Teaching Safety Skills to Adolescents

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

I am a Special Education Teacher at the high school level. A young man with autism is transitioning to my caseload from our middle school. Although there is much talk about “safety skills” amongst my colleagues, I would like to target this skill area effectively and comprehensively. Any suggestions?

Safety skills are important for learners with autism and should be addressed comprehensively over the course of the learner’s schooling and across the lifespan. The type of safety skills taught at any given time will vary depending on the learner’s age and functioning level. For example, younger learners can be taught to walk appropriately with an adult so they do not run into the street while older learners can be taught to cross the street independently. Regardless of age, safety skills should be included on the learner’s Individualized Education Plan (IEP) and reflect the goals of the individual and their families. In addition, data collection on the targeted skills is essential to ensure the learner is acquiring the skill and that the skill maintains over time.

An effective method to teach safety skills is Behavioral Skills Training (BST). BST is a comprehensive teaching method which includes delivering instructions to the learner, modeling the correct response, rehearsing the correct response in both pretend and more naturalistic environments, and delivering feedback to the participant regarding their actions. If the learner is having difficulty acquiring the skill, an additional teaching component known as In Situ Training (IST) can be added. In IST, the trainer provides immediate and direct training in the learner’s environment and allows for additional practice of the skill. Within the literature, BST and IST have been shown to be effective for teaching a wide range of safety skills such as abduction prevention skills (Beck & Miltenberger, 2009; Gunby, Carr & LeBlanc, 2010; Johnson et al., 2006) and how to seek assistance when lost (Pan-Skadden et al., 2009).

There are a number of safety skills that that could be targeted for an adolescent with autism. Targeting those that also increase independence should be a priority if appropriate, based on the adolescent’s level of functioning. Teaching him to use a cell phone is one such skill, as it can be used to improve his safety and overall independence (Hoch, Taylor, & Rodriguez, 2009; Taber, Alberto, Seltzer & Hughes, 2003). First, you will want to ensure the learner has the basic skills associated with cell phone use including: answering the phone, following directions on the phone, answering questions on the phone and negotiating all of the mechanisms associated with initiating a call. Once these basic skills are mastered, specific safety skills involving the phone can be taught. For example, a learner can be taught to answer his cell phone and provide a description of his location in the event he is separated from his caregiver or group. He could also be taught to follow instructions to seek assistance from a community member if lost (Hoch, Taylor, & Rodriguez, 2009; Taylor, Hughes, Richard, Hoch & Coello, 2004) or to call a trusted adult.

A major safety concern for most parents is abduction. Although abduction may be more likely with a young child, adolescents with autism should still be taught to identify “safe people” such as police officers, fire fighters and security guards, in the community. Many learners with autism are not able to distinguish safe or familiar people from unsafe or unfamiliar people. As a result, they cannot determine whom they can speak to or make a request for help. Learners can first learn to identify safe people, such as those noted above, in pictures. Once they can reliably do so, they should be taught what to do if a stranger approaches them. Multiple scenarios should be practiced so the learner becomes familiar with potential lures such as a stranger offering candy to get in a car or telling the student that his mom told the stranger to pick him up. Behavioral skills training and In Situ Training may be beneficial in teaching these skills (Beck & Miltenberger, 2009; Gunby, Carr & Leblanc, 2010; Mechling, 2008). In this scenario, the learner would first be provided instructions on what to do in each stranger situation. The learner should then model the correct response. If he does so successfully, a mock scenario can then be set up whereby a confederate approaches the learner and the learner has the opportunity to demonstrate the skills he has learned (i.e., do not go with the stranger, run away and tell an adult). If the learner performs the correct actions, he receives praise. If the learner does not demonstrate the correct response, the instructor immediately provides him with additional training.

Additional safety skills to target could include:

  • navigating and using community resources appropriately and independently;
  • exiting a car and crossing a parking lot or busy street safely;
  • responding appropriately in emergency situations such as a fire or earthquake;
  • addressing potential household hazards such as responding safely to cleaning chemicals, using appliances properly, or answering the doorbell when it rings;
  • identifying a need to dial 911;
  • using basic first aid procedures;
  • interacting appropriately with pets and other animals;
  • using the internet safely; and
  • managing teasing and bullying

 

There are many others that can be addressed based on the learner, his individualized goals and his future educational, vocational and residential placements. Involving the learner’s parents in the planning process will help you to identify which safety skills are most important and relevant for the individual to learn, particularly if the parents have specific concerns or if there has been a history of unsafe behavior. Finally, as you go through this program planning process, it’s helpful to keep in mind that the essential goal in teaching these skills is to promote greater independence by ensuring the learner has the tools he needs to be safe and to protect himself in his environment.

