Productive Meetings in Home ABA Programs

Creating effective meetings with your child’s BCBA and other service providers can be difficult. In this month’s ASAT feature, Preeti Chojar, Board Member of the Association for Science in Autism Treatment (ASAT), shares some valuable tips about how parents can make the most out of these meetings. 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 parent who has a home-based ABA program.  We have monthly meetings with all of the providers that work with my child.  I am looking for some ideas on how to make the most of these meetings.  Any suggestions?
 

Answered by Preeti Chojar, Mother and ASAT Board Member

It is terrific that your team meets monthly! Collaboration and consistency amongst members of the professional team is the hallmark of a successful home program. I have found that a great way to build teamwork is to have regular meetings to keep the whole team on the same page. Here are some suggestions to help you use this time effectively and efficiently. In our particular case, we meet monthly, but keep in mind that some teams may need to meet more frequently (depending on the composition of the team, level of oversight required, and needs of the child).

Meeting composition
Ideally, a time should be scheduled when the entire team can be present. A supervisor like a behavior consultant (e.g., BCBA) or a family trainer should be present as well. It could also include any related service providers, such as the speech pathologist, occupational therapist, or physical therapist. Assembling the entire team can be difficult but try your best, as the benefits will make it worthwhile.

Develop the agenda
Always create an agenda well before a team meeting. Please note that this agenda should not side-step any other communication that should be occurring (e.g., the consultant may want to know right away if a new skill-acquisition program is not going well).

  • Start by writing down any new behaviors, both positive and negative. Also note if there is evidence of lost skills or discrepancies in skill levels across settings, situations or people.
  • Any data taken by instructors should be summarized and analyzed before the meeting.
  • Add anything that the supervisor or the collective wisdom of the group could help resolve.
  • One of the agenda items should always be to review last month’s meeting notes paying close attention to any open or unfinished items.
  • If the child is also receiving services in a school or center-based environment, it is beneficial to seek input from those providers as well. Any observations made by people in the community that highlight some skill or skill deficit which had gone unnoticed can be brought to the table too.
  • Finally, make sure the agenda is well balanced and addresses everyone’s concerns. Prioritize agenda items and if necessary suggest some time limits.

Circulate the agenda

  • Make sure to circulate the agenda to everyone attending the meeting, ideally a few days before the meeting.
  • Ask all team members to notify you ahead of time of any other agenda items they might have that were not added yet.

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How Siblings Of Children With Autism Can Help Improve Behaviors

When I first came across this study, “Behavioral Training for Siblings of Autistic Children,” I was immediately hesitant. There’s something about the idea of sibling-as-therapist that makes me cringe a little bit. When I work with the families of children with autism, the hope is that the siblings of the child with autism still have a childhood without being pushed into the role of caregiver. And I also want the child with autism to have independence and feel like an individual who is heard, which may be more challenging if their siblings are issuing demands just as a parent or teacher would. But as I read the study, I realized that the work they completed had incredible social significance.

In the study, there were three pairs of siblings. The ages of the children with autism ranged from 5 years old to 8 years old. The ages of the siblings ranged from 8 years old to 13 years old. The researchers trained each sibling of a child with autism how to teach basic skills, such as discriminating between different coins, identifying common objects, and spelling short words. As part of this training, the researchers showed videos of one-on-one sessions in which these skills were taught, utilizing techniques such as reinforcement, shaping, and chaining. What the researchers did next was the part that really stood out to me: they discussed with the siblings how to use these techniques in other environments. Finally, the researchers observed the sibling working with their brother/sister with autism and provided coaching on the techniques.

It should be noted here that the goal of the study was not to have the siblings become the teacher of basic skills. Instead, it was to provide a foundation of skills in behavioral techniques for the sibling to use in other settings with the hope of overall improvement in the behaviors of the child with autism. The researchers demonstrated that, after training, the siblings were able to effectively use prompts, reinforcement, and discrete trials to effectively teach new skills. But, perhaps the most meaningful aspects of the study were the changes reported by both siblings and parents. The researchers provide a table showing comments about the sibling with autism before and after the training. One of the most striking comments after the training was, “He gets along better if I know how to ask him” (p. 136). Parents reported that they were pleased with the results and found the training beneficial.

