Category Archives: Research

Elopement and Neighborhood Safety

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As the end of the school year approaches and students are let out on vacation, it’s important for us to consider the risks of elopement and overall neighborhood safety for children with autism. This month, we’re sharing a special feature from ASAT written by Kate Britton, EdD, BCBA and Bridget Taylor, PsyD, BCBA from Alpine Learning Group in New Jersey. Here, Kate and Bridget offer their guidelines on preventing potentially harmful situations and ensuring the safety of your children. 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!

Elopement and Neighborhood Safety
Bridget Taylor, PsyD, BCBA and Kate Britton, EdD, BCBA
Alpine Learning Group, NJ

You are not alone. In fact, according to an online survey conducted by the National Autism Association in 2007, 92% of the parents indicated their child with autism was at risk of wandering away from his or her home or care provider. More recently, Kiely et. al. (2016) reported survey results of families of children with Autism Spectrum Disorders which found that 49% of those children had made an attempt to elope since the age of four. Additionally, 62% of parents of children who elope reported that this behavior prevents them from participating in activities away from home. Children with autism are especially vulnerable if they wander away from caregivers, as they may not be able to communicate that they are lost, take steps to ensure their safety such as identifying who in the community is safe vs. unsafe, asking for assistance, or stating important information such as their phone number. We hope the following guidelines can help you in preventing potentially harmful situations.

Develop a “safety / reaction plan”. Develop a family safety plan and practice that plan. In the event of your child wandering, time is most important and a quick, efficient response can make a difference. For example:

  • Which family member will call the local police?
  • Which family member(s) will go out looking and where (e.g., the route to the child’s favorite park)?
  • Which family member will call neighbors of homes with pools?
  • Which family member will stay by the phone in case the child is found and returned home or to receive updates?

You can find a sample plan at the Autism Wandering Awareness Alerts Response and Education (AWAARE) Collaboration website (www.awaare.com). It would also be important for your child’s school or treatment center to implement an emergency plan for elopement.

Secure your home and yard. Secure your home and yard area so that your child is less likely to wander away. Sometimes standard locks are not enough as many children quickly learn how to operate standard locks on doors, windows and gates. Install locks on doors and gates in the yard that your child cannot open (consider location height and lock complexity). In addition, if your home has an alarm system, keep it set to go off whenever a door or window has been opened. If your home does not have an alarm, install an alarm system that signals when a door or window is opened. There are a variety of systems available, including high-tech and low-tech options. You may consider contacting a medical or educational provider, who can help identify resources to help obtain funding for such systems/equipment. Here are some suggested websites:

Install monitoring systems. Additionally, be sure to regularly monitor your child around the house by using a video monitoring system or a baby monitor that has video monitoring capability, such as:

Make the yard and pool area safe! If you have a pool or there is a pool nearby, ensure there is a locked fence surrounding the pool. You can also purchase a pool alarm for yours and/or your neighbors’ pools (e.g., www.poolguard.com). If your child goes into pools unsupervised, you can also use the Safety Turtle (www.safetyturtle.com), which is a wristband that locks securely around your child’s wrist and sounds an alarm if it becomes immersed in water.

Inform law enforcement. It is also critical to inform your police and fire departments that an individual with autism resides in your home. You can do this by calling your local non-emergency telephone number and asking personnel to note in the 911 database that someone with autism lives at your address. If there is ever an emergency, the emergency responders will know in advance that they need to respond accordingly. We also recommend giving local police and fire departments a picture of your child with your contact information on the back which can be helpful in identifying your child if s/he is ever brought to the station by someone else. Another suggestion would be to register with the National Child Identification Program (www.childidprogram.com). The program provides a kit that includes information on everything law enforcement would need in case of an emergency.

Educate neighbors. Another tip is to make sure your trusted neighbors are aware of your situation. Give them a picture along with some helpful information about your child (e.g., s/he is unable to speak, s/he responds to simple commands, s/he likes to swim so please keep your pool gate locked) and about autism in general. Also include your cell phone and home phone numbers, and ask them to call immediately in the event they ever see your child wandering away from the house or walking the street unaccompanied by an adult. Also, assess your child’s current level of communication. For example, can s/he answer social questions and be understood by novel listeners? Strangers will be most likely to ask your child, “What’s your name?” So it is important that your child can be understood by listeners who don’t know your child. If your child will not be understood or can’t relay enough information, you could use medical identification jewelry, such as a bracelet (e.g., www.medicalert.org).

Safety on vacations. Once your home is secure, vacations may still seem unrealistic. However, there are some steps you can take to allow your family to safely stay in a hotel or space other than the safe haven you have created. When planning for a vacation, really think about your vacation destination and determine the potential risks for your child with autism. Specifically, if your child has a history of wandering (especially towards pools or other swimming areas) you may want to ask for a room furthest from the pool area or without an ocean view-or maybe even choose a location that does not have a pool. When checking into the location, inform the hotel staff about your child and advise them that s/he will require supervision at all times and if they see him/her unsupervised to call you immediately. Also, consider using portable door alarms for hotel rooms, a child-locator systems and/or a global positioning systems (GPS). You can find low-tech tracking devices and high-tech devices online.

