What Autism Awareness Should Be About

This month’s ASAT feature comes to us from David Celiberti, PhD, BCBA-D. 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!

April is Autism Awareness Month. Blue puzzle pieces will appear on thousands of Facebook pages and billboards, and the media will give greater attention to autism. Further awareness is wonderful, as detection and diagnosis are necessary first steps to accessing help in the forms of treatment, information, and support. With well over 500 treatments from which to choose, parents of children with autism need guidance, tools, and accurate information to empower them to make the best possible choices for their children: these choices will undoubtedly have a profound impact on both their current quality of life and their children’s future and potential.

When I first entered the field over 30 years ago, autism was considered a rare condition. When people asked what I did for a living, they often misheard me and thought I worked with “artistic” children. I got that a lot.  With the incidence of one in 59 children today, our own families, neighbors, and co-workers are all touched by autism. In fact, the sheer numbers have heightened awareness of autism in and of themselves. This awareness is essential: it promotes early detection, and with early detection, we hope for a relatively clearer course toward effective treatment and better outcomes.

Sadly, however, the early detection of autism alone does not provide a seamless path to intervention. Furthermore, families whose children are diagnosed with autism are still not able to access the most effective science-based treatments available expeditiously. Instead, families often have to sort through hundreds of pseudoscientific treatments until they arrive at the most effective interventions supported by peer-reviewed research to address the complexities of autism.

“Autism Awareness” should be about more than just detection and diagnosis. At the Association for Science in Autism Treatment (ASAT), it has always been our hope that the conversation around autism awareness would be broadened to focus upon addressing the obstacles that separate individuals with autism from receiving effective, science-based intervention and combatting the misinformation that distracts families, caregivers, and teachers from accessing accurate information.  I offer 11 perspectives about what “Autism Awareness” should be about, along with several ways that ASAT can assist families and providers alike in navigating the complex maze of autism treatment options. 

#1  “Autism Awareness” must differentiate effective treatments that are scientifically validated from the plethora of “therapies” and “cures” lacking scientific support. Such a distinction is critical.   

Autism treatment is a billion-dollar industry. For the majority of the 500+ available interventions, science is overlooked in favor of pseudoscience, and they are marketed using heart-wrenching testimonials, anecdotes and video montages, and often bolstered with poorly crafted and misleading surveys. Many interventions boast inaccurate and even outrageous claims that are touted as evidence of effectiveness. Marketing of these so-called “therapies” and “cures” is unambiguously aggressive in nature, and so overwhelming that it can drown out accurate information for those parents desperate to help their children access the very best treatment. We are in a time when anything can be placed before the word therapy and pushed forth as a “bonafide treatment” (Legos, llamas, bleach, sand, magnets and even Shakespeare to name but a few examples).

We do no favors for children with autism, their families, and those responsible for providing needed services when we not only ignore junk science, but allow it to proliferate by failing to counter baseless claims. Visit our website to learn more about the scientific support behind various autism treatments, the relevance of peer-reviewed research, the pitfalls of testimonials, as well as many other articles related to becoming a savvy consumer. Please also see our review of the second edition of Dr. Sabrina Freeman’s book, The Complete Guide to Autism Treatment.

#2 “Autism Awareness” must recognize our collective responsibility to make sound choices.

As adults, voters, consumers, providers, and parents, choice underlies all of our decisions. We have a right to make these decisions, even poorly; however, when we hold the futures of individuals with autism in our hand, decision-making power comes with tremendous responsibility. Responsibility that should never be abdicated. There is a myriad of “decision-makers” whose choices have profound implications for children and adults with autism – not just parents, but siblings, teachers, treatment providers, administrators, program coordinators, and taxpayers.

Please see our webpage for parents.  There you will find an article on questions to ask marketers/providers so you can make sure that the individual with autism in your life is receiving science-based treatment,  as well as questions that you can ask yourself. You can also read more about the three phases of inquiry about particular interventions and their associated questions and considerations in the Road Less Traveled: Charting a Clear Course for Autism Treatment.

