Sharing and Cooperation

by Dana Reinecke, PhD, BCBA-D

Sharing and cooperative play are among the most difficult skills for children to learn, whether or not they have a diagnosed disability. Why is sharing so hard? Because it necessarily involves giving something up, and usually it’s something highly preferred that is being forfeited. Cooperative play is similarly challenging because there’s often an element of compromise required. Play isn’t cooperative if one partner is getting his or her way the whole time; what makes it cooperative is the give and take. Taking is usually easier for some children than giving, and most children struggle when asked to share their toys or their parents’ attention, but there are ways to make it easier to learn these important social skills.

First, most simply, reinforce sharing and cooperation as you would reinforce any behavior that you want to see more of. Often when a child is asked to share or to compromise, the immediate and only consequence for that behavior is losing something that he or she was enjoying. This is not going to be effective for increasing sharing and cooperating in the long run, but we can add reinforcers that make it more motivating to engage in these responses again in the future. If a child shares his toys and receives lavish praise and maybe access to even better toys as a reward, he may be more likely to want to share in the future. Similarly, being willing to take turns or let someone else “go first” in a game might be more likely to happen in the future if that behavior is followed by some other reinforcer like getting an extra turn or the option of picking the game next time.

Second, approach sharing and cooperation as skills to be built up gradually. This might mean stacking the deck for success initially. Sharing and cooperation can be easier to teach when the target peers are likely to be cooperative and patient. Both areas of social skills may be modeled from peers, perhaps slightly older children, who are willing to demonstrate how to share and cooperate. Peers who are willing to take “short turns” and quickly return shared items, or to accept small concessions at first, are also going to be better partners for the learner who is only just developing these social skills, rather than peers who might be trying to learn the same lessons at the same time.
It can also be a lot easier to encourage sharing and cooperation if the games and activities where they are being practiced are not competitive. It may be harder to recruit cooperation or sharing when there is a clear “loser” and “winner” as an outcome, resulting in extra motivation to do the opposite of sharing and cooperating. Poker players don’t cooperate or share with each other, because they want to win. But, sharing and cooperating are less costly and in fact often enjoyable when applied in creative, productive situations. Having children practice cooperation and sharing when doing a craft together, for example, may be more effective than during a competitive activity.

Finally, don’t jump to complex social skills like sharing and cooperating until the child has the basic skills in place for the target activities. It would be a lot to expect someone to learn how to do something else while also learning to share and cooperate. To return to the idea of working on sharing and cooperating during a craft activity, make sure that craft is something that isn’t entirely new to the learner and that he or she has the basic skills to do the activity. This will take some of the pressure off and make sure that the focus of learning can be on the more complex social skills.


About The Author 

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

Ethics Part Four: Considerations On Punishment

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

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

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

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

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

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


WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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

Reaching Up! Setting Goals that are Realistic, Functional, and Meaningful

Happy New Year!  Many people are inspired by the start of the new year to set goals for themselves.  This is also an ideal time for parents to think about their goals for their children.  In setting goals for a child with a disability, there are a few important considerations that will improve the likelihood of the child’s success, as well as the parent’s satisfaction.

It’s usually a good idea to start with big picture goals, and then narrow them down.  You might start by asking yourself what your ultimate goal for your child is, and then where you would like to see him or her in 5 years.  Then, what would you like to be accomplished in this coming year? 

Let’s say your big picture goal is for your son to have a happy social life.  Your 5-year goal might then be for him to have at least 3 friends that he sees on a regular basis.  Your goal for this year might be to get him involved in an afterschool club on a regular basis. 

To take another example, your big picture goal might be for your daughter to communicate effectively with other people.  Your 5-year goal might be for her to have conversational exchanges with other people in the absence of prompts or augmentative communication.  And your goal for this year might be for her to ask for what she wants when she wants it (to “mand” for desired objects).

Starting with the big picture goal and thinking about the 5-year goal can help parents to maintain their focus.  If you start with small goals and build up, you might find yourself building in the wrong direction.  Most importantly, keeping the big picture and 5-year goals in mind help to keep your more immediate goals functional and meaningful.  When time and resources are precious, you want to make sure that you use them only to address goals that are going to help your child to attain his or her best, most important possible outcomes.