References

Beck, K. V., & Miltenberger, R. (2009). Evaluation of a commercially available program and in situ training by parents to teach abduction-prevention skills to children. Journal of Applied Behavior Analysis, 42, 761-772.

Gunby, K. V., Carr, J. E., & Leblanc, L. A. (2010). Teaching abduction-prevention skills to children with autism. Journal of Applied Behavior Analysis, 43, 107-112.

Hoch, H., Taylor, B. A., & Rodriguez, A. (2009). Teaching teenagers with autism to answer cell phones and seek assistance when lost. Behavior Analysis in Practice, 2, 14-20.

Mechling, L. C. (2008). Thirty year review of safety skill instruction for persons with intellectual disabilities. Education and Training in Developmental Disabilities, 43, 311-323.

Pan-Skadden, J., Wilder, D. A., Sparling, J., Stevenson, E., Donaldson, J., Postma, N., et al.(2009). The use of behavioral skills training and in-situ training to teach children to solicit help when lost: A preliminary investigation. Education and Treatment of Children, 32, 359-370.

Taber, T. A., Alberto, P. A., Seltzer, A., & Hughes, M. (2003). Obtaining assistance when lost in the community using cell phones. Research and Practice for Persons with Severe Disabilities, 28, 105-116.

Taylor, B. A., Hughes, C. E., Richard, E., Hoch, H., & Rodriquez-Coello, A. (2004). Teaching teenagers with autism to seek assistance when lost. Journal of Applied Behavior Analysis, 37, 79-82.

About The Author 

Shannon Wilkinson, M.ADS, BCBA is a Supervising Therapist with TRE-ADD program at Surrey Place Centre in Toronto, which is a comprehensive day treatment program that provides services for children and youth with autism and related developmental disorders and their families. Shannon has worked in the field of autism for 13 years, starting as an Instructor Therapist. She is particularly passionate about working with adolescents and has taught many vocational and life skills over the years. Shannon has a Masters in Applied Disability Studies from Brock University and is a Board Certified Behaviour Analyst.

Considerations for Parents on Grounding Kids

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Many parents choose to “ground” their kids when they make poor decisions. Maybe they lose access to video games for a week, or can’t watch TV for a month. Grounding in and of itself is not necessarily a bad thing. Here are a few considerations:

  • If you keep grounding your kid for the same behavior, then grounding is not changing the behavior. Sometimes grounding your child is a default response, but if it’s not working, you might want to consider some other options. You can take a look back at our series on 
    differential reinforcement     or our post on noncontingent reinforcement.
  • When possible, the consequence should be connected to the behavior. If your child throws a controller, then not having access to video games makes great sense. However if video games are taken away for any infraction, it may not be the most logical punishment and over time, it may even backfire. If the child is losing video games for everything, then he/she might stop trying to earn video games at all.
  • Longer durations of grounding may make you miss out on opportunities for reinforcing appropriate behaviors. Remember that reinforcement is simply any consequence that increases the future likelihood of the behavior. If you have set a rule that your child is grounded from using video games for one year, then you are missing many, many opportunities to teach the appropriate behavior. The same can be said for one month or even for one week. Especially when considering children with autism, they may requires multiple trials of the appropriate behavior before you see an increase in the appropriate behavior. In that case, grounding may just not be the best option.
  • Longer durations of grounding may backfire if you experience fatigue. Often our kids are experts at asking the same question repeatedly until you finally give in. The last thing you want to do is set a standard that when you say your child is grounded for a week, they are really only grounded until they wear you down.
  • Consider a different tactic. This isn’t possible for all behaviors, but if you are seeking a specific appropriate behavior, set a standard that if a certain duration or a certain number of appropriate behaviors results in more access to preferred items and activities. This is sort of the inversion of grounding and may be more successful.

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.

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Introducing DiffPoints!

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You might have noticed that little purple button at the bottom of our site labeled “Check DiffPoints”. What are DiffPoints? We’re glad you asked!