#3 “Autism Awareness” must alert and remind the community that available information on the Internet (and actual information from providers) varies greatly in accuracy, and, in fact, can be completely wrong.

As we know, not all information on the Internet is reliable and accurate. You have probably heard the term, caveat emptor (“Let the buyer beware”). Consumers must also practice caveat lector (“Let the reader beware”). Often, Internet information is deemed equivalent in relevance, importance, and validity to research published in peer-reviewed scientific journals, but it is not.  Testimonials and uncontrolled studies from so-called researchers can lead parents astray and be a tremendous source of distraction.  Parents of newly-diagnosed children may be particularly vulnerable. Know the red flags to avoid and learn how to evaluate research by visiting our website. Our library of articles highlights scientific concepts and methods as they relate to potential autism interventions, with the goal of providing families, educators, and clinicians with the information they need in order to be savvy consumers of marketed treatment products and therapies.

#4 “Autism Awareness” must include responsible reporting by journalists who embrace their role as “public educators” and who are committed to spreading accurate information.

There are scores of “miracle cures” and “breakthroughs” for autism that receive widespread media attention (e.g., print and online news outlets, radio and television programs), even if these treatments have not been shown to be beneficial through peer-reviewed, published research.  The media has a responsibility to scrutinize sensational claims related to a proposed treatment, and to be knowledgeable enough to report on those treatments with healthy skepticism and objectivity. To support accuracy in the media, ASAT has developed a webpage for journalists. For examples of accurate and inaccurate reporting, please learn more about our Media Watch campaign, review resources about science journalism, and peruse our bank of archived letters. You will find that some of these showcase accurate media representations whereas others highlight concerns about inaccurate representations.

#5 “Autism Awareness” must recognize the critical need for newly-diagnosed children to access effective treatment ASAP. We know that early intervention makes a huge difference.

While individuals with autism learn and progress across their lifespan, it is widely understood that the earlier intervention begins, the greater the potential for an optimal outcome. Please learn more about the research basis for early intervention.  It is also important to remember the limited window of time there is to prepare children for the “least restrictive setting” once they enter the public school system.  

The fact that resources allocated early can save a tremendous amount of resources over an individual’s lifespan does not always enter the conversation when evaluating costs and benefits. This must change. These cost savings should become an integral part of the conversation about the appropriateness of intensive early intervention. Please see the following articles on the ASAT website:

#6 “Autism Awareness” should also instill hope for a better tomorrow for those individuals who are not part of the “best outcome” group.

With the right treatment and preparation for adolescence and adulthood, all individuals with autism demonstrate improvement, and many go on to lead happy, productive, and fulfilling lives.  Much of the conversation about treatment, however, focuses on “best outcome” and this is often defined as entering “mainstreamed” education settings or losing the diagnosis of autism altogether. This may delegitimize the significant progress made by most individuals with autism, whose outcome may be different, but no less important and meaningful. We know, for example, with intensive intervention based on applied behavior analysis (ABA), individuals with autism learn to live and work in the community, access faith communities, fully participate in routine healthcare, enjoy a range of recreational pursuits including a commitment to fitness, become independent in their self-care needs, have meaningful relationships and are active, contributing members of their communities. The importance of such gains must be recognized as a significant benefit of effective treatment and are relevant conversations to have, particularly at a time when some vocal bloggers are viciously maligning any and all treatment efforts as abusive, immoral, or otherwise unethical.  This includes the denigration of parents who only want to help their child realize his or her fullest potential.

Autism awareness should definitively include a celebration of a broad array of outcomes as was touched upon in our recent interview with Catherine Maurice, author of Let Me Hear Your Voice, as well as editor of a number of other titles. Please also visit our Perspectives page that highlights success stories of young people with autism, who are not necessarily in the best outcome group, carving out sustainable vocational experiences.

#7 “Autism Awareness” must mandate accountability from all treatment providers regardless of discipline.

Accountability involves a shared commitment to objectively defined targets, data collection, and respect for the scientific method. It is every provider’s responsibility to objectively measure outcomes. No one should get a pass on accountability. No one is immune from defining their target and objectively measuring progress. No one should get away with implementing their intervention carelessly and in non-transparent manner. No one should be permitted to boast claims that they cannot demonstrate through data. These unfortunate realities should not be tolerated.

Providers using interventions that lack scientific support have an ethical obligation to share this fact with consumers, and to exercise caution in making claims about outcomes. Far too often, applications of interventions that lack any scientific support are carried out in a manner devoid of transparency and objective measures to substantiate claims of the treatment’s success. This must not be tolerated. Providers must make sound, scientifically-validated decisions and recommendations. Please visit our website for more information about ethics and evidence-based practice.

#8 “Autism Awareness” must involve recognition that an abundance of clinical research already exists, and this body of research matters.

In the world of autism intervention, peer-reviewed research, which should guide and inform treatment efforts, is too often disregarded or ignored altogether. Imagine a world in which it was deemed acceptable for mainstream cancer providers to treat childhood leukemia with methods they preferred without consideration of existing research. Sadly, that is the reality of autism treatment, as many providers use their personally-preferred methods, often divorced from scientific support and then often carried out without any objective means to assess benefit. 

If treatment providers and consumers are interested in published research on diverse topics such as improving conversation skills, promoting academic skills, eliminating self-injurious behavior, or developing tolerance for health care procedures, they can find it. Sadly, these peer-reviewed studies are often not accessed by treatment providers and caregivers. Thousands of researchers and experts in their fields have published their findings in peer-reviewed journals that can guide autism treatment, yet their findings are often overshadowed by media representations which put sensationalism about the “next big thing” in autism treatment over objective scientific research. Please visit our website often to read our ever increasing number of research synopses  and vast library of treatment summaries.

#9 “Autism Awareness” should help us identify and overcome the barriers that families and individuals with autism face even within their own communities.

Like all families, those with children with autism want to be able to live comfortably and fully within their community. That may mean simply going to the park, enjoying play dates, attending religious services, accessing routine medical care, going to the movies with friends, or eating at a restaurant with their family. Unfortunately, many families are not able to access these activities because the community is not sufficiently informed or prepared to include individuals with autism within these settings. In some cases, the children are not taught how to manage these situations well due to ineffective treatments. As a result, families of children with autism are often isolated. With 1 in 59 children being diagnosed, every facet of society should become aware of the supports necessary for individuals with autism to succeed within their communities. This could involve accessing information about success stories, receiving education and training, and an open dialogue with families about what could be helpful. It would be prudent if every facet of society evaluated what they are doing to support individuals with autism, what they are not doing, and what they could be doing differently.

#10 “Autism Awareness” is needed worldwide.  In many countries, families of individuals with autism face incredible challenges and barriers.

As a US-based organization we recognize the many benefits that exist here in our country. These include, although are not limited to, well-established special education laws, the lion’s share of board-certified behavior analysts and providers from other disciplines who are committed to science-based practice, and a longer history of the conversation about best practices. This is in contrast to the experience of families of children with autism residing in many other countries who are offered outdated therapies such as psychoanalysis, have very limited resources, face stigma and rejection within their communities, may encounter a professional community that has low expectations about what may be possible, and lack the support of laws mandating even adequate treatment and education. Providers eager to learn and use best practices will face limited education and training opportunities, a dearth of accessible supervisors, and struggle to access supporting professional networks. In some countries, the social and economic conditions may be so poor that autism treatment is relegated to the back burner. 

We believe that knowledge is power and that a global community of savvy and informed consumers can help shape the landscape of effective intervention. Please note that we have flyers about our website and our monthly publication, Science in Autism Treatment, in several languages including Arabic, Brazilian Portuguese, French, Hebrew, Hindi, Italian, Russian, Serbian, and Spanish. If you are interested in distributing our translated materials, please write us at info@asatonline.org. At the bottom of every page we make it easy to disseminate knowledge through a variety of social media platforms. Please also note the Google language translation option in the upper right-hand corner of our webpage. 

