Tag Archives: Applied Behavior Analysis

How Occupational Therapy Can Benefit ABA Programs

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This month, we’re proud to feature a wonderful piece from the Association for Science in Autism Treatment (ASAT), written by Amy McGinnis Stango, MS, OTR, MS, BCBA, on the benefits of occupational therapy as a supplement to your child’s ABA program. Amy is a nationally registered occupational therapist and board certified behavior analyst, and provides consultative direct and consultative services to families, clinics and schools across the country and internationally. She is also the co-author of Assessing Language and Learning with Pictures (ALL PICS), an assessment tool designed to make administration of the VB-MAPP more accurate, efficient, and cost-effective for schools, clinics, agencies, and private practitioners.

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!

My child is enrolled in an ABA-based program where he also receives some OT services. How can occupational therapy benefit my child’s ABA program?

Answered by Amy McGinnis Stango, MS, OTR, MS, BCBA

Occupational therapy (OT) can be beneficial as a supplemental treatment to your child’s ABA program. The goal of occupational therapy is to support an individual’s health and participation in life through engagement in occupations or everyday tasks (AOTA, 2008). The occupational therapy process begins with an evaluation. The evaluation helps to determine whether your child has met developmental milestones in a wide variety of occupations. The occupational therapy evaluation can help your child’s behavior analyst choose developmentally appropriate goals to be included in his ABA program. The OT evaluation may also be helpful in understanding why a child struggles with a particular task. For example, if your child struggles with handwriting, the evaluation can determine whether this difficulty stems from an inappropriate grasp, poor posture, muscle weakness, visual memory, or lack of eye-hand coordination. Pediatric occupational therapy typically addresses the following domains:

  • Play
  • Activities of Daily Living
  • Education
  • Social Participation

Play is the primary occupation of childhood and is often an area of need for children with autism. Occupational therapy can be effective in helping children learn new play skills (Stagnitti, O’Connor, & Sheppard, 2012). Many pediatric occupational therapists use a play-based approach to their sessions, exposing children to a variety of toys, games, and different ways to play. If your child engages in repetitive play behaviors or has limited interests, the occupational therapist may be helpful in finding other activities that share similar sensory properties of the toys your child already enjoys. Some of the sensory activities used in occupational therapy may function as reinforcers, which could be used in your child’s ABA sessions as well (McGinnis, Blakely, Harvey, Hodges & Rickards, 2013).

Occupational therapists typically include an assessment of activities of daily living (ADLs) as part of the evaluation. ADLs include those basic self-care tasks that an individual performs each day, such as eating, grooming, dressing, and using the bathroom. Occupational therapy can help to build the strength, coordination, and perception skills needed to perform these tasks. For example, if your child has oral motor deficits, occupational therapy can help your child learn the mouth movements necessary for chewing and drinking (Eckman, Williams, Riegel, & Paul, 2008; Gibbons, Williams, & Riegel, 2007). Occupational therapy can also help older children and adolescents learn more advanced ADLs, like independent bathing (Schillam, Beeman & Loshin, 1983). Occupational therapists are trained in identifying multiple ways to perform routine tasks, and can recommend an approach that will work best for your child and can be integrated into your routines at home (Kellegrew, 1998).

As individuals with autism age, occupational therapists can help teach skills that will lead to greater independence at home and in the community (McInerney & McInerney, 1992). These include preparing meals, managing money, shopping and using public transportation. Often these skills are more complex and may require an activity or task analysis that breaks the task down into simpler steps. With extensive training in developing task analyses, occupational therapists can share these analyses with your child’s ABA team so that skills can be taught across settings. If tasks are still difficult, an occupational therapist may recommend adaptive equipment to make a task easier. Occupational therapy can also help your child participate more fully in his or her educational program. Occupational therapy can help young children acquire tasks such as coloring and cutting (Case-Smith, Heaphy, Marr, Galvin, Koch, Ellis, & Perez, 1998), as well as help older children acquire skills such as handwriting (Denton, Cope, & Moser, 2006). If your child has difficulty moving through the school setting or actively participating in movement activities, occupational therapy can help your child develop functional mobility skills. Continue reading →

Is Inclusive Education Right for Children with Disabilities?

