Annotated Resources: Bullying

October is National Bullying Prevention Month! In this month’s ASAT feature, Sunbul Rai, MSc, BCBA, Renee Wozniak, PhD, BCBA-D, and Rachel L. Liebert have collected some amazing resources to address the issue of bullying. 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!

Bullying is an unfortunate reality for many individuals with (and without) autism spectrum disorder (ASD). This list of annotated resources has been created to serve as a helpful reference for individuals with ASD, parents, clinicians, and educators alike. Included are resources that provide realistic strategies around both preventing bullying and addressing existing bullying. We hope that this information will support informed decisions and assist you in taking a strong stand against bullying.

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1.  National Autism Association (2015). A & S bullying: 5 things parents can do – www.autismsafety.org/bullying-tips.php The National Autism Association (NAA, 2015) provides a brief and practical list of five steps parents can take to address and prevent bullying in school, including 1) preparing the team, 2) addressing bullying with specific goals in the Individualized Education Plan (IEP), 3) preparing your child, 4) monitoring your child for signs of being bullied and 5) using the complaint process. At the outset, the authors stress the need to clarify the school district’s policies on bullying as a first step to prepare the team. Next, NAA suggests politely making it clear that you will be involved in helping the team to avoid your child’s victimization, and clearly communicating with teachers, administrators, the school board, and possibly the child’s peers to provide information on the child’s specific strengths and challenges, autism spectrum disorder, and the problem of bullying. In the IEP, NAA suggests addressing bullying by including social skills and self-advocacy goals, applicable accommodations, a familiarization plan, and specific peer support. To prepare your child, it is suggested to talk to him/her about appropriate friendships and about bullying, obtain social skills training if possible, and to help him/her get organized and oriented to the school in advance. Next, NAA suggests monitoring your child consistently for signs of being bullied by visiting the school often and keeping the lines of communication open with your child and teachers. If the complaint process is necessary, be persistent while avoiding being overly emotional; begin with informal written resolutions, moving to filing a complaint if necessary, while keeping in mind your rights under “The Individualized with Disabilities Education Act” (IDEA, 2004). “A & S Bullying: 5 Things Parents Can Do” is a quick read that may help parents take some simple first steps in addressing and preventing bullying issues for their child.

2.  Autism Speaks (2015). Combating bullyingwww.autismspeaks.org/family-services/bullying “Combating Bullying” is a compilation of information surrounding bullying of individuals with ASD, incorporating links to a variety of Internet and other resources. Some of the links include the Interactive Autism Network (IAN)’s study on bullying experiences of children on the autism spectrum, a Special Needs Anti-Bullying Toolkit, the trailer for and information on Bully: A Documentary, links to almost 20 books, 10 websites, and to other resources including a DVD and a list of signs to look out for that your child might be being bullied. The compilation addresses bullying of individuals with ASD and Asperger’s Syndrome, and includes information on bullying in schools, cyber bullying, and more. Information may be useful for parents, caregivers, educators, school administrators, individuals with ASD, and peers/friends of individuals with ASD.

3.  Autism Intervention Research Network on Behavioral Health (2013) – Remaking Recess www.airbnetwork.org/remaking.asp The Autism Intervention Research Network on Behavioral Health provides access to a booklet on a social skills intervention called “Remaking Recess” for use in the school setting. The booklet provides a treatment overview (helping children with ASD learn to engage with peers in the school setting) and a brief summary of playground engagement states (solitary, onlooker, parallel, parallel aware, joint engagement, games with rules) followed by specific strategies that can be implemented at recess time. Intervention strategies are included for a variety of situations, including 1) transitioning to an engaging activity and setting up, 2) providing popular developmentally-appropriate games and activities, 3) in-vivo social skills instruction, 4) facilitating peer conversations, 5) playing games, 6) sustaining engagement, 6) fading out of an activity and 7) a quick guide to boosting peer engagement. One of the main purposes of the intervention is to prevent bullying by aiming to improve the social inclusion of elementary-aged children with ASD by means of facilitated interactions with peers. “Remaking Recess” may be useful for individuals in educational settings who wish to take proactive steps to reduce bullying.

