ASD Learners and Sexuality

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By: Randy Horowitz, M.S. Ed., S.A.S. and Joanne Capuano Sgambati, Ph.D., BCBA-D, LBA

Sexuality is part of normal human development for every man, woman and child. It is a basic need and an integral part of life. Sexuality is not just physical maturity and sexual intercourse; it is diverse and personal. It’s about relationships, intimacy, and thoughts and feelings about other people. Individuals with ASD follow the same physiological sexual development and interests as their typically developing peers; About 75% of individuals on the spectrum desire and engage in some form of sexual behavior. (A comparable percentage to the neuro-typical population). Behaviors range from masturbation to intercourse and many steps along the way. Individuals with ASD have the same sexual interests, needs, and rights as anyone else, they just may not have the same ways to express themselves and share their feelings.

So what else is unique about individuals with ASD in relation to sex education?

  • Poor social competence and limited peer relationships lead to few opportunities to obtain sexual information, have sexual relationships, and fulfill their desire to have a healthy romantic and sexual life.
  • Cognitive differences (difficulty with inferencing, perspective taking, and theory of mind) can impact their understanding, generalization, and application of sexual information.
  • Language and communication challenges as well as social skills deficits can get in the way of initiating and maintaining relationships.
  • Societal barriers which interfere with learning necessary sexual information that can prevent intimate relationships from taking place. 

It is a natural instinct for parents and teachers to want to protect their children; however, by avoiding speaking about sexuality and sex education, they may be suggesting that sexuality is unimportant or shameful and they may be leaving their children even more vulnerable to frustration, problematic behaviors, social isolation, anxiety, depression, low self-esteem and even victimization.

So, how can we best educate learners with ASD about sexuality?

Start early: Children with ASD may have a hard time with change and take longer to learn concepts. Start very early; and present positively in a calm and clear manner:

  • Body part ID
  • Using appropriate words and language to identify genitals.
  • Private vs. public (e.g., places, behaviors, hygiene, and eventually conversations and on-line activities etc.)

Remember what is cute as a child (like hugging teachers), may be inappropriate in middle school. So, teach appropriate social boundaries early on. Do not wait until puberty to discuss body changes as it can be alarming to teens with ASD who resist change (pubic hair, private time for masturbation, shaving, bras, maxi pads, etc.).

Use appropriate teaching strategies: You can teach sexuality skills the same way you teach other skills to those with ASD. Some ideas are use of visuals, schedules, task analysis, functional communication training, and video modeling. Remember that sexual behavior is still behavior and adheres to the laws of applied behavior analysis. If there is a behavior to increase, decrease, or maintain it is important to know the function of that behavior in order to modify it.

Remember while teaching make sure you are aware of issues regarding consent, legalities in your state, wishes of the parents, policies of your agencies and how your intervention will look to others.

Teach independence: It is natural for parents to want to protect their child with ASD but to avoid sex education and relationship development may actually make the individual vulnerable to dependency. Teach independence on skills that are transferable to sex education:

  • personal hygiene
  • dressing
  • toileting
  • use of a cell phone
  • who and how to call in an emergency

Don’t do anything for them that they can do for themselves. This will help the child be less dependent on others for “help” and able to make their own decisions.

Teach safety skills: . Children with ASD are typically taught compliance, They may not know how to self-advocate and say “No” because they have been rewarded for compliance and listening to people who are “in charge”.

  • Teach them to say “NO” when asked to do something they do not want to do (i.e. “No thank you, I do not want a hug”).
  • Teach them that “Your body belongs to you” and rules for touching (appropriate vs inappropriate touches). They need to know they have rights over their bodies and how to “report” any inappropriate sexual behaviors or abuse.

Teach the obvious: Most children learn from a variety of sources: family, peers, TV, movies, internet etc. Those on the spectrum may not pick up on all this information. They may need things spelled out for them in a concrete literal fashion. “You cannot date women younger than 18”. Avoid or explain confusing language. “A “hook-up” is slang for meeting someone for sex and not a relationship.”

Teach about relationships: Explain the variety of relationships that people have (friendship vs love vs intimacy) and (close family and friends vs professionals, acquaintances, and strangers). Help them be social, learn social communication skills, and make friendships. Best friendships form from common interests (e.g., video games, “Anime”, trains etc.). The internet can help you find special interest groups and meet ups. There are also speed dating and singles groups for those with ASD.

Teach them about themselves: They need to develop self-esteem and a healthy self-concept. Understanding their diagnosis, strengths and weaknesses will help them be better advocates for themselves. Being a better self-advocate will also help protect their sexual well-being.

Randy Horowitz, M.S. Ed., S.A.S.

Randy has a Master of Science in Education from Queens College and a Certificate of School Administration and Supervision from the College of New Rochelle. Randy is currently a doctoral candidate in the educational leadership program at Concordia University. Randy started her career as a special education teacher in public school in Nassau County and then spent close to 30 years in senior leadership positions at nonprofit organizations serving children and adults with autism in NYC and Long Island. Randy has presented at local, national and international conferences on topics relating to educating individuals with autism. Her particular areas of interest include preparing and supporting individuals with autism for integration into community activities.

In addition to her many work responsibilities, Randy is also a seasoned runner and has participated in countless road races and marathons, including our Blazing Trails Run/Walk, raising well over $65,000 in the past 15 years to benefit the autism community.

Joanne Capuano Sgambati, Ph.D., BCBA-D, LBA

Dr. Sgambati serves as the Director of Psychological Services for Eden II’s Genesis Programs on LI.  She specializes in consulting, counseling, evaluations, and behavior management of individuals with autism spectrum disorder (ASD).  For the past 30 years, she has been dedicated to using positive behavior approaches, applied behavior analysis (ABA), for enhancing the lives of students in special education and adults on the autism spectrum.  Dr. Sgambati is an active participant in Eden II’s Genesis Outreach Department conducting live presentations and webinars on a variety of topics at organizations, conferences, schools, and universities. She also conducts training seminars for local schools and various parent organizations.  Dr. Sgambati specializes in ABA interventions for families of children and adults with special needs who demonstrate challenging behaviors. She is also the proud parent of two young adults on the Autism Spectrum.