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This week, we’re honored to feature an article by Edward Fenske, MAT, EdS, the former executive director of the Princeton Child Development Institute, who shares his critique on the U.S. Departments of Health and Human Services and Education’s joint statement on inclusive education for all children with disabilities. Ed’s extensive experience in delivering intervention to children with autism, support services to their families, and training and supervision to professional staff spans 39 years. His published works address home programming, language development, and early intervention.

Is Inclusive Education Right for My Child with Disabilities?
by Edward Fenske, MAT, EdS
Princeton Child Development Institute

On September 14, 2015 the U.S. Department of Health and Human Services and the U.S. Department of Education issued a joint policy statement recommending inclusive education for all children with disabilities begin during early childhood and continue into schools, places of employment, and the broader community. The policy includes numerous assertions about the educational benefits and legal foundation of inclusion and a lengthy list of supporting evidence. This paper examines some of these assertions, the supporting evidence, and comments on the departments’ recommendation.

 

Assertion: Children with disabilities, including those with the most significant disabilities and the highest needs, can make significant developmental and learning progress in inclusive settings.

Supporting Evidence: Green, Terry, & Gallagher (2014). This study compared the acquisition of literacy skills by 77 pre-school students with disabilities in inclusive classrooms with 77 non-disabled classmates. Skill acquisition was assessed using pre/post intervention scores on the Peabody Picture Vocabulary Test, Third Edition (Dunn & Dunn, 1997) and the Phonological Awareness Literacy Screening Prekindergarten (Invernizzi, Sullivan, Meier, & Swank, 2004). The results found that children with disabilities made significant gains that mirrored the progress of their typical classmates, although the achievement gap between the two groups remained. Participants had a variety of diagnoses (e.g., developmental delays, autism, pervasive developmental disorder-not otherwise specified, speech and language impairments, cognitive impairments, and Down syndrome). There were several requirements for participation in this study that would appear to severely limit conclusions. Participants with disabilities were functioning at social, cognitive, behavioral and linguistic levels to the extent that their Individual Education Program (IEP) teams recommended participation in language and literacy instruction in the general education classroom with typical peers-an indication that these skills were considered prerequisite to meaningful inclusion.

A further restriction for participation was that only data from children who were able to complete the tasks according to standardized administrative format were included in the study. It is therefore unclear whether all students with disabilities in these inclusive preschool classes made significant developmental and learning progress. The authors suggest that had the lower achieving students received explicit, small group or individual instruction, the achievement gap between typically developing students and children with disabilities may have been narrowed. We can therefore conclude that regular instruction provided in the inclusive preschool classes in this study was not sufficient for all students with disabilities. Furthermore, because the results were not separated by disability, it is not possible to determine whether there was a significant difference in learning across disabilities.

Assertion: Some studies have shown that children with disabilities who were in inclusive settings experienced greater cognitive and communication development than children with disabilities who were in separate settings, with this being particularly apparent among children with more significant disabilities.

Supporting Evidence: Rafferty, Piscitelli, & Boettcher (2003). This study described the progress in acquiring language skills and social competency of 96 preschoolers with disabilities attending a community-based program. Sixty-eight participants received instruction in inclusive classes and 28 attended segregated special education classes. Progress was assessed using pretest and posttest scores from the Preschool Language Scale-3 (Zimmerman, Steiner, & Pond, 1992) and the Social Skills Rating System (SSRS)–Teacher Version (Gresham & Elliott, 1990). Level of disability (i.e., “severely disabled” or “not severe”) was determined by scores on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R), but the authors did not provide any information about the participants’ specific clinical diagnoses. Posttest scores were comparable for “not severe” students in both class types. Children with “severe” disabilities in inclusive classes had higher posttest scores in language development and social skills than their peers in segregated classes, but had higher rates of problem behavior. The extent to which problem behavior interfered with learning for both typical children and those with disabilities was not addressed. Problem behavior, such as tantrums, aggression, stereotypy, self-injury, property destruction and defiance; is displayed by some children with disabilities. These behaviors have very different implications for preschool-aged children than for older children. In this writer’s experience, severe problem behavior is extremely resistant to change when not successfully treated during preschool years and may ultimately result in more restrictive academic, vocational and residential placement during adolescence and adulthood. The significance of any academic gains by children with disabilities in inclusive settings should be carefully weighed against the long-term implications of unchecked maladaptive behavior.

