Tag Archives: special education

What is the Importance of Engagement When Working with Individuals with Intellectual and Developmental disabilities and Autism?

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This month’s ASAT feature comes to us from Dr. Karen Parenti, MS, PsyD CEO/Executive Director, and Heather Rothman, BS, LBS, Director of Day Services, Special Friends Foundation. 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 the parent of an adult with autism, who will soon transition from a school program to adulthood. I am reading about engagement as an indicator of good programming. What does it mean and how can I tell if a program promotes it?

Answered by Karen Parenti, MS, PsyD, CEO/Executive Director, and Heather Rothman, BS, LBS, Director of Day Services, Special Friends Foundation

Transition into adult programming is an important, but often stressful, process for families and individuals to experience. Adult programming should be designed to build skills and to promote happiness. Essentially every parent wants their adult child to have a high quality of life, to be offered activities they find enjoyable, and to be self-determining. For this to happen, the individual needs to be fully engaged in the program. Family members, clinicians, behavior analysts, program specialists, administrators, and social workers who provide services to individuals with intellectual and developmental disabilities and autism (ID/A) need to remember the importance of active engagement when planning and implementing programs as well as when designing goals.

Imagine for a minute the perspective of an individual receiving services. In most cases, this means the individual has had a diagnosis of some kind since childhood. The current model for treatment in children may result in a consistent feeling of “other-ness,” whether that looks like segregated classrooms, peer mentors, wraparound therapists, or specialized activities dependent on the label. From the perspective of the individual, this can look like endless task demands, shallow or contrived social interactions, decreased opportunities for genuine relationships, and severely limited access to the community. In addition, for a lot of the individuals served, the ability to protest “appropriately” is diminished, either because of communication barriers or skill deficits, or because they are not given opportunities to practice these skills. Empowering individuals to become architects of their experience and to express dissent and discomfort are crucial goals to ensure agency, assent, and quality of life. In addition, providing more choices can be part of a trauma-informed focus of care, and can ensure that individuals are served in a humane and compassionate manner (Rajaraman, 2021).

Although engagement as a clinical construct has yet to be deeply researched in applied behavior analysis (ABA), there has always been an ongoing interest in social validity, which is an emerging interest in the field (Morris et al, 2021). It should be noted that in the workforce, engagement has been defined for employees and became understood as a configuration of vigor, dedication, and absorption that motivates exceptional work performance (Leiter, 2019). Engagement, just like all metrics of success in the human services and special education fields, is personal and individualized for everyone. It is therefore important that engagement is individually assessed and monitored for everyone; from a parental or caregiver perspective, it is important to help the team understand how your family member expresses happiness, dissatisfaction, and protest. Teams may work to ensure high levels of satisfaction by ensuring that individuals attend the program regularly (or determine why there might be issues with attendance), and that preferences are identified in goals addressing the social, work, and living environments. It is imperative that teams ask themselves important questions such as is assent gained, routinely assessed, and honored? Moreover, does the individual seem happy while in the adult setting?

In recent years, the focus on engagement has altered the way in which quality programs are identified. Historically, there was a common focus on productivity and on compliance. While productivity remains relevant, engagement can become a main focus of intervention. In addition, the quality of interactions with individuals is also highly valued. Providers should focus on engaging the individual first by developing a positive relationship and pairing themselves with reinforcement. Individuals served, like all people, will always respond to genuine respect and regard, and this should be a foundation of service provision.

This value on engagement is consistent with heightened awareness in the field of ABA to ensure that all intervention is humane and compassionate, and that self-determinism is maximized for all individuals. In the context of adult intervention, such qualities can be seen in the extent to which engagement is observable. Some questions can be asked, and some behaviors associated with engagement can be observed.