Resources:

https://researchautism.org/sex-ed-guide/

https://www.autismspeaks.org/sites/default/files/2018-08/Puberty%20and%20Adolescence%20Resource.pdf

https://www.autismspeaks.org/recognizing-and-preventing-sexual-abuse

Ames, H. & Samowitz, P. (1995). Inclusionary standards for determining sexual consent for individuals with developmental disabilities. Mental Retardation, 4, 264-268.

Davies, C., Dubie, M. (2012). Intimate Relationships  & and Sexual Health: A Curriculum for Teaching Adolescents/Adults with High Functioning Autism Spectrum Disorders and Other Social Challenges.

Griffiths, D. (1999) Sexuality and developmental disabilities: Mythconceptions and facts. In I. Brown and M. Percy, (Eds.). Developmental Disabilities in Ontario (pp. 443-451). Toronto: Front Porch Publishing.

Griffiths, D.M., Richards, D. , Fedoroff, P., & Watson, S.L. (Eds.) 2002. Ethical dilemmas: Sexuality and developmental disabilities.  NADD Press: Kingston, NY

Hanault, I. (2006). Asperger’s Syndrome and Sexuality: from Adolescence through Adulthood. (information and lessons for students on the less cognitively impaired end of the spectrum)

McLaughlin, K., Topper, K., & Lindert, J. (2010). Sexuality Education for Adults with Developmental Disabilities, Second Edition. (structured group model) Schwier, K.M., & Hingsberger, D. (2000). Sexuality: Your sons and daughters with intellectual disabilities. Baltimore: Paul H. Brookes Publishing

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By: Nicole Gorden, M.S., BCBA, LBA 

This blog post is part 2 of 2. Read part 1 HERE

Autism spectrum disorder occurs in individuals from many different cultures and backgrounds. Therefore, cultural competency and sensitivity is imperative for effective delivery of services. To work with autistic learners, is to respect that they are the product of many environments that have shaped them and will continue to shape them throughout their life.

As stated in the most updated ethical code from the BACB, behavior analysts are responsible for incorporating and addressing diversity in practice. For example, the BACB ethical code states that behavior analysts must practice within our scope of competence, maintain competence including cultural responsiveness and diversity. Specifically, providers must “evaluate their own biases and ability to address the needs of individuals with diverse needs/backgrounds” (Ethical Code, 2022, 1.07).

However, what are the practical implementations to culturally sensitive treatment? What does this actually look like in practice? As providers, we are obligated to offer exceptional service delivery with individualized treatment goals. Considering our learner’s cultural background and the impact of their community’s beliefs and attitudes is essential to effective treatment. The following will provide guidance on how providers can apply cultural sensitivity to their clinical decisions in treatment.

Priorities in Treatment Goals

Overlooking the cultural impact can also create conflict and disparity within the stakeholders’ involvement and commitment to treatment. In contrast, “when these values and expectations align with those of the family receiving the intervention, positive outcomes are likely, including high levels of participation and response to treatment” (Dubay, Watson, & Zhang, 2018). Thus, we must also consider how we prioritize goals for culturally sensitive treatment.

For instance, I recently worked on a sleep intervention to desensitize my client to sleeping in his own bed. When discussing the intervention, and more importantly, when to introduce the treatment goal, the cultural sleeping norms had a significant impact. In some urban and minority cultures, co-sleeping is common. Yet, if a provider may think it is significant for the client to start sleeping in their own bed by the age of six, but it is common in the culture to continue co-sleeping even until the child is ten, culturally sensitive conversations can play an important role.

In another example, Filipino cultures find it respectful for younger family members to “bless” elder members by bowing towards the hand of the elder family member and placing their forehead on their hand. Thus, although the provider may find it significant for the client to learn to wave to greet others, by prioritizing cultural norms, it may have a greater influence on the client receiving natural reinforcers by working on blessing their family members, first.

The contradiction between parents following therapy targets that will be supported by their community compared to the skills that might benefit their child in the long term may prove to be challenging and demanding on the family (Dubay, Watson, & Zhang, 2018). Thus, culturally sensitive treatment is prioritizing treatment goals with the best outcome and secures family commitment.

Interdisciplinary Collaboration

By creating culturally sensitive treatments, providers will build better relationships with stakeholders and in turn, reduce the social stress that may come from raising and teaching an autistic child within various cultures. This idea does not only apply to parents, but even extends to the interdisciplinary team that could be influenced by the learner’s culture.

Within Russian communities, it is common to eat soup for lunch. When I provided services in a primarily Russian daycare, I had to consider my client’s aversion to eating these traditional meals as well as the importance of this target behavior to the daycare providers. Rather than dismiss this potential goal, despite my own perspective on the client’s needs, I modified my treatment goals to effectively collaborate with the daycare providers. By understanding the cultural impact and importance of certain behaviors to any stakeholder, the provider can often address unmet needs, gain support for treatment, and keep open communication if other issues arise (Fong et. al, 2017). We must be culturally sensitive towards the beliefs and attitudes that are different than those in the US, and not assume that the learner’s culture does not affect how they or their community respond to treatment.

Educate Ourselves. Stay Cultured. It is not required to culturally match your clients to provide adequate care and treatment. However, providers should strive to acquire knowledge and skills related to cultural responsiveness and diversity. Although we may be the experts in our particular discipline, remember that the parents are the experts on your learner. Culturally sensitive providers should strive to learn about the cultural norms of their diverse clientele. Constant dialogue, keeping an open perspective, and asking questions about cultural norms can make all the difference.

About the Author: 

Nicole Gorden, M.S., BCBA, LBA has over 14 years of experience implementing Applied Behavior Analysis principles with the Autism Population. She currently works for Comprehensive Behavior Supports in Brooklyn, NY.

References:

Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. Littleton, CO: Author.

DuBay, M., Watson, L. R., & Zhang, W. (2018). In Search of Culturally Appropriate Autism Interventions: Perspectives of Latino Caregivers. Journal of autism and developmental disorders, 48(5), 1623–1639.

Fong, E. H., Catagnus, R. M., Brodhead, M. T., Quigley, S., & Field, S. (2016). Developing the Cultural Awareness Skills of Behavior Analysts. Behavior analysis in practice, 9(1), 84–94.

Fong, E. H., Ficklin, S., & Lee, H. Y. (2017). Increasing cultural understanding and diversity in applied behavior analysis. Behavior Analysis: Research and Practice, 17(2), 103-113.

Patton, S. (2017, April). Corporal punishment in black communities: Not an intrinsic cultural tradition but racial trauma. CYF News. http://www.apa.org/pi/families/resources/newsletter/2017/04/racial-trauma

Practical Applications to Culturally Sensitive Treatment – Part I

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By: Nicole Gorden, M.S., BCBA, LBA 

Autism spectrum disorder occurs in individuals from many different cultures and backgrounds. Therefore, cultural competency and sensitivity is imperative for effective delivery of services. To work with autistic learners, is to respect that they are the product of many environments that have shaped them and will continue to shape them throughout their life.

As stated in the most updated ethical code from the BACB, behavior analysts are responsible for incorporating and addressing diversity in practice. For example, the BACB ethical code states that behavior analysts must practice within our scope of competence, maintain competence including cultural responsiveness and diversity. Specifically, providers must “evaluate their own biases and ability to address the needs of individuals with diverse needs/backgrounds” (Ethical Code, 2022, 1.07).

However, what are the practical implementations to culturally sensitive treatment? What does this actually look like in practice? As providers, we are obligated to offer exceptional service delivery with individualized treatment goals. Considering our learner’s cultural background and the impact of their community’s beliefs and attitudes is essential to effective treatment. The following will provide guidance on how providers can apply cultural sensitivity to their clinical decisions in treatment.

Awareness of Own Cultural Biases

Cultural awareness is the first step to providing culturally ethical treatment. Providers should concurrently and habitually engage in practices in which they remain aware of their own predetermined perceptions and acknowledge their own limitations to cultural competency. As mentioned in Fong et. al (2016), “cultural awareness may be important because behavioral patterns that are viewed as problematic in our own culture may be the norm in other cultures”. Due to limitations in diversity within most helping professions, a learner’s provider is often from a different cultural background.

Thus, it is essential to understand the traditions of that culture. As an example, physical punishment may be common practice in some black communities which has been perceived to be deeply rooted in racial trauma (Patton, 2017). It would be insensitive for a provider from a different cultural background to ignore that this practice is a cultural tradition, and thus blame or stigmatize black parents for their choices. Rather, “professionals can offer information about why the practice is harmful but have been told it is necessary, and offer healthier alternatives that produce better outcomes for children, families and communities” (Patton, 2017). Cultural sensitivity is facilitating the development of our programs by checking our own biases and how they may affect our choices in treatment.

Selection of Target Behaviors and Programmatic Materials

A few years ago, a client from Asian descent was transferred to me from another behavior analyst. When assessing the barriers to treatment, my client made minimal progress when asked to identify a fork. Believing that an object, rather than a picture might help, I asked the client’s parents for a fork. When obtaining the fork, the parents expressed that they do not use forks to eat. In their culture, hands and chopsticks are typical eating utensils. Thus, when considering cultural sensitivity, this includes selecting programmatic targets that are common in the client’s environment and the cultural norms.

The teaching materials should be as individualized as the treatment plan too. We should rely on diverse representation in the resources we use in treatment. Providers should use materials that represent the individual’s environment, which is typically a blend of many different ethnicities. When providing resources like visual schedules, do your cartoons or pictures represent the racial identity of your learner? If you are teaching body parts on a doll, do you provide toys that look like your learner? To be a culturally sensitive professional, one should give precedence to ethnic representation to allow the learner to feel validated and treat them with dignity.

The cultural assessment process should be used to inform treatment, specifically when designing the program for validity and selecting targets for skill acquisition (Fong et. al, 2016). When beginning a new lesson or treatment program, it is essential that providers select socially meaningful and significant target goals. However, in selecting these goals for treatment, professionals must consider the cultural norms and needs of the client.

About the Author: 

Nicole Gorden, M.S., BCBA, LBA has over 14 years of experience implementing Applied Behavior Analysis principles with the Autism Population. She currently works for Comprehensive Behavior Supports in Brooklyn, NY.

References:

Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. Littleton, CO: Author.

DuBay, M., Watson, L. R., & Zhang, W. (2018). In Search of Culturally Appropriate Autism Interventions: Perspectives of Latino Caregivers. Journal of autism and developmental disorders, 48(5), 1623–1639.

Fong, E. H., Catagnus, R. M., Brodhead, M. T., Quigley, S., & Field, S. (2016). Developing the Cultural Awareness Skills of Behavior Analysts. Behavior analysis in practice, 9(1), 84–94.

Fong, E. H., Ficklin, S., & Lee, H. Y. (2017). Increasing cultural understanding and diversity in applied behavior analysis. Behavior Analysis: Research and Practice, 17(2), 103-113.

Patton, S. (2017, April). Corporal punishment in black communities: Not an intrinsic cultural tradition but racial trauma. CYF News. http://www.apa.org/pi/families/resources/newsletter/2017/04/racial-trauma

Do You Want to be the Bringer of the Grins or the Bringer of the Power Struggles?

