Tag Archives: autism education

5 Tips on Teaching Safety Skills to Children with Autism

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By Sarah Kupferschmidt, MA, BCBA. Reposted from the Different Roads Archives

I am passionate about empowering children with special needs and their families with skills and knowledge that they can use to improve their quality of life. This is why I am super excited to be sharing tips and strategies that relate to keeping your child with autism safe on the street. Learning to navigate the real world involves a lot of complex skills that we sometimes take for granted. For example, learning to determine when it is safe to cross the street requires the ability to attend to your environment, the ability to identify moving cars from cars that are still, the ability to identify the signal at the cross walk that lets you know it is safe to cross, among many, many, more. In some cases even more advanced problem solving is required because if the sign says it is safe to cross and a motorist continues through the intersection we need to be able to identify the moving car is approaching and that we need to wait for it to pass before crossing the street. So where do we begin?

Tip #1: The Learner is Never Wrong

I love the saying “the learner is never wrong” because of what it implies. Whenever considering teaching a new skill to a child or student we need to focus on that unique child’s strengths and weaknesses. Where do we need to boost up their skills and what do they already know so that we can capitalize on those strengths. Before going out to teach your child with autism how to cross the street safely, they should have some imitation skills, be able to respond to instructions and attend to you or a teacher amidst a lot of distractions (e.g., cars, background noise and pedestrians, just to name a few). Once you have determined they are ready to learn this important skill you would want to use things that are of interest to them and that you know align with their learning style. For example, are they a visual learner and if so, how can you incorporate visuals to maximize their learning potential in how you go out and practice crossing the street safely?

Tip #2: Simplify the Complex Skills

As mentioned earlier in the post, many of the skills that we use actually have many components, something we take for granted. In this case, teaching how to cross the street might involve the following steps:

  1. Stop at the curb/crosswalk
  2. Look at the crosswalk signal
  3. Decide if it is safe to cross (e.g., does it say ‘walk,’ or does it say ‘stop’)
  4. If the sign says walk, then look both ways
  5. Decide if it is safe (e.g., is there a car moving or not)
  6. Walk safely across the street (e.g., this means walking not running, perhaps holding your hand)

It is important to remember that these steps are just an example of what you might teach. You would individualize this based on the environment in which you live (e.g., if there is a crosswalk sign or crossing guard, or not) and the expectations you have as a family (e.g., to hold the hand or not). Teach this using tools that you know are effective with your unique child. For example, you may decide to print out a visual depiction for each of the steps and show them as you talk about it and practice. This depends on your child’s unique learning style. As with every skill that that we teach, it is never enough to just tell someone or show someone how to do it. We need to actually go out and practice.

Tip #3: Practice, Practice, Practice

Use every opportunity that you have to go out and practice this very important skill. I would also recommend that you set up specific times to go out and practice. You can use the visuals that you printed and go through each of the steps while you are out. If you notice that your child is struggling on a particular step, then practice that particular step at home even more. For example, if your child is not identifying the walk signal when you are out on the street, set up times to go over that at home.

Tip #4: Monitor Progress

In order to see how your child is doing on each of the steps it is a good idea to record how they do on each of the steps. You might print off a checklist with each of the steps that looks something like this:

Street Safety Chart

You would calculate the number of times you recorded a Y over the total number of steps (e.g., in this case 6). For example, if I worked on this with my child and he did all of the steps he would get a 6/6. If he missed a step his overall score would be 5/6 or 83%. This score can then be used to monitor progress. I would also suggest that anytime you go out and practice you highlight whichever step(s) that they missed, if any. This will allow you to see if you need to work on something a little bit more before you go out and practice.

Tip #5: Notice the Good Stuff

Feedback is critical when you are teaching a new skill. Otherwise how is your child going to know how they are doing? This means that when they get it right we need to notice it and we need to be specific about what it is they did well. You can even use the visuals if you have them. You might say something like “I love the way you followed all of the steps of what to do when crossing the street safely! You stopped at the curb, looked at the signal…etc.” You may point to the visual as you tell them. If they missed a step remind them that next time they should try to remember what it is that they missed. Anytime they do one of the steps spontaneously, point it out to them and give lots of praise. Over time we can fade the praise out but it is really important when teaching a new skill, especially at the beginning.

