Journal Club #4: RBTs and Interventions

One of the tenets of ABA is to provide evidence-based practice. The best way to help us do this is to keep up with the literature! Each month, Sam Blanco, Ph.D., LBA, BCBA will select one journal article and provide discussion questions for professionals working within the ABA community. The following week another ABA professional will respond to Sam’s questions and provide further insight and a different perspective on the piece.

In my daily work, I supervise Registered Behavior Technicians (RBTs) who are providing the direct care to my clients with autism. The RBT designation is only a few years old, and there are concerns about the training and maintenance of skills for these employees. However, another concern is the low number of people available to provide frontline services for high number of individuals who require it.

The work that RBTs do is important and necessary. It’s important for our field, as well as individual organizations and BCBAs to identify potential problems with the current model of providing treatment, and work to continuously improve upon the model. One way to start the conversation within your own organization is to read the following article and identify ways in which you can address the concerns it brings to light.

Leaf, J. B., Leaf, R., McEachin, J., Taubman, M., Smith, T., Harris, S. L., … & Volkmar, F. R. (2017). Concerns about the Registered Behavior Technician™ in relation to effective autism intervention. Behavior Analysis in Practice10(2), 154-163.

  • The authors discuss the evolution of the BACB and concerns with certifying behavior analysts prior to the advent of RBTs. What did you think of the concerns identified here? Are these still concerns we have about BCBAs? How are they similar or different than concerns about RBTs?
  • How does the current training of RBTs compare to the training of behavior technicians in early behavior analytic studies?
  • Look at the RBT task list. The authors argue that the current amount of training does not meet standards set forth by research on staff training. How can BCBAs and organizations hiring RBTs support their mastery of the skills on this list?
  • Have you identified concerns with the current model (BCBAs supervising RBTs who provide direct care) that were not mentioned in the article? If so, how have you worked to address those concerns?
  • Discuss the unintended consequences described in the article. Have you seen these consequences in your current setting?
  • Many of the recommendations by the authors include changes the BACB should enact as well as research that should be conducted. How are you able to take a role in these types of recommendations?

WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

The founder of ABA Journal Club, 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.

Ask A BCBA: I’m a Brand-New BCBA! What Should I Expect??

Ask A BCBA is a new series where we take your questions to our favorite ABA professionals. Do you have a question for a BCBA? Email us at info@difflearn.com and you could be featured in a future post!

Congratulations on passing your BACB exam!  Not only did you pass this notoriously difficult test, but you completed hundreds of hours of graduate coursework and supervised experience to get to this point.  You had to have been dedicated and hard-working.  You have demonstrated your knowledge to your supervisor(s) and on a written exam.  You should feel proud!

You are now entrusted with the tools to change behavior, shape new skills, and make lives better.  Make no mistake, this is a big responsibility.  As a BCBA, you are expected to be proficient in all of the skills of a behavior analyst (as per the BACB task list) and to abide by the BACB Code of Ethics.  Part of the ethical code is that there is no excuse for not knowing the ethical code.

Some new BCBAs feel overwhelmed by their new responsibilities.  This is completely normal, and not a bad thing if it leads you to approach your new position with respect and caution.  Here are some suggestions for easing this transition and building your confidence.

  • Maintain contact with your supervisor or another mentorMost supervisors are happy to continue to have some continued less-structured contact to provide guidance.  Other seasoned BCBAs in your community might also be open to providing some informal mentoring.
  • Join a community of other BCBAs.  There are so many options for how to do this.  Joining your state ABA association is an excellent idea if you haven’t done so already.  If you are a social media person, there are many Facebook groups for BCBAs.  Other BCBAs at your job may want to connect, too.
  • Keep your resources handy.  Yes, I realize that you probably never want to see “The White Book” again – at least for a while – but don’t be afraid to look something up if you’re not sure.  Although you passed the exam, you may still need a refresher on less-familiar concepts when they come up in your work.
  • Start collecting CEUs!  Yes, now!  You need to document at least 32 CEUs every 2 years, so don’t fall behind.
  • Subscribe to journalsJABA is not expensive, even when you are no longer a student, and you may not have access to your university library anymore.

Some new BCBAs feel overwhelmed by their new responsibilities.  This is completely normal, and not a bad thing if it leads you to approach your new position with respect and caution.  Here are some suggestions for easing this transition and building your confidence.

