Focus on Generalization and Maintenance

On more than one occasion, I’ve been in the situation that a student will only demonstrate a skill in my presence. And I’ve heard from other colleagues that they have had similar experiences. This is highly problematic. When it happens with one of my students, there is only one person I can blame: myself.  A skill that a student can only demonstrate in my presence is a pretty useless skill and does nothing to promote independence.

So what do you do when you find yourself in this situation? You reteach, with a focus on generalization. This means that, from the very beginning, you are teaching with a wide variety of materials, varying your instructions, asking other adults to help teach the skill, and demonstrating its use in a variety of environments. Preparing activities takes more time on the front-end for the teacher, but saves a ton of time later because your student is more likely to actually master the skill. (Generalization, after all, does show true mastery.)

Hopefully, you don’t have to do this, though. Hopefully, you’ve focused on generalization from the first time you taught the skill. You may see generalization built into materials you already use.

Another commonly cited issue teachers of children with autism encounter is failure to maintain a skill. In my mind, generalization and maintenance go hand-in-hand, in that they require you to plan ahead and consider how, when, and where you will practice acquired skills. Here are a few tips that may help you with maintenance of skills:

  1. Create notecards of all mastered skills. During the course of a session, go through the notecards and set aside any missed questions or activities. You might need to do booster sessions on these. (This can also be an opportunity for extending generalization by presenting the questions with different materials, phrases, environments, or people.)
  2. Set an alert on your phone to remind you to do a maintenance test two weeks, four weeks, and eight weeks after the student has mastered the skill.
  3. Create a space on your data sheets for maintenance tasks to help you remember not only to build maintenance into your programs, but also to take data on maintenance.

Considering generalization and maintenance from the outset of any teaching procedure is incredibly important. Often, when working with students with special needs, we are working with students who are already one or more grade levels behind their typically developing peers. Failing to teach generalization and maintenance, then having to reteach, is a waste of your students’ time.

Sam Blanco, PhD, LBA, BCBA is an ABA provider for students ages 3-15 in NYC. Working in education for sixteen 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, and she is the Senior Clinical Strategist at Chorus Software Solutions.

A Better Way to Say “No”

By Morgan van Diepen, M.Ed., BCBA, Co-owner of ABA Visualized

Hearing “no” or “wait” can be challenging for kids of all ages! In fact, as a BCBA, this is one of the most common requests for support that I hear from families. Luckily, researchers have tested out three ways to say “no” when something is unavailable, and the results show how slightly changing our response can actually prevent challenging behaviors! Let’s look at the scenario of a child asking to play a computer game, but the parent is currently using it for work. Which of the three methods do you think was the most effective? 

  1. “No” + Explanation. In this common approach, the parent says it’s not available and gives the honest reasoning: “Not right now. I’m working on the computer.” 
  2. “No” + Explanation + Alternative. Now, we’ve added an extra suggestion of something that is available: “Not right now. I’m working on the computer, but you can play basketball outside with your brother.” 
  3. “Yes” + Contingency. Here, even though our answer is “no,” we’re actually saying “yes!” This can be described as a “yes, when…” statement, where you are describing when the requested item or activity will be available: “Yes, you can use the computer when I’m finished with this meeting at 2:00.” It can also be used to set expectations of what they need to accomplish before the request is available: “Yes, you can use the computer when you finish your homework.” 

So, which do you think resulted in the fewest challenging behaviors?

In this research study, the 2nd and 3rd approaches were equally successful at almost completely preventing vocal protests, aggression, and threats! By just changing the way we say “no,” we can help our learners accept this answer more easily. Little changes that create big results! Strategies like these are perfect for parent training sessions during ABA. Here’s a template parent training goal you could use with families who would like more support in this area:

When (client name) requests for something that is unavailable (provide examples specific to the client), parents will either respond with “No” + Explanation + Alternative (provide example specific to the client) or with “Yes” + Contingency (provide example specific to the client) in attempts to prevent challenging behaviors relating to tolerating “no,” in at least 80% of opportunities across 2 consecutive weeks. 

Looking for a more engaging way to lead parent training sessions and teach effective strategies like this one? Check out our 2nd edition ABA Visualized Guidebook, where we’ve visualized 27 evidence-based strategies (including this one!) as step-by-step illustrations, making behavior strategies easy! 

Article reference: Mace, F. C., Pratt, J. L., Prager, K. L., & Pritchard, D. (2011). An evaluation of three methods of saying “no” to avoid an escalating response class hierarchy. Journal of applied behavior analysis, 44(1), 83–94.

How to Teach Children to Wait

Reposted with permission from How To ABA

All kids have trouble waiting for things that they want. They even have trouble waiting in line at the grocery store. Waiting is a huge skill. So once our learners have mastered some early instructions, like come here or sit down, then we typically start working on the skill of responding to waiting. Today’s topic is all about how to teach children to wait. 

When my children were young and they started learning how to ride their bikes, they felt a huge sense of independence. I stayed way behind them while they rode their bikes so fast that they were about 20-30 feet in front of me. I needed them to stop at the curb because they were too young to cross the street safely. So something that we worked on was my kids listening to me saying “wait” from 20 feet behind them. They knew to wait for me and stop at the curb before crossing. 