This study provides excellent evidence that structured training for siblings has real potential for making life a little easier for the whole family. The idea isn’t that they become the therapist, but instead that knowledge truly is power.

References

Schriebman, L., O’Neill, R.E. & Koegel, R.L. (1983). Behavioral training for siblings of autistic children. Journal of Applied Behavior Analysis. 16(2), 129-138.

WRITTEN BY SAM BLANCO, MSED, BCBA

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

 

States Begin to Include ABA Coverage

It looks like progress is being made on getting treatments such as ABA covered by insurance. Disability Scoop is reporting that states are finally starting to include coverage of treatments like Applied Behavior Analysis for children with autism under Medicaid. This means that states must cover services consistent with the categories defined by Early and Periodic Screening, Diagnostic and Treatment services (EPSDT). This includes Applied Behavior Analysis, speech and occupational therapies, and other personal care services.

Read the full article here.

Has anyone in CA, NV, and CT had success with getting services like ABA covered?

 

 

 

Tip of the Week: 6 Ways to Get the Most Out of Your Home ABA Program

CHILD IN SPEECH THERAPYWhile an ABA professional should be coming in to organize and run your ABA program, as a parent or guardian, there are some simple things you can do to make the time your child spends in a home session more effective. Several tips are here, but it may be unrealistic for you to follow ALL of these tips. Consider your home environment and family’s needs, then implement the tips that are the most feasible for your situation.

Following even one of these tips can make a big difference in your child’s sessions!

1)    Make sure all ABA materials are accessible. It’s important to have a system for storing the materials and the binder the ABA providers use. Some families I work with put everything into a box, a dresser drawer, or on a shelf the child cannot reach which is great. If the child utilizes an iPad for communication or reinforcement, be sure it’s available and charged. If any other items are necessary, such as edibles for reinforcement, make sure those are available at the beginning of the session. One parent I worked with used a craft organizer container with a clear plastic lid to store edibles, so when sessions began she’d set it on the table. All the different snacks were already broken into small pieces and organized in the box, freeing up more time for teaching during the session.

2)    Keep the area for ABA therapy free from distraction. Remove any items that are highly distracting for your student. Shut windows if you live on a noisy street. Make sure your cell phone is with you. This tip is especially challenging for families that live in studio apartments or have loud neighbors.

3)    Limit the number of disruptions from siblings or other family members. As an ABA therapist who is focused on increasing my students’ opportunities for social interaction, I don’t want to discourage the siblings and other family members from coming in. Interruptions should happen from time to time, and it’s important that my students learn to refocus after an interruption. But sometimes it becomes an obstacle to learning when there are consistent interruptions, or if I have to continue to redirect a sibling to other activities.  Instead, it’s better to structure activities with siblings and other family members, perhaps by teaching the learner with autism to request the sibling come play or adding it to the student’s activity schedule.

4)    When possible, reserve one or more highly motivating activities for ABA sessions. If a child has free access to all his/her motivating activities, then those activities are not as valuable when used in a session, and therefore less motivating. Sessions are most effective when the learner is working for something that they’re highly motivated by. It’s important to note here that I don’t want the child to only have access to fun things during sessions. I also don’t want the parents miss out on opportunities to enjoy motivating activities with the learner. The idea is to save a small number of motivating activities for sessions so the child maintains motivation and focuses on learning. This tip is especially challenging for families when the learner with autism is motivated by only one or two activities or items.

5)    Don’t allow the child to engage in their highest motivating activities right before an ABA session. I’ve had more than one case in the past in which I would get to the home and find my student watching his favorite TV show or playing his favorite game on the iPad. What would typically happen is that my student would associate my arrival with the end of his favorite activity, which would lead to crying, refusal to work, and/or attempts to escape. I want my students to be able to watch their favorite shows and play with their favorite games, but our sessions are more effective when those activities don’t take place immediately beforehand.

6)    Ask your provider if there are any changes you can make to improve sessions. Every home is different and every child’s needs are different. Your provider may be able to identify small changes for your specific situation that are not mentioned above. Opening that dialogue can be a powerful way to improve your child’s learning outcomes.  

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals.