The NR Blues

What’s “NR” you ask? A common way to collect data after a trial in which the learner not only did not give a correct response, but didn’t respond at all, is to score “no response” (NR).

While motor actions can be prompted if the learner does not do anything, vocal responses cannot. I say to my staff all the time, “we can’t reach into his/her throat and pull out words”. So if you say to your client “What color is the sun? YELLOW” and they just stare at you, then that was a “no response” trial.

Many, many moons ago I worked at an early intervention clinic. We had one client in particular there, let’s call him Sam. Sam was the bane of my existence for a while, because he made me feel like an incompetent idiot.

 See, Sam was a very bright little boy with the most beautiful smile who could sing songs, answer questions, do simple academic tasks, and engage in various play skills. But then, Sam would hit a wall in his responding. He would remove all eye contact, stop smiling, and just stare blankly at…nothing. I haven’t met anyone since who could be looking directly at you, yet not looking at you at the same time. When Sam got like that he would not emit any of his target responses independently. This meant all motor actions were prompted, and good luck trying to do anything that required vocalizing. I just did not know what to do when this would happen, and it made me nervous to work with Sam because I knew it wouldhappen at some point.

Sam is who I think about when I am working with staff who are having a hard time “connecting” with a client in the session. I can absolutely relate to how it feels to bring your A-game, put on your animated face, and get a lot of nothing in return. It’s frustrating, and makes you doubt your skills.

When correct responding disappears from the session, some clients may turn super silly and distractible, or some may have a spike in aggression. Just between you and me, I would much rather deal with one of those scenarios. It’s the completely checked- out individual that I find to be the most difficult…..it is kind of like your clients body remained in the chair, but the rest of them got up, walked out of the building, and is headed somewhere FAR more exciting.

So if you are working with a Sam or two, here are a few things that definitely do not work, are ineffective, and should be avoided:

  • *Waiting the client out – I have seen a few therapists try this one, and usually the client is perfectly content to keep staring into space as you wait them out.
  • *Continue teaching/Keep up the status quo – Think of it like this, if your client has completely stopped any correct responding and you just keep plugging away: Is learning happening?
  • * Speak louder – Sound silly? I see it a lot, and back in the day I was guilty of this one too.
  • * “Saaaam…..Sam!….Helloooooo, Sam?” – If your client is not responding to demands to touch, give, open, or talk, odds are they also will not respond to their name being called.

Now that we got all the stuff that does not work out of the way, I really only have one suggestion for what you SHOULD try when those non- responsive blues kick in. It may be just one suggestion, but it can look about 900 different ways depending on the learner. 

Change something about YOU.

What my staff usually say to me (and how I used to look at this back in the day) is: “I tried this, and that, and this, and Sam just won’t attend/listen/respond! I don’t know what else to do to get him to (insert whatever response the therapist is expecting)”.

What I am suggesting, is flip that statement on its head and instead ask yourself: “What can I do differently that will motivate Sam to respond? Am I interesting? Am I reinforcing? Would I want to attend to me? Is this program interesting? Are these materials engaging? When did I last reinforce any of his behavior? Is my frustration/annoyance showing on my face? Does my voice sound irritated? Am I moving through targets too quickly? Too slowly? How can I be more fun?”.

See the difference? Instead of unintentionally blaming Sam for his lack of responding, first blame yourself. Then, look at your options and start trying them out to see what is effective.  I am a big fan of “Let’s try this and see what happens”. Even if you try something and it fails, you just learned 1 thing that does NOT work. Which is still progress.


About The Author: Tameika Meadows, BCBA

“I’ve been providing ABA therapy services to young children with Autism since early 2003. My career in ABA began when I stumbled upon a flyer on my college campus for what I assumed was a babysitting job. The job turned out to be an entry level ABA therapy position working with an adorable little boy with Autism. This would prove to be the unplanned beginning of a passionate career for me.

From those early days in the field, I am now an author, blogger, Consultant/Supervisor, and I regularly lead intensive training sessions for ABA staff and parents. If you are interested in my consultation services, or just have questions about the blog: contact me here.”