Teach skills to increase safety. Lastly, it’s essential to proactively teach your child skills that will increase his/her safety. Work with your child’s school or treatment program to include the important safety goals in your child’s individualized education plan (IEP) such as:

  • responding to “stop”
  • answering questions to provide information
  • responding to name
  • holding hands
  • requesting permission to leave the house
  • requesting preferred items/activities
  • waiting appropriately
  • using a cell phone
  • crossing the street safely (if appropriate given age and level of functioning)
  • seeking assistance when lost
  • cooperating with wearing identification jewelry
  • identifying outdoor boundaries (i.e., not leaving the front lawn)
  • learning clear rules about outdoor play (getting a parent if a stranger approaches, asking for help if ball goes into street)
  • swimming more proficiently
  • learning rules about pool use

Check out www.awaare.org for sample letters to submit to your case manager and attach to your child’s IEP. Finally, it cannot be overstated that children with autism require very close supervision when in harm’s way. We hope you find these proactive and teaching suggestions helpful in minimizing your child’s risk.

Additional toolkits and resources

References

Anderson, C., Law, J.K., Daniels, A., Rice, C., Mandell, D. Hagopian, L. & Law, P. (2012). Occurrence and family impact of elopement in children with autism spectrum disorders. Pediatrics, 130(5), 870-877.

Kiely, B., Migdal, T. R., Vettam, S., Adesman, A. (2016). Prevalence and correlates of elopement in a nationally representative sample of children with developmental disabilities in the United States. PLoS ONE 11(2): e0148337, doi:101371/journal. Pone.0148337

About the Authors

Dr. Bridget A. Taylor, PsyD, BCBA is Co-founder and Executive Director of Alpine Learning Group and is Senior Clinical Advisor for Rethink. Dr. Taylor has specialized in the education and treatment of children with autism for the past twenty-five years. She holds a Doctorate of Psychology from Rutgers University, and received her Master’s degree in Early Childhood Special Education from Columbia University. She is a Board Certified Behavior Analyst and a Licensed Psychologist. She is an Associate Editor for the Journal of Applied Behavior Analysis and serves on the editorial board of Behavioral Interventions. She is a member of the Behavior Analyst Certification Board and serves on the Autism Advisory Group for the Cambridge Center for Behavioral Studies. Dr. Taylor also serves on the Scientific and Community Advisory Board for SPARK a new program at the Simon’s Foundation Autism Research Initiative. Dr. Taylor is active in the autism research community and has published numerous articles and book chapters on effective interventions for autism. She is a national and international presenter and serves in an advisory capacity for autism education and treatment programs both locally and abroad. She has been influential in the development of autism treatment centers both locally and in Italy, India, Canada, France, Australia and Kosovo. Dr. Taylor’s current research interests are in identifying innovative procedures to increase the observational learning repertoires of children with autism.

Kate E. Cerino Britton, EdD, BCBA is a Board Certified Behavior Analyst and a certified teacher of the handicapped, and has worked with individuals with autism since 1997. She is currently the Principal of the education program at Alpine Learning Group. She holds a Masters in Education Administration from Caldwell College and Special Education from Long Island University and a doctoral degree in Educational Leadership, Management, and Policy from Seton Hall University. She serves on the New Jersey Association for Behavior Analysis Board of Directors as the Secretary and Continuing Education Chair and has presented at national and international conferences on increasing socializing, problem solving, small groups and dyad instruction, promoting safety, and augmentative communication.

Tip of the Week: Using Token Economies In Autism Classrooms

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Token economies are used in many different environments. They’re typically simple to implement and achieve desired results for behavior change, especially in autism classrooms. Furthermore, there are tons of research on how to best use them. If you want to get the best results while simultaneously promoting independence in your learners, it is not as simple as just putting some stars on a chart.

 