4.  Committee for Children (2015). Second step bullying prevention unit – www.cfchildren.org/second-step/research The Committee for Children is a non-profit organization that uses education with the aim of preventing bullying, child abuse and youth violence. The Second Step Bullying Prevention Unit is an initiative through The Committee for Children and is aimed at reducing bullying and peer victimization. The website includes information on the Second Step Bullying Prevention Unit Program as well as program outcomes. It comprises an article on the role of social-emotional learning (SEL) in bullying prevention efforts and highlights the importance of specific social and emotional skills taught in SEL programs, which include 1) empathy, 2) emotion management, 3) social problem solving, and 4) social competence. The website indicates that the implementation of the Second Step Bullying Prevention Unit can help empower schools to prevent and reduce bullying. It may be useful for professionals and parents alike to help them better understand specific skills that need to be taught to children to help prevent bullying.

5.  AbilityPath.org: Support for Parents of Children with Special Needs (2014). Bullying – www.abilitypath.org/areas-of-development/learning–schools/bullying/ AbilityPath.Org provides many bullying resources on its website and one of its highlights is the comprehensive report on bullying which focuses on supporting parents of children with special needs. The report is entitled “Walk a Mile in Their Shoes: Bullying and the Child with Special Needs” and emphasizes the “silent epidemic” of bullying that children with special needs face on a daily basis. It has several sections, which include: an overview of the report, testimonials from parents and children, targets: children with special needs, statistics, signs of being bullied, cyber bullying, teachable moments, the IEP, the law, the experts, the anti-bully program, and the call to action. Furthermore, it has several parent toolkits along with a teacher toolkit to help caregivers identify signs of bullying, and it highlights proactive steps that can be taken to protect a child with special needs. The information is also geared towards cyber bullying, which is bullying that can be conducted through the use of technology and social media sites. For example, one of the parent toolkits stresses the importance of protecting a child with special needs by teaching the child not to reveal personal information online, limiting online time, reviewing security settings on the computer and so forth. “Walk a Mile in Their Shoes: Bullying and the Child with Special Needs” promotes awareness, provides resources on bullying and its impact, and may be useful for parents, caregivers, teachers, administrators and other professionals working with children with special needs.

6.  PBIS: Positive Behavioral Interventions & Supports (2015). Bully prevention in SWPBS – www.pbis.org/school/bully-prevention PBIS: Positive Behavioral Interventions & Supports (2015) provides bully prevention manuals for the elementary, middle, and high school levels. The manuals are meant as a resource for the school setting and aim to provide students with the tools needed to be free of bullying through the use of school-wide positive behavior interventions and supports. The program described in the manual is divided into six lessons and focuses on the “stop/walk/talk procedure” for gossip, inappropriate remarks, and cyber bullying. The stop/walk/talk procedure involves physical and verbal components with examples of when these components can be used appropriately and when they should not be implemented. The manual emphasizes teaching the skill, followed by practice and roleplaying for a variety of scenarios. The lessons are easy to read and are ready for implementation in the classroom setting. PBIS’s bully prevention manuals may be useful for teachers or other educators in school and similar settings.

7.  National School Climate Center. (2015). Educating minds and hearts… because the three R’s are not enough – http://schoolclimate.org/ The National School Climate Center is an organization that utilizes relevant research to establish and distribute guidelines to encourage acceptance and safety in schools. The Center offers professional development programs for educators, parents, and after-school supervisors to better understand and promote children’s social and emotional wellness and communication. Their website offers guidelines to help educators and parents establish and maintain safe, comfortable schools and homes by understanding social and emotional learning. The “Bully Prevention” section of the website includes a toolkit entitled “The Breaking the Bully-Victim-Bystander Cycle Tool Kit.” This resource may be useful for educators who wish to create a positive school climate.

