Category Archives: Guest Blog Post

Back to Basics: Core Strategies in ABA

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Applied Behavior Analysis (ABA) is the practice of the science of behavior. Often misunderstood as a collection of techniques (or worse, one particular technique), ABA is much more complex and is based in analysis so that all interventions are individualized, functional, and effective. That being said, there are some core strategies that are useful to know about in the application of ABA to individuals with autism.

• Reinforcement is probably the best known and most widely recognized ABA strategy. The principle of reinforcement is simple: behavior that is followed by preferable outcomes increases in future probability. If the preferable outcome is something given, like praise, a toy, or a fun activity, that’s called positive reinforcement. If the preferable outcome is something taken away, like work being removed during a break, or an unpleasant noise stopping, that’s called negative reinforcement. Contrary to popular belief, negative reinforcement is not the reduction of behavior or the application of punishment. Both positive and negative reinforcement are highly individualized and will look different for different people, but the principles remain the same no matter who you are: behavior increases because it is followed by a preferable outcome.

• Prompts are another commonly used strategy in ABA, and they also look different for different people. Prompts are any stimuli added to the natural environment to make behavior more likely. We all use prompts throughout our daily lives, often without realizing it. Smart phone reminders, highway signs, and fire alarm bells are all every day prompts. Additional prompts may be added to support individuals with autism in many ways. For example, some children with autism are taught to follow activity schedules, which are prompts for sequences of actions. These prompts may be used to help the child to be more independent in an activity of daily living, like making a sandwich, or just to transition between play activities and remain actively and appropriately engaged for longer periods of time.

• Structured teaching procedures are often used to break down and teach important skills such as communication, social skills, self-care skills, and academics. Sometimes these procedures are highly structured and repetitive, such as discrete-trial teaching, and sometimes they are looser and less structured, such as natural-environment teaching. Most individuals with autism who are learning using these strategies are provided with a combination of more and less structured learning opportunities, depending on their individual needs.

• Self-management is the set of skills that enables independence. For many individuals with autism, these skills need to be explicitly taught. ABA programs should include opportunities to learn and use self-management skills, as the ultimate goal of any ABA intervention should be independence.

About The Author 

Dana Reinecke is a doctoral level Board-Certified Behavior Analyst (BCBA-D) and a New York State Licensed Behavior Analyst (LBA).   Dana is an Assistant Professor and Department Chair of the Department of Special Education and Literacy at Long Island University Post.  Dana provides training and consultation to school districts, private schools, agencies, and families for individuals with disabilities.  She has presented original research and workshops on the treatment of autism and applications of ABA at regional, national, and international conferences.  She has published her research in peer-reviewed journals, written chapters in published books, and co-edited books on ABA and autism.  Current areas of research include use of technology to support students with and without disabilities, self-management training of college students with disabilities, and online teaching strategies for effective college and graduate education.  Dana is actively involved in the New York State Association for Behavior Analysis (NYSABA), and is currently serving as President (2017-2018).

Explaining Decision to Use Science-based Autism Treatments

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This month’s ASAT feature comes to us from David Celiberti, PhD, BCBA-D and Pamela Feliciano, PhD. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

 

“I have decided to rely on science-based treatments for my child with autism. Now, how do I explain this to friends and relatives who insist I try something “cutting edge?”

 

We certainly respect any individual’s right to his or her own opinion, and certainly for parents of children with autism to make decisions for their child regarding treatment; however, we believe that scientific evidence and the use of objective data should guide treatment options for all diseases and conditions, and autism is no exception. The late Senator Patrick Moynihan eloquently said, “Everyone is entitled to their own opinions, but not their own facts.” It is simply a matter of fact that theories, hypotheses, and testimonials do not provide adequate information to guide treatment decisions.

When friends or acquaintances hear about our experiences with autism, quite often the first thing they ask is, “What is your opinion of vaccines?” despite the retraction of Andrew Wakefield’s article by the Lancet (a very rare occurrence by this highly reputable journal). Sadly, the vaccine debate has long distracted the autism community from important discussions such as how best to help children already diagnosed with autism realize their fullest potential and live a happy and meaningful life.

In an ideal world, all treatment providers would make a commitment to science and evidence-based practices, and all members of the journalism community would make a commitment to responsible journalism. Until these ideals become the norm, those who do understand science-based treatments must do what they can to inform and educate others about the benefits of scientifically validated treatment, and the use of data to guide decision-making when assessing the benefits of any and all treatments.

Although applied behavior analysis is the treatment for autism with the most scientific support, we are rarely ever asked our opinion of this therapy, or if it is effective. Instead, every few months or so, some “new” treatment (or “repackaging” of a known treatment) will gain the attention of consumers. Given the large numbers of television reports, newspaper articles, blogs, and websites putting forth “miracle cures” and “breakthroughs,” it is not surprising that parents frequently receive advice and suggestions from extended family members, neighbors, and co-workers, particularly after a news item is broadcast, printed, or otherwise disseminated. Many of these individuals have the best intentions and are eager to share what they believe is “cutting edge” information about autism. In other cases, the advice is sometimes provided in a manner that comes across as critical of what you are choosing to do or not do for your child (i.e., it may be implied that you are not doing enough as a parent to help your child with autism).

If the information is offered by a more casual acquaintance, it may be best to simply thank him or her for their interest and concern and move on; however, such a strategy may not fare as well with individuals with whom you have a closer relationship. In these cases, you might consider sharing the following:

     • There are dozens of “miracle cures” and “breakthroughs” (i.e., pseudoscience) for autism that manage to receive widespread media attention, even if they have not been proven effective. In fact, there are over 500 treatments touted to address autism;

     • It is important to be critical of all available information, regardless of the source, and to recognize that not all information on the Internet is reliable and accurate;

     • There is a large body of scientific research published in peer-reviewed journals and carried out by hundreds of researchers that supports the choices that you have made;

     • Numerous task forces (some are listed at the end) have looked closely and objectively at the available research and have determined that the vast majority of autism treatments lack any scientific support and, in fact, some may be harmful;

     • Autism treatment is a multi-million dollar industry, and many treatment proponents rely heavily on sensationalism and extraordinary claims to “sell” their products;

     • Interventions that are actually shown to be the most effective often receive the least amount of media attention; and

     • For most other medical conditions, a provider that disregards proven intervention and uses a fringe treatment may actually be sued for malpractice (you may even consider drawing an analogy to a medical condition of particular interest to the person providing the advice).