  • Use a preference assessment. This will help you identify reinforcers your learner may want to earn. As I’ve mentioned in previous posts, I often use the Reinforcer Assessment for Individuals with Severe Disability (Fisher, Piazza, Bowman, & Amari, 1996). You can view it here.
  • Define the target behavior. What behaviors do you want to increase? And how can you define them so they are clearly observable and measurable. For instance, your learner could earn tokens for raising his or her hand in class or responding to a question within 3 to 5 seconds. It is important the behavior is clear and everyone using the token economy agrees on what each behavior looks like.
  • Choose your tokens. When I was a classroom teacher, I had a class-wide token economy in which my students earned paperclips. The paperclips had no value initially, but once the students understood the system, I could put paperclips in the bags of the students who were sitting quietly while still continuing to teach my lesson. It allowed them to reinforce the appropriate behaviors and make the most of instructional time. For other students, I’ve used things such as Blue’s Clues stickers, smiley faces I drew on a piece of paper, and even tally marks on an index card.
  • Choose when and how tokens will be exchanged. With the paperclip system in my classroom, exchanges occurred at the end of the day. After everyone had their bags packed and were sitting at their desk, we did the “paperclip count” and students could decide whether to spend or save. There was a menu of options ranging in price from 10–100 paperclips. It was also a great way to reinforce some basic math skills (such as counting by fives and tens and completing basic operations). For other students, they might be able to exchange tokens after earning a set amount. Depending on their level of ability, that set amount may be very small (such as 2 to 3) or much larger (such as 25). Sometimes, students have a choice of items or activities, while at other times they earn a pre-selected item or activity.
  • Keep it individualized. Conducting a preference assessment helps to make sure it’s individualized to your learner’s preferred items. With my students, the menu of items/activities they could earn was generated through a conversation with them.
  • Decide if you will implement a response cost. For my students, I have never used a system in which they could lose tokens they had already earned. But you may find that utilizing it may help. It all depends on your particular learner, which makes the next point all the more important.
  • Take data. You need to take data so you will know if your token economy is helping you achieve your goal with the target behaviors you have set.
  • Thin the reinforcement over time or change the target behaviors. I do not want any of my learners to be using a token economy for one behavior for all eternity! Let’s say I start with a young learner who is not sitting down for instruction. I may start the token economy by having my student earn a token for every instance in which they are seated correctly for a specified period of time. As my student masters that, I will increase the amount of time required before a token will be earned. Once they’ve achieved the goal I set, I can either fade out the token economy, or keep the token economy but use it for a new behavior.

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

Using Smartphones and Tablets in Video Modeling For Autism

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There are tons of articles and lists about the best apps for kids with autism. However, you may be missing out on one of the best possible uses of smartphones and tablets for improving services for your learner: the camera app that is already built into the device.

A wealth of research has shown the efficacy of using video modeling to teach children and adults with autism, to train staff on how to implement programs and procedures, and to train parents on interventions. Smartphones and tablets make creating such videos much easier than it was in the past. Here’s why you should be using smartphones and tablets for video modeling for autism, as well as a few things to consider:

  • Be sure you have named the steps of the procedure or program you are modeling. It may be helpful to have those steps written down for the person using the video model.
  • If you are a teacher or practitioner recording your learner, be sure you have consent from the individual’s guardian(s). Also, check in about any recording policies at your school or center.
  • If you are a parent struggling to implement an intervention, request that the teacher or practitioner create a video model. It’s helpful to see someone else doing and to be able to refer back to that video as necessary.
  • If you are taking video of your learner for the first time, you may want to set up the tablet or smartphone without taking video for a few sessions before you actually create the video model. This will help avoid problems with the learner changing his or her behavior because a new (and often desirable) object is in the environment.
  • Consult the literature! As I mentioned before, there is a huge amount of research on video modeling. In recent years, it has been used to teach children with autism to make requests (Plavnick & Ferreri, 2011), increase treatment integrity for teachers implementing interventions (DiGennaro-Reed, Codding, Catania, & Maguire, 2010), teach children how to engage in pretend play (MacDonald, Sacramone, Mansfield, Wiltz, & Ahearn, 2009), increase social initiations of children with autism (Nikopoulos & Keenan, 2004), and more.

With the easy-to-use technology at our fingertips every day, video modeling is a simple and efficient way to demonstrate a new skill. This basic use of smartphones and tablets should not be overlooked because it can have a huge impact on teaching learners with autism new skills or helping parents and staff implement stronger programs and interventions.

References

DiGennaro-Reed, F. D., Codding, R., Catania, C. N., & Maguire, H. (2010). Effects of video modeling on treatment integrity of behavioral interventions. Journal of Applied Behavior Analysis, 43(2), 291–295.

MacDonald, R., Sacramone, S,. Mansfield, R., Witz, K., & Ahearn, W.H. (2009). Using video modeling to teach reciprocal pretend play to children with autism. Journal of Applied Behavior Analysis, 42(1), 43–55.

Nikopoulous, C.K. & Keenan, M. (2004). Effects of video modeling on social initiations by children with autism. Journal of Applied Behavior Analysis, 37(1), 93–96.

Plavnick, J. B., & Ferreri, S. J. (2011). Establishing verbal repertoires in children with autism using function-based video modeling. Journal of Applied Behavior Analysis, 44(4), 747–766.

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

How Occupational Therapy Can Benefit ABA Programs

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This month, we’re proud to feature a wonderful piece from the Association for Science in Autism Treatment (ASAT), written by Amy McGinnis Stango, MS, OTR, MS, BCBA, on the benefits of occupational therapy as a supplement to your child’s ABA program. Amy is a nationally registered occupational therapist and board certified behavior analyst, and provides consultative direct and consultative services to families, clinics and schools across the country and internationally. She is also the co-author of Assessing Language and Learning with Pictures (ALL PICS), an assessment tool designed to make administration of the VB-MAPP more accurate, efficient, and cost-effective for schools, clinics, agencies, and private practitioners.

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 enrolled in an ABA-based program where he also receives some OT services. How can occupational therapy benefit my child’s ABA program?