8.  The Bully Project (2015)http://www.thebullyproject.com/ The Bully Project is a website that aims to take action against bullying. It focuses on a documentary about children who were bullied during the 2009-2010 academic year and how their parents supported them and modeled “upstander” rather than “bystander” behavior. The website invites users to share their own stories and host or organize screenings of the film to raise awareness. The site also includes tools (including DVDs and toolkits that can be purchased) for students, parents, advocates, and educators, with a section devoted to individuals with special needs. The tools for educators are also available in Spanish. The “Roadmap to Building a Caring and Respectful School Community” includes work that was produced with the assistance of the Making Caring Common Initiative at the Harvard Graduate School of Education. The website also provides interested individuals a platform in which they can take action by joining regional anti-bully project teams. This resource may be useful for those looking to increase awareness and to take steps toward reducing bullying.

9.  Pacer’s National Bullying Prevention Center (2015). The end of bullying begins with you – www.pacer.org/bullying/ Pacer’s National Bullying Prevention Center’s website was developed for children and teenagers to be part of a social cause to end bullying. It includes a section dedicated to students with disabilities with legal information and template letters for parents to send to their child’s school to serve as notification of a bullying situation and a written record of having done so. The website also directs children and teenagers to other helpful resources including KidsAgainstBullying.org and TeensAgainstBullying.org. Ample information is provided about National Bullying Prevention Month (October) including a brief history, opportunities to register for events, key points to make should you wish to give a presentation, and directions to request a governor’s proclamation. Educator toolkits are available under the resources tab, and they include classroom toolkits, community toolkits, student-created toolkits, and activities for youth. Additionally, there is a guide for planning school events, and a peer advocacy guide. This website may be useful for children and teenagers who want to make a difference and provides tangible resources to reduce bullying.

10.  U.S. Department of Health & Human Services (2015). Stopbullying.gov – http://stopbullying.gov This government website provides a wealth of resources across a variety of areas, in both English and Spanish. An array of topics is covered with related subtopics and links. General topics and subtopics include:

  • What is Bullying – definition, roles kids play, and related matters (e.g., harassment, teen dating violence, peer conflict and more)
  • Cyber Bullying – what it is, how to prevent it, how to report it, and risk factors
  • Who is at Risk – warning signs, effects, and considerations for specific groups (including bullying and youth with disabilities and special health needs)
  • Preventing Bullying – how to talk about it, prevention at school, working in the community, and a training center which includes videos, reading modules, research and statistics, training manuals, toolkits, user guides and additional resources
  • Responding to Bullying – stopping it on the spot, finding out what happened, supporting the kids involved, and being more than a bystander
  • Get Help Now – includes steps to take to resolve a range of bullying situations

Cite this:
Rai, S., Wozniak, R. & Liebert, R. L. (2015). Annotated resources: Bullying. Science in Autism Treatment, 12(4), 23-27.

Bullying can be complex and the Association for Science in Autism Treatment has other resources available for help with this, as well. Please check out the links below to learn more!

1. Clinical Corner: Preventing and Addressing Bullying, Lori Ernsperger, Ph.D., BCBA-D
https://www.asatonline.org/research-treatment/clinical-corner/bullying/

2. Clinical Corner: Teaching Safety Skills to Adolescents, Shannon Wilkinson, MADS, BCaBA
https://www.asatonline.org/for-parents/education/lifespan/teaching-safety-skills-to-adolescents/


About The Authors 

Sunbul Rai, M.Sc, is a Board Certified Behavior Analyst® with a background in education and psychology.  She has extensive experience working with individuals on the Autism Spectrum in a variety of settings across Canada.  Sunbul serves as the Practicum Consultant for the University of New Brunswick’s Autism Intervention Training Program.  She is also the founder of the ABA Little Tots Program at Autism Services, the first intensive behavioural intervention (IBI) program in Saskatchewan.  She is committed to enhancing the quality of life of individuals with Autism so that they can reach their full and utmost potential.

