Tag Archives: reinforcement

Tip of the Week: Differential Reinforcement of Incompatible Behavior

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In a recent post, I talked about Skinner’s emphasis on differential reinforcement. Today, we are going to take a closer look at Differential Reinforcement of Incompatible behavior (DRI). DRI is defined as “a procedure for decreasing problem behavior in which reinforcement is delivered for a behavior that is topographically incompatible with the behavior targeted for reduction and withheld following instances of the problem behavior (e.g., sitting in seat is incompatible with walking around the room) (Cooper, Heron, & Heward, 2007).

Let’s look at a few examples of DRI in action:

  • Mrs. Clark is teaching a classroom with six students with autism. One of her students has recently begun to pinch his arms. She takes data on the behavior and discovers that it functions for attention. (When he pinches his arms, she or a teacher’s aid comes over and tells him “no pinching.”) She decided to implement an intervention that utilizes DRI. She teaches him how to sit with his hands intertwined on his desk. This is an incompatible behavior with pinching because he is not able to pinch while his hands are intertwined. She and the teacher’s aid reinforce him for intertwining his hands (come over and tell him, “great job” or “I like how you’re sitting”) and do not provide attention when he engages in arm pinching.
  • Carly has a 9-year-old daughter. When her daughter wants a break from doing homework, she reaches over and hits Carly’s arm. Carly typically says, “Do you need a break now?” Then, she allows her to take a five-minute break. Carly recognized that her daughter’s intensity with hitting seemed to be increasing, and she was worried she might get hurt. She decided to implement an intervention that utilized DRI. She put a timer on the table within her daughter’s reach, and taught her daughter to touch the timer when she wanted a break. This is an incompatible behavior because her daughter cannot simultaneously touch the timer and hit Carly. When Carly’s daughter touched the timer, she immediately received a break. When she hit Carly, she did not receive a break. This was an especially useful intervention because, over time, Carly taught her daughter to set the timer on her own and become more independent with managing break times.
  • Mr. Holley teaches a preschool class. During circle time, many of his students become very excited and can be quite loud. Sometimes it seems as though all of his students are yelling at the same time. Once they become too loud, it is very challenging to regain their attention. He decides to implement an intervention utilizing DRI. He uses a decibel meter on his tablet (such as the app Too Noisy). He teaches the students that when the noise level is below a certain number or threshold they all earn stickers. This is differential reinforcement of an incompatible behavior because the children cannot possibly speak loudly and softly simultaneously.

DRI is not always the best option. For example, it may be very challenging to come up with an incompatible behavior. Or, in the case of self-injurious or aggressive behavior, it may be dangerous to use such an intervention.

If you do use DRI, you may consider explicitly telling your learner(s) that you are implementing this new plan, such as Mr. Holley did in the third example above. And remember, this is only one form of differential reinforcement. If DRI is not appropriate for your situation, there are definitely still options for reinforcing appropriate behavior in an effective and efficient manner.

References

Cooper, J.O., Heron, T.E., & Heward, W.L. (2007). Applied Behavior Analysis – 2nd ed. Englewood Cliffs, NJ: Prentice-Hall.

WRITTEN BY SAM BLANCO, MSED, BCBA

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

Pick of the Week: I Can Do It! My Daily Checklist

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Daily planners are an effective way to help kids stay organized as they become more responsible and self-reliant. The I Can Do It! My Daily Checklist helps children with their daily routine by providing structure and reinforcement. This week, take 15% off* your order of the I Can Do It! My Daily Checklist with promo code ICANDOIT at check-out!

My Daily Checklist includes 18 sturdy reusable plastic stars and 35 interchangeable task squares with behaviors and chores. On the back of the chart are magnetic strips for securing to any metal surface. The chart measures 15.5 inches tall and 11 inches wide.

Don’t forget! Save 15%* this week only on the I Can Do It! My Daily Checklist by using promo code ICANDOIT at check-out!

*Offer is valid until 11:59pm EST on September 22nd, 2015. Not compatible with any other offers. Be sure there are no spaces or dashes in your code at checkout!

Tip of the Week: Why Differential Reinforcement is Preferred to Punishment

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In B.F. Skinner’s phenomenal book The Technology of Teaching, he briefly discusses problems with punishment. He explains that the use of punishment (defined as adding or subtracting something from the environment in order to reduce the occurrence of a behavior), is not as clear-cut as we might imagine.  When we attempt to punish a behavior, it’s quite likely that we will unintentionally suppress a broader range of behaviors than we intended.

Skinner gives the example of a child who has touched a candle flame and been burned. The child has probably been taught not to touch the flame, but Skinner argues that it’s quite possible that “in the presence of a candle flame he will not be likely to explore any part of the environment, to reach for or grasp objects of any kind” (Skinner, 1968, p. 186). This is an important consideration, especially when we consider the classroom.  We have to ask ourselves, when we punish certain behaviors, are we unintentionally suppressing other, desirable behaviors?  And in punishing the undesirable behavior, are we clearly communicating to the child what the desirable behavior is?