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This week’s blog comes from Parenting with ABA by Leanne Page.

Do you know what one of my favorite parenting tools is?

You guessed positive reinforcement, didn’t you? Close- but today I’m going with HUMOR!

When things are tense- can we help ourselves and our kids to crack a smile to defuse the situation?

When my kids are in a bad mood, it’s easy for me to slip into traditional kneejerk parenting reactions. It’s easy to become overly firm and frustrated. This is when voices rise. Tempers rise. Power struggles begin. Who exactly is winning here? I’m not happy with my own behavior following a tense interaction let alone my kids’ behavior.

What if instead of getting firm we got silly? Can we salvage the situation, the morning, the day? I say HECK YES!Mornings can be hard for so many families- mine included. Getting up on time to get out the door by 7:30am for elementary school is not easy for my oldest. After a few rough days of trying all kinds of different things to just get my girl out of her funk, I hit the jackpot. Instead of being firm in the form of “You do it or I’ll help you do it” through the morning routine, I opted for humor. My girl was grunting and moaning and making all kinds of unpleasant noises instead of doing her morning routine. I asked our smart home thingie “Hey google, can you translate cave man talk?” and “What does (insert grunting noises here) mean in English?” I communicated back to my daughter in cave man grunting noises. She cracked a smile. I turned up the silly drama with noises and gestures to communicate to her what she needed to do next in her morning routine. And guess what! It worked! Not only did it work that day but as soon as I started pantomiming things or making silly noises the next day- a grin! Mornings got smoother for several weeks without me even needing to help her do her routine. Then one day, she had a hard time again. Instead of kneejerk over firm parenting tactics, I tried humor. And it worked like a charm!

When else have you heard me sharing about being silly? In getting our kids’ attention before giving an instruction. Try talking in a silly voice, singing, whispering, or rapping. Try silly faces and hand gestures to act out what you need them to do. Get their attention before giving an instruction but also get a smile as you are interacting with your kids!

Get that grin and helping your kids follow through is a million times easier!

And the best part of all- laughing together helps that highly desired true connection with your kids. Not only does it defuse a situation or help them follow instructions- it strengthens your relationship. It helps your kids to feel safe and secure with you- you are the bringer of the smiles, not the bringer of the threats of punishment or the bringer of rasied voices and power struggles.Next time you feel your own temperature rising because your child is not listening, pause. Try hard to use some humor. The first time or two it really is HARD because your instincts are to be firm and stand your ground no matter what. But breathe and consider the big picture. Do you want your kids to think of you as the bringer of the smiles or the power struggles. Be silly. Get the smiles. Then the instruction following is easier. Save the situation and also strengthen your relationship.

Embrace the silly!

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.

Working on the Front Lines of Autism Care

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By: Stephanie Tafone, M.A., Behavioral Specialist 

Working on the front lines of Autism care in a residential facility is both rewarding and, at times, challenging. Although our residents depend on us in many ways to teach them how to complete day-to-day tasks, it is important for all staff to recognize and respect that our residents each have their own preferences and interests. Therefore, we always strive to let our residents make as many choices as possible (provided they are healthy choices that do not cause harm to anyone). Just because we as staff might complete a particular task a certain way does not mean it is the “right” or only way to do so. Recognizing and respecting residents’ choices can help avoid negative behaviors or frustration for our residents. Our goal is always to teach and foster independence and self-direction. 

It is always important to build good rapport with our residents so we are in tune with their wants and needs, while also enabling them to better trust us, work with us, and learn from us. Unfortunately, with current staffing crises and funding cuts in residential care settings, one challenge we face is securing long-term, seasoned staff. This type of setting often suffers from a high turnover rate, which this is a matter that needs more global attention, as hardworking, dedicated, and experienced/trained staff are crucial for our population. 

One of the biggest considerations we have on a daily basis, particularly during the global COVID-19 pandemic, is finding creative and entertaining recreational and leisure activities to keep our residents happy and actively engaged. Anyone can become restless and bored with nothing to do, and those with Autism are no different, which is why active engagement is one of our top priorities in a group home setting. When selecting activities, we strive to ensure that each resident’s preferences are considered and incorporated. This includes a combination of both community outings and in-house events/activities. Going into the community on outings can be challenging at times when unpredictable factors (e.g. noise, crowds, etc.) may trigger negative behaviors. However, we do our best to avoid triggering situations by researching and/or visiting the activity or location before our residents experience it in order to help determine if there are any barriers that will prevent it from being an enjoyable and successful outing for all. We also do our best to go prepared on each community outing with preferred items that can be used as a source of redirection and comfort if needed. For example, headphones to drown out noise if it gets too noisy, as well as preferred snacks or drinks if our residents get hungry or thirsty. In the residence, we also strive to think of creative leisure activities, such as dance or karaoke parties, Bingo nights, movie nights, baking, and arts and crafts. Having an enthusiastic and supportive approach, as well as using preferred reinforcers, helps to engage our residents in these activities and increase their interest level. 

In addition to recreational and leisure activities for entertainment and socialization, day-to-day life in the residence is also a learning experience for our residents, as they work on a variety of individualized goals with their assigned staff. Examples of goals may include activities such as participating in a consistent exercise regimen, learning how to independently cook rice or make tea, learning how to independently count money and make purchases, and learning how to independently vacuum or clean one’s room. The selection of a participant’s goals is a collaborative process that involves input from parents/caregivers, input from the participant(s) if possible, and input from the management team at the residence. We strive to ensure that selected goals not only address a skill deficit, but are also aligned with the participant’s interests and will help the participant become more independent in daily living skills. Similarly, participants learn increased independence by participating in various chores around the house, such as setting the table for lunch and dinner, loading and emptying the dishwasher, and doing one’s laundry. Teaching many of these goals and chores can be accomplished through the use of a visual task analysis that breaks the task down into smaller components (i.e. individual steps), which are each depicted in visual images. Visuals are a very helpful teaching technique for those with Autism, who often struggle significantly with understanding verbal language and oral directions. It is also helpful for learning, especially in the initial stages, to use a preferred reinforcer to reward correct completion of steps. In the beginning of learning a new goal or chore, one step may need to be taught for a number of consecutive days until it is mastered and the next step can be taught. 