Renee Wozniak, PhD, BCBA-D, joined the ASAT Board of Directors in 2016. Prior to serving as a Board Member, Renée was a part of ASAT’s Externship, where she assumed the roles of Media Watch Co-Coordinator and Media Watch Lead. Renée received her Ph.D. in Special Education, focusing on Autism Spectrum Disorders (ASD) and Applied Behavior Analysis (ABA), from Arizona State University. She has worked in the fields of ASD and ABA in a variety of capacities since 1998, serving in public schools as a special education teacher, behavior intervention teacher specialist and district-wide autism trainer, and in clinical and home-based ABA programs as a research assistant, clinical/behavior interventionist, and program supervisor. Renée has trained families, therapists, teachers, teacher candidates, paraprofessionals, administrators, and others working with individuals with autism, and has instructed master’s level ABA, ASD, research and special education courses. She currently serves in the roles of faculty and subject matter expert in Capella University’s Applied Behavior Analysis program. Renée is passionate about helping individuals with autism and their families by supporting and disseminating scientific research in autism treatment.

Rachel Liebert was an extern at ASAT from 2015 to 2016 while she was studying psychology at Barnard College of Columbia University.  She is currently a second-year law student at Fordham University and plans to pursue a career in public policy and child welfare.

Ethics Part Two: More on the Right to Effective Treatment

This is part two in a series on ethics and effective treatment. Part one can be found here.

 

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In Part One, I discussed the right to effective treatment as detailed by the Professional and Ethical Compliance Code for Behavior Analysts. An essential part of effective treatment is providing, as the code specifies, “scientifically supported, most-effective treatment procedures” (BACB, 2014). In order to do this, behavior analysts must contact the research literature to fully understand scientifically supported treatments. They should do this through reading journal articles, but also through attending workshops, trainings, and local conferences.
Reading journal articles should be a regular activity for behavior analysts. It is suggested that behavior analysts set aside two to four hours per week to read recent journals (Bailey & Burch, 2016, p. 24). This may seem like a lot of time, especially if you aren’t currently doing it. But this practice allows you to stay abreast of current research and have access to a broader range of possible interventions. You may also find it easier to follow through if you participate in a journal club (click here to see suggestions for that.).
Most of the behavior analytic research you’ll find is comprised of single-subject studies. You may get pushback from professionals or parents who are accustomed to seeing research with very large numbers of participants and an explanation of average results. It’s important to understand how to address those concerns in an accessible and accurate way. Here are some things to consider:
• Behavior analytic research does not utilize averages. Therefore, we learn a lot about the specific individuals who responded to an intervention, and can make a more accurate hypothesis about whether or not that intervention will work for a particular client. Furthermore, research based on averages doesn’t provide any information on the percentage of individuals who did not respond to the intervention and WHY they did not respond to the intervention. This is important information that we’re missing out on!
• Behavior analysis is focused on creating individualized interventions. We do not believe in a one-size-fits-all approach, but rather in a set of principles of behavior. Individualizing treatment means that we are looking at the environment, the basic characteristics of the individual, the motivations of the individual, and the functions of a behavior when creating an intervention. When you familiarize yourself with behavior analytic research, you are able to identify interventions that worked with individuals who similar characteristics to that of your particular client.
• Though behavior analysts utilize single subject research, we are fully aware that this does not mean an intervention that worked for a few subjects will work for everyone. This is why there is an important stress on replication of research. (Chiesa, 1994). This is also why it’s important to read several journal articles on the same subject, rather than simply reading one and considering yourself up to date.

 

The main takeaway here is that being familiar with the research is important in order to maintain an ethical practice. Supervisors should support this by providing suggestions for readings and modeling these behaviors. Organizations can support this by subscribing to journals and maintaining a small library for employees. You can support it by subscribing to journals, setting aside time to spend time reading journals, and participating in a journal club. It is incredibly important to our field, and to your practice.

 
Bailey, J. S., & Burch, M. R. (2016). Ethics for behavior analysts: 3rd edition. New York: Routledge.
Behavior Analyst Certification Board. (2014). Professional and ethical compliance code for behavior analysts.
Chiesa, M. (1994). Radical behaviorism: The philosophy and the science. Authors Cooperative.