Of course, you may also consider addressing this matter proactively. This would involve clarifying your choices and commitment to science-based treatment to more significant family members and friends on your terms and at your convenience. It may be helpful to view this tactic as a series of tiny conversations. You may even consider sharing links to websites such as the Association for Science in Autism Treatment (ASAT), which will help your family members and friends separate the wheat from the chaff. We would like to draw your attention to a few sections of ASAT’s website that bear relevance to this discussion.

     • Learn more about specific treatments

     • Summaries of published research articles

     • Making sense of autism treatments: Weighing the evidence

     • Recommendations of expert panels and task forces

Finally, ASAT’s newsletter, Science in Autism Treatment, is a free publication, so encourage your friends and family to subscribe.

It is our hope that the information shared above may help your friends and family better understand the role that science should play in the treatment of autism, the need for objective data to drive decision making, how to better identify pseudoscience, and perhaps most importantly, why parents must be such savvy consumers.

David Celiberti, PhD, BCBA-D is the part time Executive Director of ASAT and Past-President, a role he served from 2006 and 2012. He is the Co-Editor of ASAT’s newsletter, Science in Autism Treatment. He received his PhD in clinical psychology from Rutgers University in 1993. Dr. Celiberti has served on a number of advisory boards and special interest groups in the field of autism, applied behavior analysis, and early childhood education, and been an active participant in local fundraising initiatives to support after school programming for economically disadvantaged children. He works in private practice and provides consultation to public and private schools and agencies in underserved areas. He has authored several articles in professional journals and presents frequently at regional, national, and international conferences. In prior positions, Dr. Celiberti taught courses related to applied behavior analysis (ABA) at both the undergraduate and graduate levels, supervised individuals pursuing BCBA certifications, and conducted research in the areas of ABA, family intervention, and autism.

Pamela Feliciano, PhD, joined the Simons Foundation in 2013 and serves as the scientific director of SPARK (Simons Foundation Powering Autism Research through Knowledge) and is a senior scientist at SFARI. SPARK is a SFARI initiative that seeks to accelerate autism research through a vibrant and informative online platform (SPARKforAutism.org). Previously, Feliciano worked as a senior editor at Nature Genetics, where she was responsible for managing the peer review process of research publications in all areas of genetics. Feliciano holds a B.S. from Cornell University, an M.S. from New York University and a Ph.D. in developmental biology from Stanford University. Feliciano is also the mother of an adolescent boy with autism spectrum disorder.

How to Manage the Impact of Child with a Disability on Siblings

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This month’s ASAT feature comes to us from Mary Jane Weiss, Ph.D., BCBA-D,LABA and Nicole Pearson, 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!

 

I am a mother of three children, one of whom has autism and requires a tremendous amount of time and care. I worry about how this is impacting my other children, both of whom are a few years older and are very aware of how our family has changed as a result of their sibling’s diagnosis. Do you have any advice on how to best address this with them?

Answered by: Mary Jane Weiss, Ph.D., BCBA-D,LABA
Professor of Education and Director of Programs in Autism and Applied Behavior Analysis, Endicott College and
Nicole Pearson, BCBA-D
Founder, West Side Behavioral Associates

Having a child with autism spectrum disorder inevitably impacts the entire family. From the stress and anxiety that accompanies the initial diagnosis to the time-intensive nature of navigating treatment options and providers, raising a child with autism presents unique challenges for parents. It can also present challenges for siblings as the sibling relationship is inevitably different from that of typical siblings. And while many of these differences can be positive and rewarding, it’s important for parents to be aware of the needs of siblings so that they can provide meaningful guidance and support.

While children of younger ages may not be fully aware of their sibling’s disability, they likely detect parental stress, perceive inequities in the amount of time and attention given and struggle with a sense of disruption in overall family life (Feiges & Weiss, 2004; Smith & Elder, 2010). As children age and their awareness grows, siblings may experience adjustment difficulties. These difficulties are influenced by such factors as sibling age and gender as well as family size. Siblings closer in age to the child with autism, and those who are younger and have not yet developed effective coping strategies can be more affected. However, as a parent, there are many strategies you can take to support sibling coping and adjustment.

Foster a supportive environment at home: Siblings are often aware of how different their experiences are from that of others, especially their friends. As a result, they may feel many emotions, including fear, anger, embarrassment, resentment and guilt, among others. Encouraging an environment of open communication allows the sibling to safely express negative emotions and frustrations. Listen to and reassure your child that it’s okay to have these feelings, and offer suggestions on how to work through them together. Doing so also helps with positive coping and establishes a foundation for good familial communication and problem solving.

Further, as siblings become aware of such differences, they will likely look to their parents and family members for guidance. Thus, parent coping and adjustment play an important role in sibling adjustment. As such, it is important for parents to be cognizant of the impact their actions, behaviors and decisions will have on all of their children.

Ensure your child understands what autism is: Parents sometimes overestimate their typical child’s understanding of autism as the child may be able to explain what it is without fully comprehending it. They may also pick up on information they overhear but likely have more questions than answers. Making sure that siblings have developmentally-appropriate information will help reduce their fears and misconceptions (Glasberg, 2000; Harris & Glasberg, 2003). These explanations can go a long way in influencing how siblings view and interact with their sibling with autism and how well they are able to explain autism to their peers.

When speaking with children under age nine, parents should keep explanations brief and frame the sibling with autism’s deficits in the context of having not yet learned or mastered particular skills, such as playing with others or communicating in ways that other children do. For example, saying, “Your sister learns a bit differently than you and me, so she needs extra help” or “Your brother may not be able to talk but we are teaching him other ways to show us what he wants to say.”

As children age, explanations can be more involved, such as sharing that autism is a problem in the brain and that it presents differently in each child. Depending on the extent of the child with autism’s behavioral problems, it may be necessary to help the sibling understand why they’re occurring and their role in behavioral escalations. Such escalations can be scary, embarrassing and disruptive for typical siblings so providing them with clear explanations can help alleviate some of these feelings. Regardless of the children’s age, parents should offer reassurance (especially of safety) to typical siblings, and convey love and acceptance of everyone in the family.