Continue reading →

The Essential ABA Sale! – Discounted items for your ABA program

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We’re wrapping up Autism Awareness Month by discounting collection of some of our bestselling products that are most essential to creating and running an ABA program. Use our promo code APRILABA this week to take 15%* off any of these these flashcards, token boards, Time Timers, books, and more!

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Don’t forget to mention or apply our code APRILABA when you check out! View the entire sale here.

* Promotion is valid until May 3, 2016 at 11:59pm EST. Offer cannot be applied to previous purchases, combined with anyother 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 differentroads.com, enter promo code APRILABA at checkout.

What Is Procedural Fidelity In ABA?

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It is not uncommon for parents or practitioners to implement a new intervention that appears to be working well, then after a few weeks or months report that the intervention has stopped working. Often, the change in behavior in feels like a mystery and leaves people scrambling for a new intervention. But before searching for a new intervention, you should consider the possibility of problems with procedural fidelity, which “refers to the accuracy with which the intervention or treatment is implemented” (Mayer, Sulzer-Azaroff, & Wallace, 2014).

Problems with procedural fidelity in ABA are common, and you will experience more success with your interventions if you take steps to address fidelity at the outset. Here are a few suggestions:

  • Post the steps in a visible spot. Clearly list the steps of the procedure and put them in a spot where you will see them often. This might be on the actual data collection sheet or on the wall. One parent I worked with had a Post-it® note with the steps for our intervention attached to her computer screen. Another parent kept the steps inside the ID part of his wallet, where they were protected and visible each time he opened his wallet.
  • Plan meetings to go over the steps. As part of your intervention, set brief monthly or quarterly meetings to go over the steps of the intervention and be sure everyone is maintaining procedural fidelity.
  • Assess for procedural fidelity. Schedule observations to ensure that each step of the intervention is implemented as described. If you do not have someone who can supervise you, take video of yourself implementing the intervention, watch it and compare your actions to the steps outlined in the intervention plan.
  • Outline steps for systematic fading of the intervention. When implementing an intervention, the goal is to have the learner eventually exhibiting the desirable behavior without prompts or planned reinforcement. Sometimes when a parent or practitioner sees the learner’s behavior improving, they begin to remove the prompts or planned reinforcement before the learner is quite ready for it. By writing a plan for fading the intervention into the plan, you make it clear to everyone involved what the requirements are for each step towards mastery.

REFERENCES

Mayer, G.R., Sulzer-Azaroff, B., & Wallace, M. (2014). Behavior analysis for lasting change (3rd ed.). Cornwall-on-Hudson, NY: Sloan Publishing.

WRITTEN BY SAM BLANCO, MSED, BCBA

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

Product Highlight: POWER-Solving® – A new social skills curriculum

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Available in child and adolescent levels, this new social skills curriculum teaches students how to become independent problem-solvers via a hands-on and interactive approach through visual cues and supports.

We offer class kits including 5 or 10 sets of Student Workbooks and Facilitator Guides to accommodate larger groups.

This social skills curriculum teaches students to problem-solve first using their “toolbox” (i.e., the five steps of POWER-Solving®) and then to apply this “toolbox” to various social situations, allowing them to develop and enhance their social-emotional skills. Child and Adolescent Student Workbook Sets when paired with their corresponding Facilitator Guides will help students successfully solve problems in various social situations at school, home, and in the community.

Each Student Workbook Set and Facilitator’s Guide Set covers 4 areas of everyday social situations:

  1. Introduction (recommended that students complete this first)
  2. Social Conversation
  3. Developing Friendships
  4. Anger Management

Learn more about the curriculum here.

The Social Problem-Solving Model: Promoting Greater Social Independence – Part II

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In continuing our exclusive social problem-solving series, Drs. Gordon and Selbst, developers of the new POWER-Solving® Curriculum, have addressed the importance of social information processing as a framework for understanding how children and adolescents get along with their peers and adults.

The Social Problem-Solving Model: Promoting Greater Independence – Part II
Steven B. Gordon, PhD, ABPP & Michael C. Selbst, PhD, BCBA-D

Social Information Processing (SIP) is a widely studied framework for understanding why some children and adolescents have difficulty getting along with their peers and adults.

A well-known SIP model developed by Crick and Dodge (1994) describes six stages of information processing that individuals cycle through when responding to a particular social situation:

  1. encoding (attending to and encoding the relevant cues);
  2. interpreting (making a judgment about what is going on);
  3. clarifying goals (deciding what their goal is in the particular situation);
  4. generating responses (identifying different behavioral strategies for attaining the decided upon goal);
  5. deciding on the response (evaluating the likelihood that each potential strategy will help reach their goal, and choosing which strategy to implement);
  6. and performing the response (doing the chosen response).