Remember that learning is a lifelong journey.  Even though you have made an amazing accomplishment, you aren’t expected to know everything.  Take the energy and enthusiasm that got you to this point, and use them to continue to develop your skills and your network.  As B.F. Skinner wrote in Walden Two, “It is not a question of starting.  The start has been made.  It’s a question of what’s to be done from now on.”  The hard part is over, so go ahead and make the most of your accomplishment!


About The Author

Dana Reinecke, Ph.D., BCBA-D is a doctoral level Board-Certified Behavior Analyst (BCBA-D) and a New York State Licensed Behavior Analyst (LBA).   Dana is a Core Faculty member in the Applied Behavior Analysis department at Capella University.  She is also co-owner of SupervisorABA, an online platform for BACB supervision curriculum, forms, and hours tracking.  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).

What Is Procedural Fidelity In ABA?

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

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

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

REFERENCES

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


About The Author

Sam is an ABA provider for school-aged students in Brooklyn, New York. Working in education for over 15 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 the Senior Clinical Strategist at Encore Support Services.

Leisure Skills for Adults with Autism

This month’s ASAT feature comes to us from Megan McCarron, MS, 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 BCBA working in an ABA Teaching Home. I am adept with teaching play skills to younger children but would like some guidance on assessing interests and helping young adults develop hobbies that they can pursue in an independent and meaningful manner.

This is a very important question. There is an abundance of research on how to teach leisure activities using instructional methods such as modeling, video modeling, and activity schedules, moreover, it is vital that careful thought and planning be put into selecting and individualizing leisure activities.

Typically, one’s interests are developed over time via exposure to and interaction with new and varied people, places, and activities. Exposure usually occurs over the course of life without much forethought, resulting in interests that shift and change. Unfortunately, this is often not the case for individuals with autism spectrum disorder (ASD).

There are two key deficits within the diagnostic criteria for ASD that are likely to impact individuals’ exposure to and interaction within varied leisure activities. First, persistent limitations in social communication and social interaction can hinder an individual’s ability to request access to items and activities, and/or to express one’s level of interest. Second, the presence of restricted, repetitive patterns of behavior, interests, or activities may prevent an individual from exploring novel items or activities.

Individuals’ difficulty making or expressing choice limit exposure to new and varied items and activities. Limited interests or those that are markedly different from those of same-aged peers make it that much more difficult to determine ways to expand and develop interests. As a result, careful thought and planning are required to help individuals with autism engage in meaningful leisure activities.

Finding Leisure Activities

Given that there is an unending number of items or leisure activities that could be assessed, it is important to narrow down the field to things that are likely to be of interest before conducting your assessments. A few of these approaches are as follows:

Expand upon current interests. Ask caregivers, teachers, siblings, or others who spend time with the individual to complete an interview, checklist or other type of survey. Create your own questions or use published materials such as the Reinforcer Assessment for Individual with Severe Disabilities (RAISD). Do not immediately discount unusual or idiosyncratic interests. Look to see if there are groups in the community or online that share that interest. If necessary, teach when and where it is okay to engage in preferences that may be annoying to others or are socially stigmatizing. Examples:

Select novel activities that contain components of already preferred activities. Identify common features of known preferences, and then identify novel items or activities that contain the same or similar features. Examples:

Make modifications to existing activities to incorporate the preferred feature of other preferred activities. Examples:

Pair a known interest with a compatible novel activity. Examples:

Identify shared interests. In addition to identifying activities by exploring and expanding upon current interests of the individual, it can be worthwhile to identify interests of the people the individual spends a lot of time with and activities available in the individual’s school, home, and local community. These activities will offer up the opportunity for social interaction with others.

Assessing Activities

Once potential activities are selected, assessments can be conducted to determine how preferred the activities are. While preference assessments are commonly used and talked about in terms of finding reinforcers, they are equally useful for assessing preference levels for potential leisure activities. Initially, free operant assessments are very helpful in terms of assessing potential leisure activities. These can be conducted in the natural environment or a contrived and enriched setting.

Free operant preference assessments can be conducted through direct observation by providing free access to activities without demands, time limits or requirements to use items in a predetermined manner (unless it is a safety issue). Assessments can be conducted in either a natural or contrived setting, as described below (Toner, 2014; Chazin & Ledford, 2016).