A second consideration in setting year-long goals is how realistic they are.  No one knows your child better than you, as his or her parent, but even parents can have difficulty gauging just where their child may wind up after a year.  Many factors can impact the success of any goal, including the interventions available and other, unexpected barriers or supports that may arise.  It can be helpful to break year-long goals down even further into smaller steps, which will be easier to predict and monitor. 

So, for the son who you want to see be more social, consider breaking the goal of joining an afterschool club down into its parts, each of which will be easier and faster for him to accomplish than the whole:  investigate the clubs that are available, discuss his top two choices with a guidance counselor, attend the first meeting, etc.  Each of these smaller goals can be measured and celebrated, helping to keep momentum and motivation towards the bigger year-long and further aspirations.  Similarly, the daughter who is working on communication can achieve smaller goals by learning to mand using prompts as earlier goals, and then continuing to mand independently as prompts are faded. 

Finally, each of the smaller goals set for the year should be measured so that progress can be tracked.  Seeing progress is not only motivating and exciting, but can help to guide when to advance to the next set of goals.  Measurement is also important for identifying when progress is not happening as quickly as desired, so that the supports and strategies in place can be updated for better success.


About The Author

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

Are all BCBAs robots, or just mine?

This piece originally appeared on bsci21.org.

“We recently hired a behavior analyst to work with our 4 year old son. She seems like a robot! Are all BCBAs so ‘professional’ and focused on data? Should I find someone else who can be more relaxed and friendly? Does this person exist? What’s the deal with BCBAs?“

Well, is your behavior analyst Vicki from the 80s sitcom, ‘Small Wonder’? If yes, then she is a robot. If not, then let’s look at this a little more closely. You aren’t the first person to think a BCBA (Board Certified Behavior Analyst) is a little too professional and data obsessed.  And you likely won’t be the last.

Just so you know it’s not simply my own opinions here, I’ve sought some input from some stellar BCBAs I happen to know. 

Behavior analysts hold ourselves to a higher code of ethics than a lot of other professions. We follow the Behavior Analyst Certification Board Ethics Code.  It’s 24 pages long. We’re serious about ethics around here. There are multiple sections in this code regarding professional relationships and cautions us against multiple relationships, conflicts of interest, and exploitative relationships. What does this mean? That to some extent a BCBA HAS to be too professional.

Becoming besties with our clients isn’t allowed. That would become a conflict of interest and your new bestie would have to drop your services and refer you to someone else.

Another robotic attribute of BCBAs- we love data. We live for data. All programming should come directly from data. All discussions of your child’s progress should be based on data. I kind of sound like a robot just typing this. Data. Data. Data.

“The key for anyone new to ABA is to understand that it’s a science. All of our decision making is based on data collection, analyzing that data, and then using it to help us decide what steps to take next.” – Kristin Fida, BCBA.

“We count on data to indicate to us whether what we are doing is working or if we could be doing something differently to increase your child’s success. Data provides immediate feedback ensuring precious time is not wasted. While our obsession with data may seem excessive, we put our heart and soul in to what we do and with each individual data point we are assured that your child is successful and achieving their goals!” – Brittany Keener, BCBA.

And finally, BCBAs can be too professional and robotic by not using user-friendly language describing the principles of ABA. We can forget that not everyone uses words like antecedent, mand, tact, reinforcement contingency, and etcetera. Behavior analysts who throw around these big words and don’t take the time to make sure they make sense to you probably do sound like robots.

But even with all these reasons listing why BCBAs are kind of like robots- here’s the truth of the matter. We love our jobs. We love behavior analysis. We love our clients. We love to help others make progress toward goals, reduce problem behaviors, and teach new behaviors and skills.

We cry over setbacks and celebrate every small step of progress with our clients. We jump for joy when a client spontaneously engages in a behavior we’ve been working on for eons. We lay awake at night thinking about programming, about how to help our clients make progress faster. We worry about our clients, we care about our clients, we do everything we can to make effective behavior change in our clients’ lives.

We are not robots. As a group, that is. There may be a few behavior analysts out there who don’t feel this way. Find one of the many who do; they (we) are the majority.  Find the BCBA who lives for positive behavior change. Work with a team that plans for your child’s future, that helps your child be more independent, that uses your child’s interests to promote learning.  Be an active part of that team- communication and collaboration between you and the behavior analyst are the keys to serious progress!