Skinner then moves on to discuss alternatives to punishment. What he describes is known today as differential reinforcement.  Since Skinner wrote The Technology of Teaching, a great deal of research has been completed on differential reinforcement, which “consists of reinforcing particular behavior(s) of a given class (or form, pattern or topography) while placing those same behaviors on extinction and/or punishing them when they fail to match performance standards or when they occur under inappropriate stimulus conditions” (Mayer, Sulzer-Azaroff, & Wallace, 2014).  Put simply, we reinforce the desired behavior and do not reinforce the undesired behavior.

Today we have categories for many different types of differential reinforcement to better describe strategies for implementation.

Types of differential reinforcement include:

  • Differential Reinforcement of Alternative Behavior (DRA)
  • Differential Reinforcement of Other Behavior (DRO)
  • Differential Reinforcement of Incompatible Behavior (DRI)
  • Differential Reinforcement of High Rates of Behavior (DRH)
  • Differential Reinforcement of Low Rates of Behavior (DRL)

Differential reinforcement is an incredibly useful tool for teachers and parents.  So we will devote several Tips of the Week over the upcoming months to how to use it effectively, taking a closer look at each of the types listed above.

References

Mayer, G. Roy, Sulzer-Azaroff-B. & Wallace, M. (2013). Behavior analysis for lasting change (3rd ed.). Cornwall-on-Hudson, NY: Sloan Publishing.

Skinner, B. F. (1968). The technology of teaching. New York: Appleton-Century-Crofts.

WRITTEN BY SAM BLANCO, MSED, BCBA

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

Tip of the Week: Clearing Up the Misconceptions About Reinforcement

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ABA often gets a bad rap due to misunderstandings about reinforcement. In my career alone, I’ve had people tell me that people are not like rats and pigeons, that reinforcement harms intrinsic motivation, and that when I do produce behavior change, it has nothing to do with ABA but with my abilities as a teacher. Today, I’d like to clear up some misconceptions about reinforcement.

Reinforcement is not equivalent to rewards. Reinforcement is anything that occurs immediately following a behavior that increases the future likelihood of that behavior. For instance, I am more likely to say hello to my neighbor down the street because in the past he has responded by saying “hello” back to me. However, I do not say hello to my next door neighbor because she has never responded to my greeting. My history of reinforcement with the neighbor down the street increases the likelihood that I will greet him upon seeing him.

Flowers GrassReinforcement occurs in the natural environment all the time, whether we are conscious of it or not. We are reinforced by paychecks for going to work, by our favorite dessert for visiting a restaurant 30 minutes out of our way, by compliments when we get a new haircut, and more. ABA utilizes reinforcement when an individual is not acquiring skills in order to help them learn. And when ABA is implemented correctly, reinforcement should be as close to naturally occurring reinforcers as possible and should be reduced systematically over time to levels that would naturally occur in their environment.

Reinforcement works for dogs and for humans. The previous two points illustrate that humans do respond to reinforcement, and decades of scientific research back that up. Comparing the work behavior analysts do with humans to the work behavior analysts do with other animals is not far off base. What is off base is using such a comparison to imply that behavior analysts treat people with disabilities like dogs. As with other professionals who work with individuals with disabilities, (such as speech therapists, physical therapists, nurses, etc.) most behavior analysts are professionals who put a lot of time, care, and love into their work.

Child Blowing BubblesReinforcement is individualized. Everything we do in ABA is individualized, because human beings are wonderfully complex creatures that cannot be characterized by statistics, averages, or norms. One of my students may find stickers reinforcing; another may show no interest. One student may find listening to music reinforcing; another may cover his ears and ask me to turn it off. In ABA, we seek to find the items and activities that are motivating for individuals; then use those as tools not only for reinforcement, but for increasing skills and broadening interests and opportunities. In an ideal ABA session, my students spend a lot of time engaging with items and activities that they enjoy while also learning and growing.

It’s easy to fall prey to misconceptions about reinforcement, but such misconceptions can make it impossible for us to understand how to alter the environment in order to provide the best possible outcomes for our students. As Skinner put it, “The ideal of behaviorism is to eliminate coercion: to apply controls by changing the environment in such a way as to reinforce the kind of behavior that benefits everyone.”

Over the next few weeks, we will be publishing a series on Differential Reinforcement procedures that will help you become more skilled in using reinforcement to affect behavior change.