From a timing perspective, starting to discuss autism with siblings at an early age can be helpful, especially before they begin school or start having friends over. That way, they can be prepared with information about how to explain what may appear to be usual or different behavior in their sibling with autism. There are several free online resource guides available:

• Autism Speaks offers a “Siblings Guide to Autism” toolkit designed for siblings ages 6-12 that parents and siblings can read together to learn more about autism and facilitate conversation about it
• Organization for Autism Research’s “Kit for Kids” offers an illustrated booklet for elementary and middle school students, called “What’s up with Nick?” and “Autism, my sibling, and me”

Promote meaningful relationships between siblings: While every sibling relationship is special, the communication and socialization deficits inherent in autism diagnoses can make sibling bonding more difficult. Creating opportunities for younger children to play together or helping older siblings to find common interests, even if it’s as simple as doing a puzzle together or playing a video game, can go a long way in increasing the quality and quantity of interactions and ultimately building sibling bonds.
Another way to foster meaningful relationships between siblings is to teach your typical children how to be mentors to their younger sibling with autism. Doing so can be very fulfilling for siblings and promote feelings of self-efficacy and nurturing. It also creates opportunities for siblings to engage with one another socially and have positive interactions with their sibling with autism. Prior to starting, make sure that your typical children understand their sibling with autism’s skills, preferences and interests and start with easy tasks to ensure success. Such tasks might include modeling how your typical siblings can engage in simple toy play or teach their sibling with autism a basic daily living skill like putting on a coat or how to wash hands. Other skills that can be useful to teach include:

• how to get your sibling with autism’s attention,
• how to provide praise and reinforcement when he does well,
• how to assist him when he cannot do something,
• how to help him stop playing and clean up.

Build in one-on-one time for each sibling and foster individuality: Siblings are inevitably affected by the inordinate amount of time, energy and resources that are spent caring for their sibling with autism. Further, activities common in typical family life such as all spending time together, going to a movie or on vacation may be more limited. While inequities exist in all families, they are intensified in a family who has a child with autism. And if typical siblings feel dissatisfied with these inequities, their relationship with their sibling with autism is negatively impacted (Rivers & Stoneman, 2008). To help minimize the impact of these inequities, it’s important to make time for one-on-one interaction with each sibling. While this can seem difficult in the throes of managing busy schedules and the demands of therapies, carving out even a small amount of time where you’re giving your child your undivided attention can go a long way. So whether its running errands together or going for pizza, make time to check-in with your other children and let them know that even though they may not always get as much attention as their sibling, they’re loved and cared for equally.

And while having a child with autism is a 24/7 commitment, helping to foster distinct roles and interests in each child can further reduce the stress that siblings may feel. Encourage siblings to get involved in sports, clubs or other community activities where they can develop relationships with peers and just have fun. Doing so allows them the time and space to be their own person and establish a sense of individuality not defined by their sibling with autism (OAR, 2014). Ultimately, it may also make siblings more available to enjoy spending time with their sibling with autism.

Consider additional sources of support: Finally, sibling groups can be a helpful source of support. They provide siblings the chance to meet and speak with others who are going through similar experiences and can give them accurate and age-appropriate information about autism. Often these groups can help reduce fear and misconceptions among siblings as well as the feelings of isolation many experience. If a support group isn’t readily available within your children’s school or your community, consider looking at some of the following resources for more information:

• Sibling Support Project – offers more than 475 community support programs, called SibShops, for younger siblings of children with special needs.
• Online resources: There are several online communities for siblings, both teens and adults:
     o      SibTeen, an online Facebook group for teen siblings: https://www.siblingsupport.org/connect-with-others-sibs/meeting_other_sibs_online/sibteen
     o     SibNet online forum for adults: https://www.siblingsupport.org/connect-with-others-sibs/meeting_other_sibs_online/sibnet

The Organization for Autism Research (OAR) has also developed the “Autism Sibling Support Initiative” offering helpful resource guides for young children, teens and parents.

While much is often said about the challenges faced by siblings of people with autism, there are also substantial positive outcomes. Most siblings who reflect on the experience in adulthood attribute their high levels of compassion, tolerance, patience, and concern for others to having had a sibling with special needs. Furthermore, many of them develop a sense of mission and enter helping professions.

There is no universal description of the ways in which this role changes the lives of siblings of children with autism. And every sibling pair is on their own unique journey. But while this is a role that is not chosen by the sibling, it is a role that most siblings truly embrace. Parents can help their typically developing children by creating an environment of transparency and openness about autism and about issues arising in the family associated with it. They can help siblings find effective ways to interact with their brother or sister with autism, and can foster mentorship roles for them with their sibling. Parents can also ensure that every child in the family gets needed attention and permission to pursue their own dreams. Finally, they can remember that most siblings of children with autism end up being compassionate human beings who treasure their sibling and who note both the struggles and the strength that the family experienced as a result of being touched by autism.

Note: This submission was adapted from Drs. Weiss and Pearson’s book chapter, “Working effectively with families of children with autism spectrum disorders: understanding family experience and teaching skills that make a difference” which appeared in “School success for kids with autism.”

References:
Feiges, L.S., & Weiss, M.J. (2004). Sibling stories: Growing up with a brother or sister on the autism spectrum. Shawnee Mission, KS: Autism Asperger Publishing Company
Glasberg, B.A. (2000). The development of siblings’ understanding of autism and related disorders. Journal of Autism and Developmental Disorders, 30, 143-156.
Harris, S.L., & Glasberg, B.A. (2003). Siblings of children with autism. Bethesda, MD: Woodbine House.
Organization for Autism Research (OAR). (2014). Brothers, sisters and autism: A parent’s guide to supporting siblings. Retrieved from: http://www.researchautism.org/family/familysupport/documents/OAR_SiblingResource_Parents_2015.pdf
Rivers, J. W., & Stoneman, Z. (2008). Child temperaments, differential parenting, and the sibling relationships of children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 38, 1740-1750.
Smith, L. O., & Elder, J. H. (2010). Siblings and family environments of persons with autism spectrum disorder: A review of the literature. Journal of Child and Adolescent Psychiatry Nursing, 23, 189-195.
Weiss, M. J., & Pearson, N. K. (2012). Working effectively with families of children with autism spectrum disorders: Understanding family experience and teaching skills that make a difference. A. L. Egel, K. C. Holman, & C. H. Barthold (Eds.). School success for kids with autism. Waco, TX: Prufrock Press.