Collect data on:

  • Which items/activities the individual interacts with
  • Duration of each interaction
  • Can be helpful to note the individual’s observable signs of positive affect during interactions, such as smiles or laughter
  • If the individual interacts with an item in an unexpected or unusual manner, make note of what he or she did.

Once the free operant assessment data have been collected and ranked in order of which activities were engaged with the most (e.g., by calculating a percentage of time of the observation in which the student engaged in each activity), subsequent paired choice preference assessments or MSWO assessments could be conducted to better assess the individual’s relative preference for activities. With this information, you can make an informed choice about what activities are likely to provide “enjoyment” and thus fit the definition of leisure.

Selecting Teaching Targets for the IEP

It is important to help an individual build a repertoire of activities that can be used to fill the various functions of leisure. Therefore, the activities chosen as a focus of teaching should cover a variety of leisure situations.

  • Social Activities (any activity done with another person).
  • Individual Activity (any activity that can be done alone).
  • Health and Fitness.
  • Longer duration activities.
  • Short duration activities that can be done while waiting (looking at books, magazines, music on phone, etc.)

Some activities may be adaptable enough to be used across several leisure functions. For example, listening to music can be a social or individual activity; it can easily be paired with a variety of health and fitness activities and can be used for short or long durations.

In addition to selecting specific activities/skills for leisure, it is advisable to include an objective in a student’s IEP that targets the individual’s exposure to leisure activities. The goal of this objective would be to have the student continue to try out new activities over three to four opportunities to further expose them to new activities. During the sampling sessions, staff should collect data on duration of engagement, observable signs of affect, and any skill deficits that inhibit engagement.

Considerations for Increasing Functional Independence in Leisure
While identifying preferred activities is a major part of building a leisure repertoire, there are a whole host of skills that can increase an individual’s ability to access and engage in leisure activities as independently as possible.

Ensure the individual has an effective means of communication. An essential skill, regardless of the individual’s vocal verbal ability, is teaching an appropriate way to request access to activities, especially those that are not readily available in the current environment such as requesting to go to the mall or to a specific store (Schneiter & Devine, 2001). Equally important is the ability for an individual to appropriately decline participation and/or end an activity when the activity is not preferred.

Teach prerequisite skills. If a student shows interest in an activity but is not able to fully engage in the activity, it may be necessary to teach the individual specific prerequisite skills. Examples:

If a Sampling Leisure Activities objective has been included in the IEP, the sampling period can be used to help identify what types of prerequisite skills may need to be taught.

  • The individual may need to be taught skills related to any materials or equipment required for an activity. For example, gathering equipment / materials prior to starting the activity; caring for the equipment / materials putting equipment away when finished, and problem solving (e.g., what to do if materials are missing, broken, or need to be replenished).
  • Time management skills, such as identifying when it is time to engage in a leisure activity, selecting an activity that fits the amount of time for leisure, identifying when activities are essential components of increasing independence. Using schedules and calendars can be helpful to structure and prompt leisure activities but may require specific teaching. For example, using a calendar app on a phone can be very useful, but it may be necessary to start off with teaching the student to respond to an alert to engage in an activity and build up to having them enter information into the calendar.

Final Thoughts

Every individual has different interests, abilities, and obstacles to work through in establishing leisure skills. However, building on and expanding from high preference, high availability activities and using evidence-based assessment and teaching strategies to establish independence in leisure activities provides a strong foundation from which to start.


References

Blum-Dimaya, A., Reeve, S. A., Reeve, K. F., & Hoch, H. (2010). Teaching children with autism to play a video game using activity schedules and game-embedded simultaneous video modeling. Education & Treatment of Children, 33(3), 351-370.

Carlile, K. A., Reeve, S. A., Reeve, K. F., & DeBar, R. M. (2013). Using activity schedules on the iPod touch to teach leisure skills to children with autism. Education & Treatment of Children, 36(2), 33-57.

Carr, J. E., Nicolson, A. C., & Higbee, T. S. (2000). Evaluation of a brief multiple-stimulus preference assessment in a naturalistic context. Journal of Applied Behavior Analysis, 33(3), 353-357.

Chan, J. M., Lambdin, L., Van Laarhoven, T., & Johnson J. W. (2013). Teaching leisure skills to an adult with developmental disabilities using a video prompting intervention package. Education and Training in Autism and Developmental Disabilities, 48(3), 412-420.