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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How do you figure out what motivates your students?

 

This month’s ASAT feature comes to us from Niall Toner, MA, BCBA of the New York State Institute for Basic Research in Developmental Disabilities. 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!

MotivateEmail

I am a special education teacher working with students with autism. At times I find it difficult to figure out what motivates my students and what they’re interested in. Can you make some suggestions about the best way to do this?

This is an excellent question and one that highlights a challenge often experienced not only by teachers but also by family members of individuals with autism. We know that the interests and preferences of individuals with and without autism vary significantly over time. Also, we know that effective teaching of skills and behavior change are predicated upon the timely use of powerful reinforcement (i.e., positive consequences of skilled behavior that motivate and strengthen that behavior). As discussed below, identifying an individual’s preferences is a critical first step in teaching new skills because these preferences often lead to the identification of powerful reinforcers; but how we do this can be easier said than done, especially when the learner has a limited communication repertoire or very individualized interests. The best way to identify preferences is through ongoing preference assessments.

The value of preference assessments

Since many individuals with autism may have difficulty identifying and communicating their preferences directly, we must consider alternative methods of obtaining this information. At the onset, it is important to keep in mind that what may be rewarding or reinforcing for one individual may not be for another. For example, one child may enjoy bubble play, crackers or a particular cause-and-effect toy while a classmate may find one or more of these uninteresting or even unpleasant. Furthermore, an individual’s preferences change across time. For example, an individual may have demonstrated little use for music at age 11, but she may demonstrate a keen interest in music at age 13.

Preference assessments provide a systematic, data-based approach to evaluating a host of potential interests (e.g., food, toys, activities) for an individual. Although preference assessments do require time and effort up front, their use can decrease the time and energy, required to change behavior in the long run. Research indicates that when caregivers use a presumed preference that, in fact, is not the learner’s actual preference, valuable time, energy and resources are lost (Cooper, Heron, & Heward, 2006).

Types of Preference Assessments

Preference assessment can be conducted in three distinct ways: (1) Interviews and Formal Surveys; (2) Direct observation; and (3) Systematic assessment.

Interviews are a straightforward technique that can be used to gather information quickly. They involve obtaining information from the individual’s parents, siblings, friends, and teachers (and
from the individual, if communicative) by asking both open-ended and comparison questions. Examples of open-ended questions include: “What does he like to do?” “What are his favorite foods?” and “Where does he like to go when he has free time?” Comparison questions might include: “Which does he like better, cookies or crackers?” and “What would he rather do, go for a walk or eat chips?” Resultant information is then compiled in a list and identified items and activities can be piloted out as possible reinforcers.

Formal surveys can also be used to guide these discussions. One widely used survey is the Reinforcement Assessment for Individuals with Severe Disabilities (RAISD; Fisher, Piazza, Bowman, & Amari, 1996). This interview-based survey gathers information about potential reinforcers across a variety of domains (e.g., leisure, food, sounds, smells), and ranks them in order of preference. It should be noted that, although simple and time-efficient, using interviews alone can result in incomplete or inaccurate information. In fact, some studies have shown that, for the same individual, staff interviews did not reveal the same information as using a survey (Parsons & Reid, 1990; Winsor, Piche, & Locke, 1994).

Direct observation involves giving the individual free access to items and/or activities that he or she may like (presumed preferences) and recording the amount of time the individual engages with them. The more time spent with an item or activity, the stronger the presumed preference. In addition, positive affect while engaged with these items and activities could be noted (e.g., smiling, laughing). During these observations, no demands or restrictions are placed on the individual, and the items are never removed. These direct observations can be conducted in an environment enriched with many of the person’s preferred items or in a naturalistic environment such as the person’s classroom or home. Data are recorded over multiple days, and the total time spent on each object or activity will reveal the presumed strongest preferences. Direct observation usually results in more accurate information than interviews but also requires more time and effort.