DiffPoints are our way of saying “thank you” for everything you do to stay engaged with Different Roads! Purchases, reviews, and referrals are all ways to earn points that can help you save on future purchases. There are many ways to earn rewards – head to our website and click “Check DiffPoints” for more details!

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Get ready for our BIGGEST SALE OF THE YEAR!

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This year, we will be holding a 25% OFF STOREWIDE SALE* from November 24 12:00 AM EST – November 27 11:59 PM EST! Select surprise items will be 30% off, so make sure to visit our site on 11/24 for details!

But that’s not all! This Black Friday will be our first ever Flash Sale! While our kits are usually excluded from sales due to their already discounted prices, the VB-MAPP and ABLLS-R Assessment kits will be 5% off from 9am-5pm EST on November 24th!

Need gift ideas? No problem! Every day until the sale we’ll be sending you curated collections of our favorite educational tools. Our “DiffGifts” will highlight a few fun items that will make holiday shopping for your favorite learner a breeze!

 

*Promotion is valid from November 24th 2017 at 12:00am ET through November 27th 2017 at 11:59pm ET. Promotion does not apply to items DRB 682, DRB 683, DRB 770, DRB 771, DRB 772, DRB 773, DRB 774, DRB 775, DRB 776, DRB 777, DRT 200, DRT 201, DRK 700, DRK 701, DRK 702, & DRK 703.  Flash sale only applies to items DRK 700, DRK 701, DRK 702, and DRK 703 from 9am-5pm EST on November 24th, 2017. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time.

 

Ethics: Part Three

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This is part three in a series on ethics and effective treatment. The previous installment can be found here. 

At the root of ABA is a focus on reinforcing appropriate behaviors. The goal is to provide an environment that is rich in positive interactions and enjoyable activities, rather than centering attention on inappropriate behaviors.

The Professional and Ethical Compliance Code lays out clear information about how behavior-change protocols should be implemented. Not only does it require that the client be involved in planning and consent of such protocols, but it also requires that behavior analysts recommend reinforcement rather than punishment whenever possible. This is an important detail that clients should understand about ABA. There are instances in which punishment procedures may be required (more on that in Part Four of this series,) but ethically, behavior analysts are required to use reinforcement whenever possible. This means that we should:

  • Identify appropriate behaviors that are already occurring and ensure that these behaviors contact reinforcement.
  • Identify replacement behaviors for inappropriate behaviors,
  • Teach the client how to engage in replacement behaviors
  • And provide reinforcement when the client engages in the replacement behavior. (For more on replacement behaviors, you can refer to this previous Tip of the Week)

This process will look different based on the individual needs of your clients and their unique behaviors, but the basic steps are always the same. We want to create an environment that promotes appropriate behaviors. And as behavior analysts, we are required by our ethical code to do just this.

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.

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Pick of the Week: Books for HFA Learners!

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Through 11/13!

*Promotion is valid until November 13th, 2017 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at difflearn.com, enter promo code SUCCEED2017 at checkout.

How Can Parents Find Effective Reinforcers?

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This week, Leanne Page M.Ed, BCBA, answers a parent’s question on creating effective token economies.  

This piece originally appeared on bsci21.org.

“Dear Behavior BFF, I’ve tried using a token economy and it helped for a little while. But lately my son has told me that he doesn’t want to earn stickers and he doesn’t care about the new toy he can get from his sticker chart. What do I do?”

First of all- good job using some behavior analysis to help increase desired behaviors in your family! A token economy is a great tool.

Now- a token economy is a great tool when it is combined with great positive reinforcement. What your message is telling me is that it’s not the token economy that is the problem. The rewards you are offering your son are not reinforcing. It sounds like they were super reinforcing and effective for a while, but your son is just not that into these rewards anymore.

So what do you do? Throw out the whole token economy system? No! Let’s find some more effective reinforcers to help you be successful again.

As parents, we assume we know what our kiddos like. We know what they are into, what they want, and what their preferred items are. But sometimes the things they will work to earn may surprise us.

Our kids may become satiated or habituated to the rewards we are offering them. This means they have had enough and it’s no longer piquing their interest. No matter what the cause, what we do know is that our children’s preferences change. To use effective positive reinforcement, we must identify what is reinforcing to our child at this point in time.

Enter preference assessments.

A preference assessment encapsultes “a variety of procedures used to determine the stimuli that the person prefers, the relative preference values of those stimuli, and the conditions under which those preference values change when task demands, deprivation states, or schedules of reinforcement are modified” (Cooper, Heron, & Heward, 2014).