Chazin, K. T., & Ledford, J. R. (2016). Free operant observation. In Evidence-based instructional practices for young children with autism and other disabilities. Retrieved from http://vkc.mc.vanderbilt.edu/ebip/free-operant

Fisher, W. W., Piazza, C. C., Bowman, L. G., & Amari, A. (1996). Integrating caregiver report with a systematic choice assessment. American Journal on Mental Retardation, 101(1), 15-25.

Google Search. https://www.google.com/search?q=define+leisure&ie=utf-8&oe=utf-8&client=firefox-b-1 (accessed February 5, 2017).

Graff, R. B., & Karsten, A. M. (2012). Assessing preferences of individuals with developmental disabilities: A survey of current practices. Behavior Analysis in Practice, 5(2), 37-48.

MacDuff, G. S., Krantz, P. J., & McClannahan, L. E. (1993). Teaching children with autism to use photographic activity schedules: Maintenance and generalization of complex response chains. Journal of Applied Behavior Analysis, 26(1), 89-97.

Schneiter, R., & Devine, M. A. (2001). Reduction of self-injurious behaviors of an individual with autism: Use of a leisure communication book. Therapeutic Recreation Journal, 35(3), 207-219.

Toner, N. (2014). How do you figure out what motivates your students? Science in Autism Treatment, 11(1), 12-14.

Please use the following format to cite this article:

McCarron, M. (2018). Leisure skills for adults with autism. Science in Autism Treatment, 15(2), 19-26.


About The Author

Megan McCarron M.S., BCBA, LBA (CT) holds a Master of Science Degree in Child Development, is a Board Certified Behavior Analyst, and Licensed Behavior Analyst in the state of Connecticut. She has been in the field of autism treatment since 1992. Megan has experience providing services for children with autism in school, home and community settings. She has worked at Milestones Behavioral Services (formerly, The Connecticut Center for Child Development, Inc.) since 1999. During her time at Milestones, she has served in various capacities. She started out as an instructor and is now a Clinical Director. In addition to her responsibilities in and around Milestones, Megan presents lectures and workshops on autism and Behavior Analysis at local and national conferences.

How Siblings Of Children With Autism Can Help Improve Behaviors

When I first came across this study, “Behavioral Training for Siblings of Autistic Children,” I was immediately hesitant. There’s something about the idea of sibling-as-therapist that makes me cringe a little bit. When I work with the families of children with autism, the hope is that the siblings of the child with autism still have a childhood without being pushed into the role of caregiver. And I also want the child with autism to have independence and feel like an individual who is heard, which may be more challenging if their siblings are issuing demands just as a parent or teacher would. But as I read the study, I realized that the work they completed had incredible social significance.

In the study, there were three pairs of siblings. The ages of the children with autism ranged from 5 years old to 8 years old. The ages of the siblings ranged from 8 years old to 13 years old. The researchers trained each sibling of a child with autism how to teach basic skills, such as discriminating between different coins, identifying common objects, and spelling short words. As part of this training, the researchers showed videos of one-on-one sessions in which these skills were taught, utilizing techniques such as reinforcement, shaping, and chaining. What the researchers did next was the part that really stood out to me: they discussed with the siblings how to use these techniques in other environments. Finally, the researchers observed the sibling working with their brother/sister with autism and provided coaching on the techniques.

It should be noted here that the goal of the study was not to have the siblings become the teacher of basic skills. Instead, it was to provide a foundation of skills in behavioral techniques for the sibling to use in other settings with the hope of overall improvement in the behaviors of the child with autism. The researchers demonstrated that, after training, the siblings were able to effectively use prompts, reinforcement, and discrete trials to effectively teach new skills. But, perhaps the most meaningful aspects of the study were the changes reported by both siblings and parents. The researchers provide a table showing comments about the sibling with autism before and after the training. One of the most striking comments after the training was, “He gets along better if I know how to ask him” (p. 136). Parents reported that they were pleased with the results and found the training beneficial.

This study provides excellent evidence that structured training for siblings has real potential for making life a little easier for the whole family. The idea isn’t that they become the therapist, but instead that knowledge truly is power.

