good choice to design and maintain your child’s program!

 

Common Mistakes In Implementing Reinforcement

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

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

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

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

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

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

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


WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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

Improving Time-Out Procedures

Time-out is often a hotly-debated topic. Is it too punishing? Where should it take place? How long should it last? There are not easy answers to many of these questions. But there are some evidence-based suggestions that may improve a time out procedure should you decide to use one.

  • First, know the function of the behavior! If the child is engaging in the undesirable behavior for escape, then providing “time out” will likely increase the behavior. For instance, if a child gets sent out of the classroom each time he curses, this is effectively a time out from classwork. He may curse because in the past, cursing resulted in escaping from classwork. This is an instance when you would not want to use time out. A time-out may prove to be effective for behaviors that function for attention or access to tangibles. More on that next…
  • Consider a nonexclusion time-out procedure. In the past, we’ve discussed the time-out ribbon here. This is a useful tool for signaling to a learner that they have access to social or tangible reinforcers. If they engage in an inappropriate behavior, the ribbon is removed and they do not have access to social or tangible reinforcers, however they are still able to participate in the lesson or activity you have organized. It also allows them to practice more appropriate behaviors to earn the ribbon back. If the ribbon isn’t the best visual cue for your learner, you could make it anything this is visible for them and clearly delineates when they do and do not have access to reinforcement.
  • Consider the use of a release contingency. This means that a learner is unable to leave time out until a predetermined amount of time has passed without problem behavior. Perhaps if you’re working with a preschool child who has been kicking other children, the release contingency might be that they must sit with “quiet feet” or “feet on the floor” for one full minute before they can go back to play. Your other option is to put in a fixed time contingency, which is best done by setting some sort of timer so the learner can see how much time is remaining in time-out.
  • Combine time out with positive reinforcement procedures. Time-out by itself may result in decreases in behavior only when time out is a possibility. For instance, you may see a decrease in the problem behavior only when the child’s mother is at home, because the father doesn’t use time out. The goal is to decrease the problem behavior across all settings and activities. To that end, it’s helpful to teach appropriate replacement behaviors and reinforce the learner for engaging in those behaviors.

WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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