ABA Journal Club #1

            For January, I have selected not one, but two texts. The first is a foundational article that every behavior analyst has probably read more than once. However it’s an important one to revisit, and one that I gain more insight from with each read. The second is a follow-up to the original article.

Article One: Baer, D. M., Wolf, M. M., & Risley, T. R. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1(1), 91-97.

Article Two: Baer, D. M., Wolf, M. M., & Risley, T. R. (1987). Some still‐current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 20(4), 313-327.

Discussion Questions for Baer, Wolf, Risley (1968):

The tone of the 1968 article is hopeful. The authors express a belief that behavior analytic procedures will become more prevalent as people understand the technology. Do you think they were accurate in this belief? What has been your experience with people accepting the principles of ABA?

Among the seven dimensions discussed in this article, what did you find most interesting?

The authors state that the term applied is defined by the interest society shows in the problem being studied. Is this how you have thought of the term applied in the past? How does your current work fit into this description? And how do we know society is interested?

In their discussion of analytic, the authors explain two designs commonly used to demonstrate reliable control of behavior change. Do you use these designs in your every day practice? Why or why not?

Do you think all seven of these dimensions hold equal importance? Why or why not?

How do the seven dimensions make ABA different from other fields?

Discussion Questions for Baer, Wolf, Risley (1987):

Compare and contrast the descriptions of each of the seven dimensions across the two articles.

The authors identify social validity as a good measure of effectiveness. However, they also identify issues with the assessment of social validity. How do you think that has changed since they wrote this article? How do you assess social validity in your own work?

What do you think of the discussion of high-quality failures?

In what ways do you follow the seven dimensions in your current work?

Can you identify a way to improve your own work based on the seven dimensions?

If you were to identify an eighth dimension that is not currently represented in these articles, what might you add?


SAM BLANCO, PhD, LBA, BCBA 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.

Common errors with token systems

I love token systems and use them frequently with my clients. Sometimes I use Velcro stars or stickers, or the Token Towers (which are great because you can hear the token going in the plastic tube.) It’s easy to vary the token system to fit the interests and age of a client I am working with. However, I see several errors in their use. Below are a few of the common ones:

• Inconsistent Use – The use of a token system should be predictable. When I am doing an ABA session, the token system is usually available throughout the session. But token systems may be specific to certain activities or certain environments. Using them only some of the time though doesn’t improve their effectiveness.
• Lack of Clarity – You should know what behavior you are focusing on for the token system. For example, I will write down for myself that I am providing tokens for a few specific behaviors (such as whenever a client responds correctly to a current learning target, when they remain in their seats for a period of five minutes, and when they greet a person who comes into the room.) It should be clear for you, as the person implementing the token system, what behaviors you are attempting to increase so you can provide tokens when those behaviors are exhibited.
• Lack of Differentiation – One of the things I love about token systems is that it allows me to easily differentiate reinforcement. For example, let’s say I’m working with a child to teach them to name items from different categories. Usually, when I ask them to name an animal, they name one animal and I provide a token for a correct response. But on this particular day, they name three animals. I can provide more than one token for the higher quality response.
• Not Allowing the Token System to Grow with the Child – Another benefit of token systems is that they can grow with the child. Once a child has mastered a certain behavior, I no longer include it in the token system. The child is always earning tokens for behaviors or responses that are difficult. If you have a client who has been receiving tokens for the same behavior for several months, then one of the two things is happening: (1) the client has mastered the behavior and you aren’t providing reinforcement for more challenging behaviors OR (2) the client has not mastered the behavior and for some reason your token system is not working. Either way, a change needs to be made.
• Fail to Provide a Motivating Reward – I have had some experiences in which the token was supposedly reinforcing on its own. In rare cases, this might just work. However, the tokens should be used to earn a known reinforcer for that particular client.
• Fail to Provide Choices in Rewards – There’s a great body of research on how choice improves motivation. Unfortunately, many children with developmental disabilities have fewer choices in their day-to-day lives than their typically developing counterparts. Allowing your client to choose from a selection of activities or toys for reinforcement will likely improve the quality of your token system.


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.

How to Maintain a Fast Pace of Instruction

There is a common misconception that individuals with special needs require a slower pace of instruction. While they may require a slower pace through a curriculum, this does not mean that individual lessons should be taught at a slower pace. In fact, slowing the pace of instruction not only wastes precious instructional time, it may increase the occurrence of problem behaviors.