REFERENCES

Schriebman, L., O’Neill, R.E. & Koegel, R.L. (1983). Behavioral training for siblings of autistic children. Journal of Applied Behavior Analysis. 16(2), 129-138.


WRITTEN BY SAM BLANCO, PhD, LBA, BCBA

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

Pick of the Week: Timers!

Promotion is valid through March 4th, 2019 at 11:59pm EST. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time.

ABA Journal Club #2: Ethics and Social Media

One of the tenets of ABA is to provide evidence-based practice. The best way to help us do this is to keep up with the literature! Each month, Sam Blanco, PhD, LBA, BCBA will select one journal article and provide discussion questions for professionals working within the ABA community. The following week another ABA professional will respond to Sam’s questions and provide further insight and a different perspective on the piece.

Head to our Facebook page to join the discussion and let us know your thoughts!

It is important in our field to maintain an open conversation about ethics. The Professional and Ethical Compliance Code outlines how behavior analysts are expected to conduct themselves, but sometimes situations are not so black and white. And as the world changes, so do the expectations for ethical conduct. In recent years, issues related to social media have been especially relevant. This month, I’ve selected the following article which addresses the special concerns that come up with the use of social media.

O’Leary, P. N., Miller, M. M., Olive, M. L., & Kelly, A. N. (2017). Blurred lines: Ethical implications of social media for behavior analysts. Behavior Analysis in Practice10(1), 45-51 .


  1. The article reviews the codes of ethics for other professions. Why is this valuable for us to do as a profession? Did you learn anything surprising or interesting form this portion of the article?
  1. Since this article was written, our field has a new Professional and Ethical Compliance Code. How does this code differ from the previously used Guidelines for Responsible Conduct? What aspects of the code directly apply to ethical situations related to social media?
  1. “A search on an internet search engine for information related to a procedure or scientific concept may yield results as to what that procedure or concept is. The same search on a social media outlet may yield results as to whether or not that procedure or concept should be used (p. 47.) Discuss this difference.
  1. Behavior analysts and others interested in the topic may turn to social media to get answers to their questions due to the low response effort involved and the speed of reinforcement. How can we decrease response effort and increase reinforcement for referring to the scientific literature to answer our questions?
  1. The authors provide suggestions for how behavior analysts should behave on social media. Are there any suggestions you might add? Are there ways you can increase the likelihood of other behavior analysts following these suggestions?
  1. Consider your own behavior on social media. Based on recommendations from the article, what is one change you can make to increase your own ethical behavior in this context?

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.

The Salad Shoppe: Changing the Landscape of Vocational Training

Unemployment rates in the autism community are alarming, but the number of individuals entering the workforce only continues to grow. This presents an overwhelming challenge for special educators tasked with preparing learners for what is often an uncertain future. Vocational training is essential as learners with autism approach the transition to adulthood.  With this in mind, Nassau Suffolk Services for Autism (NSSA) introduced The Salad Shoppe in the fall of 2017.

The curriculum was developed by Kathryn Reres and Rebecca Chi, devoted special educators determined to ensure dignified and purposeful futures for the eight young adult students in their classroom. The focus was to create a program that would provide functional tasks for each learner based on their individual skills, interests and IEP goals. The result was an innovative vocational training curriculum that highlights the strengths of each participant, introduces new skills into their everyday lives and serves as a profitable social enterprise. 

The Salad Shoppe model requires multiple steps to be taken over the course of two days, including: Tracking and counting money, taking inventory, creating shopping lists, purchasing, food preparation, converting a customer’s order form to food assembly, delivery and clean up. This comprehensive list ensures that every learner has the opportunity to perform a task that is meaningful and functional to them. (The staff at NSSA are reaping the benefits too! Fresh, healthy, personally-delivered lunches each week have been a huge hit.)

In partnership with Different Roads to Learning, the creative teachers who designed The Salad Shoppe for NSSA are sharing their expertise with special educators everywhere. The published curriculum will allow teachers to implement The Salad Shoppe in a way that will best function for the learners they serve. Now more than ever, there is a crucial need to provide young adults with autism with the tools they will need to take on the competitive workforce. The Salad Shoppe is a cutting-edge curriculum that has opened new doors for educators, learners and parents and will continue to change the landscape of vocational training.

Ready to bring The Salad Shoppe to your school? You can save 15% on this incredible program now through February 18th!

Pick of the Week: The Salad Shoppe!

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