About the Author

Sarah Kupferschmidt, MA, BCBA, is a Board Certified Behavior Analyst (BCBA) who has worked with hundreds of children with autism and their families across Ontario. She has had the privilege of supervising ABA programs and training clinical staff in those programs.  Currently Sarah offers parent coaching and workshops to teach parents but also educators on the most effective ways to teach children using the principles of ABA.  She is also a part-time faculty member at Mohawk College in the Autism Behavioral Science program, in the social sciences program at McMaster University, and an Adjunct Professor at Sage Graduate School. Sarah has appeared as a guest on CP24, CHCH news, Hamilton Life and the Scott Thompson radio show as an authority on autism.

Back to School: Disseminating the Science for Teachers and BCBAs

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By Alicia Marshall, MAT, BCBA LBS

The transition back to school and back to a new routine is always an exciting, yet bittersweet time for students and educators. Carefree summer days are in the past, and getting back into a structured daily routine can be an overwhelming process. However, new teachers, new friends, and new settings provide the opportunity to make progress with academic, behavior, and social goals. Even while students and their families should enjoy every precious moment of summer fun, it is also important to set aside some time to prepare for the transition in the new school year.

Getting Proactive

Most school-based BCBAs can attest that the most important aspect of school consultation is assisting educators and other stakeholders to be proactive about behavior instead of reactive. This advice is especially valuable while preparing for a new school year. Teachers and families can begin to discuss and implement proactive strategies in the days prior to the first day of school.

For teachers and school based BCBAs, summer preparation days can be used to discuss simple environmental manipulations that can be made within the classroom. For instance, before students even step foot in the classroom, the teacher and other support staff can arrange seating that is limited from distraction and enhances engagement. A common suggestion from BCBAs is usually to seat students with a history of elopement behavior far away from the exit doors. Some consultants may even suggest preparing some visual supports and schedules ahead of time in order to prepare staff and students. Students thrive with structure and organization, so if the classroom has established expectations the students will find it easier to decide which behaviors lead to rewards and desired activities.

Building Rapport

Antecedent interventions do not only apply to teacher prep days. Chances are, not all students will engage in challenging behaviors on the first day of school. Hence, those first days of school are crucial because they are the opportune times for pairing. Classroom staff should prioritize gaining trust and rapport with students. This process can begin the moment the students arrive at school on the first day. Teachers and staff can begin pairing with students simply by greeting students with a smile and limiting demands. Students should be given the chance to feel happy and relaxed while adjusting to a new environment.

The more the students feel comfortable in the environment, the more likely they are to view the adults in the environment as a reinforcer, or a signal for access to preferred items and activities. When trust and rapport is established, it will also be easier for teachers and staff to engage in activities that may not be highly preferred. Of course the primary focus of the teachers should not be to place increasingly difficult demands on the students. However, establishing themselves as a person that will provide rewards and other motivators, allows the adults in the classroom to assist the students in developing pivotal behaviors that will provide access to a whole world full of reinforcing items and activities.

While students are adapting to the new enrichment, teachers and staff can use the opportunity to informally assess the students’ preferences. Enriching the enrichment with items high on the students’ preference list will not only assist in the pairing process, but can also be used as potential motivators for instances of positive reinforcement scenarios.

Embracing Collaboration

Lastly, the most important aspect of the transition back to school and adjustment to a new environment and routine is collaboration with all key stakeholders. Parents and caretakers, as well as teachers, should be involved and have input on any strategies and goals put in place. The more the students’ parents and caretakers feel involved in the decisions being made for their children, the more likely they are to carry out plans with fidelity. Also, establishing effective collaboration and communication assists with overhaul generalization of behaviors and makes the students’ support system stronger and more successful.

About the Author

Alicia Marshall, MAT, BCBA LBS, started out as a Special Education teacher and made the switch over to full-time BCBA 5 years ago. Alicia received her BCBA coursework at Rutgers and currently works as a Director of Behavioral Health in the Greater Philadelphia area. Alicia is passionate about making learning fun for all stakeholders and to encourage educators to focus on socially significant goals and compassionate care. 