How to Teach a Child with Autism to Wait

Waiting is a huge safety skill and a huge life skill. You don’t always get what you want right away. Being able to wait a little bit of time to get what you want is really important. We also want our learners to stay safe and not run and dart away from adults. So we developed a program about teaching kids to respond to the verbal instruction of “wait,” with the response of waiting quietly.

We want to start really small and with an amount of time that the student can be successful doing. Don’t expect a student to wait for 5 or 10 minutes when they’re used to not waiting at all. Start by having a preferred item that you know that this student wants and then support them in being able to wait. 

Possibly initially say the word “wait” and also hold up your hands and count aloud with the student. Starting with three seconds is a great amount of time and it’s highly supported. Be there with them and help them wait. If they could do that successfully, then you can fade the hands up, and then eventually not count with them. Do all of this while sticking with three seconds. 

Once you fade the signal, you fade the counting, and you’re just saying “wait,” then you would start to slowly increase the amount of time that the student is expected to wait before accessing the preferred item. 

Waiting Program for an Early Learner

Here is an example of the program that we would use for a very early learner. This is a learner who has really only started mastering some basic one-step instructions. Start by teaching the highly supported “wait” with your hands up and counting. You can make it really fun. Sometimes we’ll play red light green light or have a race and tell the student to stop and wait. It doesn’t have to be done just at the table. 

Do 10 trials of the first teaching step and graph it. They can be in a row or they can be spread out over time. They can also be done naturally. As soon as they are able to show mastery (80% over two consecutive sessions) you increase the amount of time the learner waits and so on. 

Waiting Program for an Older Student

A waiting program for an older student who needs to learn to wait before accessing something that they really, really want isn’t as highly supported. 

The first step would be to have the learner sit and wait for something that they want. We’d start with five seconds before giving them the reinforcement. As soon as they’re successful for two intervals in a row over two days, then we increase the time. 

Go at the pace of the student and if the student shows that 10 seconds is too long, go back to five seconds. 

Check out the How To ABA website for additional resources and free downloads.

About the Authors

Shayna Gaunt, MA, BCBA | With over 20 years in the field of ABA, Shayna is a master program developer. She has a unique knack for finding the practical application of ABA to real-life so that the interventions are doable and successful!

Shayna has been practicing Applied Behavior Analysis (ABA) since 1997. In 2005, after graduating with a Masters Degree in ABA from the University of Nevada Reno (UNR), she was one of the first in Ontario, Canada to obtain her BCBA. She is the Founder and Executive Director of Kid Mechanix, Inc. in Toronto, Canada, where she met Shira Karpel.

Shayna also has international experience, providing clinical expertise and training workshops to clients in Canada, United States, Costa Rica, England, Egypt and Qatar.

Because of her extensive training in a wide variety of interventions over the years, Shayna has a knack for developing unique, practical programs that teach across operants. She seriously thinks in data sheets!!!!

Shayna’s super-power is her ability to explain complex ABA principles in practical, relatable terms. She is a master program-developer and most of what you see in The Bx Resource is her ABA-mind put down on paper.  As a member of The Bx Resource, you get the privilege of learning from her and leveraging all that ABA knowledge for your own practice!

Shira Karpel, M.ED, BCBA | As a former teacher, Shira is passionate about spreading the benefits of ABA to more children.  She envisions a world where ABA is the go-to, accepted intervention in classrooms and homes everywhere!  She is the co-founder of How to ABA which was started to create a community where all BCBAs and ABA professionals can get support and resources so that clients can get the best treatment possible.

Shira has a Masters in Special Education and then went on to pursue her BCBA.  With extensive supervision and training (ahem, thanks Shayna!!), she has been working in the field of ABA since 2011.  Together with Shayna, they trained, and taught many therapists, clients, and parents and collected a massive bank of ABA programs and resources.  One day, the light bulb went off and Shira said, “We should be sharing all of this!” Hence, How to ABA was born!

Her passion is in creating positive, comprehensive learning environments for all students.  She loves that with her knowledge in ABA, she can now support teachers in their classrooms.  She is the Director of Behavioural Services at a private school in Toronto and is loving getting to make a difference in the lives of children and families daily. She is passionate about making the principles of ABA practical and doable and relevant to every child in any situation.

Review of Responsible and Responsive Parenting in Autism: Between Now and Dreams

Reviewed by David Celiberti, PhD, BCBA-D and William L. Heward, EdD, BCBA-D
Association for Science in Autism Treatment

This month’s ASAT feature comes to us from Executive Director David Celiberti, PhD, BCBA-D, Association for Science in Autism Treatment and William L. Heward, EdD, BCBA-D, Professor Emeritus, the College of Education and Human Ecology at Ohio State University. 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!

Parents of children with autism face many challenges beyond those directly associated with raising a child who may have a myriad of needs. They face a dizzying array of treatment options with interventions lacking any scientific basis, which are cleverly marketed and often eclipse those interventions enjoying scientific support. Access to qualified, compassionate providers may be difficult or delayed, particularly for children in rural communities, children of color, individuals who age out of the educational system, and families outside of the United States. Misconceptions and misinformation about autism and ways to help people with autism abound and those messages often distract and derail many parents from obtaining accurate information, support, and intervention. Parents who seek help for their children are often harshly criticized and labeled by some bloggers as lacking love or acceptance. Taken together, these realities can weigh heavily on parents who are just trying to help their children with autism develop independence and purpose, pursue their dreams, and live their best lives.