Systematic assessment involves presenting objects and activities to the individual in a preplanned order to reveal a hierarchy or ranking of preferences. This method requires the most effort, but it is the most accurate. There are many different preference assessments methods, all of which fall into one of the following formats: single item, paired items, and multiple items (Cooper, Heron, & Heward, 2006).

Single item preference assessment (also known as “successive choice”) is the quickest, easiest method. Objects and activities are presented one at a time and each item is presented several times in a random order. After each presentation, data are recorded on duration of engagement with each object or activity.

Paired method or “forced-choice” (Fisher et al., 1992) involves the simultaneous presentation of two items or activities at the same time. All items are paired systematically with every other item in a random order. For each pair of items, the individual is asked to choose one. Since all objects and activities have to be paired together, this method takes significantly longer than the single-item method but will rank in order the strongest to weakest preferences. Researchers found that the paired method was more accurate than the single item method (Pace, Ivancic, Edwards, Iwata & Page, 1985; Paclawskyj & Vollmer, 1995).

The multiple-choice method is an extension of the paired method (DeLeon & Iwata, 1996). Instead of having two items to choose from, there are three or more choices presented at the same time. There are two variations to this method: with and without replacement. In the multiple choice with replacement method, when an object is selected, all other objects are replaced in the next trial. For example, if the individual is given a choice of cookies, crackers, and chips, and he chooses cookies, the cookies will be available for the next trial, but the crackers and chips are replaced with new items. In the without replacement method, the cookies would not be replaced and the choice would only be between the crackers and chips. No new items would be available.

A few final recommendations

When conducting preference assessments, consider testing leisure items/activities and food assessments separately because food tends to motivate individuals more than toys and other leisure items (Bojak & Carr, 1999; DeLeon, Iwata, & Roscoe, 1997). Also, be sure to assess preferences early and often. Preference assessments should be conducted prior to starting any new intervention or behavior change program. And remember that preferences change over time and require continuous exploration. Therefore, assessments should be updated monthly or whenever an individual appears tired of or bored with the preferred items. Keep in mind too, that the identification of one type of preference may provide ideas for other potential reinforcers. For example, if an individual loves a certain type of crunchy cereal, he/she may like other cereals or crunchy snacks. Or if an individual enjoys coloring with crayons, consider exploring whether he/she may enjoy coloring with markers or using finger paints.

Finally, when selecting a preference assessment method, a practitioner or parent should consider the individual’s communication level, the amount of time available for the assessment, and the types of preferred items that will be available. Taken together, these preference assessment methods can provide the valuable information necessary to help motivate and promote behavior change in individuals with autism.

References

Bojak, S. L., & Carr, J. E. (1999). On the displacement of leisure items by food during multiple stimulus preference assessments. Journal of Applied Behavior Analysis, 32, 515-518.

Cooper, J. O., Heron, T. E., & Heward W. L. (2006). Applied Behavior Analysis (2nd ed.). Upper Saddle River, New Jersey: Prentice Hall.

DeLeon, I. G., & Iwata, B. A. (1996). Evaluation of multiple-stimulus presentation format for assessing reinforcer preferences.Journal of Applied Behavior Analysis, 29, 519-533.

DeLeon, I. G., Iwata, B. A., & Roscoe, E. M. (1997). Displacement of leisure reinforcers by food during preference assessments. Journal of Applied Behavior Analysis, 30, 475-484.

Fisher, W. W., Piazza, C. C., Bowman, L. G., & Amari, A. (1996). Integrating caregiver report with a systematic choice assessment. American Journal on Mental Retardation, 101, 15-25.

Fisher, W. W., Piazza, C. C., Bowman, L. G., Hagopian, L. P., Owens, J. C., & Slevin, I. (1992). A comparison of two approaches for identifying reinforcers for persons with severe to profound disabilities. Journal of Applied Behavior Analysis, 25, 491-498.

Pace, G. M., Ivancic, M. T., Edwards, G. L., Iwata, B. A., & Page, T. J. (1985). Assessment of stimulus preference and reinforcer value with profoundly retarded individuals. Journal of Applied Behavior Analysis, 18, 249-255.