Behavior analysts are not robots.  We may like data a lot (bordering on obsession), but we use it to help people in real ways.

“Essentially, don’t give up. Talk to your BCBA and communicate your concerns and ask about what approach she is using and why she feels it is an appropriate intervention. The data should show that your son is making progress in goals that you want to increase while decreasing any maladaptive behaviors.  Just like with teachers, BCBAs all have a different style. If the style is working, don’t change it right away! Communication and being open with your BCBA is best!”- Jessi French, BCBA

“Developing positive relationships coupled with data driven decision making for our interventions is a sure recipe for success and progress with any client.”- Kristin Fida, BCBA

Talk to your BCBA. Tell them your concerns, listen to their explanations for why programming is done a certain way. If they use jargon- tell them you aren’t familiar with all the ABA terms. The more collaboration between you and your BCBA- the better for your son!


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

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

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

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

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

Setting Up the Classroom to Optimize Learning Opportunities and Effective Instruction

This month’s ASAT feature comes to us from Melissa Taylor, BCaBA. 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!

I recently accepted my first teaching position.  It’s a new classroom for the district serving students with autism. I have lots of materials, but nothing is organized or set up in my classroom. What are some tips to set up and organize the classroom to optimize learning opportunities and effective instruction?

Congratulations on your first teaching position! This is a common question for new teachers. When we talk about classroom organization, there are several things to take into account. Good classroom organization effectively makes use of space and barriers, has accessible materials for instruction and data collection, and facilitates efficient time management. It is critical that when you set up your classroom, you review the needs of your individual students as well as make sure to address the core characteristics of autism. You probably already know that many of your students will present with deficits in social interactions and communication, including challenges with requesting items from adults and peers. It will be important to create an environment that makes it necessary for students to interact frequently with other people to increase communication opportunities.  Once the environment is conducive to optimizing instruction, the instructors can implement effect behavioral strategies to teach desired behaviors.

Organizing the Space

Seating. When organizing a space, we want to make sure that the seating arrangement will allow students to access the materials needed for activities and respond accurately to instruction. For younger students, make sure the chairs allow their feet to touch the floor. Likewise, older students should be able to sit up straight with feet on the floor and legs at approximately 90-degree angle. Try to arrange seating so that you have space for group, as well as individual sessions. Also, allow enough room that additional support staff can sit behind students to make prompting less intrusive (e.g., sitting behind student and using physical guidance to help them learn the expected motor responses during the, “Wheels on the Bus” song).

Pathways for transitions. The furniture should be set up in a way that enables smooth transitions from one area to another without traffic jams. Walking between areas will be easier if there are not large dividers or barriers that slow down transitioning. Having open spaces and clear pathways between defined areas could also allow instructors to move quickly to different areas of the classroom if there is an episode of problem behavior or an unexpected opportunity to support a social interaction.

Defining areas. Some instructors find that using dividers helps clearly separate sections of the classroom. Keep in mind that every area should be open enough that the classroom teacher is able to see every student and classroom assistant. This will allow the teacher opportunities to provide immediate feedback to staff on interactions with students and to offer frequent student praise.  Try to avoid tall dividers that make it impossible to see into the other areas and dividers that are easily knocked over. Shelving units, desks, carpets, and tables can create more natural space dividers that can help define the areas. Keep in mind the function and purpose of each classroom area, and make sure that the instructional materials needed are in the area and replaced as needed. For example, if students are going to be required to request items during circle time, those items should be easy for the instructor to reach during group rather than requiring the instructor to get up, leave the group and look in a cabinet for items.  

Putting away preferred items. Children, including those with autism, are often good at finding and gaining access to the things they like without the help of other people. By keeping items out of reach, in clear containers that are difficult to open, and on high shelves, you can create new requesting opportunities and make communication with adults more valuable to students. Resalable plastic storage bags, totes, bins, shelving units, and aprons with pockets may all be useful to make it more likely that the students will need to request help from others to access the items they want or need. If the student already has a valuable item, you have lost an opportunity for communication.  By restricting access to valuable items, teachers can prompt requests for specific items and deliver items to students. Furthermore, when delivering the item, the teacher becomes more valuable to the student, who learns the significance of communicating. When these types of natural communication trials with preferred items occur in areas where instruction will occur, it becomes more likely that students will approach instructors and instructional areas. One important consideration with using such materials that in some cases, direct visibility to highly preferred items can be distracting to students or result in attempts to retrieve items outside of appropriate or scheduled times. In such instances, evaluate the situation and determine whether moving the student’s seat so that it is not facing those items or moving the items themselves will address the issue.