Overall, working in a residential setting has been a great learning experience and we know that our work has had, and continues to have, a significant influence on our residents’ lives, which is very rewarding for all staff. 

About the Author: 

Stephanie Tafone, M.A., has over a decade of experience working with individuals with disabilities. She currently works as a behavioral specialist supporting both children and adults who have a range of diagnoses, including Autism Spectrum Disorder.

A Parent’s Guide to ABA Facilities

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When a child first gets diagnosed with Autism, parents are often overwhelmed. A good doctor will give a prescription for ABA therapy as well as other necessary therapies such as Speech, OT,  PT, Feeding, etc. However, of those therapies, the one that is usually not familiar is ABA. A simple Google search or, even worse, joining a Facebook group is going to lead a parent down a path full of controversy, fear mongering, and misinformation. This will often leave parents very leery of any ABA facility they meet with, or completely turned off from the best medically-proved therapy for young Autistic children.

So I created a list of questions for parents to ask potential ABA facilities to find the best match for their family. After all, they’re entrusting you with their child for hours upon hours. The child is often non-verbal and unable to tell you how their day was. So a parent must trust the facility completely. In writing this list, I also kept in mind the warnings/worries of abuse touted by certain internet groups, in hopes to appease them should they come across this list. Parents can use this list in their ABA search and clinics can have this list on hand for parents, and their potential answers ready.

1) Do you force eye contact or stop unharmful stims? This is one of the top citations of “abuse” from certain internet groups. Some parents don’t want to force eye contact and view their child’s non-harmful, non-disruptive stims as a beautiful part of their personality.

2) How do you avoid meltdowns? Knowing that you are going to avoid meltdowns will help parents feel far more comfortable about sending their child.

3) Do you ever withhold food? Even neurotypical kids are picky. Us “Autism Parents” are usually self-conscious about the fact that our kids survive on pretzels and Pediasure. Telling a child “No chicken nuggets until you’ve finished your green beans” will probably mean a hungry child, and an unhappy parent.

4) How do you handle naps? With the diagnostic age of Autism getting increasingly lower, children are starting ABA before they are ready to phase out of naps. Having a plan in place for nap time will make a parent know their child is getting their needs met.

5) What are your parent training session requirements? ABA is a fantastic therapy, but without the parents upholding it at home, it’s pretty hard to fully instill the methodology and give the child all the help they deserve Parent training lets parents feel more involved in their child’s therapy which is essential!

6) What are the requirements of your staff? Parents researching ABA are shocked to hear you only need a high school diploma to be an RBT. If you have a higher standard for your staff of any sort, parents will feel more comfortable sending their children to your facility.

7) What will my child’s daily schedule look like? Knowing what a child does throughout the day helps a parent make the decision for what works best for their child.

8) How do you incorporate academics? Many parents are choosing between ABA and Preschool. Being able to tell parents your ABA facilitates some sort of Academics (We focus on writing, the alphabet, etc) will make the decision far easier!

9) How do you prevent harmful stims? Parents recoil at the thought of their child being restrained. What are your rules around touching kids? How do you keep our child from harming themselves, or anyone else?

10) How do you communicate with me? My child can’t tell me about his day. So I need his therapists to do so. What are you doing to tell me about his day? What he ate? Did he name? Diaper changes? Injuries? The more communication, the better!

This list isn’t comprehensive. It won’t work for every facility. However, these are the questions I have found most parents want the answers to in order to find the best facility for their kids. And to feel they aren’t sending their children to an “abusive” environment.

About the Author:

Cassie Hauschildt is the mother of her Autistic son, Percival, who was diagnosed at 20 months old. Since his diagnosis, she has become an advocate for autistic children. She dedicates her time to mentoring parents of autistic kids through the tough first few months post-diagnosis. She also is trying to get rid of the negativity surrounding ABA therapy. She does this through humor, while using real talk, on her TikTok @AnotherAutismMom. She also runs “The Dino and Nuggets Corner” Facebook Group.

Posted in ABA

Whose behavior needed to be fixed? The kids’ or the parents’??

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At a recent family meeting, I had put an item on the agenda- listening to mom and dad so we don’t have to repeat ourselves. In the past week, I had noticed that I was having to say things many more items than usual and my husband and I had both raised our voice more often. So I brought this up in a problem solving format with all 4 of us- two kids, my husband, and myself. Everyone was given a chance to propose solutions- no matter how off the wall.

I expected the conversation about listening better to go one of two ways when the kids are allowed to make the call: either all about earning rewards, or about getting trouble. One extreme or the other. But I sat quietly and let my little ones (ages 7 and 4) have the floor and share what they thought would fix this issue we were having. Things started to go down the punishment lane- maybe we should lose allowance when we don’t listen- and I shut that down. I told them that allowance is not tied to their behavior and we wouldn’t be making changes to our allowance system. Then things got interesting. My FOUR year old shared that her pre-kindergarten teacher would say “1, 2, 3, eyes on me” and then the kids would listen to her. So my littlest suggested a change to MY behavior to fix the problem. So the 7 year jumps in and says “Remember how you used to do silly poses to get our attention? Maybe you can do that again.” Again – they wanted to change the PARENTS’ behavior, not their own. I was all in on this train of thought. I suggested I use things I used to do consistently when we were in full-on virtual school mode- clapping patterns, hand gestures, silly voices- to get their attention before asking them to do something. That way they are actually listening the first time and we won’t have to repeat ourselves. As a family, we agreed the solution to the problem of the kids not listening was to make a change to Mom & Dad’s behavior- we would do something to make sure we had their attention FIRST and then tell them whatever we needed them to hear.