#11 “Autism Awareness” should be about the reality that the hundreds of thousands of children with autism will soon become hundreds of thousands of young adults with autism; unfortunately, we are woefully ill-prepared to meet their needs.

When children with autism become adults (at the age of twenty-one in the U.S.), funding for services drastically changes. As a result, there are very few quality programs for adults with autism.We are facing a crisis in the field, with a scarcity of services for adults with autism and the absence of a clear strategy for closing the gap between the ever-increasing need, and an unprepared supply of resources. Quality evidence-based services for individuals with autism must continue into the adult years. Research indicates that interventions such as applied behavior analysis (ABA) can effectively help adolescents and adults with autism continue to work toward their fullest potential.

At ASAT, we have broadened our scope so that we can be a part of this important and essential dialogue and have written extensively about that commitment and are continuing to add to our webpage that addresses lifespan topics. Here one can learn about maximizing employment opportunities, strategies to support older learners, and transitioning to adulthood. We are expanding our collection of research synopses to include adolescent and adult participants with autism and we have written about this topic extensively within Media Watch with the letters showcased on our Lifespan page.

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We hope these 11 perspectives have furthered your appreciation of the complexities and nuances surrounding autism awareness. We all play a role in advancing science, bettering the lives of individuals with autism, and helping their families and supporters become skilled and savvy consumers. Embrace that role with an eye toward identifying what additional steps you can take to become a contributor to important discussions and an even bigger part of the solution. For more information on how to join ASAT and be part of the solution, please subscribe to Science in Autism Treatment, visit our website, and follow us on Facebook. Learn more about how to become a sponsor, volunteer, or extern. Or you can support our work by making a donation. Join us in making a difference in the autism community!


David Celiberti, PhD, BCBA-D, is the Executive Director of ASAT and Past-President, a role he served from 2006 to 2012. He is the Co-Editor of ASAT’s monthly publication, Science in Autism Treatment. He received his PhD in clinical psychology from Rutgers University in 1993 and his certification in behavior analysis in 2000. Dr. Celiberti has served on a number of advisory boards and special interest groups in the field of autism, applied behavior analysis (ABA), and early childhood education. He works in private practice and provides consultation to public and private schools and agencies in underserved areas. He has authored several articles in professional journals and presents frequently at regional, national, and international conferences. In prior positions, Dr. Celiberti taught courses related to ABA at both undergraduate and graduate levels, supervised individuals pursuing BCBA certifications, and conducted research in the areas of ABA, family intervention, and autism.

Pick of the Week: Timers!

Promotion is valid through March 4th, 2019 at 11:59pm EST. 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.

ABA Journal Club #2: Ethics and Social Media

One of the tenets of ABA is to provide evidence-based practice. The best way to help us do this is to keep up with the literature! Each month, Sam Blanco, PhD, LBA, BCBA will select one journal article and provide discussion questions for professionals working within the ABA community. The following week another ABA professional will respond to Sam’s questions and provide further insight and a different perspective on the piece.

Head to our Facebook page to join the discussion and let us know your thoughts!

It is important in our field to maintain an open conversation about ethics. The Professional and Ethical Compliance Code outlines how behavior analysts are expected to conduct themselves, but sometimes situations are not so black and white. And as the world changes, so do the expectations for ethical conduct. In recent years, issues related to social media have been especially relevant. This month, I’ve selected the following article which addresses the special concerns that come up with the use of social media.

O’Leary, P. N., Miller, M. M., Olive, M. L., & Kelly, A. N. (2017). Blurred lines: Ethical implications of social media for behavior analysts. Behavior Analysis in Practice10(1), 45-51 .