Higbee (2009) writes that “appropriately paced instruction helps students to maintain attention to the instructor and instructional materials. Though student attention can be lost when instruction is happening too rapidly, it is most often lost when the pace of instruction is not rapid enough” (p. 20).

So how can you maintain a fast pace of instruction that is appropriate for your student? Here are some things to consider:

  1. Prepare! Set out your materials in such a way that they are easy to access quickly. I keep all the mastered skills on index cards so I can easily add maintenance questions into instruction. Organization is often the simplest way to increase efficiency in your session.
  2. Take data. You want to increase attention and decrease problem behaviors. Try different paces of instruction and measure the behaviors you are wanting to change. For instance, if I have a student who is often grabbing for my shirt during a session, I may try a pace of instruction that includes 15 questions each minute, then try a pace of 20 questions per minute, another of 25 per minute. Next, I will compare the rates of grabbing for my shirt with each pace of instruction. Remember, these aren’t 15 questions for the target skill; some mastered skills will be intermixed.
  3. Record a session. By taking video of yourself working with a child, you may see opportunities for increasing efficiency on your own. You may also observe specific times at which problem behaviors tend to increase, then be able to target those specifically. For instance, perhaps problem behaviors occur when you turn to write data in a binder, but didn’t recognize that pattern until you watched a recording later.
  4. Use reinforcement effectively. Usually, pace of instruction in and of itself will not change behavior. Instead, pair it with reinforcement and be systematic with how you implement reinforcement. We’ve talked about reinforcement here on the blog a lot, so you can read about that in more detail here.
  5. If possible, get input from supervisors or the individual you are working with. Supervisors may be able to observe your session and provide insight on how to increase your pace of instruction. And the individual you are working with may be communicating that they are bored through misbehavior, stating “I’m bored,” or nonvocal behaviors such as yawning. This may be an indication that you need to provide more challenging material or increase the pace of instruction.

REFERENCES

Higbee, T. (2009). Establishing the prerequisites for normal language. In R. A. Rehfeldt, Y. Barnes-Holmes, & S.C. Hayes (Eds.), Derived relational responding applications for learners with autism and other developmental disabilities: A progressive guide to change (7-24). Oakland, CA: New Harbinger Publications, Inc.


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.

Things You Should Know About BCBAs

Maybe you’ve never heard of Board Certified Behavior Analysts (BCBAs), or you’ve heard of them frequently but never been provided an explanation of how a BCBA differs from an ABA therapist. Here are a few things you should know:

BCBAs are required to take extensive coursework in applied behavior analysis and complete 1500 hours of supervised work. Furthermore, they are required to take a difficult comprehensive exam at the end of their coursework and supervision hours. Once they have completed the hours and passed the exam, they are officially a BCBA.
BCBAs must complete 32 units of continuing education every two years. There is a requirement that some of these hours pertain to ethics, but the rest can be focused on skills such as addressing verbal behavior, feeding issues, aggressive behaviors, and more.

BCBAs are held to the Professional and Ethical Compliance Code for Behavior Analysts. If a BCBA does not comply with the code, they can be reported to the Behavior Analyst Certification Board. Several states have also introduced licensure for behavior analysts, so there may be a state board for reporting any ethical violations.
BCBAs are required to utilize evidence-based practice. A BCBA should be aware of current research in the field and should be able to easily reference the literature when encountering a difficult problem or working on an intervention.

One of my favorite parts of the ethical code for BCBAs is that “clients have a right to effective treatment.” Your BCBA should be taking data and implementing interventions that are effective in creating behavior change for clients. If an intervention is not working, then adjustments should be made.

The goal of Behavior Analyst Certification Board is to ensure appropriate training and accountability for behavior analysts.


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.

Beyond Light Up Toys

There are many things that I would love to change about the treatment of individuals with Autism Spectrum Disorder. One of them is the notion that all kids with ASD are motivated by the same things. Certainly, some kids with autism love light up toys, squeezes, or music, but that’s true of the population at large. After all, I am mesmerized by Christmas lights, love a good head massage, and have songs I listen to on repeat.
The issue with the assumption that all kids with ASD are motivated by these small number of things is that it can lead to some very specific problems, such as practitioners trying out a smaller number of toys or activities with the child, practitioners depending solely on “sensory toys” for reinforcers instead of working to expand the number of reinforcers a child responds to, or the larger community making assumptions about the preferences of the child. Furthermore, there is evidence that the broader the range of reinforcers is for a child, the better the learning outcomes (Klintwall & Eikeseth, 2012.) Failing to think beyond the stereotypes about the interests of kids with ASD impedes their ability to learn and develop new skills.