WRITTEN BY SAM BLANCO, MSED, BCBA

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

Tip of the Week: Use a Time-Out Ribbon

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Time-out can be an effective procedure for addressing behaviors that do not function for escape. However, often it can be difficult to implement, and in some schools is not even allowed. There are valid concerns related to time-out. For example, you may not have the opportunity to supervise a child in a separate location for time-out, or you might want to keep them in the same place so they don’t miss a lesson during class.

The time-out ribbon may be an excellent solution for just those types of instances. When Foxx and Shapiro (1978) first wrote about the time-out ribbon, they referred to it as “nonexclusionary time-out,” meaning the individual does not have to be excluded from an environment or activity to be “in time-out.” In their initial study, all students wore a ribbon on their wrist. When the individual has the time-out ribbon on, they have access to socially-mediated reinforcement. If the time-out ribbon is removed, they do not have access to that reinforcement. (Foxx & Shapiro also note that it does not have to be a ribbon, but could be anything that is easy to wear and easy to remove.) However, by again demonstrating appropriate behavior, the ribbon can be placed again on the individual’s wrist.

In a time where we often focus on new, high tech solutions, such as the use of iPads or SmartBoards to introduce behavior change procedures, it’s important to draw attention to low-tech solutions that are easy to implement. Another aspect of the time-out ribbon that is attractive for our particular population is that it provides a clear visual indication that reinforcement is available.

A possible drawback is that, in a classroom setting, if the ribbon is removed, the student could continue to engage in disruptive behavior. Foxx and Shapiro emphasize the need to pair the ribbon with social reinforcement when first introducing it to the individual. This increases the likelihood that the individual will correct their behavior to earn the ribbon back.

Foxx & Shapiro demonstrated the effectiveness of the time-out ribbon with five boys with developmental disabilities. Since then, two more studies have demonstrated the efficacy of the procedure. We know that time-out can be highly effective from a wealth of research over recent decades, but if it’s not available, you should definitely consider the possible use of the time-out ribbon.

Further Reading

Alberto, P.A., Heflin, L.J., & Andrews, D. (2002). Use of the timeout ribbon procedure during community-based instruction. Behavior Modification, 26(2), 297-311.

Foxx, R.M. & Shapiro, S.T. (1978). The timeout ribbon: A nonexclusionary timeout procedure. Journal of Applied Behavior Analysis. 11(1), 125-136.

Laraway, S., Snycerski, S., Michael, J. & Poling, A. (2001). The abative effect: A new term to describe the action of antecedents that reduce operant responding. The Analysis of Verbal Behavior, 18, 101-104.

WRITTEN BY SAM BLANCO, MSED, BCBA

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

Simplifying the Science: Teaching Hand-Raising to Children with Autism

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There are many concerns that come up when considering moving a child with autism to a general education setting. One is that the child with autism may not initiate interactions, which makes it less likely they’ll raise their hand to either ask or answer questions. Hand-raising is an important social behavior in the classroom setting as it facilitates learning as well as teacher-understanding of a child’s comprehension of the current topic. In the general education setting, there is much more group instruction than in the special education setting, which makes hand-raising all the more important. A study by Charania, LeBlanc, Sabanathan, Ktaech, Carr, & Gunby (2010) focuses on this skill, stating “Failure to raise a hand when one could answer means a missed opportunity for reinforcement or error correction, whereas raising a hand when one has no subsequent response to provide could be embarrassing or disruptive to ongoing instruction.”

The participants in the study were three boys with autism, ages 8, 9, and 10 who were preparing to transition from a center-based program to a general education setting and had substantial verbal repertoires as assessed by the VB-MAPP. The researchers recognized that often the boys would know the correct answer to a question posed by the teacher during a group activity, but would not raise their hands to respond. They addressed this by building three successive skills. The goal was to teach the boys to raise their hand when they did know the answer, and keep their hands down when they did not know the answer.

In the first task, the boys were placed together for group instruction. Each child was given an opaque bag with a different item in it. The instructor would ask “Who has the [item]?” The boy with that item would raise his hand. Once this skill was mastered, the second task was introduced. In this task, the instructor would tell one boy a “secret” word, while whispering a greeting to the other two boys. The instructor would then ask “Who knows the secret word?” The boy who heard the secret word would raise his hand. Finally, after mastering the second task, the final task would be introduced. Here, the task involved providing verbal responses to factual questions, such as “What animal has a tail and four legs?”

This successive teaching of skills is important to the acquisition of the target skill. In the first task, there was an auditory and a visual stimulus provided to elicit the target response of hand raising (the question and the object in the bag). In the second task, the visual stimulus was replaced with another auditory stimulus, making it two auditory stimuli (the question and the whispered secret word). Finally, the last task consisted of the auditory stimulus, the question itself. The final task emulated the stimulus that would naturally occur in the classroom to elicit hand-raising.