Engagement is observable when a person is enthusiastically participating in their program. Choice has emerged as a necessary piece of engagement; individuals should be offered a range of meaningful activities from which to select, while still retaining the right to refuse. This is closely related to the Positive Approaches paradigm defined by Guy Legare (2002), who “encourages us to see clearly and honestly the good reasons and adaptive qualities of even the most troubling behavior, no matter whose behavior it is.” Provider agency staff and special education school personnel who excel at this skill set seem to be the ones to whom an individual is a person first, and these professionals never see an individual as a “case” or “set of behaviors.”

Although clinicians have considerable access to different types of preference assessments, as well as training on how to use them, it’s valuable to keep in mind all the factors that influence the efficacy of reinforcers with regards to engagement. For example, an individual may be more likely to be engaged in an activity in which they are participating with others, in a novel location. Engagement is a reinforcer unto itself but requires a deep knowledge of the individual and their preferences as well as focusing on the relationship between the individual and the staff member. As with any other treatment focus, engagement depends heavily on a positive, nurturing, and entertaining relationship between two people.

Engagement has to be individualized so that it can be maximized. It is observable, able to be defined and measured, and important to consider in placement, goal development, and in the ongoing assessment of progress. Programs can follow some general guidelines to increase the likelihood of enthusiastic participation, build active engagement, and foster self-determinism. These concepts include but are not limited to:

  1. Demonstrating unconditional positive regard – Staff and clinicians need to ensure that the individual they are working with is always treated with respect and dignity. Building rapport with each individual and communicating with those individuals regularly is essential to creating a compassionate, humane treatment environment.
  2. Attain Assent – Assent is emphasized in the Ethics Code (BACB, 2022), and should be secured whenever possible. Recent research indicates that this is an area that can improve and can also be done with individuals who are non-vocal (Morris, 2021). The team should ensure that the individual is continually involved in making choices regarding their daily activities. Attain assent for activities, and regularly check in about whether the individual is still willing to do the tasks. Honor withdrawal of assent.
  3. Solicit and accept feedback – Being receptive to feedback means allowing individuals to critique and course-correct staff behavior. Although feedback can be directly solicited, individuals provide feedback in lots of indirect ways as well. It is important to ensure there is reciprocal shaping of interactions between staff and individuals. Being open to changing the approach, based on cues from the individual, allows for the individuals served to have a measure of control over their own treatment, which increases the likelihood they will be enthusiastic participants, and therefore engaged.
  4. Prioritize needs – Staff and clinicians need to ensure that the individual they are working with has their basic needs always met.
  5. Respect all forms of communication – Staff and clinicians need to respect all verbal and nonverbal communication from that individual. These subtleties can be missed if the staff is not paying close enough attention. It’s important to remember that challenging behaviors are often an important form of communication.
  6. Create a supportive environment – An environment where the individual is supported and connected is one where they will be actively engaged, will thrive, will learn, and will master skills and increase competencies. Individuals can get discouraged easily and can become disengaged. In these situations, a little support or assistance can go a long way. Other considerations for a supportive environment could include instruction and activities in novel locations, with persons that are preferred by the individual, and by attending to the individual’s preferences to the maximum extent possible.
  7. Create Novelty – As stated earlier, novelty also helps increase engagement. When educators introduce something new, they provide opportunities for learning skills with a new item. In many cases, exploring a new item (or scenario, song, story, etc.) creates new opportunities for thinking, for understanding how things work, or connecting existing concepts in a new way. Novelty can also allow staff to engage the individual in a new way.
  8. Be willing to share control of the instructional context – Clinicians or staff can ensure that choices are presented as often as possible. There is always a choice to be offered. For example, instead of saying “now it’s time to get dressed”, a staff can say, “Would you rather put on your shirt or your socks first?” It’s also important to find a way to say “Yes” to a request as often as possible. If an individual is asking for something that is unavailable, instead of saying “No,” staff can offer a different time when the item/activity is available. It is important to be as specific as possible.

In summary, if a provider, agency, or special education school wants to increase active engagement while being genuinely helpful, staff and clinicians should partner with the individuals and their team members in selecting goals, developing instructional procedures, and identifying meaningful outcomes. This is the essence of social validity and is essential to compassionate care.