As parents, we can do this in a number of ways.

  1. Observe your child and see what they choose to play with. This can take place at home but also outside your home. If you go to a friend or family member’s house, what things does your child choose to interact with? If you go to a museum, bookstore, other outings, what interests does your child show?
  2. Make a list of things/activities you think would be good reinforcers and ask your child how he feels about them. Depending on age and ability you could have him rate them on a scale of 1-10 or have them choose a happy face for each one. You could read each item and have your child give thumbs up, thumb sideways, or thumbs down to indicate preference. If you can’t think of ideas, google it. There are many reinforcer surveys or preference assessment checklists floating around on the internet.
  3. Let your child generate the list. Ask “What do you want to earn?” Let them say the big things that are unlikely and help to identify ones that are reasonable.
  4. If you are going to use new items- let your son choose. Take your child shopping. I let me daughter pick one or two things from the dollar spot every time we go to Target. She doesn’t get to keep them that day. She puts them in her prize bag to earn with good behavior or reaching goals on a token economy.

Any time we have a valid system of positive behavior supports in place, such as your token economy, and it stops working- it’s not the system. It’s the reinforcement. The reinforcement you are offering is simply not strong enough.

Up the ante. Give better options for rewards. Identify potential reinforcers by conducting a preference assessment. Let your son choose his reinforcer.

Whenever there is a new problem behavior, or a behavior management system not working- my first response is increase the positive reinforcement for appropriate behaviors.

Be prepared to continue to do preference assessments every once in a while. Our children’s interests and preferences change, so if we stay in the know we can have effective reinforcers at hand.

References

Carr, J. E., Nicolson, A. C., & Higbee, T. S. (2000). Evaluation of a brief multiple‐stimulus preference assessment in a naturalistic context. Journal of Applied Behavior Analysis, 33(3), 353-357.

Cooper, J.O, Heron, T.E., & Heward, W. L. (2014). Applied behavior analysis. Pearson Education International.

DeLeon, I. G., Fisher, W. W., Rodriguez‐Catter, V., Maglieri, K., Herman, K., & Marhefka, J. M. (2001). Examination of relative reinforcement effects of stimuli identified through pretreatment and daily brief preference assessments. Journal of Applied Behavior Analysis, 34(4), 463-473.

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.

Pick of the Week: Token Economies!

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We have great tools to help learners meet goals and stay on task! Sale ends 11/6!

*Promotion is valid until November 6th, 2017 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at difflearn.com, enter promo code REINFORCE2017 at checkout.

10 Common Mistakes Parents Make In Playing With Their Children With ASD

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This week’s post comes to us from Stephanny Freeman, PhD and Kristen Hayashida, MEd, BCBA, and Dr. Tanya Paparella, our partners on the Play Idea Cards app. Play Idea Cards is a full curriculum on teaching play – right in the palm of your hand! Check it out on the Apple App Store! 

Parents of young children with developmental disabilities are truly tireless. At times when one would think a break could be had – the time when they get to enjoy watching their children play, enjoy a conversation with another adult while their children play, or even relaxing by playing and having fun with their children – instead they are working with and teaching their children…and rightly so!

 
I’ve spent a good part of my career watching parents play with their young children with a variety of developmental disabilities (severe intellectual delay, Down syndrome, and autism spectrum disorder). Across the board, parents are remarkable. In a beautiful coordination of grace and direction, they work on controlling behavior, developing language, teaching concepts, maintaining attention, and building fun and relationships. Parents of children with disabilities are more directive and more instructional – yielding evidence of tremendous benefits for their children’s development as a result of these tireless warriors.

 
Children with autism in particular, have a significant and very specialized deficit in their ability to play with toys. Sometimes it can be in the functional domain but it is always difficult for them to think symbolically and abstractly about play. Teaching play to children with ASD is incredibly important and parents know this – they try!
For parents of children with ASD, here are 10 mistakes that are commonly made during play that can really disrupt their child’s growth in play.

 
1. Thinking that play develops on its own and randomly. Play in neurotypical children develops generally in a sequence and children with ASD do not naturally follow or progress through that sequence. Most books you find on children’s play show a fairly consistent developmental pathway for play. Skills build upon skills. Children start with very functional and constructional acts and develop into symbolic and creative play.