Answered by Amy McGinnis Stango, MS, OTR, MS, BCBA

Occupational therapy (OT) can be beneficial as a supplemental treatment to your child’s ABA program. The goal of occupational therapy is to support an individual’s health and participation in life through engagement in occupations or everyday tasks (AOTA, 2008). The occupational therapy process begins with an evaluation. The evaluation helps to determine whether your child has met developmental milestones in a wide variety of occupations. The occupational therapy evaluation can help your child’s behavior analyst choose developmentally appropriate goals to be included in his ABA program. The OT evaluation may also be helpful in understanding why a child struggles with a particular task. For example, if your child struggles with handwriting, the evaluation can determine whether this difficulty stems from an inappropriate grasp, poor posture, muscle weakness, visual memory, or lack of eye-hand coordination. Pediatric occupational therapy typically addresses the following domains:

  • Play
  • Activities of Daily Living
  • Education
  • Social Participation

Play is the primary occupation of childhood and is often an area of need for children with autism. Occupational therapy can be effective in helping children learn new play skills (Stagnitti, O’Connor, & Sheppard, 2012). Many pediatric occupational therapists use a play-based approach to their sessions, exposing children to a variety of toys, games, and different ways to play. If your child engages in repetitive play behaviors or has limited interests, the occupational therapist may be helpful in finding other activities that share similar sensory properties of the toys your child already enjoys. Some of the sensory activities used in occupational therapy may function as reinforcers, which could be used in your child’s ABA sessions as well (McGinnis, Blakely, Harvey, Hodges & Rickards, 2013).

Occupational therapists typically include an assessment of activities of daily living (ADLs) as part of the evaluation. ADLs include those basic self-care tasks that an individual performs each day, such as eating, grooming, dressing, and using the bathroom. Occupational therapy can help to build the strength, coordination, and perception skills needed to perform these tasks. For example, if your child has oral motor deficits, occupational therapy can help your child learn the mouth movements necessary for chewing and drinking (Eckman, Williams, Riegel, & Paul, 2008; Gibbons, Williams, & Riegel, 2007). Occupational therapy can also help older children and adolescents learn more advanced ADLs, like independent bathing (Schillam, Beeman & Loshin, 1983). Occupational therapists are trained in identifying multiple ways to perform routine tasks, and can recommend an approach that will work best for your child and can be integrated into your routines at home (Kellegrew, 1998).

As individuals with autism age, occupational therapists can help teach skills that will lead to greater independence at home and in the community (McInerney & McInerney, 1992). These include preparing meals, managing money, shopping and using public transportation. Often these skills are more complex and may require an activity or task analysis that breaks the task down into simpler steps. With extensive training in developing task analyses, occupational therapists can share these analyses with your child’s ABA team so that skills can be taught across settings. If tasks are still difficult, an occupational therapist may recommend adaptive equipment to make a task easier. Occupational therapy can also help your child participate more fully in his or her educational program. Occupational therapy can help young children acquire tasks such as coloring and cutting (Case-Smith, Heaphy, Marr, Galvin, Koch, Ellis, & Perez, 1998), as well as help older children acquire skills such as handwriting (Denton, Cope, & Moser, 2006). If your child has difficulty moving through the school setting or actively participating in movement activities, occupational therapy can help your child develop functional mobility skills. Continue reading →

Is Inclusive Education Right for Children with Disabilities?

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This week, we’re honored to feature an article by Edward Fenske, MAT, EdS, the former executive director of the Princeton Child Development Institute, who shares his critique on the U.S. Departments of Health and Human Services and Education’s joint statement on inclusive education for all children with disabilities. Ed’s extensive experience in delivering intervention to children with autism, support services to their families, and training and supervision to professional staff spans 39 years. His published works address home programming, language development, and early intervention.

Is Inclusive Education Right for My Child with Disabilities?
by Edward Fenske, MAT, EdS
Princeton Child Development Institute

On September 14, 2015 the U.S. Department of Health and Human Services and the U.S. Department of Education issued a joint policy statement recommending inclusive education for all children with disabilities begin during early childhood and continue into schools, places of employment, and the broader community. The policy includes numerous assertions about the educational benefits and legal foundation of inclusion and a lengthy list of supporting evidence. This paper examines some of these assertions, the supporting evidence, and comments on the departments’ recommendation.

 

Assertion: Children with disabilities, including those with the most significant disabilities and the highest needs, can make significant developmental and learning progress in inclusive settings.

Supporting Evidence: Green, Terry, & Gallagher (2014). This study compared the acquisition of literacy skills by 77 pre-school students with disabilities in inclusive classrooms with 77 non-disabled classmates. Skill acquisition was assessed using pre/post intervention scores on the Peabody Picture Vocabulary Test, Third Edition (Dunn & Dunn, 1997) and the Phonological Awareness Literacy Screening Prekindergarten (Invernizzi, Sullivan, Meier, & Swank, 2004). The results found that children with disabilities made significant gains that mirrored the progress of their typical classmates, although the achievement gap between the two groups remained. Participants had a variety of diagnoses (e.g., developmental delays, autism, pervasive developmental disorder-not otherwise specified, speech and language impairments, cognitive impairments, and Down syndrome). There were several requirements for participation in this study that would appear to severely limit conclusions. Participants with disabilities were functioning at social, cognitive, behavioral and linguistic levels to the extent that their Individual Education Program (IEP) teams recommended participation in language and literacy instruction in the general education classroom with typical peers-an indication that these skills were considered prerequisite to meaningful inclusion.