This piece originally appeared at www.iloveaba.com

 

Back to Basics: Core Concepts in ABA

Over the past two decades, dozens of task forces, panels, and independent research studies have found that Applied Behavior Analysis (ABA) is the only effective intervention for autism spectrum disorder (ASD).  Although ABA is helpful for many issues other than autism, and in fact is not a treatment of autism in and of itself, the practice of the science is often linked to ASD.  I’d like to share some of the core principles of ABA that are associated with the many ways in which ABA is helpful for supporting individuals on the autism spectrum.

First, ABA works from the crucially important framework of determinism.  This means that behavior analysts see behavior as being determined by the environment.  In other words, the reasons for behavior are external, not particular to the person.  As we like to say, “The student is always right.”  This perspective is tremendously helpful because it means that there’s always something that can be done to help.  If an individual is having difficulty learning, we can adjust the environment to improve his or her ability to learn.  If someone is engaging in behavior that is dangerous or upsetting, we can adjust the environment to reduce the likelihood of that behavior.  We never try to change a PERSON; rather we attempt to change the events that occur before and after behavior, making that behavior more or less likely.

Next, ABA is highly individualized.  One of the reasons that it is so effective as a practice in teaching and supporting individuals with ASD is that each person receives a tailor-made intervention that addresses his or her needs, strengths, and preferences.  ASD does not look the same in every person who has it, therefore intervention should not look the same.  Furthermore, continuous data collection and analysis allow for continuous updating and refining of interventions, so that each individual should be receiving the most effective strategies at all times.

Finally, ABA focuses on lifestyle changes and involves parents and significant others in all interventions.  ABA is not something that is done by behavior analysts to people with autism.  Rather, it’s the practical application of the science of behavior by the people who interact with – and care for – those in need of intervention the most.  In many cases, behavioral programming is carried out by teachers or paraprofessionals, but ABA is most effective when it’s also carried out by parents, siblings, grandparents, aunts, uncles, cousins, and friends.  The design of effective strategies and ongoing analysis of outcomes should be overseen by a well-qualified behavior analyst, but the strategies themselves should involve everyone in the individual’s life.  This helps to ensure generalization and maintenance of behavior change, and to provide the individual with ASD maximum exposure to supportive strategies throughout his or her day.

For these reasons and more, ABA is the intervention of choice for individuals on the autism spectrum.  It is humane, effective, and fair.  Given the right intervention, those with ASD can achieve personal goals and reach increased levels of independence in their lives.


About The Author

Dana Reinecke is a doctoral level Board-Certified Behavior Analyst (BCBA-D) and a New York State Licensed Behavior Analyst (LBA).   Dana is an Assistant Professor and Department Chair of the Department of Special Education and Literacy at Long Island University Post.  Dana provides training and consultation to school districts, private schools, agencies, and families for individuals with disabilities.  She has presented original research and workshops on the treatment of autism and applications of ABA at regional, national, and international conferences.  She has published her research in peer-reviewed journals, written chapters in published books, and co-edited books on ABA and autism.  Current areas of research include use of technology to support students with and without disabilities, self-management training of college students with disabilities, and online teaching strategies for effective college and graduate education.  Dana is actively involved in the New York State Association for Behavior Analysis (NYSABA), and is currently serving as President (2017-2018).

Back to Basics: Core Strategies in ABA

Applied Behavior Analysis (ABA) is the practice of the science of behavior. Often misunderstood as a collection of techniques (or worse, one particular technique), ABA is much more complex and is based in analysis so that all interventions are individualized, functional, and effective. That being said, there are some core strategies that are useful to know about in the application of ABA to individuals with autism.

• Reinforcement is probably the best known and most widely recognized ABA strategy. The principle of reinforcement is simple: behavior that is followed by preferable outcomes increases in future probability. If the preferable outcome is something given, like praise, a toy, or a fun activity, that’s called positive reinforcement. If the preferable outcome is something taken away, like work being removed during a break, or an unpleasant noise stopping, that’s called negative reinforcement. Contrary to popular belief, negative reinforcement is not the reduction of behavior or the application of punishment. Both positive and negative reinforcement are highly individualized and will look different for different people, but the principles remain the same no matter who you are: behavior increases because it is followed by a preferable outcome.