  1. The article reviews the codes of ethics for other professions. Why is this valuable for us to do as a profession? Did you learn anything surprising or interesting form this portion of the article?
  1. Since this article was written, our field has a new Professional and Ethical Compliance Code. How does this code differ from the previously used Guidelines for Responsible Conduct? What aspects of the code directly apply to ethical situations related to social media?
  1. “A search on an internet search engine for information related to a procedure or scientific concept may yield results as to what that procedure or concept is. The same search on a social media outlet may yield results as to whether or not that procedure or concept should be used (p. 47.) Discuss this difference.
  1. Behavior analysts and others interested in the topic may turn to social media to get answers to their questions due to the low response effort involved and the speed of reinforcement. How can we decrease response effort and increase reinforcement for referring to the scientific literature to answer our questions?
  1. The authors provide suggestions for how behavior analysts should behave on social media. Are there any suggestions you might add? Are there ways you can increase the likelihood of other behavior analysts following these suggestions?
  1. Consider your own behavior on social media. Based on recommendations from the article, what is one change you can make to increase your own ethical behavior in this context?

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.

The Salad Shoppe: Changing the Landscape of Vocational Training

Unemployment rates in the autism community are alarming, but the number of individuals entering the workforce only continues to grow. This presents an overwhelming challenge for special educators tasked with preparing learners for what is often an uncertain future. Vocational training is essential as learners with autism approach the transition to adulthood.  With this in mind, Nassau Suffolk Services for Autism (NSSA) introduced The Salad Shoppe in the fall of 2017.

The curriculum was developed by Kathryn Reres and Rebecca Chi, devoted special educators determined to ensure dignified and purposeful futures for the eight young adult students in their classroom. The focus was to create a program that would provide functional tasks for each learner based on their individual skills, interests and IEP goals. The result was an innovative vocational training curriculum that highlights the strengths of each participant, introduces new skills into their everyday lives and serves as a profitable social enterprise. 

The Salad Shoppe model requires multiple steps to be taken over the course of two days, including: Tracking and counting money, taking inventory, creating shopping lists, purchasing, food preparation, converting a customer’s order form to food assembly, delivery and clean up. This comprehensive list ensures that every learner has the opportunity to perform a task that is meaningful and functional to them. (The staff at NSSA are reaping the benefits too! Fresh, healthy, personally-delivered lunches each week have been a huge hit.)

In partnership with Different Roads to Learning, the creative teachers who designed The Salad Shoppe for NSSA are sharing their expertise with special educators everywhere. The published curriculum will allow teachers to implement The Salad Shoppe in a way that will best function for the learners they serve. Now more than ever, there is a crucial need to provide young adults with autism with the tools they will need to take on the competitive workforce. The Salad Shoppe is a cutting-edge curriculum that has opened new doors for educators, learners and parents and will continue to change the landscape of vocational training.

Ready to bring The Salad Shoppe to your school? You can save 15% on this incredible program now through February 18th!

3 Ways To Fade Prompts

Prompts are ways we help our learners demonstrate new skills. We use prompts to get our students to greet a peer, flush the toilet, name the color blue, and clap their hands. Prompts are something we add to the situation because the natural or teaching cue was not enough to cause the student to respond. The natural cue of being finished using the toilet was not a strong enough reminder to flush the toilet so we added the verbal prompt, “flush the toilet” and the student now responds. Prompts are important but fading them is just as important.  Prompt fading in ABA needs to be planned from the start and is an integral and essential component to the plan. Unless you are committing to following that child around for the rest of his life and tell him to flush the toilet – prompt fading is essential.

Some rules for prompt fading in ABA:

* Plan it out from the start.
* Train your staff.
* Do it gradually.
* If incorrect responding begins, return to last prompt level.

1. Least to Most Prompt Fading

Like we discussed in Monday’s post, least to most prompting involves starting with the least intrusive prompts and moving up in the prompting hierarchy. This can be beneficial because it gives students to the opportunity to be independent and you are only providing as much prompting as needed. This is a strategy we tend to use naturally. When you meet a your friend’s toddler you put out your hand to give a high five. If she doesn’t respond you say, “give high five.” If she still doesn’t respond you move her hand to your hand to give a high five. This is a natural method of prompting. When using this prompt fading technique, ideally the prompts will be somewhat self fading. If you are always starting at the least intrusive prompt, your students will have the opportunity to demonstrate independence. As the student begins to learn the task, he will need less and less prompts to perform it correctly.