A further restriction for participation was that only data from children who were able to complete the tasks according to standardized administrative format were included in the study. It is therefore unclear whether all students with disabilities in these inclusive preschool classes made significant developmental and learning progress. The authors suggest that had the lower achieving students received explicit, small group or individual instruction, the achievement gap between typically developing students and children with disabilities may have been narrowed. We can therefore conclude that regular instruction provided in the inclusive preschool classes in this study was not sufficient for all students with disabilities. Furthermore, because the results were not separated by disability, it is not possible to determine whether there was a significant difference in learning across disabilities.

Assertion: Some studies have shown that children with disabilities who were in inclusive settings experienced greater cognitive and communication development than children with disabilities who were in separate settings, with this being particularly apparent among children with more significant disabilities.

Supporting Evidence: Rafferty, Piscitelli, & Boettcher (2003). This study described the progress in acquiring language skills and social competency of 96 preschoolers with disabilities attending a community-based program. Sixty-eight participants received instruction in inclusive classes and 28 attended segregated special education classes. Progress was assessed using pretest and posttest scores from the Preschool Language Scale-3 (Zimmerman, Steiner, & Pond, 1992) and the Social Skills Rating System (SSRS)–Teacher Version (Gresham & Elliott, 1990). Level of disability (i.e., “severely disabled” or “not severe”) was determined by scores on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R), but the authors did not provide any information about the participants’ specific clinical diagnoses. Posttest scores were comparable for “not severe” students in both class types. Children with “severe” disabilities in inclusive classes had higher posttest scores in language development and social skills than their peers in segregated classes, but had higher rates of problem behavior. The extent to which problem behavior interfered with learning for both typical children and those with disabilities was not addressed. Problem behavior, such as tantrums, aggression, stereotypy, self-injury, property destruction and defiance; is displayed by some children with disabilities. These behaviors have very different implications for preschool-aged children than for older children. In this writer’s experience, severe problem behavior is extremely resistant to change when not successfully treated during preschool years and may ultimately result in more restrictive academic, vocational and residential placement during adolescence and adulthood. The significance of any academic gains by children with disabilities in inclusive settings should be carefully weighed against the long-term implications of unchecked maladaptive behavior.

Continue reading →

What Is Procedural Fidelity In ABA?

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It is not uncommon for parents or practitioners to implement a new intervention that appears to be working well, then after a few weeks or months report that the intervention has stopped working. Often, the change in behavior in feels like a mystery and leaves people scrambling for a new intervention. But before searching for a new intervention, you should consider the possibility of problems with procedural fidelity, which “refers to the accuracy with which the intervention or treatment is implemented” (Mayer, Sulzer-Azaroff, & Wallace, 2014).

Problems with procedural fidelity in ABA are common, and you will experience more success with your interventions if you take steps to address fidelity at the outset. Here are a few suggestions:

  • Post the steps in a visible spot. Clearly list the steps of the procedure and put them in a spot where you will see them often. This might be on the actual data collection sheet or on the wall. One parent I worked with had a Post-it® note with the steps for our intervention attached to her computer screen. Another parent kept the steps inside the ID part of his wallet, where they were protected and visible each time he opened his wallet.
  • Plan meetings to go over the steps. As part of your intervention, set brief monthly or quarterly meetings to go over the steps of the intervention and be sure everyone is maintaining procedural fidelity.
  • Assess for procedural fidelity. Schedule observations to ensure that each step of the intervention is implemented as described. If you do not have someone who can supervise you, take video of yourself implementing the intervention, watch it and compare your actions to the steps outlined in the intervention plan.
  • Outline steps for systematic fading of the intervention. When implementing an intervention, the goal is to have the learner eventually exhibiting the desirable behavior without prompts or planned reinforcement. Sometimes when a parent or practitioner sees the learner’s behavior improving, they begin to remove the prompts or planned reinforcement before the learner is quite ready for it. By writing a plan for fading the intervention into the plan, you make it clear to everyone involved what the requirements are for each step towards mastery.

REFERENCES

Mayer, G.R., Sulzer-Azaroff, B., & Wallace, M. (2014). Behavior analysis for lasting change (3rd ed.). Cornwall-on-Hudson, NY: Sloan Publishing.

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3–12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

The Social Problem-Solving Model: Promoting Greater Social Independence – Part II

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In continuing our exclusive social problem-solving series, Drs. Gordon and Selbst, developers of the new POWER-Solving® Curriculum, have addressed the importance of social information processing as a framework for understanding how children and adolescents get along with their peers and adults.