When Alicia is not disseminating the science of ABA, she can be found on the beaches of the Jersey Shore (and occasionally Hawaii) with her husband and two dogs.

Focus on Generalization and Maintenance

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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 Spotlight On Executive Function in the Early Childhood Classroom

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By: Stephanny Freeman, PhD and Kristen Hayashida, MEd, BCBA

The new year brings opportunities for introducing new ideas and refining existing techniques for young learners. This week, we’re revisiting a blog from our archives that focuses on executive function.

When kindergarten teachers are asked what skills they would like their students to have the beginning of the year, their answers might be surprising!  Parents and caregivers are often concerned with making sure their children can say their ABC’s, count to 10, and know their colors. Some may believe that their children should be reading by the time they start kindergarten.  However, kindergarten teachers often have a different set of priorities, and instead are looking for skills such as:

  • The ability to listen to and follow directions
  • Follow classroom routines
  • Control impulses
  • Resolve a conflict or solve a problem calmly with another child

Kindergarten teachers value these skills because they are critical for school readiness, paving the way for children to be academically and socially successful.  Moreover, children who are behind in these skills can require disproportionate amounts of teachers’ attention, derail classroom activities and routines, and interfere with other children’s learning.

Underlying these school readiness skills are a set of higher order thinking skills collectively referred to as Executive Functions (EFs). EFs are the cognitive control functions that help us inhibit our initial impulses and think before acting.

But while most teachers agree that EF skills are very important, they are not explicitly taught in most early education settings (or at any point in most children’s educational experiences).

What skills are part of executive functioning?

Three key skills are generally agreed upon as the core of EF:

  1. Working memory: holding information in mind to manipulate, work with, or act on at a later time.
  2. Inhibitory control: the ability to regulate one’s attention, behavior, thinking, and emotion particularly in response to distractions or temptations.
  3. Cognitive flexibility: the capacity to shift one’s thinking, such as changing one’s approach to solving a problem if the previous approach is not working or recognizing and responding when the demands of that task have changed.

Seven additional skills are also considered to fall under the umbrella of EF, often relying and building on the three foundational EF skills:

  1. Initiation: the ability to begin a task or activity or to generate ideas independently in order to answer questions, solve problems, or respond to environmental demands.
  2. Fluency: how fluidly one can access and use relevant knowledge or skills.
  3. Planning: the ability to identify and sequence all the different steps needed to achieve a specific goal.
  4. Organization: the capacity to prioritize and make decisions about which tasks to undertake, and the needed resources to complete those tasks.
  5. Problem solving: carrying out the steps to achieve a desired goal, while monitoring progress making necessary adjustments.
  6. Time awareness: part of the broader skill of Time Management, which includes to the ability to anticipate how long tasks might take, to be aware of time constraints, track one’s progress, and adjust one’s behavior in order to complete tasks efficiently.
  7. Emotion regulation: skills including identifying one’s own emotion states and responding appropriately to emotional experiences.

Why do executive function skills matter?

Executive function skills predict a host of short-term and long-term outcomes!

  • They are a stronger predictor of school readiness than IQ.
  • They are also associated with higher achievement in both reading and math throughout children’s schooling.
  • EF skills, when tested in early childhood predict outcomes later in childhood and adolescence, including psychological and physical health.

Because EF skills are so predictive of later outcomes, they are being increasingly recognized as a critically important focus of intervention. 

Early EF training is … an excellent candidate for leveling the playing field and reducing the achievement gap between more- and less-advantaged children.

Diamond and Lee (2011, p. 6)

Can executive function skills improve?

Yes! All young children (typically developing and those with difficulties) can benefit greatly from instruction in EF!  Frequent practice of these skills and gradually raising the difficulty benefits children most in generalization and increasing gains. Practitioners and parents should consider:

  • Providing focused instruction in EF skills.
  • Combining explicit targeted instruction in EF skills with other activities in which they can then apply and practice those skills.
  • Building targeted EF skills into daily routines.
  • Providing multiple opportunities every day, particularly for children with disabilities, to test out and practice EF skills.