Paclawskyj, T. R., & Vollmer, T. R. (1995). Reinforcer assessment for children with developmental disabilities and visual impairments. Journal of Applied Behavior Analysis, 28, 219-224.

Parsons, M. B., & Reid, D. H. (1990). Assessing food preferences among persons with profound mental retardation: Providing opportunities to make choices. Journal of Applied Behavior Analysis, 23, 183-195.

Windsor, J., Piche, L. M., & Locke, P. A. (1994). Preference testing: A comparison of two presentation methods. Research in Developmental Disabilities, 15, 439-455.


About The Author

Niall Toner MA, BCBA, LBA is a licensed behavior analyst and board certified behavior analyst with over 10 years experience working in the fields of applied behavior analysis and developmental disabilities. Niall is currently the Clinical Director for Lifestyles for the Disabled. Prior to the position he served as a consultant to various organizations including the New York City Department of Education. He also held the position of Assistant Director at the Eden II Programs. Niall has presented locally, nationally and internationally. His interests are Preference Assessments and Functional Analysis, which he presents and publishes.

 

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Ethics Part One: Data Collection and The Right to Effective Treatment

In the next few weeks I will be writing about ethics in the field of applied behavior analysis. This is the first part in a multi-part series.

Sometimes behavior analysts get a bad rap because we are so focused on the data. Somehow, there is a perception that writing down the numbers and graphing the information is “cold” or “unfeeling” towards the client. Over the course of my career, I’ve had more than one person say to me that I was more fun or more playful than they expected me to be as a behavior analyst. I’m not exactly sure where these misperceptions started, but today I want to get to the root of them.
As a BCBA, I am bound by the Professional and Ethical Compliance Code for Behavior Analysts. Within this code, it clearly states “Clients have a right to effective treatment.” This is something I take to heart every day in my work. And it’s the primary reason that I have my clipboard and am taking data. I want to ensure that the treatment I am introducing is actually effective. My data is what shows me when something is clearly not working, and allows me to be efficient with making changes the best benefit my client.
Clear, objective data allows me to be responsive to data and provide information in a responsible manner. Here are a few things to consider:
• When I graph data daily and look at that information, it’s very easy for me to see if a client’s performance has plateaued, is improving, or is actually getting worse. I can make adjustments based on the trend in the data.
• When all practitioners working with the client graph daily, I might (as the supervisor) see that the client is not performing as well with one practitioner. This might indicate that more training needs to occur. Or, I might see that one practitioner is getting far better results than the others. This might indicate that the practitioner is not recording data correctly or is doing something as part of the intervention that everyone should be doing.
• Data should be collected daily and the teaching programs should be clearly outlined. This way, if for some reason a practitioner abruptly stops working with the client or if the client moves, it is much easier for future practitioners to pick up where the last ones left off.
• Looking at data daily gives an idea of the individual client’s general trends in mastering new skills. For instance, last year I had a client who generally mastered new skills within one week, and his trend in the data was very consistent across all types of skills. So if we introduced a new program and he wasn’t mastering it for three weeks, it was an indication that we needed to re-evaluate what we were teaching or how we were teaching it. Being well-versed in your individual client’s learning patterns allows you to more clearly make individualized decisions!
We’d love to hear from you. What outcomes have you discovered in the relationship between being responsive to data and providing effective treatment for your clients?


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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Got Questions: Help for Socially Anxious Preschooler Who Has Autism

This piece originally appeared at Autism Speaks as part of their Got Questions? series.

My almost 3-year-old was recently diagnosed as having autism spectrum disorder. We struggle going places such as open gym or even the library because he doesn’t like other kids in his space. He does okay with adults, but other kids make him extremely anxious. How do I help him become more comfortable when other children are playing in the same area or with the same set of toys?

I commend you for seeking support for your son at this young age. Receiving a diagnosis of autism spectrum disorder can be challenging and confusing. Yet research shows that early intervention can help maximize cognitive, language and social development.