Please use the following format to cite this article:
Weiss, M. J. (2016). Clinical Corner: How to Manage the Impact of Child With a Disability on Siblings. Science in Autism Treatment, 13(2), 22-26.

Mary Jane Weiss, Ph.D., BCBA-D, LABA is a Professor at Endicott College, where she directs the Master’s Program in ABA and Autism and is a mentoring faculty member in the Doctoral program. She also does research at Melmark. Dr. Weiss has worked in the field of ABA and Autism for over 30 years. She received her Ph.D. in Clinical Psychology from Rutgers University in 1990 and she became a Board Certified Behavior Analyst in 2000. She previously worked for 16 years at the Douglass Developmental Disabilities Center at Rutgers University, where she served as Director of Research and Training and as Clinical Director. Her clinical and research interests center on defining best practice ABA techniques, exploring ways to enhance the ethical conduct of practitioners, evaluating the impact of ABA in learners with autism, teaching social skills to learners with autism, training staff to be optimally effective at instruction, and maximizing family members’ expertise and adaptation. She serves on the Scientific Council of the Organization for Autism Research, is on the Professional Advisory Board of Autism New Jersey, is a regular reviewer for a variety of professional journals, and is a frequent member of service committees for the Behavior Analyst Certification Board. She is also a Past President of the Autism Special Interest Group of the Association for Behavior Analysis International, a former member of the Board of the Association for Professional Behavior Analysts, and a former Vice President of the Board of Trustees for Autism New Jersey.

Dr. Nicole Pearson is a licensed psychologist and Board Certified Behavior Analyst (BCBA-D) who has specialized in working with individuals with autism and other developmental disabilities for almost a decade. Dr. Pearson received her initial training in Applied Behavior Analysis (ABA) at the Alpine Learning Group and went on to work in a number of other public and private educational settings, including NYC Autism Charter School where she served as Director of Education. She has also worked with autism programs internationally in Kenya and the Maldives. Most recently, Dr. Pearson served as a Behavioral Psychologist at St. Mary’s Hospital for Children, working with children with complex medical needs and training clinical staff in treatment protocols. She holds Masters and Doctoral degrees in Psychology from Fairleigh Dickinson University and a BS in Business Administration from Villanova University.

Your Behavior Plan Made Everything Worse!

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“We have been working with a behavior analyst and it seems like every time they give us a new behavior intervention things just get worse, not better. What gives?”

Well, if you are working with a Board Certified Behavior Analyst, I’d like to believe that the interventions they are recommending for you are good ones. (i.e. research-based, effective, only have behavior analytic principles). So it’s likely that you are just experiencing an extinction burst.

Got it? Okay, now go do the steps your behavior analyst gave you.

Wait, what? You don’t know what an extinction burst is? Let me try to clear things up for you a bit.

Here is the definition of an extinction burst (Cooper, Heron, & Heward, 2007): an increase in the rate of responding when reinforcing consequences are withheld after the occurrence of the target behavior.

Basically, things usually get worse before they get better.  Great news, I know.  You’re welcome.

Why is this? Let’s try an example to make sense out of this technical stuff.

What if my daughter screeched and yelled every time she saw something on the kitchen counter? I could give her the item each time she screamed. She would then be quiet.  But who wants to live with a toddler who screams and yells constantly for things that are out of reach?

So one day I realize this isn’t a great plan and decide to teach her a replacement behavior- to ask nicely for things. I stop giving her the item every time she yells and instead wait for her to ask nicely for it.

What do you think will happen first? She’ll scream louder and longer. This has worked for her for so long that she just increases the intensity of the problem behavior to try to get access to the items out of reach (aka the reinforcers for the problem behavior). This is the extinction burst.

My daughter is probably thinking, “This screaming thing has worked forever. I just need to do it louder and more often to make sure she hears me and gives me what I want!” My girl gets louder and louder and eventually stops, realizing that the stuff just isn’t coming.

The behavior got worse before she recognized that screaming was not going to get her access to the desired item.

In behavior analytic terms:

Child screaming = problem behavior

Me giving her whatever she wanted= reinforcer

I stop providing the reinforcer to try to extinguish the behavior = intervention

Child screams louder and longer= extinction burst

Child stops screaming altogether= success

Now what would have happened had I given in to the louder screaming? Next time my daughter saw something she wanted, she would probably start screaming at the louder volume immediately to get access to the reinforcer, the preferred item.

I would have to stay strong and make it through the loud screaming without giving in so that the problem behavior would stop.

If I want this plan to be successful – if I want her to ask nicely for things – I need to stay strong through the increased screaming. Eventually she will realize that the screaming just isn’t working and that all she has to do is ask nicely for items. We can move on with our lives and be ready to teach more appropriate behaviors with less screaming and yelling involved.

The exact same thing applies to the interventions your behavior analyst is recommending. If the problem behavior gets stronger, more frequent, more intense, more anything as soon as you stop reinforcing it – you’re doing the right thing!

Stick to your guns, even though it can be really hard. Follow the steps your behavior analyst laid out and ride the wave of the extinction burst. To decrease that problem behavior and replace it with something appropriate will be so very worth it.

If an extinction burst leads to an increase in aggression, unsafe behaviors toward self or others, or a level of problem behavior you cannot reasonably live with – talk to your behavior analyst. Let them know what will or will not work for your child or your family and work together to create a plan that will work.

Extinction bursts aren’t fun for anyone. But replacing a problem behavior with something functional for your child is worth it. You can do it!

Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis.

Lerman, D.C., & Iwata, B.A. (1995). Prevalence of the extinction burst and its attenuation during treatment. Journal of Applied Behavior Analysis, 28, 93-94.

Lerman, D.C., Iwata, B.A., & Wallace, M.D. (1999). Side effects of extinction: Prevalence of bursting and aggression during the treatment of self-injurious behavior. Journal of Applied Behavior Analysis, 32, 1-8.

This piece originally appeared at www.bsci21.org. 