The authors note in their discussion that “The results suggest the importance of conducting both hand-up and hands-down learning trials to establish discriminated responding, rather than simply reinforcing hand raises on every question (i.e., excessive hand raising during hands-down trials might be just as problematic as a complete lack of hand raising).” The method of successive conditional discrimination can be useful for teaching both children who do not raise their hands when they should or who raise their hands when they shouldn’t. All three boys learned how to raise hands appropriately for each of the three tasks. And while there are many more skills related to hand-raising that the three participants would need to learn, the skills taught in this study are essential to promoting success in the general education environment.

WRITTEN BY SAM BLANCO, MSED, BCBA

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

Tip of the Week: Two Essential Considerations When Toilet Training Boys

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Last year, I had the opportunity to interview Gary Weitzen, the Executive Director of POAC Autism Services and the Autism Shield Program. (You can see the blog post about that interview here.) In the months since our interview, many of his comments have stuck with me, but one in particular has impacted my daily work with students. He said, “A lot more boys have autism than females but the vast majority of educators in special ed, and in particular with autism, are females.” He went on to provide examples of how this fact influences some skill development, specifically with toilet training.

Child on Toilet 2 BlogThis leads to several considerations to take into account when toilet training boys. I agree with Weitzen that some of these issues arise from the simple fact that women are predominantly toilet training boys. However, it’s also possible that such issues arise from the fact that many boys are trained in early intervention or preschool years without consideration of the implications of those training techniques several years down the line, and without further intervention or training later in life. Either way, it’s important to recognize that training of life skills should be completed in such a way as to develop effective skills that are similar to those of the child’s same-age peers. To that end, here are two considerations:

Consider hygiene. Something I had never thought about prior to my conversation with Weitzen is that after boys use the bathroom, then zip up their pants, it’s easy for a little urine to drip onto their pants. Especially once children reach upper elementary and middle school grades, a spot of urine can be socially isolating or an invitation for bullying. Weitzen acknowledges that it can be difficult to teach boys to gently shake their penis before zipping up, especially because teachers don’t want to inappropriately touch the students. However, for the long term, it’s essential that teachers find a way to teach this simple action.

Consider the topography of the behavior. When we think about topography, we basically mean, “What does the behavior look like.” When initially toilet training, teachers will typically have the student pull his/her pants down to the floor. Weitzen shared a personal experience from several years ago, when he was a chaperone on a field trip with his son who is autistic. At one point, the teachers asked him to take the boys to the bathroom, so Weitzen went in with eight 14-year-old boys with autism. He said, “They took their pants and pushed them right down to their knees at the urinal at Medieval Times. So we had seven hairy tushies in the room. Out in public! And what happens is other dads and other boys came in there and everyone’s laughing and commenting and pointing.” This is the type of situation that teachers and parents do not want students to experience. When toilet training, it’s essential to recognize that the topography of the behavior in the male restroom is to unzip the pants, and then pull the fabric aside in order to urinate in the urinal. While it may be easier to teach students to pull their pants down in the initial phases of toilet training, it’s important to continue shaping behavior until it has the appropriate topography.

If our students continue to pull their pants down completely, they become targets for bullying, or worse. Weitzen says that on multiple occasions, he’s had parents report to him that their child used the bathroom at the urinal, and when they pulled their pants to the floor, another student took a picture of them. “Four different moms told me that, and if four moms told me that, I can’t imagine how often that’s happening,” Weitzen said. “And even if they’re not sharing the photo, well now you’re the weird kid who sticks his butt out. And you’re isolated and you’re picked upon, so we have to be real. We have to realize our guys live in the real world and teach them the skills that they need.”

WRITTEN BY SAM BLANCO, MSED, BCBA

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

Simplifying the Science: Teaching Siblings About Behavior

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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.

Siblings Playing Together BlogIn 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, MSED, BCBA

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

Autism Awareness Month Interview Series: Creating Positive Change in ASD Treatment Through Science, Support and Education with David Celiberti, PhD, BCBA-D

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We couldn’t be more thrilled to wrap up our Autism Awareness Month Interview Series with David Celiberti, PhD, BCBA. Dr. David Celiberti is the Executive Director of the Association for Science in Autism Treatment (ASAT) and provides consultation to public and private schools and agencies in the U.S. and Canada. Here, Dr. Celiberti shares his wealth of knowledge and experience in creating positive change in autism treatments through scientific research and high-quality education and support.

Don’t forget to check out the other interviews from our Autism Awareness Month Interview Series here!

Creating Positive Change in ASD Treatment
Through Science, Support, and Education
with David Celiberti, PhD, BCBA-D

SAM BLANCO: I consider the Association for Science in Autism Treatment (ASAT) to be an invaluable resource for both parents and practitioners. You serve as the Executive Director. Before we discuss ASAT, can you tell us a bit about your background?