Most experts consider the development of self-regulation skills, of which executive functions are the crown jewel, to be the most important objective of high quality preschool—to help children focus attention, be emotionally expressive, not be impulsive, and to engage in purposeful and meaningful interactions with caregivers and other children.

Blair (2017, p.4)

About The Authors

Dr. Stephanny Freeman is a clinical professor at UCLA, a licensed clinical psychologist, and Co-Directs the Early Childhood Partial Hospitalization Program (ECPHP).  For 20 years, she has educated children with ASD and other exceptionalities as a teacher, studied interventions for social emotional development, and designed curriculum and behavior plans in school and clinic settings.

Kristen Hayashida is a Board Certified Behavior Analyst at the UCLA Early Childhood Partial Hospitalization Program (ECPHP).  For the last 10 years she has served as a therapist, researcher and educator of children and families living with autism spectrum disorder through the treatment of problem behavior.

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

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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?

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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.

Special Needs Registries to Inform First Responders

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By: Cassie Hauschildt

When a child is diagnosed with autism, there are a number of resources, therapies, and programs recommended  to parents. They are told all about ABA, ST, OT, PT, and FT, among others, receiving an alphabet soup of therapies. We explain the importance of early intervention. For parents of older children or teens, they learn how to navigate the school system with BIPs, IEPs, ARDs, and more. They begin to understand the behaviors of their children in a new light, and may even gain a few new fears from behaviors of other children. They learn the proper term for eloping and steps to take to help prevent sensory overload. And while many behaviors are explained, it also becomes obvious that there is not an immediate fix for many of them.

One service that professionals may not tell parents  about at the time of diagnosis is their local police department’s registry program for individuals on the Autism Spectrum (along with other disorders or special needs). However, if this is a service is available to them, it could help alleviate many of the concerns that come along with an autism diagnosis. This free and essential service is often not openly advertised to the public, but rather, lives on a corner of their local webpage. Some don’t even have an obvious link on the homepage, requiring citizens to use the search function in order to get their child included on the list. This service can have a variety of names, including but not limited to: “Safe Return Program,” “[Autism and] Special Needs Registry,” “C.A.R.E.S,” and “Voluntary Registry Program for Vulnerable Populations.”

Registering your ASD Child for this program will create a note associated with your home address in the local police’s internal system. This can help participants in multiple ways. First, if there is ever an officer dispatched to your home, they will be alerted that an ASD individual lives in the home and be prepared to accommodate that person’s needs. Additionally, if a child was to elope, many programs have the option to upload a recent photo. This will make it easier for law enforcement to distribute the child’s picture quickly. For some cities, , this information could also be shared with the any firefighters or paramedics sent to the home by the dispatch team.

The method for finding if your local police department offers this program will differ depending on your city. The best start is to try searching “[CITY NAME] Special Needs Registry” on a search engine such as Google. If this doesn’t work, you may have to do some detective work on the local police website. When trying to find this program locally, I had to find the “Community Programs” tab on the menu bar of the police website.

Each program will require different information to register. At a base, caregivers should expect to provide name, address, diagnosis, and physical description of the registrant as well as the contact information for all caregivers. If the registrant is able to drive, information about their primary vehicle will also be required. Any additional required information will vary depending on the local program. Some require a doctor’s letter proving diagnosis, others ask for a recent picture, and other ask for communication methods and support items.

If you find that your local police department doesn’t have a program, consider approaching them about implementing one. With the updated CDC estimate of 1 in 44 children getting diagnosed with autism, it is almost guaranteed that this program will be useful to more than just you. Additionally, these programs can be utilized for individuals with Alzheimer’s, Dementia, Down Syndrome, and many other special needs. BCBAs and Educators are the perfect individuals to partner with  police on  program parameters. Additionally, it’s a great opportunity to broach your local police department  about training for interacting with ASD individuals.