• Prompts are another commonly used strategy in ABA, and they also look different for different people. Prompts are any stimuli added to the natural environment to make behavior more likely. We all use prompts throughout our daily lives, often without realizing it. Smart phone reminders, highway signs, and fire alarm bells are all every day prompts. Additional prompts may be added to support individuals with autism in many ways. For example, some children with autism are taught to follow activity schedules, which are prompts for sequences of actions. These prompts may be used to help the child to be more independent in an activity of daily living, like making a sandwich, or just to transition between play activities and remain actively and appropriately engaged for longer periods of time.

• Structured teaching procedures are often used to break down and teach important skills such as communication, social skills, self-care skills, and academics. Sometimes these procedures are highly structured and repetitive, such as discrete-trial teaching, and sometimes they are looser and less structured, such as natural-environment teaching. Most individuals with autism who are learning using these strategies are provided with a combination of more and less structured learning opportunities, depending on their individual needs.

• Self-management is the set of skills that enables independence. For many individuals with autism, these skills need to be explicitly taught. ABA programs should include opportunities to learn and use self-management skills, as the ultimate goal of any ABA intervention should be independence.


About The Author 

Dana Reinecke is a doctoral level Board-Certified Behavior Analyst (BCBA-D) and a New York State Licensed Behavior Analyst (LBA).   Dana is an Assistant Professor and Department Chair of the Department of Special Education and Literacy at Long Island University Post.  Dana provides training and consultation to school districts, private schools, agencies, and families for individuals with disabilities.  She has presented original research and workshops on the treatment of autism and applications of ABA at regional, national, and international conferences.  She has published her research in peer-reviewed journals, written chapters in published books, and co-edited books on ABA and autism.  Current areas of research include use of technology to support students with and without disabilities, self-management training of college students with disabilities, and online teaching strategies for effective college and graduate education.  Dana is actively involved in the New York State Association for Behavior Analysis (NYSABA), and is currently serving as President (2017-2018).

Simplifying The Morning Routine

ABA therapy can be used to teach/increase a variety of adaptive skills, such as tooth brushing, toileting, hair brushing, shoe tying, making a bed, etc. My favorite definition of an adaptive skill is anything that will have to be done for the learner, if the learner does not learn the skill. So if I don’t teach my child how to dress him/herself, then I will have to dress my child.

A common concern many of my clients have around adaptive functioning is the dreaded Morning Routine. Since my clients are usually school age, I have ample opportunity to help families target issues that regularly pop up during that frenzied time in the morning of trying to get the child out of the door on time. Issues like: task refusal, off task behavior, prompt dependency, skipping steps of the routine/completing the routine out of order, etc.

ABA interventions should always be individualized, but some of my most effective strategies for simplifying the morning routine include:

–          Visuals! Visuals are your friend 🙂

–          Use of auditory cues (timers)

–          ORGANIZATION

 With some simple tweaks here and there and adding in more supports, the morning routine can be less stressful, more efficient, and require less intrusive prompting which equals more independence for your child.

Let’s jump in:

Add visuals: I say “add visuals” and not “add more visuals”, because usually what I see is that families who struggle the most with the morning routine are not using any visual supports. If you are regularly struggling during the morning routine but you already have visual supports in place, then that’s a gold star for you. You are ahead of the game. If you are new to visual supports, just keep reading. Think of a visual support as a way to minimize prompting or assistance. If you have to stand in the bathroom doorway, physically assist your child, or keep giving the same demand over and over (“Make up your bed Evan ……. Evan, did you make your bed?”), then you definitely need to add some visuals. It is much easier to fade the prompt of a visual, than to fade your voice or your presence. Or to put it another way, do you want to have to stand in the doorway to make sure tooth brushing happens when your child is 25? Here are some awesome examples of visual supports, all were found on Pinterest.