The Social Problem-Solving Model: Promoting Greater Independence – Part II
Steven B. Gordon, PhD, ABPP & Michael C. Selbst, PhD, BCBA-D

Social Information Processing (SIP) is a widely studied framework for understanding why some children and adolescents have difficulty getting along with their peers and adults.

A well-known SIP model developed by Crick and Dodge (1994) describes six stages of information processing that individuals cycle through when responding to a particular social situation:

  1. encoding (attending to and encoding the relevant cues);
  2. interpreting (making a judgment about what is going on);
  3. clarifying goals (deciding what their goal is in the particular situation);
  4. generating responses (identifying different behavioral strategies for attaining the decided upon goal);
  5. deciding on the response (evaluating the likelihood that each potential strategy will help reach their goal, and choosing which strategy to implement);
  6. and performing the response (doing the chosen response).

These steps operate in real time and frequently outside of conscious awareness. Many studies have demonstrated that children and adolescents have deficits at multiple stages of the SIP model which impact their development of appropriate peer interactions and the development of aggressive behaviors (Lansford, Malone, Dodge, Crozier, Pettit and Bates, 2006).

As a result, they have difficulty attending to and interpreting social cues, adopting pro-social goals and utilizing safe, effective and non-aggressive strategies to handle conflict situations. The development of strong social skills has been shown to contribute to the initiation and maintenance of positive relationships with others.

POWER-Solving BooksThe POWER-Solving® Curriculum (Selbst and Gordon, 2012) is heavily influenced by the components of the SIP model as seen in the five steps of POWER-Solving, easily learned in the acronym POWER:

  • Put the problem into words;
  • Observe your feelings;
  • Work out your goal;
  • Explore possible solutions;
  • Review your plan

The curriculum is comprised of several modules, each with their own materials for facilitators and students. While it is critical for the student to learn the POWER-Solving® Steps first (i.e., the “toolbox”), the facilitator can determine the sequence of the subsequent modules. For example, one may prefer to move to the Anger Management module after the introduction. Alternatively, one may decide to move to Social Conversation or Developing Friendships. The goal is for students to learn valuable POWER-Solving skills that they can apply to an infinite number of social situations throughout their lives.

REFERENCES

Crick, N.R., & Dodge, K.A. (1994). A review and reformulation of social information-processing mechanisms in children’s social adjustment. Psychological Bulletin, 115(1), 74–101. doi:10.1037/0033-2909.115.1.74.

Lansford, J.E., Malone, P.S., Dodge, K.A., Crozier, J.C., Pettit, G.S., & Bates, J.E. (2006). A 12-year prospective study of patterns of social information processing problems and externalizing behaviors. Journal of Abnormal Child Psychology, 34, 715-724.

Selbst, M.C. and Gordon, S.B. (2012). POWER-Solving: Stepping stones to solving life’s everyday social problems. Somerset, NJ: Behavior Therapy Associates.

ABOUT STEVEN B. GORDON, PHD, ABPP

Steven B. Gordon, PhD, ABPP is the Founder and Executive Director of Behavior Therapy Associates, P.A. He is a clinical psychologist and is licensed in New Jersey. Dr. Gordon is also Board Certified in Cognitive and Behavioral Psychology by the American Board of Professional Psychology and is a Diplomate in Behavior Therapy from the American Board of Behavioral Psychology. Dr. Gordon has co-authored three books, published numerous articles, presented papers at local and national conferences, and served on editorial boards of professional journals. Most recently, Dr. Gordon and Dr. Selbst have co-authored the new social-emotional skills program POWER-Solving: Stepping Stones to Solving Life’s Everyday Social Problems. Dr. Gordon’s professional interests range from providing assessment and treatment for individuals diagnosed with Autism Spectrum Disorders, AD/HD and other disruptive behavior disorders associated with childhood and adolescence. He has co-founded and is the Executive Director of HI-STEP® Summer Program, which is an intensive five-week day program for children to improve their social skills and problem solving ability. In addition, Dr. Gordon has had extensive experience providing clinical services not only for children diagnosed with phobias, stress, selective mutism, obsessive compulsive disorders and depression, but also with adults coping with anxiety,depression and relationship difficulties. Dr. Gordon is a member of the American Psychological Association, the Association for Behavioral and Cognitive Therapies, and the New Jersey Psychological Association.