About The Author 

Leanne Page, MEd, BCBA, is the author of Parenting with Science: Behavior Analysis Saves Mom’s Sanity. As a Behavior Analyst and a mom of two little girls, she wanted to share behavior analysis with a population who could really use it- parents!

Leanne’s writing can be found in Parenting with Science and Parenting with ABA as well as a few other sites. She is a monthly contributor to bSci21.com , guest host for the Dr. Kim Live show, and has contributed to other websites as well.

Leanne has worked with children with disabilities for over 10 years. She earned both her Bachelor’s and Master’s degrees from Texas A&M University.  She also completed ABA coursework through the University of North Texas before earning her BCBA certification in 2011. Leanne has worked as a special educator of both elementary and high school self-contained, inclusion, general education, and resource settings.

Leanne also has managed a center providing ABA services to children in 1:1 and small group settings. She has  extensive experience in school and teacher training, therapist training, parent training, and providing direct services to children and families in a center-based or in-home therapy setting.

Leanne is now located in Dallas, Texas and is available for: distance BCBA and BCaBA supervision, parent training, speaking opportunities, and consultation. She can be reached via Facebook or at Lpagebcba@gmail.com.

Are We Ready For A Play Date And Social Groups?

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This piece was originally posted at www.aba-interventions.com. 

Play skills and social skills should be a part of an ABA treatment plan and are absolutely important for children with autism or I/DD. Many parents eagerly place their child in social groups, play dates, or insist that their child participates in group activities. These are WONDERFUL if your child is ready, but can be difficult and stressful if they are placed in these groups too soon. First, ask yourself these questions to determine if your child is ready for play dates and social groups:

Does my child allow peers into his space and allow peers to touch his toys?

Is my child able to successfully sit and engage in leisure activities?

Does my child have an interest in toys and activities?

Is my child able to engage in parallel play and turn taking?

If you responded “no”, work with your child’s therapist to write specific play date goals into the treatment plan. If your child engages in frequent, aggressive behaviors or stereotypic behaviors, they may also struggle in play groups.

Simply placing a child in a group environment is NOT social training or an effective play date. Our goal is to teach a child successfully without having to constantly do “damage control.” If a child has a history of negative experiences with peers, your child may be very averse towards peers. Imagine how you would feel if EVERY time you walked into Kroger people bumped into you, yelled and screamed around you, and followed you around asking questions and stealing your shopping cart. If this was your experience every single time, you would most likely avoid grocery shopping. It is our goal to turn that aversive peer experience into an experience that is motivating and positive.

When I first begin play dates and social skills groups with early learners, I like to start with a peer model or sibling. Once certain goals have been mastered with a peer model, we can begin generalizing skills to other peers and environments. Remember, we want successful peer interactions…even if our play date is 8 minutes long! We can work up to that 30 minute karate class, the birthday party at the zoo, or some of the other amazing social groups Knoxville has to offer!

Here is a fantastic blog article on special needs playdates!

Remember, appropriate play skills includes more than sharing and sitting next to a peer. Other goals may include:

  • Keeping hands to self
  • Greetings, initiating and reciprocating conversations, staying on topic
  • Responding and asking questions
  • Eye contact
  • Imitating peers
  • Social manners (i.e. asking “what happened” if someone is crying or very excited)
  • Problem solving with peers

About The Author

Elizabeth Ginder, MSSW, BCBA, LBA is the Clinical Director of ABA Interventions, LLC. Elizabeth specializes in working with children ages 2 through early adulthood. She has experience working with children diagnosed with intellectual and developmental disabilities, as well as children with severe, challenging behaviors. Elizabeth also has a strong background in parent, teacher and staff training. Her focus is on verbal behavior, skill acquisition and teaching children how to have fun! You can find more information on ABA Interventions at their Facebook page or at www.aba-interventions.com.

Being Realistic about Changing the Environment

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Recently I visited the home of one of my clients. I asked the RBT working there if our client was still throwing materials. She said he hadn’t thrown anything all week. I was excited to hear this news, until I heard her next sentence. “I realized he always throws the materials when he asks to be all done and I say ‘not yet.’ So now, whenever he says he’s all done, we just clean it up.”

While it is true that behavior analysts make changes to the environment to improve behaviors, that doesn’t mean we change the environment at the expense of teaching new skills. Our ultimate goal for any client is that they lead as independent a life as possible. For this particular client, I hope that one day he will be employed. This means that we need to start teaching him now that sometimes he will have to complete a task, even when he doesn’t feel like it.

So how do you know when you’re being realistic about changing the environment?  Here are a few questions you should ask yourself:

Is the environmental change I’m suggesting something that will be implemented in the natural environment? If no, then you should think about how to shape appropriate behaviors rather than simply avoid the problematic behavior. For this client, refusing to work further would not be acceptable in a school or in future work environments. It could also potentially result in more restrictive learning environments for the client.

In what future circumstances might this behavior cause problems for my client? If you can envision scenarios in employment, social situations, or in public, then you need to focus on teaching an appropriate behavior rather than simply avoiding the problematic behavior. Furthermore, thinking about these circumstances may help you identify potential replacement behaviors that you can teach.

How can I shape an appropriate behavior? Think about the steps you can plan for shaping a replacement behavior. For instance, with the example of my client, we could start by requiring him to complete one more simple instruction before putting the activity away (such as placing one more puzzle piece, responding to one more question, or imitating one more action.) After he’s mastered that step, we could increase the requirement to completing two more simple instructions, then to working for one more minute, then two more minutes, etc. We can implement a systematic plan for teaching an appropriate response and completing the work even if he doesn’t want to anymore.

Is what I’m asking reasonable? In another case, one of my clients’ goals was to pull her hair back into a ponytail independently. The intention behind this goal was to do it in situ, when she would naturally be pulling her hair back. However, the implementation of the goal resulted in her practicing pulling her hair back and taking it down multiple times. Her hair would often tangle and she would feel pain while taking her hair out of the ponytail. It’s fair to say that asking a client to put up and take down her hair several times is an unreasonable request. If your request isn’t reasonable, think about how to change it so the client still learns the skill without it becoming aversive.

Ultimately, we should not change the environment in order to avoid behaviors, unless there is something unreasonable or unnecessary about what we are requesting the client to do. It is our job to teach the client how to communicate effectively, as well as to teach and reinforce appropriate behaviors to promote independence.

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.