This is not a new and noteworthy idea. But it is a good idea! I’ve even written about it before here: https://www.parentingwithaba.org/get-my-kids-to-listen-part-1/. Here’s an excerpt from that to help you (and me) remember: Get their attention first. We have to interrupt whatever is currently going on- and somehow win that battle for attention from something they prefer more than listening to mom giving instructions. I mean, what could be more fun than listening to mom giving instructions? Oh- everything? I see.

  1. Be silly. Interrupt with silliness. Make silly faces, silly poses, or use different voices. Get their attention AND a smile on their face before you even start to give instructions.
  2. Start with a joke, then give the instructions.
  3. Say something absurd. Instead of “Go wash your hands” try “Go wash your earlobes”. Let your kids correct you- now they have said the instructions themselves! “Oh silly me. Wash your hands, not your earlobes!”

By letting the kids help come up with this solution, they’ve been all in. If we do anything to get their attention first, they freeze and make big eyes and stare at us. It’s a little overboard with the dramatics, which I find hilarious and awesome. And when I forget, they will say “1, 2, 3, eyes on me” to me as a reminder. So far things are better in my house with no major reward system, no punishments or loss of allowance, no big drama. We just needed to talk through a problem and whose behavior needed a change? Not the kids. It was the parents’ behavior that was changed this time (and most of the time if we’re honest with ourselves here). What things to do you use to get your kids’ attention? What works for you?

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.

Flashcards: Prompting for Success

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My own introduction to prompting and fading

I was first introduced to the idea of prompting and fading when I co-ordinated a home based early learning program for my eldest son, Christopher, who is on the spectrum of autism. I soon came to appreciate how important these strategies were and are in supporting his learning. We are now into his teenage years and whilst the skills he is learning are far more complex compared with those early years, the use and importance of prompting and fading remains unchanged.

About prompting.

A prompt is a cue (or hint) given to a student to encourage them to learn a new skill. There is extensive evidence to support my own experience that prompting is a highly effective way of teaching. An example of this evidence is noted at the end of this article.

Flashcards and prompting

A lot of the work we did around prompting with Christopher in the early years of his life related to the use of flashcards. We used them to expand his vocabulary, articulate words clearly and put together sentences. We also used them to build his academic skills in literacy and numeracy and his capacity for problem solving.

The different types of prompts

There are five different types of prompts and we used all of them in our flashcard based activities. These prompts are ranked accordingly to the level of support they offer, with 1 being the most supportive and five the least.

  1. Full physical
    Example: I placed my hand over Christopher’s hand and guided him to place the flashcard he was holding over the associated one on the table – so the image of the sock was placed on top of the shoe, rather than on the image of the bed or the bowl
  2. Partial physical
    Example: I gently touched Christopher’s shoulder – to indicate it was time for him to respond to my request of naming the flashcard I was showing him.
  3. Modelling
    Example: I sorted the flashcards on the table into groups – animal, transport and instrument. I then shuffled the cards and asked Christopher to sort them in the same way
  4. Gestural
    Example: I nodded as he started to place the letter A next to the image of the apple. It provided him with the encouragement and confidence to continue with B and C.
  5. Positional
    Example: I placed two associated cards on the table next to one another so that Christopher could connect the two – so the picture of the fork was next to the picture of the person eating and the picture of the bed was next to the picture of the person sleeping

The goal is to select the type of prompt that is the least intrusive and results in the student providing the correct response. So, if a modelling prompt is not working then a partial or full physical prompt should be tried.

Why prompts need to be faded

Whilst prompts are a great teaching strategy, it is equally important that they be faded over time. You might ask why. The answer is so that the student doesn’t become dependent on the prompt. We were mindful of this in Christopher’s early learning program. There were instances where we started with a full hand over hand prompt. We then faded to a gestural prompt (by pointing at the flashcard) before omitting the prompt all together.

I like to think of prompting and fading as stepping stones on the way to independence with a new skill. Christopher and I have trod on those stones for a number of years now and going forward I know there will be more. I hope there will be more, As I’m so appreciative of the opportunities for learning they ultimately afford my son.

1 Hayes, D., (2013) The Use of Prompting as an Evidence Based Strategy to Support children with ASD in School Settings in New Zealand. ERIC 1-5

About The Author 

Kate is the owner of Picture My Picture, an international business which specializes in educational flashcards. She is the mother of three boys, Christopher, Louis and Tom. Christopher is on the spectrum of Autism. The flashcard based teaching program she oversaw in the early years of his life was the inspiration for the business she owns today. 

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5 Tips to Creating and Maintaining Classroom Expectations

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The First Step of Teaching Self-Monitoring and
Implementation of The Self & Match System

Educators have long known the wide-range of variables that impact the behavioral success of our students.  Prior to the COVID-19 pandemic, the majority of students were educated in-person; learning classwide expectations from their teachers and peers from a young age. During virtual instruction throughout the pandemic, some of our “tried and true” classroom strategies to help students learn how to be successful were derailed in numerous ways due to the sudden and extreme shift in our instructional modalities and the necessity to quickly pivot to a virtual format.  

As we return to brick & mortar learning, it is clear that the behaviors displayed in many classrooms has become even greater, given that student experiences ranged  dramatically throughout their time in distance learning.  Without a doubt, behavioral expectations throughout distance learning varied greatly in homes given each family’s unique circumstances. As a result, children have returned to “in-person” instruction demonstrating a variety of social, behavioral, and academic skills/needs.  Not to mention, the majority of students who are currently enrolled in grades K-2 have never experienced a full “typical” year of elementary school. Many of them had their preschool experience flipped upside down! Preschool and early elementary is a developmental time where students often learn school readiness and behavioral/social group interactions. Yet many children missed that opportunity due to the necessity to learn at home.  As a result of these various factors,  many classrooms around the globe are experiencing higher rates of behavioral challenges than pre-pandemic levels (1). 