References

Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. https://bacb.com/wp-content/ethics-code-for-behavior-analysts

Legare, G. (2002). Positive approaches as a paradigm. In Positive approaches: Identifying mental illness in people with developmental disabilities, (2nd Ed.) OMR Statewide Training and Technical Assistance Initiative.

Leiter, M. The psychology of work engagement. Oxford Research Encyclopedia of Psychology. Retrieved 20 Oct. 2022, from https://oxfordre.com/psychology/view/10.1093/acrefore/9780190236557.001.0001/acrefore-9780190236557-e-36.

Morris, C., Detrick, J. J., & Peterson, S. M. (2021). Participant assent in behavior analytic research: Considerations for participants with autism and developmental disabilities. Journal of Applied Behavior Analysis, 54(4), 1300-1316. doi: 10.1002/jaba.859.

Rajaraman, A., Austin, J., Gover, H., Cammilleri, A., Donnelly, D., & Hanley, G. (2021). Toward trauma‐informed applications of behavior analysis. Journal of Applied Behavior Analysis, 55(1), 40-61. 10.1002/jaba.881

Schramm, R. (2011). Motivation and reinforcement: Turning the tables on autism. Pro-ABA.

Tennant K., Long A., & Toney-Butler, T. J. (2022, May 8). Active Listening. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK442015.

Citation for this article:

Parenti, K., & Rothman, H. (2023). What is the importance of engagement when working with individuals with intellectual and developmental disabilities and autism? Science in Autism Treatment, 20(01).

About the Authors

Dr. Karen Parenti works as the CEO/Executive Director of Special Friends Foundation.  She has extensive experience in ABA and in developing and overseeing group homes, day services, and rehabilitative programs for individuals with intellectual and developmental disabilities and autism. She also serves as the treasurer of the MAX association’s board where she continues to advocate for the needs of the individuals she serves. Karen earned her Bachelor’s degree in psychology from York College of PA, her Master’s Degree in Human Services Administration from Springfield College in Wilmington, DE and her Doctorate Degree in Clinical Psychology from Immaculata University.

Heather Rothman works as the Director of Day Services for the Special Friends Foundation. She has worked with individuals with disabilities in a variety of settings and roles for over twenty years. Heather is committed to helping individuals with disabilities and Autism access choices, connect with their communities, and design the life they want. She is a Licensed Behavior Specialist with extensive experience with behavior support services in early intervention, school-aged, and adult populations. She designed and built a school-to-work transition program that won an international award for Variety-The Children’s Charity. She has taught at Penn State, developed trainings for the Public Health Management Corporation, and worked with Merrill Lynch on accessibility and community inclusion programs. She is passionate about universal accessibility and designing programs that create strong communities. Heather has her Bachelors of Arts in Organizational Management from Ashford University and a Master’s Degree in Applied Behavior Analysis from Saint Joseph’s University.

This article was reposted with permission from ASAT from https://asatonline.org/research-treatment/clinical-corner/engagement/

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

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Reviewed by David Celiberti, PhD, BCBA-D and William L. Heward, EdD, BCBA-D
Association for Science in Autism Treatment

This month’s ASAT feature comes to us from Executive Director David Celiberti, PhD, BCBA-D, Association for Science in Autism Treatment and William L. Heward, EdD, BCBA-D, Professor Emeritus, the College of Education and Human Ecology at Ohio State University. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

Parents of children with autism face many challenges beyond those directly associated with raising a child who may have a myriad of needs. They face a dizzying array of treatment options with interventions lacking any scientific basis, which are cleverly marketed and often eclipse those interventions enjoying scientific support. Access to qualified, compassionate providers may be difficult or delayed, particularly for children in rural communities, children of color, individuals who age out of the educational system, and families outside of the United States. Misconceptions and misinformation about autism and ways to help people with autism abound and those messages often distract and derail many parents from obtaining accurate information, support, and intervention. Parents who seek help for their children are often harshly criticized and labeled by some bloggers as lacking love or acceptance. Taken together, these realities can weigh heavily on parents who are just trying to help their children with autism develop independence and purpose, pursue their dreams, and live their best lives.