Fortunately, a new book provides a break from the vitriol, snake oil, and antagonism. Between Now and Dreams thoughtfully and artfully explains the complementary concepts of responsible and responsive parenting of children with autism. It provides a space for parents to reflect, to engage, and to look ahead.

Prior to offering details about this book, the first reviewer would like to share some background. I first met Shahla Ala’i-Rosales and Peggy Heinkel-Wolfe thirty years ago at the University of North Texas (UNT) when I was a newly hired Assistant Professor in the Department of Psychology. Shahla was a behavior analyst, researcher, and practitioner in early autism intervention; Peggy, the mother of a son with autism, held an administrative job at the University. With a few other UNT colleagues, we formed a small working group to support each other in our individual efforts as well as to develop a community in which future collective efforts could take root. My time at UNT was brief, but I am so pleased (and a tad jealous) to know that Shahla and Peggy continued to collaborate and form a long-term friendship and professional alliance. Their book, Responsible and Responsive Parenting in Autism: Between Now and Dreams is a timely, and much needed gift to the autism community. Ala’i-Rosales and Heinkel-Wolfe share a series of interrelated events – challenges, plans, setbacks, and victories, large and small – in the lives of real children and their families (including their own). These stories demonstrate the importance of recognizing and celebrating children’s capabilities while encouraging and nurturing their self-actualization, individuality, and independence.

The authors put forth that raising a child with autism with an abundance of joy, purpose, and serenity relies on three interconnected powers: learning, connecting, and loving. Although the authors state that these powers are interconnected and that they influence and strengthen each other, Ala’i-Rosales and Heinkel-Wolfe have used them to organize their book into three unique parts. Each part is composed of several chapters; each chapter opens with a thoughtful quote that sets the stage for the lessons and wisdom that follows.

Part One: The Power of Learning  

Between Now and Dreams opens with a section devoted to principles of learning and how those principles can guide parents’ efforts to help develop their child’s fullest potential. The authors stress the need for creating and implementing carefully planned, intensive, positive applied behavior analysis (ABA) interventions in the home to keep children learning and moving forward in their lives. The abundance of examples discussed throughout this section showcase the vast applications of the science of behavior. Parents who are new to the autism journey will gain comfort in learning about principles that can be readily incorporated into their daily lives and appreciate a shift away from resolving problems to one of promoting empowerment and skill building, both for themselves, as well as for their children.

This section also chronicles the journey of ABA from its early applications to autism treatment, and to what the discipline has become today. The authors provide a sensitive and honest discussion of the bumps along the way.

Part Two: The Power of Connecting

This section of Between Now and Dreams will be invaluable for caregivers who may struggle with feelings of isolation, associated with both raising a child with many needs and experiencing the loss or shift in other relationships and career pursuits that may have followed their child’s diagnosis. Ala’i-Rosales and Heinkel-Wolfe beautifully capture the pursuit of supportive relationships, including with those who offer expertise and experience, as well as with other parents on very similar journeys. How one seeks and nurtures these relationships, as well as opting out when needed, is described with the same compassion and generosity reflected throughout the book.

Part Three: The Power of Loving 

The third section of Between Now and Dreams ties together the two prior sections. On its surface, a reader may assume that the section might focus myopically on positive emotions. Instead, the authors are realistic and don’t sugarcoat the challenges parents of children with autism face. Loss, fear, and disappointment are discussed openly in the context of numerous experiences, observations, and epiphanies. We left this section feeling grateful to the authors for being so incredibly transparent and vulnerable, yet insightful and encouraging in guiding us to be more active and loving parents.

Responsible and Responsive Parenting in Autism: Between Now and Dreams is an important, eloquently written, and engaging book for parents of children with autism of any age and who fall anywhere on the spectrum. It does not provide a cookie cutter approach, but rather a compassionately delivered collection of useful and practical suggestions that parents can select and tailor to their own home and goals.

Aside from behavior analysts, this book is also a must-read for teachers, therapists, medical providers, and others who work with children with autism. The content is accessible to those who are new to ABA and autism intervention, yet impactful for professionals with extensive training and experience.

Citation for this article:

Celiberti, D., & Heward, W. L. (2023). Book Review: Between Now and Dreams. Science in Autism Treatment, 20(3).

About the Authors

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 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.

William L. Heward, Ed.D., BCBA-D, is Professor Emeritus in the College of Education and Human Ecology at Ohio State University. He has taught at universities in Brazil, Japan, Portugal, and Singapore and lectured and given workshops in 23 other countries. A Past President and Fellow of the Association for Behavior Analysis International, Bill’s publications include co-authoring the books, Let’s Make a Contract: A Positive Way to Change Your Child’s Behavior (2022), Applied Behavior Analysis (3rd ed., 2020), and Exceptional Children: An Introduction to Special Education (12th ed., 2022). Awards recognizing Dr. Heward’s contributions to education and behavior analysis include the Fred S. Keller Behavioral Education Award from the American Psychological Association’s Division 25, the Ellen P. Reese Award for Communication of Behavioral Concepts from the Cambridge Center for Behavioral Studies, and the Distinguished Psychology Department Alumnus Award from Western Michigan University.