Auditory cues: The use of a timer can be such a helpful addition to the morning routine because time is usually of the essence. We have to go, and we have to go now. For many of my defiant kiddos, those with attention issues, or those with lots of escape maintained behaviors, the simplest demand  (e.g. “Put your socks on”) can take ages and ages to actually happen. Decide on a specific amount of time for the skill to occur, and then set a timer. If the child can beat the timer, then allow them to contact reinforcement. Depending on the child, this could mean a treat, getting to pick what they wear that day, 2 minutes of TV time, etc. Make the concept of “hurry up” more concrete by helping the child understand how quickly tasks needs to be completed.

Organization: This tip is more for you than the child. Organization or proper set up for the morning routine does not begin that morning, it begins the night before. Part of the bedtime routine can include setting up items for the next day. This could mean lining up the soap, face towel, toothpaste, and toothbrush by the bathroom sink. Or this could mean putting the backpack by the front door, so there is no frantic search for it in the morning. How you organize will depend on the specific issues you are having in your home. The point is to set the child up for success. For younger children (especially if you want to increase independence) line up needed items/materials in their correct order so your assistance is not needed. For example, in the bedroom line up underwear, socks, pants, shirt, and shoes. In the kitchen, line up the bowl, spoon, and cereal box. For some children you may need to put number cards on each item (e.g. put a “1” card on the underwear). Any step you can do the night before will save precious time the next morning, and the materials being visible helps serve as a prompt of what to do next.

*Bonus Tip: A good way to practice the skills required for a successful morning routine is to incorporate weekend practice. If these skills are only performed M-F with a time crunch, then you’re setting yourself up for lots of frustration. On the weekends, still have your child go through the morning routine. Use this to fine- tune skills, or provide more repetition than is possible on a Monday morning. If tooth brushing is always a struggle, consider modifying the visuals or making them larger/more detailed. Try removing yourself, and only checking on your child periodically. If the child is older or needs less support, try implementing a checklist that the child completes. As they perform each skill, they check a box. When all the boxes are checked they bring the checklist to you for review.


About The Author: Tameika Meadows, BCBA

“I’ve been providing ABA therapy services to young children with Autism since early 2003. My career in ABA began when I stumbled upon a flyer on my college campus for what I assumed was a babysitting job. The job turned out to be an entry level ABA therapy position working with an adorable little boy with Autism. This would prove to be the unplanned beginning of a passionate career for me.

From those early days in the field, I am now an author, blogger, Consultant/Supervisor, and I regularly lead intensive training sessions for ABA staff and parents. If you are interested in my consultation services, or just have questions about the blog: contact me here.”

This piece originally appeared at www.iloveaba.com

 

Ethics Part Four: Considerations On Punishment

Punishment procedures are, with reason, very controversial. Today, I’d like to clear up a few concerns and issues about punishment procedures, especially in regards to the ethical obligations of behavior analysts.

First, it’s important to define the terms we’re discussing. In behavior analysis, when we refer to punishment, we mean any response to a behavior that decreases the future likelihood of that behavior. This means that we won’t categorize a particular intervention as punishment unless we have actual proof that it decreases the behavior. When I was a classroom teacher, I had a student who at the beginning of math class would break his pencil and begin cursing. My immediate response to this behavior was to send him out of the room. But this wasn’t actually punishment because it did not decrease the behavior. Instead, his ability to escape the math class actually maintained the pencil-breaking and cursing behavior. If I wanted to punish, or decrease, that behavior, then I needed to change my response.

Often, when we’re talking about interventions, we lump several responses into the punishment category (such as time out, verbal reprimands, or detention) without any evidence that they are actually decreasing the target behavior. So the question becomes, what is an aversive stimulus for the individual you’re working with?

While this distinction is important in order to create effective interventions, it is also important to reference the Professional and Ethical Compliance Code for Behavior Analysts. Item 4.08 details the responsibilities of behavior analysts in regards to punishment. First, it states “behavior analysts recommend reinforcement rather than punishment whenever possible.” If behavior analysts have exhausted all possibilities and must use a punishment procedure, access to reinforcement must be a part of the intervention. This can be as part of reinforcing replacement behaviors that should be taught and reinforced in lieu of any problematic behavior.

Another important aspect of our ethical code is that when punishment procedures are being utilized, there is an increase in training, supervision, and oversight. A BCBA should not come in, explain a punishment procedure, and then not show up again for three months while teachers or practitioners are implementing the punishment procedure. Instead, there should be ongoing support and supervision and a plan to discontinue aversive procedures when they are no longer needed.