Organizing Materials

Materials for data collection. In preparing materials for instruction, we want to make sure that all instructors have easy access to necessary materials such as data collection tools and sheets. These items should be able to be easily accessed at any point of the day, so that instructors are more likely to capture all opportunities of the behaviors they are tracking. When data are recorded immediately following student behavior it is more likely to be accurate. Clipboards that have pockets attached to them are good for storing writing utensils, timers and additional data sheets. Student item lists, teaching stimuli, and data sheets can be kept in a cart with drawers to make it easily accessible during teaching. When collecting any type of data that require instructors to count the number of occurrences of a behavior, instructors can use clickers attached to their clothing with carabiner clips for convenience. Blank student specific datasheets can be carried with the student on clipboards, kept in a drawer on a cart, or hung on bulletin boards in centers where instructional activities occur.

Materials for instruction. Pencil cases or small craft boxes help organize small materials such as pieces of edibles, small toys, pencils, highlighters, picture cards, visual schedules or index cards for instruction.  For larger instructional items such as toys needed for teaching imitation skills, items needed for simply following direction tasks, or items needed to teach daily living skills, boxes, rolling carts with larger drawers, or labeled shelves can be used to organize materials by student or goal areas.

Consider posting wall cues, table/desk cue cards, or other reminders in places where staff will easily see them. These cues can be helpful to guide instruction without the need to flip through pages in consultation notes or program books to reference procedures. Types of items to post include specific teaching protocols and prompt hierarchies, reinforcement schedule reminders, behavior management strategies, toilet training schedules, reminders of how to teach play skills and student to student requesting, or other items that you want to generalize from one classroom area to another. Cue cards, wall cues, or student data sheets with specific targets listed can also guide instructor presentation during less structured teaching opportunities.  For example, if the student has been working on labeling the picture of gloves, and during circle time the teacher is dressing a weather bear, the instructor can ask that student to label the weather bear’s gloves. Additional targets to be posted for staff could include specific peer-to-peer requests or interactions (e.g., give item to peer, accept item from peer), specific motor skills (e.g., copying a line, opening a container), self-help skills (e.g., putting on shoes, washing hands), and other activities.  This allows for easy implementation of strategies such as natural environment teaching and incidental teaching.  Another point is to consider limiting other “wall clutter” that often serves as highly distracting stimuli to students. When possible, keep to salient items such as a classroom schedule, current student work or points of study (e.g., pictures of alphabet) but don’t feel the need to cover every available space with something!

Classroom Schedule

Time is valuable, and students with autism do not have time to waste. It is important to make the most of your day by having many opportunities to practice all targeted skills. Having a classroom schedule that allows for enough instructional time to make significant progress is critical. When creating a classroom schedule, make sure to address the who, when, what, and where questions. In other words, it should be easy to see who is working with a student at any given time as well as what skill they are working on and where they are working on that skill (e.g., red table, art table, hallway, etc.). Assigning student names to specific instructors can save valuable time during an emergency situation (student elopes, fire emergency).  Avoid unnecessary large chunks of non-academic or unstructured times. What each student will be working on should vary based on assessments conducted in the classroom. Instructors should consider posting the schedule on a wall, centrally located and large enough that all team members can see it. However, if you have many students and paraeducators going in and out of the room, you may consider having a master calendar but printing out individual copies for each staff member.  When you have a master schedule that is easy to change when students and staff are absent will cut down on unnecessary talk about who is with specific students and what they should be working on. Additionally, color-coding by students or staff will allow for staff member or administrators to easily follow from across the room or with a quick glance. Staff should be assigned to students at all time.  If a student is engaged in independent work, having a staff member still assigned to that child will help everyone know who is tracking data or responsible if an emergency occurs. 