What Kind of Assessment is Right for Your Child?

By Mariela Vargas-Irwin, PSYD, BCBA-D, LABA, Executive Director of ABLS

Every day was hard with 5-year-old Tony. He would purposely find ways to annoy others and just did not seem to respond to consequences. The school tested him and said that there was nothing wrong; in fact, they said he was gifted.

Another child, Latoya, was never the same after being in a car accident. She cried all night and refused to get into any car. She also seemed to be unable to play with any of her previously preferred toys for long and had frequent tantrums.

Then there was 10-year-old Maria, who didn’t seem to be making any progress at school. She had an intellectual disability and her Individualized Education Program looked good on paper. However, she was becoming more aggressive each day and her language continued to be very limited.

Finally, Autumn, 2 years old, was in a fog. She stopped saying mama and dada, cried for no apparent reason, and ran in circles all the time.

Developmental and behavioral concerns about your children, such as those listed above, can be extremely distressing. Of course, you would do anything for your child!

But where to start?

What Tools Do I Need?

The first step is to consult your pediatrician. They will be able to rule out any possible medical problems and are more likely than a specialist to be able to see you quickly. Once a physical cause for your concerns is ruled out, your pediatrician will most likely refer you to a psychologist for an assessment. There are, however, several kinds of assessments that can be conducted.

A Comprehensive Diagnostic Assessment will include a cognitive and an adaptive assessment. It may include both norm-referenced assessments that compare children to others, as well as criterion-referenced tests that compare students to themselves. A Comprehensive Diagnostic assessment may result in a diagnosis such as Autism or Attention Deficit Hyperactivity Disorder.

The psychologist or a behavior analyst may also perform a Functional Behavior Assessment. A Functional Behavior Assessment examines the functions of the behavior via direct and indirect methods helping guide the development of a Behavior Support Plan.

Another type of assessment that may be helpful is a Program Assessment. A Program Assessment includes a visit to your child’s school to determine whether their needs are being met and their Individualized Education Program is being implemented properly.

Lastly, a Neuropsychological Assessment examines executive functioning skills, attention, and memory, in addition to cognitive and adaptive skills. 

How Would Assessments Help My Child?

To speak to the above examples, Tony would need a Comprehensive Diagnostic Assessment and a Functional Assessment to ascertain the function of his aggressive and disruptive behavior. The fact that he is gifted intellectually does not rule out that he may be struggling with Attention Deficit Disorder with Hyperactivity, Autism, or Post Traumatic Stress Disorder.

Latoya would need a neuropsychological assessment that will examine executive functions, language, and attention to ascertain the impact of the accident on her neuropsychological functions. Typically, a complete neuropsychological assessment is conducted immediately after the accident and then repeated every six months.

Meanwhile, Maria would require a Program Assessment to determine whether her school program is meeting her needs. This assessment should include a complete review of her progress reports in addition to a visit to her school. She may also need a Functional Assessment of her aggressive behavior at home.

Lastly, Autumn urgently needs a Comprehensive Diagnostic Assessment to rule out Autism.  If she does have Autism, she will need intensive early behavior analytic intervention to be implemented as soon as possible so time is of the essence. 

Whatever the assessment process holds for your learner, it is important that the instruments used are both reliable and valid, and ideally they would be able to be utilized to track progress over time. Every child is different; therefore, no assessment process will proceed identically. 

About the Author

Dr. Mariela Vargas obtained her doctoral degree from Rutgers University, completed her internship at Boston Children’s Hospital, and pursued post-doctoral training at the Baker Children’s Center. She has over thirty years of experience working with children with autism and other developmental disorders with behavioral challenges. Dr. Vargas has worked as a home-based behavioral therapist, overseen home-based programs, designed training protocols for ABA therapists and supervisors, and consulted with families and schools. She was the second president of the Massachusetts Association for Behavior Analysis and has presented in numerous national and international Autism and ABA conferences. A licensed Psychologist and Board Certified Behavior Analyst, she is the founder and executive director of Applied Behavioral Learning Services (ABLS). Her interests include inclusion, psychometrics, social skills, and executive behavior.

By: Nicole Gorden, M.S., BCBA, LBA 

This blog post is part 2 of 2. Read part 1 HERE


Autism spectrum disorder occurs in individuals from many different cultures and backgrounds. Therefore, cultural competency and sensitivity is imperative for effective delivery of services. To work with autistic learners, is to respect that they are the product of many environments that have shaped them and will continue to shape them throughout their life.

As stated in the most updated ethical code from the BACB, behavior analysts are responsible for incorporating and addressing diversity in practice. For example, the BACB ethical code states that behavior analysts must practice within our scope of competence, maintain competence including cultural responsiveness and diversity. Specifically, providers must “evaluate their own biases and ability to address the needs of individuals with diverse needs/backgrounds” (Ethical Code, 2022, 1.07).

However, what are the practical implementations to culturally sensitive treatment? What does this actually look like in practice? As providers, we are obligated to offer exceptional service delivery with individualized treatment goals. Considering our learner’s cultural background and the impact of their community’s beliefs and attitudes is essential to effective treatment. The following will provide guidance on how providers can apply cultural sensitivity to their clinical decisions in treatment.