Sharing and Cooperation

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by Dana Reinecke, PhD, BCBA-D

Sharing and cooperative play are among the most difficult skills for children to learn, whether or not they have a diagnosed disability. Why is sharing so hard? Because it necessarily involves giving something up, and usually it’s something highly preferred that is being forfeited. Cooperative play is similarly challenging because there’s often an element of compromise required. Play isn’t cooperative if one partner is getting his or her way the whole time; what makes it cooperative is the give and take. Taking is usually easier for some children than giving, and most children struggle when asked to share their toys or their parents’ attention, but there are ways to make it easier to learn these important social skills.

First, most simply, reinforce sharing and cooperation as you would reinforce any behavior that you want to see more of. Often when a child is asked to share or to compromise, the immediate and only consequence for that behavior is losing something that he or she was enjoying. This is not going to be effective for increasing sharing and cooperating in the long run, but we can add reinforcers that make it more motivating to engage in these responses again in the future. If a child shares his toys and receives lavish praise and maybe access to even better toys as a reward, he may be more likely to want to share in the future. Similarly, being willing to take turns or let someone else “go first” in a game might be more likely to happen in the future if that behavior is followed by some other reinforcer like getting an extra turn or the option of picking the game next time.

Second, approach sharing and cooperation as skills to be built up gradually. This might mean stacking the deck for success initially. Sharing and cooperation can be easier to teach when the target peers are likely to be cooperative and patient. Both areas of social skills may be modeled from peers, perhaps slightly older children, who are willing to demonstrate how to share and cooperate. Peers who are willing to take “short turns” and quickly return shared items, or to accept small concessions at first, are also going to be better partners for the learner who is only just developing these social skills, rather than peers who might be trying to learn the same lessons at the same time.
It can also be a lot easier to encourage sharing and cooperation if the games and activities where they are being practiced are not competitive. It may be harder to recruit cooperation or sharing when there is a clear “loser” and “winner” as an outcome, resulting in extra motivation to do the opposite of sharing and cooperating. Poker players don’t cooperate or share with each other, because they want to win. But, sharing and cooperating are less costly and in fact often enjoyable when applied in creative, productive situations. Having children practice cooperation and sharing when doing a craft together, for example, may be more effective than during a competitive activity.

Finally, don’t jump to complex social skills like sharing and cooperating until the child has the basic skills in place for the target activities. It would be a lot to expect someone to learn how to do something else while also learning to share and cooperate. To return to the idea of working on sharing and cooperating during a craft activity, make sure that craft is something that isn’t entirely new to the learner and that he or she has the basic skills to do the activity. This will take some of the pressure off and make sure that the focus of learning can be on the more complex social skills.

About The Author 

Dana Reinecke is a doctoral level Board-Certified Behavior Analyst (BCBA-D) and a New York State Licensed Behavior Analyst (LBA).   Dana is an Assistant Professor and Department Chair of the Department of Special Education and Literacy at Long Island University Post.  Dana provides training and consultation to school districts, private schools, agencies, and families for individuals with disabilities.  She has presented original research and workshops on the treatment of autism and applications of ABA at regional, national, and international conferences.  She has published her research in peer-reviewed journals, written chapters in published books, and co-edited books on ABA and autism.  Current areas of research include use of technology to support students with and without disabilities, self-management training of college students with disabilities, and online teaching strategies for effective college and graduate education.  Dana is actively involved in the New York State Association for Behavior Analysis (NYSABA), and is currently serving as President (2017-2018).

Ethics Part Four: Considerations On Punishment

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Punishment procedures are, with reason, very controversial. Today, I’d like to clear up a few concerns and issues about punishment procedures, especially in regards to the ethical obligations of behavior analysts.

First, it’s important to define the terms we’re discussing. In behavior analysis, when we refer to punishment, we mean any response to a behavior that decreases the future likelihood of that behavior. This means that we won’t categorize a particular intervention as punishment unless we have actual proof that it decreases the behavior. When I was a classroom teacher, I had a student who at the beginning of math class would break his pencil and begin cursing. My immediate response to this behavior was to send him out of the room. But this wasn’t actually punishment because it did not decrease the behavior. Instead, his ability to escape the math class actually maintained the pencil-breaking and cursing behavior. If I wanted to punish, or decrease, that behavior, then I needed to change my response.

Often, when we’re talking about interventions, we lump several responses into the punishment category (such as time out, verbal reprimands, or detention) without any evidence that they are actually decreasing the target behavior. So the question becomes, what is an aversive stimulus for the individual you’re working with?

While this distinction is important in order to create effective interventions, it is also important to reference the Professional and Ethical Compliance Code for Behavior Analysts. Item 4.08 details the responsibilities of behavior analysts in regards to punishment. First, it states “behavior analysts recommend reinforcement rather than punishment whenever possible.” If behavior analysts have exhausted all possibilities and must use a punishment procedure, access to reinforcement must be a part of the intervention. This can be as part of reinforcing replacement behaviors that should be taught and reinforced in lieu of any problematic behavior.

Another important aspect of our ethical code is that when punishment procedures are being utilized, there is an increase in training, supervision, and oversight. A BCBA should not come in, explain a punishment procedure, and then not show up again for three months while teachers or practitioners are implementing the punishment procedure. Instead, there should be ongoing support and supervision and a plan to discontinue aversive procedures when they are no longer needed.

Ultimately, behavior analysts should be focused on reinforcement procedures. But when it becomes necessary to use aversive procedures to address dangerous behaviors, behavior analysts are required to be aware of and follow this compliance code.

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.

Are all BCBAs robots, or just mine?

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This piece originally appeared on bsci21.org.

“We recently hired a behavior analyst to work with our 4 year old son. She seems like a robot! Are all BCBAs so ‘professional’ and focused on data? Should I find someone else who can be more relaxed and friendly? Does this person exist? What’s the deal with BCBAs?“

Well, is your behavior analyst Vicki from the 80s sitcom, ‘Small Wonder’? If yes, then she is a robot. If not, then let’s look at this a little more closely. You aren’t the first person to think a BCBA (Board Certified Behavior Analyst) is a little too professional and data obsessed.  And you likely won’t be the last.

Just so you know it’s not simply my own opinions here, I’ve sought some input from some stellar BCBAs I happen to know. 