Ultimately, behavior analysts should be focused on reinforcement procedures. But when it becomes necessary to use aversive procedures to address dangerous behaviors, behavior analysts are required to be aware of and follow this compliance code.


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.

Can the principles of ABA be used to toilet train a child with an autism spectrum disorder?

This month’s ASAT feature comes to us from Dr. Frank Cicero, Ph.D., BCBA, LBA. 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!

Here is the good news…children with autism can be toilet trained through the exact same methods that are used with typically-developing children. And what are these methods? Applied behavior analysis! If you have ever toilet trained a typically-developing child, you probably used a combination of praise and rewards for going on the toilet, explaining your expectations, removing the child‘s diaper, prompting to the toilet on some type of schedule, rushing him or her to the toilet when they seemed like they needed to go, and teaching how to notify you that he or she needs to use the bathroom. You might or might not have added in some form of punishment or verbal reprimand for accidents. Well…here is my advice for toilet training a child on the spectrum…use exactly the strategies that I just described.

So then, why does it seem so much more difficult? One of the biggest obstacles is simply getting started. Because parents think that toilet training will be very difficult, and something so different than anything else they have taught their child in the past, they delay training. Toilet training for a girl typically is recommended to begin at around two years of age. For a boy it is a little later (about two and a half). When it comes to a child with a developmental disability it is difficult to use these age guidelines. Instead, a child is ready to begin training when they can hold urine in the bladder for at least 1 hour, can remain seated on a toilet for at least three minutes, have an awareness of the relationship between following instructions and getting rewarded, and do not have significantly interfering problem behavior. Another challenge with toilet training a child on the spectrum is the absolute need for consistency and intensity of training once you begin. The more intense you implement a plan, the quicker you will see results. For the most intense procedure, I recommended toilet training for at least 6-8 hours per day. I also usually implement the training directly in a bathroom with the child wearing the least amount of clothing possible (usually underwear, shirt and socks). In this way, he or she can easily get to the toilet when needed and also you, as the trainer, can easily and quickly see when they are beginning to have an accident.

Toilet training consists of four main components: prompting to the toilet on a schedule, rewarding success, teaching how to request, and quickly prompting to the toilet at the start of an accident. For the schedule, I usually recommend starting with 30 minutes. The child sits on the toilet and tries to urinate for 1 minute. If the child is successful, immediately provide him/her with a very powerful reward with verbal praise. If the child is not successful, simply prompt him/her to try again in 30 minutes. In order to teach requests, prompt the child to request the bathroom each time you are about to prompt him/her to the toilet. You can use whatever communication system (i.e., verbal speech, picture exchange, signs, etc.) your child is used to and does best with.

Now, what to do with the accidents? Accidents in toilet training are a good thing. In fact, without accidents, you will only be reinforcing prompted trips to the toilet, thereby resulting in a child that is schedule trained instead of independent. You have two choices here, prompting/reinforcement or punishment. I usually recommend the first choice, prompting/reinforcement instead of punishment, at least in the beginning of training. Try encouraging a lot of drinking during training hours. Within the first second of the child having an accident, produce a loud verbal startle such as “HURRY, HURRY, HURRY.” This is not a reprimand but should be stated in a very loud, surprising, urgent tone of voice. The idea is to temporarily produce a startle response in the child so that urination is reflexively held for a brief moment. In that moment, you physically prompt the child to the toilet, where you instruct him or her (now in a very calm voice) to continue their urination. If they continue (which is likely), you reward the behavior with a reward and verbal praise. In this way, you turned an accident into a positive teachable moment. Continue with these strategies until the child begins to show fewer accidents, goes more on the schedule and begins to independently request. Throughout training it is very important to collect data on accidents and successes, so that you can make data-based decisions along the way. Fade the intensity of the schedule, fade out of the bathroom and ultimately fade the tangible rewards. With this intensive treatment program, I have seen complete training in as little as 1 week; however do not get discouraged if your child takes longer. What about training for bowel movements? Good news….you often get bowel training along with urination training without doing any additional procedures. Bad news…this is not always the case. When a child is trained for urination, but continues to have bowel accidents, you need to figure out the reason behind the problem before you can treat it. Is it simply a lack of knowledge? An ingrained ritual or routine? Noncompliance? A medical problem such as constipation? The nature of the accidents will guide your treatment. Very briefly, if the problem is a lack of knowledge, a reinforcement / punishment procedure should work. This procedure is similar to the procedure that I described for urination training, except that it is rarely implemented for 6-8 hours per day. Instead, you bowel train only when the child is likely to need to have a bowel movement. If the problem is more consistent with a ritual or noncompliance, you need a traditional behavior plan more than a toilet training intervention. And finally, if the problem is medical in nature, follow the recommendations of a physician or dietician.