Priorities in Treatment Goals

Overlooking the cultural impact can also create conflict and disparity within the stakeholders’ involvement and commitment to treatment. In contrast, “when these values and expectations align with those of the family receiving the intervention, positive outcomes are likely, including high levels of participation and response to treatment” (Dubay, Watson, & Zhang, 2018). Thus, we must also consider how we prioritize goals for culturally sensitive treatment.

For instance, I recently worked on a sleep intervention to desensitize my client to sleeping in his own bed. When discussing the intervention, and more importantly, when to introduce the treatment goal, the cultural sleeping norms had a significant impact. In some urban and minority cultures, co-sleeping is common. Yet, if a provider may think it is significant for the client to start sleeping in their own bed by the age of six, but it is common in the culture to continue co-sleeping even until the child is ten, culturally sensitive conversations can play an important role.

In another example, Filipino cultures find it respectful for younger family members to “bless” elder members by bowing towards the hand of the elder family member and placing their forehead on their hand. Thus, although the provider may find it significant for the client to learn to wave to greet others, by prioritizing cultural norms, it may have a greater influence on the client receiving natural reinforcers by working on blessing their family members, first.

The contradiction between parents following therapy targets that will be supported by their community compared to the skills that might benefit their child in the long term may prove to be challenging and demanding on the family (Dubay, Watson, & Zhang, 2018). Thus, culturally sensitive treatment is prioritizing treatment goals with the best outcome and secures family commitment.

Interdisciplinary Collaboration

By creating culturally sensitive treatments, providers will build better relationships with stakeholders and in turn, reduce the social stress that may come from raising and teaching an autistic child within various cultures. This idea does not only apply to parents, but even extends to the interdisciplinary team that could be influenced by the learner’s culture.

Within Russian communities, it is common to eat soup for lunch. When I provided services in a primarily Russian daycare, I had to consider my client’s aversion to eating these traditional meals as well as the importance of this target behavior to the daycare providers. Rather than dismiss this potential goal, despite my own perspective on the client’s needs, I modified my treatment goals to effectively collaborate with the daycare providers. By understanding the cultural impact and importance of certain behaviors to any stakeholder, the provider can often address unmet needs, gain support for treatment, and keep open communication if other issues arise (Fong et. al, 2017). We must be culturally sensitive towards the beliefs and attitudes that are different than those in the US, and not assume that the learner’s culture does not affect how they or their community respond to treatment.

Educate Ourselves. Stay Cultured. It is not required to culturally match your clients to provide adequate care and treatment. However, providers should strive to acquire knowledge and skills related to cultural responsiveness and diversity. Although we may be the experts in our particular discipline, remember that the parents are the experts on your learner. Culturally sensitive providers should strive to learn about the cultural norms of their diverse clientele. Constant dialogue, keeping an open perspective, and asking questions about cultural norms can make all the difference.


About the Author: 

Nicole Gorden, M.S., BCBA, LBA has over 14 years of experience implementing Applied Behavior Analysis principles with the Autism Population. She currently works for Comprehensive Behavior Supports in Brooklyn, NY.


References:

Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. Littleton, CO: Author.

DuBay, M., Watson, L. R., & Zhang, W. (2018). In Search of Culturally Appropriate Autism Interventions: Perspectives of Latino Caregivers. Journal of autism and developmental disorders48(5), 1623–1639.

Fong, E. H., Catagnus, R. M., Brodhead, M. T., Quigley, S., & Field, S. (2016). Developing the Cultural Awareness Skills of Behavior Analysts. Behavior analysis in practice9(1), 84–94.

Fong, E. H., Ficklin, S., & Lee, H. Y. (2017). Increasing cultural understanding and diversity in applied behavior analysis. Behavior Analysis: Research and Practice, 17(2), 103-113.

Patton, S. (2017, April). Corporal punishment in black communities: Not an intrinsic cultural tradition but racial trauma. CYF News. http://www.apa.org/pi/families/resources/newsletter/2017/04/racial-trauma

Practical Applications to Culturally Sensitive Treatment – Part I

By: Nicole Gorden, M.S., BCBA, LBA 


Autism spectrum disorder occurs in individuals from many different cultures and backgrounds. Therefore, cultural competency and sensitivity is imperative for effective delivery of services. To work with autistic learners, is to respect that they are the product of many environments that have shaped them and will continue to shape them throughout their life.

As stated in the most updated ethical code from the BACB, behavior analysts are responsible for incorporating and addressing diversity in practice. For example, the BACB ethical code states that behavior analysts must practice within our scope of competence, maintain competence including cultural responsiveness and diversity. Specifically, providers must “evaluate their own biases and ability to address the needs of individuals with diverse needs/backgrounds” (Ethical Code, 2022, 1.07).

However, what are the practical implementations to culturally sensitive treatment? What does this actually look like in practice? As providers, we are obligated to offer exceptional service delivery with individualized treatment goals. Considering our learner’s cultural background and the impact of their community’s beliefs and attitudes is essential to effective treatment. The following will provide guidance on how providers can apply cultural sensitivity to their clinical decisions in treatment.