If you take all of these suggestions into consideration when you begin planning your classroom, you will be well on your journey to make a big difference in the outcomes of your students. An organized classroom allows teachers to focus on effective instructional strategies and behavior management strategies that are individualized to each child and not waste valuable time locating materials, guiding staff behaviors, and planning groups.  We wish you well in your new teaching position and in the years to come.


About The Author

Melissa Taylor, BCaBA is a Consultant on the Autism Initiative for the Pennsylvania Training and Technical Assistance Network. Her current position focuses on training educators on the principles and implementation of behavior analysis within classroom settings. In addition, Melissa provides in-home behavior consultation to children and adults with autism. Currently, she serves as the Sponsorship Coordinator for the Association for Science in Autism Treatment.   

 

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

This month’s ASAT feature comes to us from Dr. Frank Cicero, Ph.D., BCBA, LBA. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

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

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

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

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

Please use the following format to cite this article:

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


About The Author

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

Build and Generalize: Strategies for Systematic Language Instruction

This week’s blog comes to us from Rosemarie Griffin, MA, CCC/SLP BCBA, creator of the Action Builder Cards! Head to our site to check out some of Rosemarie’s favorite supports for language instruction! 

 

Helping students with autism and other communication disorders increase their expressive language skills can be overwhelming. It can be difficult to know what targets are the most important to start with. Every situation is so very individualized but following a general framework has made these decisions easier for me and has helped my students make progress in this area.

If we were to focus on the skill of labeling, for example, I would start with labeling items, people or places that are preferred for the student. If you have a student who really loves bubbles, chips and basketball – these would make wonderful first targets. Working on labeling can be difficult for students, so we want to make sure we make the programming fun and engaging. We should also include a plan for generalization at the start of this programming. Showing the student multiple pictures of bubbles, chips and basketball will allow for us to plan for the generalization of materials. This helps to build a bridge between the therapy environment and novel exemplars they may see in the natural environment.

When we start to work on labeling actions, the same framework can be implemented. Starting with preferred actions when available is a great idea. If the student is more motivated by the action or seeing the action, this may help to keep the student engaged in the task of labeling. We could choose targets that are related to the nouns chosen above: blowing, eating and playing. If the student enjoys these actions we could work on engaging in these actions and labeling them as they take place in real time, or we could show them pictures of these actions taking place.

When a student is able to label a variety of nouns and actions, it is time to combine these into action object or agent action phrases. To keep language instruction systematic, we start by combining previously mastered nouns and actions. Using the example from before, we would show the student pictures of the above action and nouns combined: blowing bubbles, eating chips and playing basketball. After the student has worked on creating these phrases with his/her words, pictures or device we can work on multiple exemplars to help plan for generalization. These could include blowing candles, blowing a kiss, eating pizza, eating an apple, playing soccer, playing tennis, etc.

Using a framework can help us plan for systematic language instruction for learners. This framework can help our learners have fun while learning, increase their expressive language, and help them generalize skills along the way.


About the Author

Rosemarie Griffin, MA, CCC/SLP BCBA, is an ASHA certified Speech-Language Pathologist and a Board Certified Behavior Analyst. She divides her time between a public school and a private school for students with autism in Ohio. She’s presented at the national, state and local level about systematic and collaborative language instruction for students with autism. Her professional mission is to help all students expand their communication step by step. She can be reached at www.abaspeech.org, on Facebook or Instagram. 

Ten tips to prevent autism-related shopping meltdowns

This week’s blog comes to us from Lucia Murillo, Autism Speaks’ assistant director of education research. and was originally posted on Autism Speaks as part of their Got Questions? series.

“How can I help my child avoid meltdowns at the store? Everything is okay with him until he gets into the store.”

Thanks so much for your question. You are far from alone in this challenge. For good reason, outings such as shopping can be particularly challenging for families who have children with autism.

The abundance of sights, sounds, crowds and other sensory stimuli can easily trigger challenging behaviors that seem near-impossible to handle in a public place. Unfortunately, this prompts many families to avoid taking children with autism to public places unless absolutely necessary. This, in turn, can contribute to isolation for the whole family.

So I’m so pleased for this opportunity to share a few meltdown-prevention strategies that, when practiced ahead of time, can help promote a calmer shopping experience.