The children I’ve worked with over the years have varied interests, ranging from dinosaurs and maps to bean bag toss and board games. And while some of the kids I work with love light up toys or trains, it’s important that we don’t take a whole swath of the population and decide that they all have similar interests. It doesn’t serve their skill development or our potential to develop real relationships with people with ASD.
As a practitioner, here are some important questions to ask yourself in relation to reinforcers and developing interests:

• Have you conducted a preference assessment? This should be one of the first things you do whenever you start a new case, and something you should continue to do informally.

• Have you talked to the client and/or the parents about what interests they would like to develop? If the client is able to discuss goals and interests with you, you should definitely be having that conversation with them. You should also talk to the parents about their goals. Perhaps they have seen some interest in one area that they would like to further develop. It’s also possible that there are specific family activities or traditions they would like their child to enjoy with the family.

• Have you read about this topic? A great place to start is Chapter 3 of the book A Work in Progress. It clearly explains how to use reinforcers and expand the reinforcer repertoire. There is also a ton of research out there about reinforcement. Take the time to search journals such as Journal of Applied Behavior Analysis and Journal of Developmental Disabilities.

Klintwall, L., & Eikeseth, S. (2012). Number and controllability of reinforcers as predictors of individual outcome for children with autism receiving early and intensive behavioral intervention: A preliminary study. Research in Autism Spectrum Disorders, 6(1), 493-499.
McEachin, J. & Leaf, R. B. (1999). A work in progress: Behavior management strategies and a curriculum for intensive behavioral treatment of autism. New York: DRL Books.


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.

Preparing For The Holidays: Managing Changes

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

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

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


WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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

Implementing the Intervention…Even When Things are Going Well

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

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

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

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

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

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

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

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

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

 

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

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


WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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

Common Mistakes In Implementing Reinforcement

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

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

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

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

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

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

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


WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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

Improving Time-Out Procedures

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

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

WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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

How To Prepare To Reinforce Appropriate Behavior

Often when we’re working with children with autism there are two areas we focus on: communication and play. However, due to the nature of your day or a specific activity, you may unintentionally punish spontaneous communication or play. So before we learn how to prepare to reinforce appropriate behavior, let’s consider a couple of examples:

Julie is a teacher in a first grade classroom with six children with autism. One of her students is Marcos, who rarely uses spontaneous language. While Julie is running the morning meeting, Marcos suddenly interrupts and says “I like elephants.” Julie says, “It’s quiet time, right now, Marcos.”

David is a teacher in a fourth grade inclusion classroom. Jaylene is a student with autism who rarely initiates interactions. He is speaking with another teacher when Jaylene approaches with a puppet, hands it to David, and says “puppet.” David tells her, “In just a minute, Jaylene.”

In both of these instances, the teacher has not done anything wrong. In fact, we have all done this from time to time in the midst of busy days in which we’re managing multiple tasks. But there’s an argument to be made here that both Marcos and Jaylene missed opportunities for reinforcement of the behaviors we most want them to exhibit.

One thing that can help is to prioritize your goals. If the primary goal for Marcos is to use spontaneous language, then when we start out we want to provide a continuous rate of reinforcement. This means that it will sometimes interrupt other tasks, but if it is the biggest priority, that’s okay! The long term gains of reinforcing Marcos’s spontaneous language likely outweigh the frustration of an interrupted lesson.

The second thing that can help is communicating the priorities to other adults and staff. If David lets other teachers and administrators know that Jaylene’s foremost goal is to initiate interactions related to play, then a brief interruption in a conversation should not be an issue. Again, the long term gains of reinforcing Jaylene’s initiation of play likely outweigh any issues around an interrupted conversation.

Finally, try to plan ahead. Think about instances in which the child is most likely to engage in the targeted behaviors and talk with staff about how to ensure reinforcement takes place. The last thing we want to do is to unintentionally punish the desired behaviors.


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