Some key tips for using this prompt fading in ABA procedure:

  • allow wait time; if you do not provide wait time you may be providing more prompts than needed and taking away the opportunity for the student to respond correctly
  • take data; data is key to track progress. Every time you utilize this prompting method – note the level of prompt you used. You want to see that your student is requiring less intrusive prompts as time goes on. This will help avoid prompt dependence.
  • use high powered reinforcers; use an item that is actually a reinforcer that your student wants to work for. The sooner he demonstrates the skills, the sooner he gets the reinforcer.

2. Most to Least Prompt Fading

Most to Least prompt fading is another effective method of using prompts. With this method you start the most intrusive prompts and gradually fade to less intrusive prompts. The prompt fading is build right in. However, sometimes people forget that and in their head rename this most to most prompting. The key to errorless learning and using the most intrusive prompts first is that you fade the prompts out. The idea behind most to least prompting is that students will contact reinforcement right away and you will avoid errors and the students developing any incorrect habits.

How to fade prompts in Most to Least Prompting:

  • set criteria for changing prompts; once your student hits a particular number of days or sessions or trials at a particular prompt level, fade to the next level; take data to track progress
  • once you hit the criteria move to the next type of prompt; refer to our prompt hierarchy or order that is in Monday’s post. Move up the list to less and less intrusive prompts.
  • fade magnitude than switch prompt type; before you switch from a gestural to a verbal prompt adjust the magnitude of the prompt. A dramatic point to an object is different that a nod of your head.

Data is critically important for avoiding prompt dependence. You want to set a criteria ahead of time and take data to make sure you are sticking with the criteria. The criteria you set will depend on the student and the task. Maybe you want 3 consecutive days with each prompt level. If you are taking data you can ensure that you are sticking to that schedule. If errors begin occurring, go back a prompt level. The data will guide your implementation of this procedure. If you are fading too quickly, your data will tell you!

Prompt fading in ABA isn’t scary. Plan ahead and make sure you train your staff. This is a group endeavor!

3. Time Delay

One effective way we can fade prompts is using a time delay. A time delay inserts a set amount of time between the natural or teaching cue and our prompt. When utilizing a time delay, start with a zero second (i.e. no) time delay – so it will basically be like errorless teaching. For the first few trials, give the prompt right away so the student knows how to respond. Then after several trials, increase the time delay. For example, you may start with 2 seconds. If the student does not respond within 2 seconds – provide the prompt. If the student responds before the 2 seconds, provide loads of reinforcement. Once the student is successful and responding under the 2 seconds for several trials, increase the time delay. Now wait until 4 seconds to provide the prompt. Continue on. If the student does not respond with the 4 second time delay, move back to the 2 second time delay.

The key to time delay is planning and data. Set the criterion ahead of time. Plan how many sessions you will do at 0 seconds before moving to the first time delay. Determine what the mastery criteria is – how many times do you want the student to respond within the time delay before increasing the time delay length? Take data on this. It can easily and quickly get confusing if you don’t have a data sheet to track what you are doing. Write the plan in simple terms at the top of your data sheet. I like to track prompted correct (PC), prompted incorrect (PI), unprompted correct (UC), and unprompted incorrect (UI) using those abbreviations on my data sheet. If the student responds before the prompt it is counted as unprompted and if it’s after the prompt it is prompted!

There is no magic number of trials or days you should stay within the 0 second or 2 second time delay. It depends on the student’s level of functioning and the difficulty of the task. This is where data majorly comes in to play. If you’ve moved along too quickly, you will know and you can scale back.

Time delay works really well with verbal prompts. Another key component to time delay working successfully is making sure the reinforcement you give for the unprompted responses is better than the reinforcement for prompted responses. So if Johnny responds before the time delay and says the color blue on his own – give him 3 m&ms and praise but if you are using a 2 second time delay and he doesn’t respond and you provide the verbal prompt “bl…” and then he says blue only provide praise. You want the independent responses to be getting more reinforcement so your student is motivated to engage in those responses more!