Cassie Hauschildt received her autism diagnosis at 32 years of age and is the mother of an ASD son, who was diagnosed at 20 months old. Since his diagnosis, she has become an advocate for ASD children. She dedicates her time to mentoring parents of ASD kids through the tough first few months post-diagnosis. She also is trying to get rid of the negativity surrounding ABA therapy. She does this through humor, while using real talk, on her TikTok @AnotherAutismMom. She also runs the “Dino and Nuggets Corner” Facebook Group.

ASD Learners and Sexuality

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By: Randy Horowitz, M.S. Ed., S.A.S. and Joanne Capuano Sgambati, Ph.D., BCBA-D, LBA

Sexuality is part of normal human development for every man, woman and child. It is a basic need and an integral part of life. Sexuality is not just physical maturity and sexual intercourse; it is diverse and personal. It’s about relationships, intimacy, and thoughts and feelings about other people. Individuals with ASD follow the same physiological sexual development and interests as their typically developing peers; About 75% of individuals on the spectrum desire and engage in some form of sexual behavior. (A comparable percentage to the neuro-typical population). Behaviors range from masturbation to intercourse and many steps along the way. Individuals with ASD have the same sexual interests, needs, and rights as anyone else, they just may not have the same ways to express themselves and share their feelings.

So what else is unique about individuals with ASD in relation to sex education?

  • Poor social competence and limited peer relationships lead to few opportunities to obtain sexual information, have sexual relationships, and fulfill their desire to have a healthy romantic and sexual life.
  • Cognitive differences (difficulty with inferencing, perspective taking, and theory of mind) can impact their understanding, generalization, and application of sexual information.
  • Language and communication challenges as well as social skills deficits can get in the way of initiating and maintaining relationships.
  • Societal barriers which interfere with learning necessary sexual information that can prevent intimate relationships from taking place. 

It is a natural instinct for parents and teachers to want to protect their children; however, by avoiding speaking about sexuality and sex education, they may be suggesting that sexuality is unimportant or shameful and they may be leaving their children even more vulnerable to frustration, problematic behaviors, social isolation, anxiety, depression, low self-esteem and even victimization.

So, how can we best educate learners with ASD about sexuality?

Start early: Children with ASD may have a hard time with change and take longer to learn concepts. Start very early; and present positively in a calm and clear manner:

  • Body part ID
  • Using appropriate words and language to identify genitals.
  • Private vs. public (e.g., places, behaviors, hygiene, and eventually conversations and on-line activities etc.)

Remember what is cute as a child (like hugging teachers), may be inappropriate in middle school. So, teach appropriate social boundaries early on. Do not wait until puberty to discuss body changes as it can be alarming to teens with ASD who resist change (pubic hair, private time for masturbation, shaving, bras, maxi pads, etc.).

Use appropriate teaching strategies: You can teach sexuality skills the same way you teach other skills to those with ASD. Some ideas are use of visuals, schedules, task analysis, functional communication training, and video modeling. Remember that sexual behavior is still behavior and adheres to the laws of applied behavior analysis. If there is a behavior to increase, decrease, or maintain it is important to know the function of that behavior in order to modify it.

Remember while teaching make sure you are aware of issues regarding consent, legalities in your state, wishes of the parents, policies of your agencies and how your intervention will look to others.

Teach independence: It is natural for parents to want to protect their child with ASD but to avoid sex education and relationship development may actually make the individual vulnerable to dependency. Teach independence on skills that are transferable to sex education:

  • personal hygiene
  • dressing
  • toileting
  • use of a cell phone
  • who and how to call in an emergency

Don’t do anything for them that they can do for themselves. This will help the child be less dependent on others for “help” and able to make their own decisions.

Teach safety skills: . Children with ASD are typically taught compliance, They may not know how to self-advocate and say “No” because they have been rewarded for compliance and listening to people who are “in charge”.

  • Teach them to say “NO” when asked to do something they do not want to do (i.e. “No thank you, I do not want a hug”).
  • Teach them that “Your body belongs to you” and rules for touching (appropriate vs inappropriate touches). They need to know they have rights over their bodies and how to “report” any inappropriate sexual behaviors or abuse.