ABOUT MICHAEL C. SELBST, PHD, BCBA-D

Michael C. Selbst, PhD, BCBA-D is Director of Behavior Therapy Associates, P.A. He is a Licensed Psychologist and a Certified School Psychologist in New Jersey and Pennsylvania. He is also a Board Certified Behavior Analyst at the Doctoral level. Dr. Selbst has co-founded and is the Executive Director of HI-STEP® Summer Program, which is an intensive five-week day program for children to improve their social skills and problem solving ability, and the Director of the Weekend to Improve Social Effectiveness (W.I.S.E.). He has extensive experience working with pre-school aged children through adults, including individuals who have social skills deficits, emotional and behavioral difficulties, learning disabilities, gifted, and children with developmental delays, including those with Autism and Asperger’s Syndrome. Dr. Selbst consults to numerous public and private schools, assisting parents, teachers, and mental health professionals, and presents workshops on all topics highlighted above, as well as Parenting Strategies, Depression, and Suicide Prevention. Dr. Selbst and Dr. Gordon have co-authored the new social-emotional skills program POWER-Solving: Stepping Stones to Solving Life’s Everyday Social Problems. Dr. Selbst is a member of the following professional organizations: American Psychological Association; National Association of School Psychologists; Association for Behavioral and Cognitive Therapies; Association for Behavior Analysis International; Association for Contextual Behavioral Science; New Jersey Psychological Association; and New Jersey Association of School Psychologists.

The Social Problem-Solving Model: Promoting Greater Social Independence – Part I

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This week, in continuing the spirit of Autism Awareness, we’re excited to feature a two-part expert article on a social problem-solving intervention method by Steven Gordon, PhD, ABPP, and Michael Selbst, PhD, BCBA-D, who are the founder and directors of Behavior Therapy Associates, P.A.  Here in Part I, Drs. Gordon and Selbst have addressed the outcomes of different types of social skills training and what an effective social skills teaching program encompasses in order to promote independence in learners.

The Social Problem-Solving Model: Promoting Greater Independence – Part I
Steven B. Gordon, PhD, ABPP & Michael C. Selbst, PhD, BCBA-D

Students with social skills deficits often have difficulty in many of the following areas: sharing, handling frustration, controlling their temper, ending arguments, responding to bullying and teasing, making friends, and complying with requests.

These impairments require direct instruction to address the deficits. In addition, these impairments are exacerbated for those with a mental health diagnosis of Autism Spectrum Disorder, Attention Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, and Nonverbal Learning Disorder.

A large body of research indicates that social skills training produces short and long term positive outcomes. The improvement in social skills has many benefits: an increase in students’ positive behavior, reduction in negative behavior, improvements in academic performance, more positive attitudes toward school, and increase preparation for success in adulthood.

 

Social skills learning programs have yielded significant benefits in many studies conducted to date. “The ultimate goal of a social skills program is to teach the interpersonal, problem-solving, and conflict resolution skills that students need relative to interpersonal, problem-solving, and conflict resolution interactions. In a generic sense, then, students with good social skills are unlikely to engage in inappropriate internalizing or externalizing behaviors” (Knoff, 2014). In one important meta-analysis by the Collaborative for Academic, Social and Emotional Learning (CASEL), it was concluded that social and emotional programs are effective in both school and after-school settings, for students with and without behavioral and emotional problems, for racially and ethnically diverse students from urban, rural, and suburban settings across the K-12 grade range.

Social and Emotional Learning (SEL) interventions improve students’ social-emotional skills, attitudes about self and others, connection to school, and increase positive social behavior while reducing conduct problems and emotional distress. CASEL’s review also indicates that school-based programs are most effectively conducted by school staff (e.g., teachers, student support staff) and suggest that they can be effectively incorporated into routine educational practice. In light of CASEL’s positive findings, it has recommend that federal, state, and local policies and practices encourage the broad implementation of well-designed, evidence-based social and emotional programs in schools. Continue reading →

“Cooperating with Dental Exams” – Strategies for Parents, by Jennifer Hieminga, MEd, BCBA

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This month’s featured article from ASAT is by the Associate Director of the New Haven Learning Centre in Toronto Jennifer Hieminga, MEd, BCBA, on several research-based strategies for parents to encourage cooperative behavior in their children with ASD during routine dental visits. 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 daughter with autism was very resistant during her first dental visit. Are there any steps we can take to help her tolerate a dental exam? We were actively involved in her home-based early intervention program for the last two years and have a working knowledge of ABA. Our daughter’s program is overseen by a board certified behavior analyst.

Answered by Jennifer Hieminga, MEd, BCBA
Associate Director, New Haven Learning Centre, Toronto, Canada

Boy Dental VisitFor many individuals with autism, routine appointments such as medical, dental and haircuts can be extremely difficult to tolerate. There are many factors that may contribute to this intolerance such as novel environments, novel adults, novel or aversive sounds, bright lights, foreign tastes, painful sensations, sitting for long periods of time and physical touch. As a result, many children with autism display noncompliant or avoidant behavior in response to these stimuli or events. Fortunately, there is a growing body of research published in peer-reviewed journals describing effective strategies to target dental toleration. Several different behavior interventions and programs have been used to increase an individual’s tolerance or proximity to an avoided stimulus or event, such as a dental exam. For example, the use of escape and reward contingent on cooperative dental behavior was shown to be effective for some individuals (Allen & Stokes, 1987; Allen, Loiben, Aleen, & Stanley, 1992). Non-contingent escape, in which the child was given periodic breaks during the dental exam, was also effective in decreasing disruptive behavior (O’Callaghan, Allen, Powell, & Salama, 2006). Other strategies such as using distraction and rewards (Stark et al., 1989), providing opportunities for the individuals to participate in the dental exam (Conyers et al., 2004), and employing systematic desensitization procedures (Altabet, 2002) have been shown to be effective. Most recently, Cuvo, Godard, Huckfeldt, and Demattei (2010) used a combination of interventions including, priming DVD, escape extinction, stimulus fading, distracting stimuli, etc. The board certified behavior analyst overseeing your daughter’s program is likely familiar with these procedures.