One simple way to support our student’s behavioral success as they return to in-class learning is to prioritize setting clear expectations and then systematically teaching our students the tools needed to self-monitor their behavior(s) to match these expectations using Self & Match.  All students thrive on having expectations and the value of setting clear classroom expectations has been researched for over 70 years (2).  So, let’s take a look at some key tips to setting up effective classroom expectations as well as tools to teach self-monitoring as we go back to the basics and prepare our students to be successful, lifelong learners. 

5 Tips to Consider As You Set Expectations With Your Students and Develop your Self & Match Systems:

1) Create 3-5 clear/explicit class expectations that are stated positively.  

Set expectations of what you would like your student to do (i.e. “Be Responsible by coming to class on time”) rather than what you don’t want your student to do (i.e. “Don’t Come to Class Late”).  (3) 

2) Make the expectations easy to remember, simple to understand, age-appropriate, and enforceable.  

Ensure that all students can identify the class expectations and, if possible, explain them in their own words.  Consider incorporating visuals and teach examples and non-examples that align with each expectation.  Remember to use language that is familiar to your students, make it fun, tied to your classroom themes, school-wide PBIS culture, and (if applicable) your Self & Match Questions!  For example, if you have a space themed classroom, using terms like “Out of this world!” might be language to reinforce the expectations and connect for your students.   (4)

3) If possible, co-construct the expectations with your students and allow them to have a voice in the process of creating and setting expectations.

If a class expectation is to “Be Kind”, ask your students what “Being Kind” means to them and include the student definitions on the clearly posted expectations within the classroom.  Allow students to develop clear examples and non-examples of the class expectations and remember that the examples can be added to or modified throughout the year.  Including example(s) and non-examples increases the rate at which students follow through with classroom expectations (5).  

4) Promote fluency by explicitly teaching and practicing the expectations.

Go further than simply posting the expectations in a visible location by referencing them frequently, make it a part of your daily schedule, and (if applicable) review at each Self & Match check-in opportunity.  Infuse the language of the expectations throughout your school day by catching students engaging in the class expectation and reinforcing/labelling it (i.e. – “Kai, I love the way you are Following Directions by starting your classwork”). 

5) Empower students to take ownership and responsibility for their own behavior.  Recognizing expectations is the first step of teaching self-monitoring within an educational setting.

In its simplest terms, self-management involves the personal/self-application of behavior-change procedures that supports goal achievement.  How can we expect students to accurately reflect on their behavior, if they do not have a clear understanding of the expectations?  This is why it is critical that the first step you take is establishing classroom expectations with your students. 

Taking it a step further… 

HOW CAN I SET-UP A SELF & MATCH SYSTEM TO FURTHER ENHANCE SELF- AWARENESS OF CLASS EXPECTATIONS 

As we are returning to our physical classrooms amidst the pandemic, teachers are looking to add additional user-friendly tools to their toolkit in order to promote the behavioral success of our students.  The Self & Match System is a tool that many educators and practitioners have turned to to implement individually or class-wide.

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

Self & Match has been implemented internationally across a variety of settings including: special and general education classrooms; homes; sports programs; camps; clinics; as well as public, private, parochial schools, post-secondary education. 

The 6th edition of The Self & Match System: Systematic Use of Self-Monitoring as a Behavior Intervention includes all the materials necessary to guide the development and implementation of individualized Self & Match Systems. Included in the manual is a forward by a trailblazer in the ABA world, Dr. Saul Axelrod; an introduction that provides a review of the literature supporting self-monitoring; a “Considerations Prior to Implementation Guide”; 20 sample Self & Match forms, five reproducible Self & Match forms; and an assortment of supplemental materials.  The manual also includes access to an online portal of customizable digital forms and a PDF form creator called the “Self & Match Maker”.

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

Want to learn even more about the Who’s, What’s Where’s, Why’s, When’s, and How’s of Self-Monitoring interventions?  Check out our 2018 DRL blog here

About The Authors 

Jamie Salter, Ed.S., BCBA

Jamie S. Salter, Ed.S., BCBA co-authored the Self & Match System; an evidence-based self-monitoring intervention that is grounded in principles of Applied Behavior Analysis. Jamie consults with teams around the globe in the development and implementation of Self & Match interventions as a Tier 1, 2, or 3 behavioral tool within the school, clinic, and home settings.

Previously, Jamie served for a decade as a Senior Program Specialist at the San Diego County Office of Education. In her role, she trained educators on writing effective and legally-defensible Behavior Intervention Plans, provided leadership and guidance to special educators, consulted with teams utilizing the Self & Match system, and supported students, families, and IEP teams in determining appropriate programs for students in their least-restrictive environment. Jamie has been actively involved in supporting children with autism for over 20 years. These experiences include serving as Supervisor of an U.S. Department of Education Training Grant (focused on inclusion of students with low incidence disabilities) and presenter at multiple International Conferences. She has also operated a school-based clinic that provided an emphasis on Intensive Behavioral Interventions, led social skills groups, sibling support groups, and provided in-home behavioral intervention. She has served on the state-wide PENT Cadre Leadership team since 2016.  Jamie received her Masters of Education, Educational Specialist degree, Nationally Certified School Psychologist status, and BCBA certification through Lehigh University. 