In my pre-doctoral work at UCLA and my post-doctoral training at Pediatric Minds Early Childhood Treatment Center, my colleagues and I have seen many forms of anxiety in children and teens who have autism. Like your son, many of them experience anxiety around other children, especially groups of children. Understanding the reasons for this anxiety can help select approaches that help.

For example, you mention that your son “does okay” with adults, but not other kids. This is very common. While adults tend to be more consistently friendly and accommodating, children can be very unpredictable. For instance, it’s not unusual for three-year-olds to grab toys from each other, cry, get very close to each other and just be loud! This can be particularly anxiety provoking for someone with autism.

In addition, many people with autism are hypersensitive to sensory input. As a result, public places such as open gyms or even a lively children’s library can be over-stimulating. The sights, sounds and smells can feel intense, uncomfortable and overwhelming. Understandably, this can lead a child to avoid these environments and become upset in the midst of them.

I strongly encourage you to work with your son’s therapists to develop a personalized intervention plan. Children with autism who are under age 3 can qualify for such services through their state’s Early Intervention program. After age 3, these services can be accessed as part of an Individualized Education Plan (IEP) through your school district.

Also see “Access autism services,” for more information on early intervention and individualized education services.
Fortunately, many programs are available to help young children with the type of social anxiety you describe. These include play-based forms of Applied Behavioral Analysis, occupational therapy that includes sensory integration, communication-focused intervention, social skills play groups and other options. Many children do best with a multidisciplinary approach that combines two or more of these methods with close collaboration among the care providers.

Also see, “Autism therapies and supports,” in the “What is autism?” section of this website. While every child has different needs, here are some strategies you can try – ideally in collaboration with your son’s therapists.

Practice. Are there specific social situations that tend to trigger your son’s anxiety? For instance, does he get upset when another child tries to take his hand or pull him into a game? Consider teaching him simple phrases he can use in these situations. For example, a simple “no.” You can also teach and practice toy sharing and turn taking at home. If your child enjoys play dough, for example, place just a few pieces on the table and take turns modeling each of the pieces, handing them back and forth. This can help him learn sharing and even waiting for gradually increasingly periods before getting what he wants. These skills can be difficult to learn. So start with brief periods of waiting and offer plenty of praise along the way. Providing this type of structured opportunities to practice social skills can encourage your son to use them in social settings.

Start slow. A room full of children may be too overwhelming for your child to use the new skills that he’s practiced with you at home. Consider hosting a playdate with one other child who is relatively calm and engaging. Sometimes, a slightly older child will understand how to be more accommodating.

In selecting where to have the playdate, consider your son’s comfort level. You might start at home or maybe a relatively quiet place at a nearby park.

Choose some relatively structured activities such as games or sharable toys that your child knows and likes. Keep the playdates relatively short to further the chances of success.

Bring the familiar. When entering a loud or anxiety producing environment, a comfort object may help provide a sense of security in an otherwise overwhelming environment. Consider allowing your son to bring a familiar toy, stuffed animal or book. Another possibility is a toy or game that actively engages his attention – and so directs his attention away from the hubbub around him.

Be patient. I encourage parents to appreciate that their child’s stage of development may not match what’s typical for his or her age. This is particularly true of social development in children on the autism spectrum. By focusing on small steps, you can foster your child’s confidence and decrease the likelihood of setbacks.

Remember, your child – like all children – is continually developing. You can support his social development – while decreasing anxiety around other children – by providing ample opportunities for success.


About The Author 

Dr. John Danial is a 2012 Autism Speaks Weatherstone predoctoral fellow. Dr. Danial’s fellowship supported his work with mentor Jeffrey Wood at the University of California, Los Angeles, developing and evaluating behavioral interventions that reduce anxiety in children, teens and adults with autism and low verbal skills. He is currently completing his post-doctoral placement at Pediatric Minds Early Childhood Center, working with families of children with developmental delays and social-emotional challenges.

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