Teach the obvious: Most children learn from a variety of sources: family, peers, TV, movies, internet etc. Those on the spectrum may not pick up on all this information. They may need things spelled out for them in a concrete literal fashion. “You cannot date women younger than 18”. Avoid or explain confusing language. “A “hook-up” is slang for meeting someone for sex and not a relationship.”

Teach about relationships: Explain the variety of relationships that people have (friendship vs love vs intimacy) and (close family and friends vs professionals, acquaintances, and strangers). Help them be social, learn social communication skills, and make friendships. Best friendships form from common interests (e.g., video games, “Anime”, trains etc.). The internet can help you find special interest groups and meet ups. There are also speed dating and singles groups for those with ASD.

Teach them about themselves: They need to develop self-esteem and a healthy self-concept. Understanding their diagnosis, strengths and weaknesses will help them be better advocates for themselves. Being a better self-advocate will also help protect their sexual well-being.

Randy Horowitz, M.S. Ed., S.A.S.

Randy has a Master of Science in Education from Queens College and a Certificate of School Administration and Supervision from the College of New Rochelle. Randy is currently a doctoral candidate in the educational leadership program at Concordia University. Randy started her career as a special education teacher in public school in Nassau County and then spent close to 30 years in senior leadership positions at nonprofit organizations serving children and adults with autism in NYC and Long Island. Randy has presented at local, national and international conferences on topics relating to educating individuals with autism. Her particular areas of interest include preparing and supporting individuals with autism for integration into community activities.

In addition to her many work responsibilities, Randy is also a seasoned runner and has participated in countless road races and marathons, including our Blazing Trails Run/Walk, raising well over $65,000 in the past 15 years to benefit the autism community.

Joanne Capuano Sgambati, Ph.D., BCBA-D, LBA

Dr. Sgambati serves as the Director of Psychological Services for Eden II’s Genesis Programs on LI.  She specializes in consulting, counseling, evaluations, and behavior management of individuals with autism spectrum disorder (ASD).  For the past 30 years, she has been dedicated to using positive behavior approaches, applied behavior analysis (ABA), for enhancing the lives of students in special education and adults on the autism spectrum.  Dr. Sgambati is an active participant in Eden II’s Genesis Outreach Department conducting live presentations and webinars on a variety of topics at organizations, conferences, schools, and universities. She also conducts training seminars for local schools and various parent organizations.  Dr. Sgambati specializes in ABA interventions for families of children and adults with special needs who demonstrate challenging behaviors. She is also the proud parent of two young adults on the Autism Spectrum.

Resources:

https://researchautism.org/sex-ed-guide/

https://www.autismspeaks.org/sites/default/files/2018-08/Puberty%20and%20Adolescence%20Resource.pdf

https://www.autismspeaks.org/recognizing-and-preventing-sexual-abuse

Ames, H. & Samowitz, P. (1995). Inclusionary standards for determining sexual consent for individuals with developmental disabilities. Mental Retardation, 4, 264-268.

Davies, C., Dubie, M. (2012). Intimate Relationships  & and Sexual Health: A Curriculum for Teaching Adolescents/Adults with High Functioning Autism Spectrum Disorders and Other Social Challenges.

Griffiths, D. (1999) Sexuality and developmental disabilities: Mythconceptions and facts. In I. Brown and M. Percy, (Eds.). Developmental Disabilities in Ontario (pp. 443-451). Toronto: Front Porch Publishing.

Griffiths, D.M., Richards, D. , Fedoroff, P., & Watson, S.L. (Eds.) 2002. Ethical dilemmas: Sexuality and developmental disabilities.  NADD Press: Kingston, NY

Hanault, I. (2006). Asperger’s Syndrome and Sexuality: from Adolescence through Adulthood. (information and lessons for students on the less cognitively impaired end of the spectrum)

McLaughlin, K., Topper, K., & Lindert, J. (2010). Sexuality Education for Adults with Developmental Disabilities, Second Edition. (structured group model) Schwier, K.M., & Hingsberger, D. (2000). Sexuality: Your sons and daughters with intellectual disabilities. Baltimore: Paul H. Brookes Publishing

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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 disorders, 48(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 practice, 9(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

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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 disorders, 48(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 practice, 9(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