Clinical practice suggests that dental exams can indeed be modified to teach children with autism component skills related to dental exams (Blitz & Britton, 2010). However, a major challenge to implementing such skill-acquisition programs is the reduced opportunities to actually target these skills. One highly effective way to address this is to create a mock dental exam scenario in your home, as it provides opportunities to teach and practice the skills consistently and frequently. These scenarios should emulate, as best as possible, an actual dental office (e.g., similar tools, sounds, light, reclining chair), making it easier for the skills mastered in the mock teaching scenario to generalize to the dental office exam later on.

Developing a “Cooperates with a Dental Exam” Program
Following is a detailed example of the components involved with creating and implementing a “Cooperates with a dental exam” program.

  1. Speak to your family dentist to identify all the components of the exam with which your child will be required to participate.
  2. Based on the dentist’s input, develop a detailed task analysis outlining each step of the dental exam. See sample task analysis provided in the next section below.
  3. Collect necessary materials required for the exam. Many of these items may be obtained or borrowed from your dentist and may include:
    • Reclining chair (e.g., lazy boy)
    • Dental bib
    • Flouride foam dental plates
    • Electric Toothbrush with round head (to ensure polishing)
    • Dental mask
    • Dental mirror
    • Plastic gloves
    • X-ray plates
    • Flossing pics
  4. Take baseline data to determine your child’s ability to cooperate with each step of the exam and to identify skills that need to be taught. For example, baseline data may indicate there is a skill deficit with tolerating novel noises at the dentist and not with the exam itself. In this situation, a specific program for tolerating novel sounds found in the dental office should be introduced. It cannot be overstated that an intervention to address this area would need to be individualized. However, for the purpose of this reply it will be assumed that your daughter presents with difficulty in all, or the majority of the steps involved in a dental exam.
  5. Lastly, before starting the program, establish highly-potent reinforcers which your daughter will access for correctly responding within this program, and collect the items that you will need to teach this skill.

Continue reading →

Tip of the Week: Consider Behavioral Momentum in Improving Compliance

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If I were to ask you right now, what types of activities does your learner like to do, and what types of activities is your learner resistant to, you’d probably be able to respond pretty quickly to both questions. For instance, you might say, my son loves to practice addition facts, but he is resistant to working on spelling homework. Or you might say, my student enjoys passing out papers in class, but is resistant to lining up with the rest of the class when it’s time to go to lunch.

You can use this information to increase the likelihood of compliance for those tasks your learner does not like. First, let’s call the tasks your learner enjoys high-p tasks (or high probability tasks) and the tasks your learner does not enjoy the low-p tasks (or low probability tasks). Once you have identified high-p and low-p tasks, you can use this information to produce behavioral momentum.

So what might this look like? Let’s take our first example of the learner who liked to practice addition facts, but is resistant to spelling. The conversation might look like this:

Parent: 2 + 4
Son: 6
Parent: 3 + 5
Son: 8
Parent: 4 + 3
Son: 7
Parent: Spell “apple.”
Son: A-P-P-L-E

Behavioral momentum is a quite broad topic. The conversation above is an example of just one element of behavioral momentum: a high-probability (or high-p) request sequence. This is “an antecedent intervention in which two to five easy tasks with a known history of learner compliance (high-p request) are presented in quick succession immediately before requesting the target task, the low-p request” (Cooper, Heron, & Heward, 2007, p. 492).

By providing several sequences such as the one above, you can practice all of the spelling words without fighting him to sit down at the table and practice only spelling for ten to fifteen minutes.

With the example of the young girl who likes to hand out papers but doesn’t like lining up before lunch, it might look something like this:

Teacher: Can you take this paper to Lucy?
Student takes paper to Lucy.
Teacher: Can you give this one to Marcos?
Student takes paper to Marcos.
Teacher: Nice work. Can you stand behind Henry?
Student gets in line behind Henry.

It should be noted that the goal is to move the low-p tasks to high-p tasks. We don’t want the learner to always require two to five high-p tasks before they engage in the low-p task! You can do this by decreasing the number of high-p tasks before giving a low-p task, or by increasing the number of low-p tasks. For instance, maybe the first learner is responding quickly each time his parent gives him a spelling word, so the parent can start giving two spelling words after the series of high-p tasks, then systematically increase the number of spelling words over time.

Overall, the high-p request sequence is an easy-to-implement strategy that can improve compliance and reduce stress for all parties involved.

REFERENCES

Cooper J.O, Heron T.E, & Heward W.L. Applied behavior analysis (2nd ed.) Upper Saddle River, NJ: Pearson, 2007.

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.