Fortunately, a new book provides a break from the vitriol, snake oil, and antagonism. Between Now and Dreams thoughtfully and artfully explains the complementary concepts of responsible and responsive parenting of children with autism. It provides a space for parents to reflect, to engage, and to look ahead.

Prior to offering details about this book, the first reviewer would like to share some background. I first met Shahla Ala’i-Rosales and Peggy Heinkel-Wolfe thirty years ago at the University of North Texas (UNT) when I was a newly hired Assistant Professor in the Department of Psychology. Shahla was a behavior analyst, researcher, and practitioner in early autism intervention; Peggy, the mother of a son with autism, held an administrative job at the University. With a few other UNT colleagues, we formed a small working group to support each other in our individual efforts as well as to develop a community in which future collective efforts could take root. My time at UNT was brief, but I am so pleased (and a tad jealous) to know that Shahla and Peggy continued to collaborate and form a long-term friendship and professional alliance. Their book, Responsible and Responsive Parenting in Autism: Between Now and Dreams is a timely, and much needed gift to the autism community. Ala’i-Rosales and Heinkel-Wolfe share a series of interrelated events – challenges, plans, setbacks, and victories, large and small – in the lives of real children and their families (including their own). These stories demonstrate the importance of recognizing and celebrating children’s capabilities while encouraging and nurturing their self-actualization, individuality, and independence.

The authors put forth that raising a child with autism with an abundance of joy, purpose, and serenity relies on three interconnected powers: learning, connecting, and loving. Although the authors state that these powers are interconnected and that they influence and strengthen each other, Ala’i-Rosales and Heinkel-Wolfe have used them to organize their book into three unique parts. Each part is composed of several chapters; each chapter opens with a thoughtful quote that sets the stage for the lessons and wisdom that follows.

Part One: The Power of Learning  

Between Now and Dreams opens with a section devoted to principles of learning and how those principles can guide parents’ efforts to help develop their child’s fullest potential. The authors stress the need for creating and implementing carefully planned, intensive, positive applied behavior analysis (ABA) interventions in the home to keep children learning and moving forward in their lives. The abundance of examples discussed throughout this section showcase the vast applications of the science of behavior. Parents who are new to the autism journey will gain comfort in learning about principles that can be readily incorporated into their daily lives and appreciate a shift away from resolving problems to one of promoting empowerment and skill building, both for themselves, as well as for their children.

This section also chronicles the journey of ABA from its early applications to autism treatment, and to what the discipline has become today. The authors provide a sensitive and honest discussion of the bumps along the way.

Part Two: The Power of Connecting

This section of Between Now and Dreams will be invaluable for caregivers who may struggle with feelings of isolation, associated with both raising a child with many needs and experiencing the loss or shift in other relationships and career pursuits that may have followed their child’s diagnosis. Ala’i-Rosales and Heinkel-Wolfe beautifully capture the pursuit of supportive relationships, including with those who offer expertise and experience, as well as with other parents on very similar journeys. How one seeks and nurtures these relationships, as well as opting out when needed, is described with the same compassion and generosity reflected throughout the book.

Part Three: The Power of Loving 

The third section of Between Now and Dreams ties together the two prior sections. On its surface, a reader may assume that the section might focus myopically on positive emotions. Instead, the authors are realistic and don’t sugarcoat the challenges parents of children with autism face. Loss, fear, and disappointment are discussed openly in the context of numerous experiences, observations, and epiphanies. We left this section feeling grateful to the authors for being so incredibly transparent and vulnerable, yet insightful and encouraging in guiding us to be more active and loving parents.