These steps operate in real time and frequently outside of conscious awareness. Many studies have demonstrated that children and adolescents have deficits at multiple stages of the SIP model which impact their development of appropriate peer interactions and the development of aggressive behaviors (Lansford, Malone, Dodge, Crozier, Pettit and Bates, 2006).

As a result, they have difficulty attending to and interpreting social cues, adopting pro-social goals and utilizing safe, effective and non-aggressive strategies to handle conflict situations. The development of strong social skills has been shown to contribute to the initiation and maintenance of positive relationships with others.

POWER-Solving BooksThe POWER-Solving® Curriculum (Selbst and Gordon, 2012) is heavily influenced by the components of the SIP model as seen in the five steps of POWER-Solving, easily learned in the acronym POWER:

  • Put the problem into words;
  • Observe your feelings;
  • Work out your goal;
  • Explore possible solutions;
  • Review your plan

The curriculum is comprised of several modules, each with their own materials for facilitators and students. While it is critical for the student to learn the POWER-Solving® Steps first (i.e., the “toolbox”), the facilitator can determine the sequence of the subsequent modules. For example, one may prefer to move to the Anger Management module after the introduction. Alternatively, one may decide to move to Social Conversation or Developing Friendships. The goal is for students to learn valuable POWER-Solving skills that they can apply to an infinite number of social situations throughout their lives.

REFERENCES

Crick, N.R., & Dodge, K.A. (1994). A review and reformulation of social information-processing mechanisms in children’s social adjustment. Psychological Bulletin, 115(1), 74–101. doi:10.1037/0033-2909.115.1.74.

Lansford, J.E., Malone, P.S., Dodge, K.A., Crozier, J.C., Pettit, G.S., & Bates, J.E. (2006). A 12-year prospective study of patterns of social information processing problems and externalizing behaviors. Journal of Abnormal Child Psychology, 34, 715-724.

Selbst, M.C. and Gordon, S.B. (2012). POWER-Solving: Stepping stones to solving life’s everyday social problems. Somerset, NJ: Behavior Therapy Associates.

ABOUT STEVEN B. GORDON, PHD, ABPP

Steven B. Gordon, PhD, ABPP is the Founder and Executive Director of Behavior Therapy Associates, P.A. He is a clinical psychologist and is licensed in New Jersey. Dr. Gordon is also Board Certified in Cognitive and Behavioral Psychology by the American Board of Professional Psychology and is a Diplomate in Behavior Therapy from the American Board of Behavioral Psychology. Dr. Gordon has co-authored three books, published numerous articles, presented papers at local and national conferences, and served on editorial boards of professional journals. Most recently, Dr. Gordon and Dr. Selbst have co-authored the new social-emotional skills program POWER-Solving: Stepping Stones to Solving Life’s Everyday Social Problems. Dr. Gordon’s professional interests range from providing assessment and treatment for individuals diagnosed with Autism Spectrum Disorders, AD/HD and other disruptive behavior disorders associated with childhood and adolescence. He has co-founded and is the Executive Director of HI-STEP® Summer Program, which is an intensive five-week day program for children to improve their social skills and problem solving ability. In addition, Dr. Gordon has had extensive experience providing clinical services not only for children diagnosed with phobias, stress, selective mutism, obsessive compulsive disorders and depression, but also with adults coping with anxiety,depression and relationship difficulties. Dr. Gordon is a member of the American Psychological Association, the Association for Behavioral and Cognitive Therapies, and the New Jersey Psychological Association.