But when I say “ahead of time,” I don’t mean right before you head to the store. These strategies involve time and patience. Ideally, you’ll also have the guidance of a behavioral therapist skilled in working with children who have autism.

#1 Give fair warning
Research and experience tells us that “knowing what to expect” helps children with autism cope with potentially stressful situations. This means resisting the understandable temptation to try to sneak a quick shopping trip into your son’s day. Whenever possible, I strongly recommend letting him know ahead of time where he is going and what he can expect.

#2 Take a virtual tour 
You and your son may be able to take a virtual tour of the store on the store’s website. If that’s not available, consider visiting the store on your own to take pictures and/or a cell-phone video.

This approach is particularly useful for preparing your child to accompany you to a new store. Sit down and look at the pictures and/or watch the video together so your son can become familiar with the new environment.

You might even take a virtual drive to the store using Google Maps.

#3 Practice and build tolerance

When you feel your child is ready to make an actual trip to the store, I suggest starting with a short trip and small purchase. Reward any degree of success with praise and perhaps a small prize or favorite activity.

As you sense your child is getting more comfortable with the short trips, gradually increase the length of time that the two of you are in the store. At this point, try to incorporate these trips into a regular routine – but always with fair warning – so your child can learn to expect them.

Repetition is important. And occasional reversals are likely. So don’t give up!

#4 Prepare a schedule 
Many children – and adults – on the autism spectrum greatly benefit from having a clear schedule for the day ahead. Visual schedules are particularly helpful, and the Autism Speaks visual supports guide can help you make one.

A morning review of the day’s activities can help your child gain a sense of where he’s going and what he’ll be doing. So on the morning of a shopping trip – or even the night before – sit down with your child as you add a shopping trip to the schedule. Or invite him to add it at the specified time.

It can help to schedule one of your child’s favorite activities following the shopping trip and together enter it on the day’s schedule. This can be as simple as time to play with a favorite toy or game with you.

#5 Remember: Rest is best
It can greatly increase your son’s chances of success if you make sure he’s well rested before the outing. In fact, the same goes for you! Being tired tends to shorten everyone’s tolerance.

#6 Identify triggers 
You know your child best. Are there certain sights, sounds or situations that tend to produce to a meltdown? You might try visiting the store without your son with an eye for such triggers. For some people with autism, fluorescent lighting is a trigger. Others are bothered by the loud hum of air conditioners or the blare of clerks calling to each other over the intercom.

#7 Provide personalized “armor”
Identifying triggers enables you to provide personalized support. For example, if loud sounds provoke anxiety in your son, he might be helped by headphones. If overhead lighting is a problem, he might be willing to wear sunglasses or a baseball cap. Many parents find these strategies make a world of difference for their kids.

#8 Getting ready to shop …
Before leaving the house, consider prompting your son with a finer breakdown of what you’re going to do on this shopping trip. For instance:

* We will drive to the store.

* We will park in the lot.

* We will walk into the store.

* We will find the items we want.

* We will pay for them at the register.

* We will walk back to the car.

* We will drive home.

* And we will play a game of Uno.

If, like many people with autism, your child responds best to visual information, try making a personalized story with pictures about the above steps. Autism Speaks has partnered with the University of Washington READI Lab to provide a series of personalized story templates that include Going to the Store. Learn more and download them for free here.

#9 Have a signal
Make sure there’s a way for your child to communicate to you when he begins to feel overwhelmed. We know that children who have autism vary widely in their ability to communicate. So one child might be able to simply say “I need a break.” Another might need to learn a sign – such as hands over ears. Picture communication systems are yet another option. (See the Autism Speaks visual supports guide mentioned above.)

Even if you child can’t reliably communicate when he’s getting overwhelmed, there are often behavioral cues that you can learn to recognize in time to leave the store or otherwise provide support before the meltdown.

#10 Bring “cool down” items
Meltdowns happen. Sometimes, having a favorite comfort item on hand can help ease the crisis.Despite all the best plans, meltdowns happen. You can ease the crisis by bringing an object or activity that you know will soothe. This could be a favorite toy or blanket. It could be a special little song.