About The Author

Sasha Long, BCBA, M.A., is the founder and president of The Autism Helper, Inc. She is a board certified behavior analyst and certified special education teacher. After ten years of teaching in a self-contained special education classroom, Sasha now works full time as a consultant, writer, and behavior analyst. Sasha manages and writes The Autism Helper Blog, as a way to share easy to use and ready to implement strategies and ideas. Sasha also travels internationally as a speaker and consultant providing individualized training and feedback to parents, educators, therapists and administrators in the world of autism. She is currently an adjunct professor in the school of Applied Behavior Analysis at The Chicago School of Professional Psychology. Sasha received her undergraduate degree in Special Education from Miami University and has a Masters Degree in Applied Behavior Analysis from The Chicago School of Professional Psychology. Contact Sasha at sasha.theautismhelper@gmail.com.

Learn the Lingo

automatic punishment  Punishment that occurs independent of the social mediation of others (i.e., a response product serves as a punisher independent of the social environment).

Cooper, J.O., Heron, T.E., & Heward, W.L. (2007). Applied Behavior Analysis. Upper Saddle River, NJ: Pearson Merrill Prentice Hall.

Implementing the Intervention…Even When Things are Going Well

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

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

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

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

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

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

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

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

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

 

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

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


WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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

How Parents Can Fit ABA Into Their Busy Schedules

“Dear Behavior BFF, I have followed your posts for a while now. The problem I see is that in order for me to be successful as a parent, I have to follow ABA 100% of the time. In order to be effective, do I need to enroll in graduate classes and learn everything I can about ABA? Do I need to become a BCBA to manage my own kids’ behavior better? Feeling overwhelmed over here…”

Thank you for learning about ABA as a parent. The science of behavior can help us SO much with our own kids. But does that mean you need to know every technical definition and fact before you can use some behavior strategies in your own home? NO! Heck no!

You are a busy parent. I am a busy parent. Most people reading this are busy parents (at least that’s the intended audience).  Do you have time to complete a master’s degree in behavior analysis just to help you be a more efficient parent who capitalizes on the science of behavior? Ummm…no. You don’t have that kind of time. So does that mean you should give up on using behavior analysis as a parent? Also no.

Behavior analysis teaches us to focus on the behavior itself. It teaches us to manipulate the environment to help our kids engage in desired and proactive behaviors. It helps us find ways to increase positive reinforcement, increase positive interactions, and teach our kids to effectively communicate their wants and needs.

The good news is we can do all of those things within the constraints of our busy family schedules! You can use positive reinforcement effectively without knowing the difference between differential reinforcement of incompatible or alternative behaviors.

And more good news: when you need to get technical, there are Board Certified Behavior Analysts (BCBAs) to do that with you! We like talking behavior science. We are ABA nerds. Let us do that part for you. If you want to join us, then enroll in that ABA graduate program. If you don’t want a new career- then learn what you can as a parent in the time that you have.

So where do you start in order to not be overwhelmed and get the benefit of decades of behavioral research? You’re in the right place. Peruse these non-academic articles offered at bSci21 that help make the science easier to digest. Learn about positive reinforcement and how to use it effectively.

Start by providing positive reinforcement for desired behaviors. Decide what you want your child to do more of, then reward them for doing it! Start small with one behavior strategy at a time, then continue to learn and add another positive behavior support as you go.

You don’t have to become a behavior expert in order to effectively use behavior analysis to save your sanity as a parent. Start small, build a little at a time. Celebrate your successes. Reward your child(ren) for their successes. Shape your own behavior by building on with baby steps. Every step in the right direction is a success. Make it work for you and your family in the time that you have. You CAN do this!


About The Author 

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.

Common Mistakes In Implementing Reinforcement

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

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

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

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

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

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

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


WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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