ABOUT MICHAEL C. SELBST, PHD, BCBA-D

Michael C. Selbst, PhD, BCBA-D is Director of Behavior Therapy Associates, P.A. He is a Licensed Psychologist and a Certified School Psychologist in New Jersey and Pennsylvania. He is also a Board Certified Behavior Analyst at the Doctoral level. Dr. Selbst has co-founded and is the Executive Director of HI-STEP® Summer Program, which is an intensive five-week day program for children to improve their social skills and problem solving ability, and the Director of the Weekend to Improve Social Effectiveness (W.I.S.E.). He has extensive experience working with pre-school aged children through adults, including individuals who have social skills deficits, emotional and behavioral difficulties, learning disabilities, gifted, and children with developmental delays, including those with Autism and Asperger’s Syndrome. Dr. Selbst consults to numerous public and private schools, assisting parents, teachers, and mental health professionals, and presents workshops on all topics highlighted above, as well as Parenting Strategies, Depression, and Suicide Prevention. Dr. Selbst and Dr. Gordon have co-authored the new social-emotional skills program POWER-Solving: Stepping Stones to Solving Life’s Everyday Social Problems. Dr. Selbst is a member of the following professional organizations: American Psychological Association; National Association of School Psychologists; Association for Behavioral and Cognitive Therapies; Association for Behavior Analysis International; Association for Contextual Behavioral Science; New Jersey Psychological Association; and New Jersey Association of School Psychologists.

Pick of the Week: NEW! Visual Schedule Boards for the Classroom and On the Go

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Help students stay on task throughout their day with these newly added visual schedule boards. This week, we’re offering 15% off the Visual Schedule Board and the Small Travel Schedule Board, so you can hang them up in the home or classroom, or take them with you on the go! Use our promo code VISUAL15 at the check-out to redeem your savings!

The Visual Schedule Board measures 36″ long and 6″ wide and comes with Velcro strips for easy attachment, as well as a pocket to hold completed tasks.

 

 

The Small Travel Schedule Board measures 15″ long and 4″ wide and comes with a detachable pocket to hold completed tasks. Available in blue and yellow.

 

 

 

Promotion is valid until April 19, 2016 at 11:59pm EST. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code VISUAL15 at checkout.

Facilitating Social Groups for Students with Autism

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In honor of Autism Awareness Month, we’re pleased to highlight an NYC-based agency called East Side Social this week! Alicia Allgood is a BCBA and co-founder of East Side Social. With her co-founder Kimia Tehrani, BCBA, they organize social groups and also provide a wealth of additional services for both parents and practitioners in the field of autism. Alicia was kind enough to provide some very comprehensive answers to our BCBA consultant Sam Blanco’s questions about facilitating social groups for learners with autism. You can learn more about East Side Social here.

Autism Awareness Highlights: Interview with Alicia Allgood, MSEd, BCBA
Co-founder of East Side Social, New York, NY

Facilitating Social Groups for Students with AutismSam: What prompted you to begin East Side Social?

Alicia: I co-facilitated social groups in San Diego in the early 2000’s with an amazing group, Comprehensive Autism Services and Education. They provided a number of other services, but the social group was the directing psychologists’ pet project, and you could really tell for the quality. It was wonderful to see these quirky, amazing kids that were struggling socially come into this group and make friends. They engaged with one another in significant ways that impacted their sense of well-being and confidence, all the while learning how to be more and more socially appropriate. I was inspired. When I met Kimia in New York, she and I found we worked very well together. I mentioned my interest in starting such a group in New York, and Kimia held me to it. We both saw a need for these services here, but there really wasn’t much being offered at the time, and that which was being offered didn’t have a behavior analytic approach. In our mind, this suggested they weren’t objectively verifying the effect of their programs, nor were they necessarily using evidence-based practiced to teach the skills these kids needed to learn. We saw a need, we were inspired, and so made the necessary movements to begin East Side Social.

Sam: What is the primary challenge to organizing social skills groups? How have you addressed it?

Alicia: We were both private practitioners prior to starting this social group. Starting a business is a whole other beast in its own right, and being a good technician doesn’t necessarily mean you’re prepared to grow that skill into an actual business. We were caught a bit by surprise by all that would be necessary on the back end. From marketing to balancing the budget and handling insurance billing, we were not prepared to take all of that on while maintaining our private clients and actually preparing for and leading the social group. Realizing our deficits along the way, we’ve hired consultants and people to support the back end, and that is what has really made this possible. We couldn’t do what we do without the support of a small group of really wonderful people. It’s also been extremely challenging to find a way to collect data on target behavior during our groups. We’re suddenly extremely sympathetic to classroom teachers who are asked to collect data on their students. We have tried data collection systems into our token economies. We’ve also used time sampling data, and once when feeling highly ambitious and having approval of all parents, we video-taped all groups and spent hours upon hours watching and re-watching these videos, tracking target group behavior and individual learner behavior. This is a continuous work in progress that we feel dedicated to on account of our commitment to ethical behavior analytic practice. It’s also a bit fun to solve this puzzle. Continue reading →

10 Things Autism Awareness SHOULD Be About

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We’re so thrilled to be kicking off Autism Awareness Month with a special guest article from the Executive Director of the Association for Science in Autism Treatment (ASAT) David Celiberti, PhD, BCBA-D, who shares with us 10 things autism awareness should be about. David has also provided a wealth of information and resources for parents and professionals to utilize in finding the best treatments out there, seeking out reliable research and asking good questions, helping individuals with ASD find a place in the workforce, and much more. 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!