DAVID CELIBERTI: First and foremost, thank you for the opportunity to participate in this interview, particularly as you are asking about topics that are near and dear to my heart. I have been fortunate to have a career in the treatment of autism spectrum disorders (ASD) where the journey has been just as reinforcing as the destination. I continually urge young people to work hard at finding a career path consistent with their passions. Among my many reinforcers in the field of ASD treatment are interactions with parents and siblings who did not choose a life that included ASD, but still love unconditionally, roll up their sleeves and embrace powerful roles as agents of change. Additionally reinforcing has been my collaboration with myriad professionals, particularly those who are grounded in, and informed by, science. Perhaps most inspiring, though, are the individuals with ASD themselves who work so hard to acquire new skills, learn effective strategies for negotiating their experiences, and remind us daily that science-based treatments, such as applied behavior analysis (ABA), truly make a difference.

I currently serve as the halftime Executive Director of ASAT. I view this role not as a job but as a “lifestyle”, and I am so proud of what ASAT accomplishes every year, even with a tiny operating budget. We have an incredible board of directors from diverse professional backgrounds such as special education, behavior analysis, psychology, social work, sociology, law, medicine, speech-language pathology, computer science, family advocacy and business. Many of our board members have family members with ASD. Their commitment to helping other families and professionals find a clearer path to effective intervention is astounding to me. We also have scores of volunteer coordinators, externs, and an active Media Watch team who do much of the “heavy lifting”, helping ASAT remain productive, current, and responsive to the needs of the autism community.

SB: For those out there who aren’t familiar with ASAT, can you talk a little bit more about the organization’s mission and why it continues to be such an essential resource?

DC: With respect to our mission, we improve the quality of life for individuals with ASD and their families by promoting the use of safe, effective treatments, which are grounded in science, for people with ASD. As you know, there are over 400 treatments for autism, with the vast majority lacking any semblance of scientific support. We achieve our mission by sharing accurate, scientifically-sound information with professionals, parents and journalists; and by countering inaccurate or unsubstantiated information regarding autism and its treatment as it comes up. Unfortunately, there is so much out there which distracts consumers from making the best possible choices. Our overarching goal is to help parents and providers become savvy consumers of information who can truly discriminate science from pseudoscience. This means being armed with the knowledge to ask practitioners and marketers of ASD interventions critically important questions related to the state of their science, consult with knowledgeable and impartial professionals about potential treatments, and establish methods for assessing the benefits of treatments when they are adopted by the family and their intervention team. It is absolutely heartbreaking that autism treatment has become the type of business in which parents of children with autism must work so hard just to sort through so many options and mixed messages just in order to help their sons and daughters.

For more information, your readers can visit ASAT’s comprehensive website at www.asatonline.org. On the website, they will find extensive information about the scientific support (or lack thereof) behind the full array of treatments proposed for autism; resources and guidelines on how to make informed choices and weigh evidence in selecting treatment options, and information for various groups such as parents of newly diagnosed children, parents of older individuals, teachers, medical providers, and members of the media community. We encourage people to revisit ASAT’s website often, as information about autism treatments is frequently updated to reflect the latest research, and new content is routinely added.

ASAT also publishes a free quarterly newsletter, Science in Autism Treatment. Sign-up information is available at https://asatonline.org/signup. The quarterly e-newsletter features:

  • Invited articles by leading advocates of science-based treatment;
  • A Clinical Corner which responds to frequently asked questions about autism treatment;
  • A Consumer Corner which recommends resources that can guide and inform treatment decisions;
  • A Focus on Science column which is designed to empower families to make educated treatment decisions by highlighting those elements that constitute science-based interventions as well as warning signs of unsubstantiated treatment;
  • Detailed summaries of specific treatments for autism;
  • Book reviews;
  • Highlights of our Media Watch efforts and discussion of accurate, and inaccurate, portrayals of autism and its treatment by the media;
  • Reviews of published research to help consumers and professionals understand and gain access to the science;
  • Critiques of policy statements related to autism treatment; and
  • Interviews with those who advance science-based treatment and confront pseudoscience.

Finally, your readers can also follow us on Facebook and on Twitter at @asatonline.

SB: You have dedicated a lot of your time to providing services for underserved populations, from direct services to organizing fundraisers that support organizations that serve economically disadvantaged children. Why is this an important area of work for you?

DC: When I was in graduate school in the late 1980s and early 1990s at Rutgers University under the mentorship of Dr. Sandra Harris, I was struck that only a tiny percentage of students with ASD were receiving the lion’s share of the available expertise and resources. This disparity was troubling to me as I recognized that there were scores of other children with ASD who were receiving “generic” special education services which did not yet incorporate state-of-the-art behavior analytic intervention. My hope was to one day dedicate a portion of my time to supporting students with ASD in inner city communities. As my career unfolded, I had the opportunity to work at the Rutgers Autism Program, where part of my duties focused on outreach. I started working in rural Maine in 1997, helping public schools develop and implement educational programs to students with ASD, and have now returned over 110 times! It is not that urban setting that I had envisioned as an idyllic graduate student; however, I quickly realized how rewarding it was to provide services in geographic areas that did not have the existing resources, and to assist public schools in providing high quality educational experiences.