Behavior analysts hold ourselves to a higher code of ethics than a lot of other professions. We follow the Behavior Analyst Certification Board Ethics Code.  It’s 24 pages long. We’re serious about ethics around here. There are multiple sections in this code regarding professional relationships and cautions us against multiple relationships, conflicts of interest, and exploitative relationships. What does this mean? That to some extent a BCBA HAS to be too professional.

Becoming besties with our clients isn’t allowed. That would become a conflict of interest and your new bestie would have to drop your services and refer you to someone else.

Another robotic attribute of BCBAs- we love data. We live for data. All programming should come directly from data. All discussions of your child’s progress should be based on data. I kind of sound like a robot just typing this. Data. Data. Data.

“The key for anyone new to ABA is to understand that it’s a science. All of our decision making is based on data collection, analyzing that data, and then using it to help us decide what steps to take next.” – Kristin Fida, BCBA.

“We count on data to indicate to us whether what we are doing is working or if we could be doing something differently to increase your child’s success. Data provides immediate feedback ensuring precious time is not wasted. While our obsession with data may seem excessive, we put our heart and soul in to what we do and with each individual data point we are assured that your child is successful and achieving their goals!” – Brittany Keener, BCBA.

And finally, BCBAs can be too professional and robotic by not using user-friendly language describing the principles of ABA. We can forget that not everyone uses words like antecedent, mand, tact, reinforcement contingency, and etcetera. Behavior analysts who throw around these big words and don’t take the time to make sure they make sense to you probably do sound like robots.

But even with all these reasons listing why BCBAs are kind of like robots- here’s the truth of the matter. We love our jobs. We love behavior analysis. We love our clients. We love to help others make progress toward goals, reduce problem behaviors, and teach new behaviors and skills.

We cry over setbacks and celebrate every small step of progress with our clients. We jump for joy when a client spontaneously engages in a behavior we’ve been working on for eons. We lay awake at night thinking about programming, about how to help our clients make progress faster. We worry about our clients, we care about our clients, we do everything we can to make effective behavior change in our clients’ lives.

We are not robots. As a group, that is. There may be a few behavior analysts out there who don’t feel this way. Find one of the many who do; they (we) are the majority.  Find the BCBA who lives for positive behavior change. Work with a team that plans for your child’s future, that helps your child be more independent, that uses your child’s interests to promote learning.  Be an active part of that team- communication and collaboration between you and the behavior analyst are the keys to serious progress!

Behavior analysts are not robots.  We may like data a lot (bordering on obsession), but we use it to help people in real ways.

“Essentially, don’t give up. Talk to your BCBA and communicate your concerns and ask about what approach she is using and why she feels it is an appropriate intervention. The data should show that your son is making progress in goals that you want to increase while decreasing any maladaptive behaviors.  Just like with teachers, BCBAs all have a different style. If the style is working, don’t change it right away! Communication and being open with your BCBA is best!”- Jessi French, BCBA

“Developing positive relationships coupled with data driven decision making for our interventions is a sure recipe for success and progress with any client.”- Kristin Fida, BCBA

Talk to your BCBA. Tell them your concerns, listen to their explanations for why programming is done a certain way. If they use jargon- tell them you aren’t familiar with all the ABA terms. The more collaboration between you and your BCBA- the better for your son!

Leanne Page, MEd, BCBA, is the author of Parenting with Science: Behavior Analysis Saves Mom’s Sanity. As a Behavior Analyst and a mom of two little girls, she wanted to share behavior analysis with a population who could really use it- parents!

Leanne’s writing can be found in Parenting with Science and Parenting with ABA as well as a few other sites. She is a monthly contributor to bSci21.com , guest host for the Dr. Kim Live show, and has contributed to other websites as well.

Leanne has worked with children with disabilities for over 10 years. She earned both her Bachelor’s and Master’s degrees from Texas A&M University.  She also completed ABA coursework through the University of North Texas before earning her BCBA certification in 2011. Leanne has worked as a special educator of both elementary and high school self-contained, inclusion, general education, and resource settings.

Leanne also has managed a center providing ABA services to children in 1:1 and small group settings. She has  extensive experience in school and teacher training, therapist training, parent training, and providing direct services to children and families in a center-based or in-home therapy setting.

Leanne is now located in Dallas, Texas and is available for: distance BCBA and BCaBA supervision, parent training, speaking opportunities, and consultation. She can be reached via Facebook or at Lpagebcba@gmail.com.

Setting Up the Classroom to Optimize Learning Opportunities and Effective Instruction

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This month’s ASAT feature comes to us from Melissa Taylor, BCaBA. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

I recently accepted my first teaching position.  It’s a new classroom for the district serving students with autism. I have lots of materials, but nothing is organized or set up in my classroom. What are some tips to set up and organize the classroom to optimize learning opportunities and effective instruction?

Congratulations on your first teaching position! This is a common question for new teachers. When we talk about classroom organization, there are several things to take into account. Good classroom organization effectively makes use of space and barriers, has accessible materials for instruction and data collection, and facilitates efficient time management. It is critical that when you set up your classroom, you review the needs of your individual students as well as make sure to address the core characteristics of autism. You probably already know that many of your students will present with deficits in social interactions and communication, including challenges with requesting items from adults and peers. It will be important to create an environment that makes it necessary for students to interact frequently with other people to increase communication opportunities.  Once the environment is conducive to optimizing instruction, the instructors can implement effect behavioral strategies to teach desired behaviors.

Organizing the Space

Seating. When organizing a space, we want to make sure that the seating arrangement will allow students to access the materials needed for activities and respond accurately to instruction. For younger students, make sure the chairs allow their feet to touch the floor. Likewise, older students should be able to sit up straight with feet on the floor and legs at approximately 90-degree angle. Try to arrange seating so that you have space for group, as well as individual sessions. Also, allow enough room that additional support staff can sit behind students to make prompting less intrusive (e.g., sitting behind student and using physical guidance to help them learn the expected motor responses during the, “Wheels on the Bus” song).

Pathways for transitions. The furniture should be set up in a way that enables smooth transitions from one area to another without traffic jams. Walking between areas will be easier if there are not large dividers or barriers that slow down transitioning. Having open spaces and clear pathways between defined areas could also allow instructors to move quickly to different areas of the classroom if there is an episode of problem behavior or an unexpected opportunity to support a social interaction.