 
2. Forgetting to use play to actually teach play. Parents often use play to teach other skills (e.g. language or early concepts). Children with ASD have a core deficit in play so take time during your play with your child to actually teach them how to play with the toys regularly.

 
3. Thinking that your child will love play right away. For children with ASD, symbolic play is very difficult and likely your child would rather do other things than play. For example, a child with ASD may rather roll a car down a ramp repetitively then have the car “feel hungry” and go to the gas station for some “food.” It actually falls on the parent, at first, to convince the child that play is fun! This means you must have high positive affect (e.g., show excitement in your body language and in your words), work through difficulties with a huge smile, and laugh and enjoy using positive language.

 
4. Playing at a level that is way too difficult. Knowing what your child can do will help you teach them what comes next. If you child is just starting to put puzzles together, asking them to pretend to be Buzz Lightyear and talk like him is much too difficult.
5. Forgetting to imitate. It is critical for engagement building to imitate your child’s appropriate play behavior. Directiveness is still great but integrate imitation in your play. You should have a good balance of both. If your child is building blocks, grab a few and copy your child.

 
6. Constantly shifting your child’s attention. Sometimes it is necessary to move your child away from something that is a perseveration or a repetitive interest but in general, try to stick with what your child is doing. Sustained engagement with toys and people in coordination is a great skill and something children with ASD need to work on. It’s not a race to see how many different things you can do during a play time. Be patient and tolerant and build off of their interests rather than shifting their attention. Enjoy playing similar routines every time you play – just slowly build off of them.

 
7. Prompting intrusively. Starting off by hand-over-hand prompting or being very verbally directive (“put that block here and the train here”) your child is forced to shifts their attention without their own consideration. Instead, focus on what they pick up or are interested in, then move them forward by showing them something related to what they are doing, or general verbal comments (“Boy, that doll is super hungry!” as your child is holding a piece of play food).

 
8. Being concrete. If your child wants to do something a little imaginative, don’t bring them back to the concrete. If a child grabs a block and starts to eat it like a burger, please don’t tell them “It’s not food it’s a block!” Instead, imitate and say, “You have a burger, I have a hot dog!”

 
9. Missing the surprise factor. Every play session, even if it’s pretty routine and organized, should include something surprising by the parent. Parents should throw in a fun “wrench” and make a huge facial expression that indicates surprise. It’s called “violating” a routine or a play scheme. So if Mickey Mouse always goes to his top bunk in the play house, make sure one day the top bunk has cats in it! Your child will laugh and you can laugh too. This makes for enjoyment and further eye contact and engagement. It also facilitates problems solving.

 
10. Allowing your child to get away from play. Although the prior points suggest to following your child’s lead and imitate, the line should be drawn when your child doesn’t follow through with play. So if you are playing with your child’s interest (e.g. play food) and you make the suggestion of showing him dolls or plates or cups, then you verbally request his participation, he must follow through. Don’t allow your child to not follow through on play. Remember it’s a core problem for them so it’s hard!

 
Although play is still a “work” time for parents, hopefully these tips will help make it smoother and more enjoyable for everyone. This builds interest, sustained engagement, longer schemes and ideas for play, and positive practice of play skills. Ready Set PLAY!

About The Authors

Dr. Stephanny Freeman is a clinical professor at UCLA, a licensed clinical psychologist, and Co-Directs the Early Childhood Partial Hospitalization Program (ECPHP).  For 20 years, she has educated children with ASD and other exceptionalities as a teacher, studied interventions for social emotional development, and designed curriculum and behavior plans in school and clinic settings.

Kristen Hayashida is a Board Certified Behavior Analyst at the UCLA Early Childhood Partial Hospitalization Program (ECPHP).  For the last 10 years she has served as a therapist, researcher and educator of children and families living with autism spectrum disorder through the treatment of problem behavior.

Dr. Tanya Paparella is a specialist in the field of autism having spent more than 20 years in intervention and research in autism. She is an Associate Clinical Professor in the Division of Child Psychiatry at UCLA, a licensed clinical psychologist, and Co-Director of UCLA’s Early Childhood Partial Hospitalization Program (ECPHP), an internationally recognized model treatment program for young children on the autism spectrum.

Pick of the Week: Games!

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Now through 10/30!

*Promotion is valid until October 30th, 2017 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at difflearn.com, enter promo code GAMES2017 at checkout.