Awareness of Own Cultural Biases

Cultural awareness is the first step to providing culturally ethical treatment. Providers should concurrently and habitually engage in practices in which they remain aware of their own predetermined perceptions and acknowledge their own limitations to cultural competency. As mentioned in Fong et. al (2016), “cultural awareness may be important because behavioral patterns that are viewed as problematic in our own culture may be the norm in other cultures”. Due to limitations in diversity within most helping professions, a learner’s provider is often from a different cultural background.

Thus, it is essential to understand the traditions of that culture. As an example, physical punishment may be common practice in some black communities which has been perceived to be deeply rooted in racial trauma (Patton, 2017). It would be insensitive for a provider from a different cultural background to ignore that this practice is a cultural tradition, and thus blame or stigmatize black parents for their choices. Rather, “professionals can offer information about why the practice is harmful but have been told it is necessary, and offer healthier alternatives that produce better outcomes for children, families and communities” (Patton, 2017). Cultural sensitivity is facilitating the development of our programs by checking our own biases and how they may affect our choices in treatment.

Selection of Target Behaviors and Programmatic Materials

A few years ago, a client from Asian descent was transferred to me from another behavior analyst. When assessing the barriers to treatment, my client made minimal progress when asked to identify a fork. Believing that an object, rather than a picture might help, I asked the client’s parents for a fork. When obtaining the fork, the parents expressed that they do not use forks to eat. In their culture, hands and chopsticks are typical eating utensils. Thus, when considering cultural sensitivity, this includes selecting programmatic targets that are common in the client’s environment and the cultural norms.

The teaching materials should be as individualized as the treatment plan too. We should rely on diverse representation in the resources we use in treatment. Providers should use materials that represent the individual’s environment, which is typically a blend of many different ethnicities. When providing resources like visual schedules, do your cartoons or pictures represent the racial identity of your learner? If you are teaching body parts on a doll, do you provide toys that look like your learner? To be a culturally sensitive professional, one should give precedence to ethnic representation to allow the learner to feel validated and treat them with dignity.

The cultural assessment process should be used to inform treatment, specifically when designing the program for validity and selecting targets for skill acquisition (Fong et. al, 2016). When beginning a new lesson or treatment program, it is essential that providers select socially meaningful and significant target goals. However, in selecting these goals for treatment, professionals must consider the cultural norms and needs of the client.


About the Author: 

Nicole Gorden, M.S., BCBA, LBA has over 14 years of experience implementing Applied Behavior Analysis principles with the Autism Population. She currently works for Comprehensive Behavior Supports in Brooklyn, NY.


References:

Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. Littleton, CO: Author.

DuBay, M., Watson, L. R., & Zhang, W. (2018). In Search of Culturally Appropriate Autism Interventions: Perspectives of Latino Caregivers. Journal of autism and developmental disorders48(5), 1623–1639.

Fong, E. H., Catagnus, R. M., Brodhead, M. T., Quigley, S., & Field, S. (2016). Developing the Cultural Awareness Skills of Behavior Analysts. Behavior analysis in practice9(1), 84–94.

Fong, E. H., Ficklin, S., & Lee, H. Y. (2017). Increasing cultural understanding and diversity in applied behavior analysis. Behavior Analysis: Research and Practice, 17(2), 103-113.

Patton, S. (2017, April). Corporal punishment in black communities: Not an intrinsic cultural tradition but racial trauma. CYF News. http://www.apa.org/pi/families/resources/newsletter/2017/04/racial-trauma

Do You Want to be the Bringer of the Grins or the Bringer of the Power Struggles?

This week’s blog comes from Parenting with ABA by Leanne Page.

Do you know what one of my favorite parenting tools is?

You guessed positive reinforcement, didn’t you? Close- but today I’m going with HUMOR!

When things are tense- can we help ourselves and our kids to crack a smile to defuse the situation?

When my kids are in a bad mood, it’s easy for me to slip into traditional kneejerk parenting reactions. It’s easy to become overly firm and frustrated. This is when voices rise. Tempers rise. Power struggles begin. Who exactly is winning here? I’m not happy with my own behavior following a tense interaction let alone my kids’ behavior.

What if instead of getting firm we got silly? Can we salvage the situation, the morning, the day? I say HECK YES!Mornings can be hard for so many families- mine included. Getting up on time to get out the door by 7:30am for elementary school is not easy for my oldest. After a few rough days of trying all kinds of different things to just get my girl out of her funk, I hit the jackpot. Instead of being firm in the form of “You do it or I’ll help you do it” through the morning routine, I opted for humor. My girl was grunting and moaning and making all kinds of unpleasant noises instead of doing her morning routine. I asked our smart home thingie “Hey google, can you translate cave man talk?” and “What does (insert grunting noises here) mean in English?” I communicated back to my daughter in cave man grunting noises. She cracked a smile. I turned up the silly drama with noises and gestures to communicate to her what she needed to do next in her morning routine. And guess what! It worked! Not only did it work that day but as soon as I started pantomiming things or making silly noises the next day- a grin! Mornings got smoother for several weeks without me even needing to help her do her routine. Then one day, she had a hard time again. Instead of kneejerk over firm parenting tactics, I tried humor. And it worked like a charm!

When else have you heard me sharing about being silly? In getting our kids’ attention before giving an instruction. Try talking in a silly voice, singing, whispering, or rapping. Try silly faces and hand gestures to act out what you need them to do. Get their attention before giving an instruction but also get a smile as you are interacting with your kids!