Hoboken, New Jersey, where I live, is home to a significant number of economically disadvantaged students. I began to seek collaborative relationships between ASAT and other local organizations which focused on poverty. The common thread was the importance of providing children with meaningful, socially valid and effective opportunities to realize their fullest potential despite the myriad obstacles that they face. That resonated well with me as someone whose career focuses on the treatment of ASD. To date, my fundraising efforts have benefited four Hoboken-based organizations combating the barriers associated with poverty.

SB: I would like to go back to your reference about public school programs. In your view, what are some of the key elements of a high quality education for students with autism?

DC: This is such an important question! In a nutshell, a high-quality education would include the following elements:

  • Be truly individualized – An educational plan should truly fit the child like a glove fits a hand. Services should not be about what a provider likes to do, but rather what the student needs, as determined through ongoing, valid assessment.
  • Be comprehensive – A high quality education targets the full array of skills that will promote success at home, school and community and uses a wide range of techniques based on science that are well fitted to the skills being targeted.
  • Keep the future in mind when selecting goals – The skills needed to be successful and marketable in the next setting (be that a particular job or even Mr. Walker’s 4th grade classroom) must be identified and addressed.
  • Use well conceptualized behavior management strategies – When addressing challenging behavior, these strategies should take into account the underlying function of the behavior, include carefully selected antecedent and consequence based supports, and build skills to help students better meet their needs in a way which promotes their day-to-day independence and opportunities.
  • Consider and offer inclusion opportunities carefully – Ensure that it occurs with the appropriate supports and is delivered by adequately trained staff. Social skill development does not occur through pure exposure alone; rather, skill acquisition occurs when inclusion is approached as a systematic, individualized process, with proper supports, monitoring of data, and a goal of challenging the individual with ASD while not overwhelming them, or inadvertently creating isolation.
  • Carefully implement instruction, including modifications and accommodations – Promote early success and carryover, identify and use powerful motivators, and consider how to motivate students to work hard, to learn new skills, and to minimize frustration.
  • Allocate resources thoughtfully – Intervention and teaching-team members need solid training in order to implement teaching procedures and services. Regularly scheduled team meeting promote coordination, particularly when multiple disciplines are involved.
  • Engage parents – Not only is it important to continually seek input from parents about treatment priorities and goal selection, parents benefit from the training, collaboration, and information that will enable them to embrace their role as a co-pilot in their child’s intervention. This support should include siblings, grandparents, and other significant individuals for whom parents consent to their involvement. Engagement should occur throughout the educational journey and be adjusted to face the unique needs and challenges at each point in time.
  • Take data collection seriously – Ongoing data collection enables one to objectively assess progress, make timely adjustments, and remain accountable to those we serve. No provider should get a “pass” on data collection.
  • Start early and get it right from the start! – We know that early intervention can make an incredible difference. Don’t squander precious time on interventions that are not time-tested and research based.

SB: You’ve been instrumental in implementing change in many aspects of our field of ABA and ASD treatment in general. Do you have your thoughts on two or three areas that you think need to be addressed differently? How can we improve our work there?

DC: There is certainly room for improvement. Promoting science and science-based interventions such as ABA is not an area in which we have been very successful. Media representations tend to favor less science-based treatments, perhaps because their promoters use more sensationalized language when describing both their methods and their outcomes. Behavior analysts must take a closer look at how they market their work so that their outcomes can be more understandable and appreciated by various stakeholders (e.g., media, funding sources, consumers). We must also be more proactive in helping the media approach autism treatment in a more accurate manner.

Autism is clearly a spectrum disorder. In recent years, we have seen many higher functioning persons with ASD who have been very vocal; generously sharing their views about the appropriateness of treatment. Although their views and perspectives are important, I worry that the public, policy makers, and other important stakeholders may take these views as applicable to the entire spectrum. I believe this has the potential to do parents a tremendous disservice when they try to acquire the resources, tools, and experiences which will enable their son or daughter (who may not be on the upper end of the spectrum) to realize his or her fullest potential. On the other hand, one important take-away message is the importance of cultivating and celebrating the strengths of individuals with ASD rather than approach our work from a pure deficit model.