Katharine Croce, Ed.D., BCBA

Dr. Katharine Croce is a Board Certified Behavior Analyst-Doctoral (BCBA-D).  Dr. Croce received her Doctorate in Educational Leadership at Saint Joseph’s University in Philadelphia.  Dr. Croce earned a MS. Ed., in Applied Behavior Analysis from Temple University, a BA in Psychology and Criminal Justice from La Salle University, and an Autism Certificate from Pennsylvania State University.  

Dr. Croce is an Assistant Professor in the School of Education at Felician University teaching undergraduate and graduate courses in Applied Behavior Analysis. Previously, Dr. Croce was the Director of the ASERT Collaborative Eastern Region at Drexel University. ASERT (Autism Services, Education, Resources and Training) and brings together autism resources (locally, regionally, and statewide) to improve access to quality services and information, provide support to individuals with autism and caregivers, train professionals in best practices and facilitate the connection between individuals, families, professionals and providers. 

Dr. Croce has worked as a Special Education Coordinator and behavior analyst in public/private schools, home settings, and an in-patient hospital for children with autism spectrum disorders (ASD) and other developmental disabilities.  Dr. Croce has also worked in a clinic setting developing programs for individuals with ASD, a support program for college students with ASD, and training undergraduate and graduate education and psychology majors who wanted to work in the field of ASD.  

Contact Jamie or Katie at selfandmatch@gmail.com

  1. National Association of School Psychologists. (2020). Providing effective social–emotional and behavioral supports after COVID-19 closures: Universal screening and Tier 1 interventions [handout]. 
  1. Zimmerman, E. H., & Zimmerman, J. (1962). The alteration of behavior in an elementary classroom. Journal of the Experimental Analysis of Behavior, 5, 50-60.
  1. Burden, P. (2006). Classroom management: Creating a successful K-12 learning community. (3rd ed.). Hoboken, NJ: Wiley.
  1. Grossman, H. (2004). Classroom behavior management for diverse and inclusive schools. (3rd ed.). New York: Rowman & Littlefield Publishers, Inc.

Kerr, M. M., & Nelson, C. M. (2010). Strategies for addressing behavior problems in the classroom. (6th Ed.). Columbus OH: Merrill.

Burden, P. (2006). Classroom management: Creating a successful K-12 learning community. (3rd ed.). Hoboken, NJ: Wiley.

  1. Neef, N. A., Shafer, M. S., Egel, A. L., Cataldo, M. F., & Parrish, J. M. (1983). The class specific effects of compliance training with ―do‖ and ―don’t‖ requests; analogue analysis and class-room application. Journal of Applied Behavior Analysis, 16(1), 81-99.
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Raising Expectations for the Treatment of Children With ASD

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On November 6th 2021 in NYC, Dr. Ronald Leaf will describe the Autism Partnership Method (APM) in a free seminar at St Monica’s Church from 2-4pm. Free CEUs will be available! 

Children with Autism Spectrum Disorder (ASD) have amazing potential that can and should result in a high quality of life. However, this is highly dependent on the treatment received. Unfortunately, the current standard of care—Conventional Applied Behavior Analysis (ABA)—is quite rigid and formulaic in its approach, yielding treatment that is not tailored to the unique needs of the children and their families. Typically, treatment only addresses limited areas such as behavior and communication deficits. Although children may receive some benefits from Conventional, protocol-based ABA, the results usually do not endure over time, nor do they translate to more natural settings that are essential for self-sufficient adulthood.

Autism Partnership Method is an extremely individualized approach to ASD that yields lifelong benefits.  Rather than follow a “one size fits all” treatment recipe. Progressive ABA training is not time based, but performance based — no less rigorous or precise than the training regimens of surgeons or civil engineers. Quality treatment focuses on the entire child, thereby addressing the child’s foundational behaviors, including communication, socialization, play, and independent living skills — as opposed to addressing a more limited set of behavioral or communication needs. Progressive ABA treatment is designed so that children can succeed in mainstream settings, such as regular education classes, and can thrive in extracurricular activities. Children who receive progressive treatment, have been shown to make the progress their parents dream of, such as playing with their sibling and developing meaningful friendships.

In 2011, the journal Education and Treatment of Children published A Program Description of a Community-Based Intensive Behavioral Intervention for Individuals with Autism Spectrum Disorder. This study evaluated the progress of 64 children at Autism Partnership agencies in Seal Beach, California; Hong Kong; Leeds, United Kingdom; and Melbourne, Australia. The results found that 70.3% of children achieved best outcomes when individualized ABA services were provided early (i.e., before the age of 9), and intensively (i.e., 10–40 hours a week), by quality therapists.

At Autism Partnership we are deeply concerned about the expectations regarding the outcomes for children diagnosed with ASD!  Simply put, we feel that the expectations are too low. Children with ASD have a far more favorable prognosis than believed achievable decades ago, yet there still seems to be a lack of understanding regarding children’s’ actual potential. Children with ASD have amazing potential! The majority of children can become conversational, achieve success in school, develop meaningful friendships and most importantly, experience a high quality of life!  However, achieving this requires high quality intervention with highly trained staff. 

Register for the Autism Partnership seminar here! 

About The Author

Ronald Leaf, Ph.D. is a licensed psychologist who began his career working with Ivar Lovaas in 1973 while receiving his undergraduate degree at UCLA.  Subsequently he received his doctorate under the direction of Dr. Lovaas.  During his years at UCLA he served as Clinic Supervisor, Research Psychologist, Interim Director of the Autism Project and Lecturer.  He was extensively involved in several research investigations, contributed to the Me Book and is a co-author of the Me Book Videotapes, a series of instructional tapes for teaching autistic children.  Dr. Leaf has consulted to families, schools, day programs and residential facilities on a national and international basis.  Ron is a Director of Autism Partnership.  Dr. Leaf has published extensively in research journals.  Dr. Leaf is the co-author of: A Work in Progress, Time for School, It Has to Be Said!, Crafting Connections, A Work in Progress Companion Series and Clinical Judgement.