Get that grin and helping your kids follow through is a million times easier!

And the best part of all- laughing together helps that highly desired true connection with your kids. Not only does it defuse a situation or help them follow instructions- it strengthens your relationship. It helps your kids to feel safe and secure with you- you are the bringer of the smiles, not the bringer of the threats of punishment or the bringer of rasied voices and power struggles.Next time you feel your own temperature rising because your child is not listening, pause. Try hard to use some humor. The first time or two it really is HARD because your instincts are to be firm and stand your ground no matter what. But breathe and consider the big picture. Do you want your kids to think of you as the bringer of the smiles or the power struggles. Be silly. Get the smiles. Then the instruction following is easier. Save the situation and also strengthen your relationship.

Embrace the silly!


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.

Parenting For Joy

Editor’s note:  Autism Awareness month is becoming a call to action from the autism and neurodivergent communities for change from the rest of society. In this edited excerpt from their upcoming book with Different Roads, co-authors Shahla Ala’i-Rosales and Peggy Heinkel-Wolfe offer a specific call to action to both parents and professionals—to seek and maintain joy’s radiating energy in our relationships with our children.

Parents have the responsibility of raising their children with autism the best they can. This journey is part of how we all develop as humans—nurturing children in ways that honor their humanity and invite full, rich lives. Ala’i-Rosales and Heinkel-Wolfe’s upcoming book offers a roadmap for a joyful and sustainable parenting journey. The heart of this journey relies on learning, connecting, and loving. Each power informs the other and each amplifies the other. And each power is essential for meaningful and courageous parenting.

Ala’i-Rosales is a researcher, clinician, and associate professor of applied behavior analysis at the University of North Texas. Heinkel-Wolfe is a journalist and parent of an adult son with autism.

Joy gives us wings! ― Abdul-Baha

“Up, up and awaaay!” all three family members said at once, laughing. A young boy’s mother bent over and pulled her toddler close to her feet, tucking her hands under his arms and around his torso. She looked up toward her husband and the camera, broke into a grin, and turned back to look at her son. “Ready?” she said, smiling eagerly. The boy looked up at her, saying “Up . . .” Then he, too, looked up at the camera toward his father before looking back up at his mother to say his version of “away.” She squealed with satisfaction at his words and his gaze, swinging him back and forth under the protection of her long legs and out into the space of the family kitchen. The little boy had the lopsided grin kids often get when they are proud of something they did and know everyone else is, too. The father cheered from behind the camera. As his mother set him back on the floor to start another round, the little boy clapped his hands. This was a fun game.

One might think that the important thing about this moment was the boy’s talking (it was), or him engaging in shared attention with both his mom and dad (it was), or his mom learning when to help him with prompts and how to fade and let him fly on his own (it was), or his parents learning how to break up activities so they will be reinforcing and encourage happy progress (it was) or his parents taking video clips so that they could analyze them to see how they could do things better (it was) or that his family was in such a sweet and collaborative relationship with his intervention team that they wanted to share their progress (it was). Each one of those things is important and together, synergistically, they achieved the ultimate importance: they were happy together.

Shahla has seen many short, joyful home videos from the families she’s worked with over the years. On first viewing, these happy moments look almost magical. And they are, but that joyful magic comes with planning and purpose. Parents and professionals can learn how to approach relationships with their autistic child with intention. Children should, and can, make happy progress across all the places they live, learn, and play–home, school, and clinic. It is often helpful for families and professionals to make short videos of such moments and interactions across places. Back in the clinic or at home, they watch the clips together to talk about what the videos show and discuss what they mean and how the information can give direction. Joyful moments go by fast. Video clips can help us observe all the little things that are happening so we can find ways to expand the moments and the joy.

Let’s imagine another moment. A father and his preschooler are roughhousing on the floor with an oversized pillow. The father raises the pillow high above his head and says “Pop!” To the boy’s laughter and delight, his father drops the pillow on top of him and gently wiggles it as the little boy rolls from side to side. After a few rounds, father raises the pillow and looks at his son expectantly. The boy looks up at his father to say “Pop!” Down comes the wiggly pillow. They continue the game until the father gets a little winded. After all, it is a big pillow. He sits back on his knees for a moment, breathing heavily, but smiling and laughing. He asks his son if he is getting tired. But the boy rolls back over to look up at his dad again, still smiling and points to the pillow with eyebrows raised. Father recovers his energy as quickly as he can. The son has learned new sounds, and the father has learned a game that has motivated his child and how to time the learning. They are both having fun.

The father learned that this game not only encourages his child’s vocal speech but it was also one of the first times his child persisted to keep their interaction going. Their time together was becoming emotionally valuable. The father was learning how to arrange happy activities so that the two of them could move together in harmony. He learned the principles of responding to him with help from the team. He knew how to approach his son with kindness and how to encourage his son’s approach to him and how to keep that momentum going. He understood the importance of his son’s assent in whatever activity they did together. He also recognized his son’s agency—his ability to act independently and make his own choices freely—as well as his own agency as they learned to move together in the world.