All these strategies have the same goal: To provide optimal conditions for your child when taking him into an overly stimulating environment. By preparing ahead of time, you can increase the chances that the shopping trip – or any outing – will be more tolerable for your child and entire family.

 

Easy Data Collection for the Classroom

This week we have an introduction to our newest book from one of the authors, Sam Blanco PHD, LBA, BCBA. ABA Tools of the Trade is available now!

 

From the beginning of my career, I have loved data collection. Not only does it help me track what interventions are working and how quickly my students are learning, it also provides excellent structure and organization of what needs to be done on a daily basis. Much of this love of data collection was influenced by my colleague Val Demiri. While Val and I both looked at data as a way to make our lives easier, for many of our colleagues, data appeared to be more of an obstacle than a useful tool. So we set out to change that.

 

We’re both so thrilled about the release of ABA Tools of the Trade: Easy Data Collection for the Classroom. Our goal is to make data collection easier, more useful, and possible considering the many tasks a teacher is already doing on a daily basis in their classroom. Here are few things we’re really excited to have in the book:

 

  • An overview of some of our favorite tools for data collection, including why we love them and when they might be useful for you

 

  • An easy-to-use guide based on the specific behavior challenges you are currently facing, with suggestions for data collection and recommended readings

 

  • A task analysis of the data collection process that breaks down each step for pre-data collection phase, data collection phase, and post-data collection phase

 

  • A wealth of strategies to use to address problem behavior before they occur

 

  • An entire section devoted to BCBA Supervision that not only aligns with Task List 5 but also contains lesson plans and rubrics for assessing supervisees

 

We hope that by making data collection methods more accessible, we can motivate you to appreciate tools for data collection as much as we do!


WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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

Teaching Safety Skills to Adolescents

SafetyWebslide11.png

This month’s ASAT feature comes to us from Shannon Wilkinson, M.ADS, BCBA. 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!

I am a Special Education Teacher at the high school level. A young man with autism is transitioning to my caseload from our middle school. Although there is much talk about “safety skills” amongst my colleagues, I would like to target this skill area effectively and comprehensively. Any suggestions?

Safety skills are important for learners with autism and should be addressed comprehensively over the course of the learner’s schooling and across the lifespan. The type of safety skills taught at any given time will vary depending on the learner’s age and functioning level. For example, younger learners can be taught to walk appropriately with an adult so they do not run into the street while older learners can be taught to cross the street independently. Regardless of age, safety skills should be included on the learner’s Individualized Education Plan (IEP) and reflect the goals of the individual and their families. In addition, data collection on the targeted skills is essential to ensure the learner is acquiring the skill and that the skill maintains over time.

An effective method to teach safety skills is Behavioral Skills Training (BST). BST is a comprehensive teaching method which includes delivering instructions to the learner, modeling the correct response, rehearsing the correct response in both pretend and more naturalistic environments, and delivering feedback to the participant regarding their actions. If the learner is having difficulty acquiring the skill, an additional teaching component known as In Situ Training (IST) can be added. In IST, the trainer provides immediate and direct training in the learner’s environment and allows for additional practice of the skill. Within the literature, BST and IST have been shown to be effective for teaching a wide range of safety skills such as abduction prevention skills (Beck & Miltenberger, 2009; Gunby, Carr & LeBlanc, 2010; Johnson et al., 2006) and how to seek assistance when lost (Pan-Skadden et al., 2009).

There are a number of safety skills that that could be targeted for an adolescent with autism. Targeting those that also increase independence should be a priority if appropriate, based on the adolescent’s level of functioning. Teaching him to use a cell phone is one such skill, as it can be used to improve his safety and overall independence (Hoch, Taylor, & Rodriguez, 2009; Taber, Alberto, Seltzer & Hughes, 2003). First, you will want to ensure the learner has the basic skills associated with cell phone use including: answering the phone, following directions on the phone, answering questions on the phone and negotiating all of the mechanisms associated with initiating a call. Once these basic skills are mastered, specific safety skills involving the phone can be taught. For example, a learner can be taught to answer his cell phone and provide a description of his location in the event he is separated from his caregiver or group. He could also be taught to follow instructions to seek assistance from a community member if lost (Hoch, Taylor, & Rodriguez, 2009; Taylor, Hughes, Richard, Hoch & Coello, 2004) or to call a trusted adult.