10 Things Autism Awareness SHOULD Be About

10 Things Autism Awareness SHOULD Be About
by David Celiberti, PhD, BCBA-D

April is Autism Awareness Month. The blue puzzle pieces will appear on thousands of Facebook pages and billboards, and the media will give greater attention to, and information about autism. Further awareness is a wonderful thing, as detection and diagnosis are necessary first steps to accessing help in the form of treatment, information, and support. With well over 400 treatments from which to choose, parents of children with autism need guidance, tools, and accurate information to make the best possible choices for their children: choices that will undoubtedly have a profound impact on both their current quality of life and their children’s future.

Clearly, autism spectrum disorder (ASD) is no longer the rare diagnosis that it once was. With the incidence of one in 68 children, and one in 42 boys, our own families, neighbors, and co-workers are all touched by autism. In fact, the sheer numbers have heightened awareness of autism in and of themselves. This awareness is essential: it promotes early detection, and with early detection, we hope for a relatively clearer course toward effective treatment and better outcomes. Sadly, however, the early detection of autism alone does not always mean a seamless path to intervention. Furthermore, families whose children are diagnosed with autism are still not able to expeditiously access the most effective science-based treatments available. Instead, families often have to sort through over 400 pseudo-scientific treatments until they arrive at the most effective and research-proven intervention in addressing the complex disorder of autism. We must do better!

“Autism Awareness” should be about more than just detection and diagnosis. It has always been ASAT’s hope that the conversation around autism awareness would be broadened to focus upon the obstacles that separate individuals with autism from effective, science-based intervention and distract their families, caregivers, and teachers from accurate information about effective autism intervention. Below are 10 ideas about what Autism Awareness should be about, along with ways that the Association for Science in Autism Treatment (ASAT) can assist families and providers in navigating the complex maze of autism treatment options.

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Autism treatment is a multi-million dollar industry. For the majority of the 400+ available interventions, science is overlooked in favor of pseudoscience, and they are marketed with heart-wrenching testimonials, anecdotes and video montages, and often bolstered with poorly crafted and misleading surveys. Many boast inaccurate and even outrageous claims that are touted as evidence of effectiveness. Aggressive marketing of these so-called “therapies” and “cures” is absolutely overwhelming and it drowns out accurate information for parents who are desperate to help their children.

For most other medical conditions, a provider who disregards a proven intervention in favor of using a “fringe” treatment could be sued for malpractice! Such safeguards do not widely exist for autism treatment. We do no favors for children with autism, their families, and those charged with providing effective services when we not only ignore quackery, but allow it to proliferate by failing to counter baseless claims. Families deserve better. Individuals with autism deserve better. Visit our website to learn more about the scientific support behind various autism treatments, the relevance of peer-reviewed research, the pitfalls of testimonials, as well as many other articles related to becoming a more savvy consumer. Please also see our review of Sabrina Freeman’s book, A Complete Guide to Autism Treatments.

As adults, voters, consumers, providers, and parents, choice underlies all of our decisions. Decision-making power comes with tremendous responsibility. There is a myriad of stakeholders whose decisions have profound implications for children and adults with autism – not just parents, but siblings, teachers, treatment providers, administrators, program coordinators, and taxpayers.