In creating the game of pillow pop, parent and child found their own dance. Each moved with their own tune in time and space, and their tunes came together in harmony. When joy guides our choices, each person can be themselves, be together with others, and make progress. We can recognize that individuals have different reinforcers in a joint activity and that there is the potential to also develop and share reinforcers in these joint activities. And with strengthening bonds, this might simply come to mean enjoying being in each other’s company.

In another composite example, we consider a mother gently approaching her toddler with a sock puppet. The little boy is sitting on his knees on top of a bed, looking out the window, and flicking his fingers in his peripheral vision. The mother is oblivious to all of that, the boy is two years old and, although the movements are a little different, he’s doing what toddlers do. She begins to sing a children’s song that incorporates different animal sounds, sounds she discovered that her son loves to explore. After a moment, he joins her in making the animal sounds in the song. Then, he turns toward her and gently places his hands on her face. She’s singing for him. He reciprocates with his gaze and his caress, both actions full of appreciation and tenderness.

Family members might dream of the activities that they will enjoy together with their children as they learn and grow. Mothers and fathers and siblings may not have imagined singing sock puppets, playing pillow pop, or organizing kitchen swing games. But these examples here show the possibilities when we open up to one another and enjoy each other’s company. Our joy in our child and our family helps us rethink what is easy, what is hard, and what is progress. 

All children can learn about the way into joyful relationships and, with grace, the dance continues as they grow up. This dance of human relationships is one that we all compose, first among members of our family, and then our schoolmates and, finally, out in the community. Shahla will always remember a film from the Anne Sullivan School in in Peru. The team knew they could help a young autistic boy at their school, but he would have to learn to ride the city bus across town by himself, including making several transfers along the way. The team worked out a training program for the boy to learn the way on the city buses, but the training program didn’t formally include anyone in the community at large. Still, the drivers and other passengers got to know the boy, this newest traveling member of their community, and they prompted him through the transfers from time to time. Through that shared dance, they amplified the community’s caring relationships. 

When joy is present, we recognize the caring approach of others toward us and the need for kindness in our own approach toward others. We recognize the mutual assent within our togetherness, and the agency each of us enjoys in that togetherness. Joy isn’t a material good, but an energy found in curiosity, truth, affection, and insight. Once we recognize the radiating energy that joy brings, we will notice when it is missing and seek it out. Joy occupies those spaces where we are present and looking for the good. Like hope and love, joy is sacred.

“When there is so much hate and so much resistance to truth and justice, joy is itself is an act of resistance.” ― Nicolas O’Rourke

Photo Credit: Bruno Nascimento c/o Unsplash

Teach For Generalization With The R.E.A.L. Model!

Do you want to just teach skills or teach meaningful responses?

Many ABA practitioners and parents struggle to generalize learned skills, whether to parents or other people, to school, community or natural environments. Sometimes they question — will this child ever really learn this behavior? I mean, REALLY do this behavior. Like when it actually counts?!?!

One of the first clients I have ever worked with transferred from another provider. He had received intensive ABA programming for 2 years. He had already acquired a number of skills — colors, numbers, letters, matching, categorization, even self-help skills. Yet, nothing was functional. If the question wasn’t given in the same format (e.g., touch this, where’s red, wash hands) he would not demonstrate the skill. He lacked the ability to generalize to the natural environment…where it actually counted! It led me to ask myself….

  • Does ABA just create robots? Am I creating a robot? Are all of the responses just rote? When should the behavior occur? Does it?
  • Will this individual’s ABA program result in being able to join a typical classroom?
  • Will this child recognize his hands are dirty and wash them with complete independence?
  • Will this child respond to greetings when in the community with someone she’s never seen before?
  • Will this child interact with their peers when no trainer is present?
  • Will all of these skills being targeted actually result in a meaningful way?

“ABA is not a commodity, but a whole treatment process designed to address all aspects of a child’s life, ultimately improving the overall quality. Generalization should be viewed as an active process of ‘skills learning’ which also requires a systematic approach to teaching.”

Brenda Terzich-Garland, author and creator of The R.E.A.L. Model.

All of these questions can be answered in the new book, The R.E.A.L. Model, Rethinking Generalization: A Practitioner’s Guide to Teach for Generalization in ABA Treatment for Autism and Other Disabilities.

Here are some take home points:

  • We live in an ever changing world, you need to program for this. The R.E.A.L. Model sets up a very practical way to plan for generalization.
  • You must plan for Generalization across trainers, stimuli, environments and to the verbal community. The R.E.A.L. Model gives you a systematic way to plan for generalization in a simple step by step manner, across five unique levels of generalization. Each level has specific guidelines,
  • You must plan for Generalization systematically and from the very start of programming. The R.E.A.L. Model focuses on Case Formulation within the Assessment Process, as well as a unique Real Matrix to plan for generalization throughout ABA programming.


Sometimes we do not know what we are missing, simply because we have not been exposed to something. The R.E.A.L. Model is this exact reference. Pick up a copy today to forever change your programming to be more efficient and create more flexibility and adaptivity across all programs!


WRITTEN BY MARI UEDA-TAO, MA, BCBA

Mari is the Chief Clinical Officer for Applied Behavior Consultants, Inc. (ABC) CA. Working in the field of ABA for almost 20 years with students with Autism Spectrum Disorders and other developmental delays, Mari has worked across ten different countries, spreading Behavior Analysis globally.