Another significant concern is that the hundreds of thousands of children with ASD who were diagnosed in the last two decades are growing up and becoming hundreds of thousands of young adults with ASD; as a society, we are failing them. When children with ASD turn twenty-one, funding for services drastically changes. As a result, there are very few quality programs for adults. We are facing a crisis in the field, with a scarcity of services for adults with ASD and the absence of a clear strategy for closing the gap between the ever-increasing need, and an unprepared supply of resources. Autism awareness must include important conversations about how we can help adults with ASD live and work independently, develop meaningful relationships, reduce challenging behaviors that may limit opportunities, access faith communities, and enjoy the array of recreational pursuits which are available within their communities. Those are important conversations to have and these conversations should translate into actionable items at every level of service delivery.

SB: With Autism Awareness month drawing to a close, what would you like the general public to know about autism treatment?

DC: Even though ASD is no longer the rare disorder it once was, each person with ASD is unique. Efforts to help them realize their fullest potential should be individualized to meet the specific needs of each individual with ASD across settings such as home, school, community and the workplace; and informed by input from the individual, as well as his or her family.

Do not believe everything you hear. There are dozens of purported “miracle cures” and “breakthroughs” for ASD which receive widespread media attention, even if they have not been proven effective. Sadly, effective treatments rarely gain media attention.

On a related vein, do not believe everything you read. Not all information on the internet is reliable and accurate, and celebrities are neither trained nor equipped to define or guide ASD treatment even though many appear comfortable in that role. On the other hand, there is a large body of research published in peer-reviewed scientific journals which should guide autism treatment. Visit our website to learn more at www.asatonline.org.

Lastly, there is hope and tremendous opportunity. With the right treatment, individuals with autism can lead happy and fulfilling lives. Research indicates that interventions such as ABA can effectively help children and adults with ASD realize their fullest potential. As stated earlier, we know that early and intensive behavioral intervention can make a huge difference, both with respect to human potential and significant cost savings across the lifespan.

SB: How can the general public make a positive difference?

DC: It cannot be overstated that it takes a village to help individuals with ASD learn to enjoy and benefit from all that their communities have to offer. Every member of the public can make a difference in supporting individuals with ASD and their families. There are so many positive ways the public can help. Although I will share several examples here, this list is by no means exhaustive:

  1. If you have a family member or a neighbor who has a child with ASD, ask specifically how you may be helpful (e.g., assist with siblings, offer play dates, help with transportation to therapies, or provide an empathic ear).
  2. If you see a family struggle in the community, do not stare, comment, or judge. In some cases, it may be appropriate to go over and assist (e.g., “I see you are helping your little guy, may I help you put your bags in the car?”). Family members may take you up on your kind offer or may just decline.
  3. If your children are interested, inquire if there are opportunities for them to help classmates with ASD at their school (e.g., becoming a lunch buddy, peer tutor). This is particularly beneficial in the later grades when opportunities for students with ASD to interact meaningfully with their typically-developing peers is lessened.
  4. At school board meetings encourage board members to learn about best practices in special education which are scientifically validated. Inquire if special education resources are being spent on interventions that lack scientific support or are not being spent on those that do possess such support (e.g., ABA). In fact, a research basis should inform most decisions.
  5. Some faith communities are very welcoming to families of individuals with ASD, whereas others are not. Discuss this within your place of worship. Identify steps that can be taken to help individuals with ASD participate in their religious communities in a positive and meaningful manner. This applies to both religious ceremonies, as well as day to day participation.
  6. Encourage organizations to be more accepting of persons with ASD and to take appropriate steps to learn how to create meaningful inclusion opportunities (e.g., seeking out information, soliciting training and education, learning from others who are doing this with success).
  7. If you are involved with youth sports or other extracurricular activities, offer to coach and/or mentor a player with ASD.
  8. Encourage your town or city to provide and/or create recreational opportunities that include individuals with ASD as there is often a tendency to focus only on separate experiences.
  9. Support ASD organizations that put science first. Research how your donations are used.

ABOUT DAVID CELIBERTI, PHD, BCBA-D

DCelibertiDr. David Celiberti is the Executive Director of the Association for Science in Autism Treatment (ASAT). He previously served as the President of the Board of Directors of ASAT from 2006 through 2012. In response to the increasing number of parents attending professional conferences to learn about applied behavior analysis, he also founded the Parent-Professional Partnership SIG for the Association for Behavior Analysis International in 2000 and served as its Co-President until 2014. He had also served as President of the Autism Special Interest Group (SIG) from 1998 to 2006. He currently sits on a number of Advisory Boards in the area of autism, as well as in early childhood education. He has organized fundraising initiatives to support afterschool programming for economically disadvantaged children in Northern New Jersey. Dr. Celiberti is in private practice and provides consultation to public and private schools and agencies in the U.S. and Canada. He received his Ph.D. in clinical psychology from Rutgers University in 1993. He has authored several articles in professional journals and presents frequently at regional, national, and international conferences. He has taught courses related to ABA at both the undergraduate and graduate levels, supervised individuals pursuing their BCBA and BCaBA, and in prior positions had conducted research in the areas of applied behavior analysis, family intervention, and autism.