Please use the following format to cite this article:

Cicero, F. (2009). Clinical corner: Toilet training. Science in Autism Treatment, 6(1), 3-4.


About The Author

Dr. Frank Cicero, Ph.D., BCBA, LBA is a New York State licensed psychologist, licensed behavior analyst and board certified behavior analyst with over 20 experience working in the fields of applied behavior analysis and autism spectrum disorders. He received his master’s degree in school psychology from St. John’s University and his doctoral degree in educational psychology from the City University of New York Graduate Center. Dr. Cicero is currently an assistant professor and aba program director for Seton Hall University, New Jersey. Prior to this position, he served as the Director of Psychological Services for the Eden II Programs, an applied behavior analysis agency in the New York City area serving children and adults on the autism spectrum. Dr. Cicero continues a private practice for child/adolescent psychology and aba as well as conducts program consultations in best practice treatment for autism, developmental disabilities and problem behavior. Dr. Cicero frequently conducts workshops and trainings nationally on a variety of topics within his fields of expertise. He also has several publications including peer reviewed articles, book chapters and a training book titled “Toilet Training Success.”

How Can Parents Find Effective Reinforcers?

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

This piece originally appeared on bsci21.org.


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

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

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

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

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

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

Enter preference assessments.

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

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

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

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

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

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

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

References

Carr, J. E., Nicolson, A. C., & Higbee, T. S. (2000). Evaluation of a brief multiple‐stimulus preference assessment in a naturalistic context. Journal of Applied Behavior Analysis33(3), 353-357.

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

DeLeon, I. G., Fisher, W. W., Rodriguez‐Catter, V., Maglieri, K., Herman, K., & Marhefka, J. M. (2001). Examination of relative reinforcement effects of stimuli identified through pretreatment and daily brief preference assessments. Journal of Applied Behavior Analysis34(4), 463-473.


Leanne Page, MEd, BCBA, is the author of Parenting with Science: Behavior Analysis Saves Mom’s Sanity. As a Behavior Analyst and a mom of two little girls, she wanted to share behavior analysis with a population who could really use it- parents!

Leanne’s writing can be found in Parenting with Science and Parenting with ABA as well as a few other sites. She is a monthly contributor to bSci21.com , guest host for the Dr. Kim Live show, and has contributed to other websites as well.

Leanne has worked with children with disabilities for over 10 years. She earned both her Bachelor’s and Master’s degrees from Texas A&M University.  She also completed ABA coursework through the University of North Texas before earning her BCBA certification in 2011. Leanne has worked as a special educator of both elementary and high school self-contained, inclusion, general education, and resource settings.

Leanne also has managed a center providing ABA services to children in 1:1 and small group settings. She has  extensive experience in school and teacher training, therapist training, parent training, and providing direct services to children and families in a center-based or in-home therapy setting.

Leanne is now located in Dallas, Texas and is available for: distance BCBA and BCaBA supervision, parent training, speaking opportunities, and consultation. She can be reached via Facebook or at Lpagebcba@gmail.com.

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.

 

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.

 

Ethics2emailer

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.

Pick of the Week: Verb and Action Cards!

VerbsEmail10317

Ready, set, GO! Save on some of our favorite cards to teach actions with code VERBS2017 at checkout!

 

*Promotion is valid until October 9th, 2017 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at difflearn.com, enter promo code VERBS2017 at checkout.