A major safety concern for most parents is abduction. Although abduction may be more likely with a young child, adolescents with autism should still be taught to identify “safe people” such as police officers, fire fighters and security guards, in the community. Many learners with autism are not able to distinguish safe or familiar people from unsafe or unfamiliar people. As a result, they cannot determine whom they can speak to or make a request for help. Learners can first learn to identify safe people, such as those noted above, in pictures. Once they can reliably do so, they should be taught what to do if a stranger approaches them. Multiple scenarios should be practiced so the learner becomes familiar with potential lures such as a stranger offering candy to get in a car or telling the student that his mom told the stranger to pick him up. Behavioral skills training and In Situ Training may be beneficial in teaching these skills (Beck & Miltenberger, 2009; Gunby, Carr & Leblanc, 2010; Mechling, 2008). In this scenario, the learner would first be provided instructions on what to do in each stranger situation. The learner should then model the correct response. If he does so successfully, a mock scenario can then be set up whereby a confederate approaches the learner and the learner has the opportunity to demonstrate the skills he has learned (i.e., do not go with the stranger, run away and tell an adult). If the learner performs the correct actions, he receives praise. If the learner does not demonstrate the correct response, the instructor immediately provides him with additional training.

Additional safety skills to target could include:

  • navigating and using community resources appropriately and independently;
  • exiting a car and crossing a parking lot or busy street safely;
  • responding appropriately in emergency situations such as a fire or earthquake;
  • addressing potential household hazards such as responding safely to cleaning chemicals, using appliances properly, or answering the doorbell when it rings;
  • identifying a need to dial 911;
  • using basic first aid procedures;
  • interacting appropriately with pets and other animals;
  • using the internet safely; and
  • managing teasing and bullying

 

There are many others that can be addressed based on the learner, his individualized goals and his future educational, vocational and residential placements. Involving the learner’s parents in the planning process will help you to identify which safety skills are most important and relevant for the individual to learn, particularly if the parents have specific concerns or if there has been a history of unsafe behavior. Finally, as you go through this program planning process, it’s helpful to keep in mind that the essential goal in teaching these skills is to promote greater independence by ensuring the learner has the tools he needs to be safe and to protect himself in his environment.

References

Beck, K. V., & Miltenberger, R. (2009). Evaluation of a commercially available program and in situ training by parents to teach abduction-prevention skills to children. Journal of Applied Behavior Analysis, 42, 761-772.

Gunby, K. V., Carr, J. E., & Leblanc, L. A. (2010). Teaching abduction-prevention skills to children with autism. Journal of Applied Behavior Analysis, 43, 107-112.

Hoch, H., Taylor, B. A., & Rodriguez, A. (2009). Teaching teenagers with autism to answer cell phones and seek assistance when lost. Behavior Analysis in Practice, 2, 14-20.

Mechling, L. C. (2008). Thirty year review of safety skill instruction for persons with intellectual disabilities. Education and Training in Developmental Disabilities, 43, 311-323.

Pan-Skadden, J., Wilder, D. A., Sparling, J., Stevenson, E., Donaldson, J., Postma, N., et al.(2009). The use of behavioral skills training and in-situ training to teach children to solicit help when lost: A preliminary investigation. Education and Treatment of Children, 32, 359-370.

Taber, T. A., Alberto, P. A., Seltzer, A., & Hughes, M. (2003). Obtaining assistance when lost in the community using cell phones. Research and Practice for Persons with Severe Disabilities, 28, 105-116.

Taylor, B. A., Hughes, C. E., Richard, E., Hoch, H., & Rodriquez-Coello, A. (2004). Teaching teenagers with autism to seek assistance when lost. Journal of Applied Behavior Analysis, 37, 79-82.


About The Author 

Shannon Wilkinson, M.ADS, BCBA is a Supervising Therapist with TRE-ADD program at Surrey Place Centre in Toronto, which is a comprehensive day treatment program that provides services for children and youth with autism and related developmental disorders and their families. Shannon has worked in the field of autism for 13 years, starting as an Instructor Therapist. She is particularly passionate about working with adolescents and has taught many vocational and life skills over the years. Shannon has a Masters in Applied Disability Studies from Brock University and is a Board Certified Behaviour Analyst.