Defining areas. Some instructors find that using dividers helps clearly separate sections of the classroom. Keep in mind that every area should be open enough that the classroom teacher is able to see every student and classroom assistant. This will allow the teacher opportunities to provide immediate feedback to staff on interactions with students and to offer frequent student praise.  Try to avoid tall dividers that make it impossible to see into the other areas and dividers that are easily knocked over. Shelving units, desks, carpets, and tables can create more natural space dividers that can help define the areas. Keep in mind the function and purpose of each classroom area, and make sure that the instructional materials needed are in the area and replaced as needed. For example, if students are going to be required to request items during circle time, those items should be easy for the instructor to reach during group rather than requiring the instructor to get up, leave the group and look in a cabinet for items.  

Putting away preferred items. Children, including those with autism, are often good at finding and gaining access to the things they like without the help of other people. By keeping items out of reach, in clear containers that are difficult to open, and on high shelves, you can create new requesting opportunities and make communication with adults more valuable to students. Resalable plastic storage bags, totes, bins, shelving units, and aprons with pockets may all be useful to make it more likely that the students will need to request help from others to access the items they want or need. If the student already has a valuable item, you have lost an opportunity for communication.  By restricting access to valuable items, teachers can prompt requests for specific items and deliver items to students. Furthermore, when delivering the item, the teacher becomes more valuable to the student, who learns the significance of communicating. When these types of natural communication trials with preferred items occur in areas where instruction will occur, it becomes more likely that students will approach instructors and instructional areas. One important consideration with using such materials that in some cases, direct visibility to highly preferred items can be distracting to students or result in attempts to retrieve items outside of appropriate or scheduled times. In such instances, evaluate the situation and determine whether moving the student’s seat so that it is not facing those items or moving the items themselves will address the issue.

Organizing Materials

Materials for data collection. In preparing materials for instruction, we want to make sure that all instructors have easy access to necessary materials such as data collection tools and sheets. These items should be able to be easily accessed at any point of the day, so that instructors are more likely to capture all opportunities of the behaviors they are tracking. When data are recorded immediately following student behavior it is more likely to be accurate. Clipboards that have pockets attached to them are good for storing writing utensils, timers and additional data sheets. Student item lists, teaching stimuli, and data sheets can be kept in a cart with drawers to make it easily accessible during teaching. When collecting any type of data that require instructors to count the number of occurrences of a behavior, instructors can use clickers attached to their clothing with carabiner clips for convenience. Blank student specific datasheets can be carried with the student on clipboards, kept in a drawer on a cart, or hung on bulletin boards in centers where instructional activities occur.

Materials for instruction. Pencil cases or small craft boxes help organize small materials such as pieces of edibles, small toys, pencils, highlighters, picture cards, visual schedules or index cards for instruction.  For larger instructional items such as toys needed for teaching imitation skills, items needed for simply following direction tasks, or items needed to teach daily living skills, boxes, rolling carts with larger drawers, or labeled shelves can be used to organize materials by student or goal areas.

Consider posting wall cues, table/desk cue cards, or other reminders in places where staff will easily see them. These cues can be helpful to guide instruction without the need to flip through pages in consultation notes or program books to reference procedures. Types of items to post include specific teaching protocols and prompt hierarchies, reinforcement schedule reminders, behavior management strategies, toilet training schedules, reminders of how to teach play skills and student to student requesting, or other items that you want to generalize from one classroom area to another. Cue cards, wall cues, or student data sheets with specific targets listed can also guide instructor presentation during less structured teaching opportunities.  For example, if the student has been working on labeling the picture of gloves, and during circle time the teacher is dressing a weather bear, the instructor can ask that student to label the weather bear’s gloves. Additional targets to be posted for staff could include specific peer-to-peer requests or interactions (e.g., give item to peer, accept item from peer), specific motor skills (e.g., copying a line, opening a container), self-help skills (e.g., putting on shoes, washing hands), and other activities.  This allows for easy implementation of strategies such as natural environment teaching and incidental teaching.  Another point is to consider limiting other “wall clutter” that often serves as highly distracting stimuli to students. When possible, keep to salient items such as a classroom schedule, current student work or points of study (e.g., pictures of alphabet) but don’t feel the need to cover every available space with something!

Classroom Schedule

Time is valuable, and students with autism do not have time to waste. It is important to make the most of your day by having many opportunities to practice all targeted skills. Having a classroom schedule that allows for enough instructional time to make significant progress is critical. When creating a classroom schedule, make sure to address the who, when, what, and where questions. In other words, it should be easy to see who is working with a student at any given time as well as what skill they are working on and where they are working on that skill (e.g., red table, art table, hallway, etc.). Assigning student names to specific instructors can save valuable time during an emergency situation (student elopes, fire emergency).  Avoid unnecessary large chunks of non-academic or unstructured times. What each student will be working on should vary based on assessments conducted in the classroom. Instructors should consider posting the schedule on a wall, centrally located and large enough that all team members can see it. However, if you have many students and paraeducators going in and out of the room, you may consider having a master calendar but printing out individual copies for each staff member.  When you have a master schedule that is easy to change when students and staff are absent will cut down on unnecessary talk about who is with specific students and what they should be working on. Additionally, color-coding by students or staff will allow for staff member or administrators to easily follow from across the room or with a quick glance. Staff should be assigned to students at all time.  If a student is engaged in independent work, having a staff member still assigned to that child will help everyone know who is tracking data or responsible if an emergency occurs. 

If you take all of these suggestions into consideration when you begin planning your classroom, you will be well on your journey to make a big difference in the outcomes of your students. An organized classroom allows teachers to focus on effective instructional strategies and behavior management strategies that are individualized to each child and not waste valuable time locating materials, guiding staff behaviors, and planning groups.  We wish you well in your new teaching position and in the years to come.

About The Author

Melissa Taylor, BCaBA is a Consultant on the Autism Initiative for the Pennsylvania Training and Technical Assistance Network. Her current position focuses on training educators on the principles and implementation of behavior analysis within classroom settings. In addition, Melissa provides in-home behavior consultation to children and adults with autism. Currently, she serves as the Sponsorship Coordinator for the Association for Science in Autism Treatment.