Tip of the Week: Use Noncontingent Reinforcement – A Powerful Addition to Your Intervention

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Noncontingent reinforcement (NCR) is the presentation of reinforcement independent of behavior, and there are many studies out there that demonstrate it can have a significant impact on behavior.

Before we get to how you can use it with children with autism or other developmental disabilities, it’s important to recognize that noncontingent reinforcement happens all the time with all of us. A few common examples:

  • You’re walking alongside your child. Your child reaches up and grabs your hand. This is a behavior you like, but it did not occur because of any one behavior you exhibited, such as reaching for their hand or requesting their hand. They just did it spontaneously. This probably changes your behavior: you may smile, initiate a conversation, or give their hand a special squeeze.
  • It’s snack time at your preschool. You realize the bag of popcorn you’re giving for snack is almost empty, so you give each student a few extra kernels of popcorn. They did not “earn” it for good behavior, it was just a little extra reinforcement. This may change your students’ behavior: they may sit still a little longer as they eat the additional snack, say thank you, or exclaim, “More popcorn! Yay!”
  • A common example in preschool is placing a child on your lap during story time. They didn’t earn it, but it may change their behavior. For example, instead of calling out to get your attention, they may sit quietly for the duration of the story.
  • You’ve come home from a stressful day at work. You want to just sit down and veg in front of the TV for a few minutes, but discover that your husband has cooked dinner. This may change your behavior: you may sit down at the dining room table or give him a hug. Again, you didn’t exhibit a specific behavior that “earned” you dinner; it was presented independent of your behavior.

Noncontingent reinforcement can be a powerful addition to your interventions. But it looks a bit different when you’re using it as part of your intervention. You want to provide continuous access to the reinforcer maintaining the problem behavior so that the problem behavior becomes unnecessary. The preschooler sitting on the teacher’s lap is an excellent example, because the child has continuous access to the teacher’s attention. This can be faded over time, but can be an effective starting point for reducing problem behaviors when used in conjunction with other strategies.

Research has shown that noncontingent attention can decrease destructive behavior, noncontingent juice can decrease rumination, noncontingent access to preferred items can decrease inappropriate mealtime behavior, and noncontingent social interaction can decrease vocal stereotypy (Hanley, Piazza, & Fisher, 1997; Kliebert & Tiger, 2011; Gonzalez, Rubio, & Taylor, 2014; Enloe & Rapp, 2013). There is much more research out there that demonstrates that noncontingent reinforcement can impact behavior. Here are a few tips for using it:

  1. Make sure it matches the function. If your student is engaging in destructive behavior in order to escape a task, then providing noncontingent attention is unlikely to produce the behavior change you are expecting.
  2. Decide on a method for providing noncontingent reinforcement. Will you provide it continuously (like the preschooler sitting in the teacher’s lap) or provide it on an interval schedule (such as providing verbal attention every 2 minutes)?
  3. Take data! You need to know if the noncontingent reinforcement is actually decreasing the problem behavior or increasing the desired behavior. Define the behavior you want to change and then take data on its frequency, rate, or duration.
  4. Account for other students’ needs. If you are only using noncontingent reinforcement for one student, you need to be prepared to address the needs of other students. For example, if just one preschooler gets to sit in the teacher’s lap every day at story time, you may see an increase in problem behaviors from the other preschoolers in the class.
  5. Plan ahead! Our ultimate goal is that our learners be as independent as possible. Plan for how to fade your intervention over time.
  6. Take a look at the research. There are a few studies cited at the end of this article, but you may be able to find research simply by searching for “noncontingent” and the name of your problem behavior.

Noncontingent reinforcement is much easier to implement than many interventions that are available and can have a huge impact on your learner’s behaviors.

References
Enloe, K., & Rapp, J. (2013). Effects of noncontingent social interaction on immediate and subsequent engagement in vocal and motor stereotypy in children with autism. Behavior Modification , 38(3), 374-391.

Gonzalez, M., Rubio, E., & Taylor, T. (2014). Inappropriate mealtime behavior: The effects of noncontingent access to preferred tangibles on responding in functional analyses. Research in Developmental Disabilities , 35(12), 3655-3664.

Hanley, G. P., Piazza, C. C., & Fisher, W. W. (1997). Noncontingent presentation of attention and alternative stimuli in the treatment of attention-maintained destructive behavior. Journal of Applied Behavior Analysis , 30(2), 229-237.

Kliebert, M. L., & Tiger, J. H. (2011). Direct and distal effects of noncontingent juice on rumination exhibitied by a child with autism. Journal of Applied Behavior Analysis , 44(4), 955-959.

WRITTEN BY SAM BLANCO, MSED, BCBA

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