  • Scientists need to take responsibility in making their findings about an intervention’s effectiveness clear, unambiguous, and unexaggerated. Efforts should be taken to promote replication.
  • Administrators and program leaders need to take responsibility in identifying internal and external training opportunities that further their staff’s competence with evidence-based practice. Additionally, they should make sure their staff receives the support needed to sustain these efforts and to continually engage in data-based decision making when both selecting and monitoring interventions. They must be savvy and selective in their selections of trainings for their staff and not fall prey to gimmicks, splashy sales pitches or fads.
  • Providers need to select procedures that are based on published research, adhere to their discipline’s ethical guidelines about evidence-based practices, and maintain a commitment to ensuring that parents have truly been given the opportunity to provide informed consent. For example, if there is no scientific evidence to support an intervention that one is using, then it is an ethical obligation of the professional to inform parents of this lack of evidence. Please see Principle #1 and #2 of the Ethical Code for Occupational Therapists, Section 2.04 of the Ethical Principles of Psychologists and Code of Conduct, and Section 2 of the Guidelines for Responsible Conduct for Behavior Analysts.
  • Parents must continue to exercise caution in sorting through autism treatment options to make the best possible choice for their children, particularly since many providers do not make the path to effective treatment clear and simple.

There are far too many individuals with autism who do not have access to effective treatment, are receiving ineffective treatment, or are subjected to treatments that are, in fact, dangerous. Every minute of ineffective intervention is one less minute spent accessing effective intervention. Every dollar spent on an intervention that does not work depletes resources available for interventions that do work. For questions to ask to make sure that the individual with autism in your life is receiving science-based treatment, please see our article on questions to ask marketers and read more about the following three phases of inquiry about particular interventions and their associated questions and considerations in The Road Less Traveled: Charting a Clear Course for Autism Treatment:

  • Phase I: Exploring the viability and appropriateness of a particular treatment approach.
  • Phase II: Assessing the appropriateness of an intervention under the supervision of a specific service provider for a specific individual with autism.
  • Phase III: Monitoring the implementation of the treatment and evaluating effectiveness.

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As we know, not all information on the Internet is reliable and accurate. You have probably heard the term, caveat emptor (“Let the buyer beware”). Consumers must also practice caveat lector (“Let the reader beware”).

Often Internet information is deemed equivalent in relevance, importance, and validity to research published in peer-reviewed scientific journals, but it is not. Testimonials and uncontrolled studies from so-called researchers can lead parents astray and be a tremendous source of distraction. Parents of newly-diagnosed children may be particularly vulnerable. Know the red flags to avoid and learn how to evaluate research by visiting our website. Our library of articles highlights scientific concepts and methods as they relate to potential autism interventions, with the goal of providing families, educators and clinicians with the information they need in order to be savvy consumers of marketed treatment products and therapies.

Continue reading →

Tip of the Week: Improving Time-Out Procedures

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Time Out ChairTime-out is often a hotly-debated topic. Is it too punishing? Where should it take place? How long should it last? There are not easy answers to many of these questions. But there are some evidence-based suggestions that may improve a time out procedure should you decide to use one.

  • First, know the function of the behavior! If the child is engaging in the undesirable behavior for escape, then providing “time out” will likely increase the behavior. For instance, if a child gets sent out of the classroom each time he curses, this is effectively a time out from classwork. He may curse because in the past, cursing resulted in escaping from classwork. This is an instance when you would not want to use time out. A time-out may prove to be effective for behaviors that function for attention or access to tangibles. More on that next…
  • Consider a nonexclusion time-out procedure. In the past, we’ve discussed the time-out ribbon here. This is a useful tool for signaling to a learner that they have access to social or tangible reinforcers. If they engage in an inappropriate behavior, the ribbon is removed and they do not have access to social or tangible reinforcers, however they are still able to participate in the lesson or activity you have organized. It also allows them to practice more appropriate behaviors to earn the ribbon back. If the ribbon isn’t the best visual cue for your learner, you could make it anything this is visible for them and clearly delineates when they do and do not have access to reinforcement.
  • Consider the use of a release contingency. This means that a learner is unable to leave time out until a predetermined amount of time has passed without problem behavior. Perhaps if you’re working with a preschool child who has been kicking other children, the release contingency might be that they must sit with “quiet feet” or “feet on the floor” for one full minute before they can go back to play. Your other option is to put in a fixed time contingency, which is best done by setting some sort of timer so the learner can see how much time is remaining in time-out.
  • Combine time out with positive reinforcement procedures. Time-out by itself may result in decreases in behavior only when time out is a possibility. For instance, you may see a decrease in the problem behavior only when the child’s mother is at home, because the father doesn’t use time out. The goal is to decrease the problem behavior across all settings and activities. To that end, it’s helpful to teach appropriate replacement behaviors and reinforce the learner for engaging in those behaviors.

WRITTEN BY SAM BLANCO, MSED, BCBA

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