Responsible and Responsive Parenting in Autism: Between Now and Dreams is an important, eloquently written, and engaging book for parents of children with autism of any age and who fall anywhere on the spectrum. It does not provide a cookie cutter approach, but rather a compassionately delivered collection of useful and practical suggestions that parents can select and tailor to their own home and goals.

Aside from behavior analysts, this book is also a must-read for teachers, therapists, medical providers, and others who work with children with autism. The content is accessible to those who are new to ABA and autism intervention, yet impactful for professionals with extensive training and experience.

Citation for this article:

Celiberti, D., & Heward, W. L. (2023). Book Review: Between Now and Dreams. Science in Autism Treatment, 20(3).

About the Authors

David Celiberti, PhD, BCBA-D, is the Executive Director of ASAT and Past-President, a role he served from 2006 to 2012. He is the Editor of ASAT’s monthly publication, Science in Autism Treatment. He received his PhD in clinical psychology from Rutgers University in 1993 and his certification in behavior analysis in 2000. Dr. Celiberti has served on a number of advisory boards and special interest groups in the field of autism, applied behavior analysis (ABA), and early childhood education. He works in private practice and provides consultation to public and private schools and agencies in underserved areas. He has authored several articles in professional journals and presents frequently at regional, national, and international conferences. In prior positions, Dr. Celiberti taught courses related to ABA at both undergraduate and graduate levels, supervised individuals pursuing BCBA certifications, and conducted research in the areas of ABA, family intervention, and autism.

William L. Heward, Ed.D., BCBA-D, is Professor Emeritus in the College of Education and Human Ecology at Ohio State University. He has taught at universities in Brazil, Japan, Portugal, and Singapore and lectured and given workshops in 23 other countries. A Past President and Fellow of the Association for Behavior Analysis International, Bill’s publications include co-authoring the books, Let’s Make a Contract: A Positive Way to Change Your Child’s Behavior (2022), Applied Behavior Analysis (3rd ed., 2020), and Exceptional Children: An Introduction to Special Education (12th ed., 2022). Awards recognizing Dr. Heward’s contributions to education and behavior analysis include the Fred S. Keller Behavioral Education Award from the American Psychological Association’s Division 25, the Ellen P. Reese Award for Communication of Behavioral Concepts from the Cambridge Center for Behavioral Studies, and the Distinguished Psychology Department Alumnus Award from Western Michigan University.

Special Needs Registries to Inform First Responders

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By: Cassie Hauschildt

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

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

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

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

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

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

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

ASD Learners and Sexuality

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Resources:

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

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

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

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

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

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

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

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

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

Practical Applications to Culturally Sensitive Treatment – Part I

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By: Nicole Gorden, M.S., BCBA, LBA 

Autism spectrum disorder occurs in individuals from many different cultures and backgrounds. Therefore, cultural competency and sensitivity is imperative for effective delivery of services. To work with autistic learners, is to respect that they are the product of many environments that have shaped them and will continue to shape them throughout their life.

As stated in the most updated ethical code from the BACB, behavior analysts are responsible for incorporating and addressing diversity in practice. For example, the BACB ethical code states that behavior analysts must practice within our scope of competence, maintain competence including cultural responsiveness and diversity. Specifically, providers must “evaluate their own biases and ability to address the needs of individuals with diverse needs/backgrounds” (Ethical Code, 2022, 1.07).

However, what are the practical implementations to culturally sensitive treatment? What does this actually look like in practice? As providers, we are obligated to offer exceptional service delivery with individualized treatment goals. Considering our learner’s cultural background and the impact of their community’s beliefs and attitudes is essential to effective treatment. The following will provide guidance on how providers can apply cultural sensitivity to their clinical decisions in treatment.

Awareness of Own Cultural Biases

Cultural awareness is the first step to providing culturally ethical treatment. Providers should concurrently and habitually engage in practices in which they remain aware of their own predetermined perceptions and acknowledge their own limitations to cultural competency. As mentioned in Fong et. al (2016), “cultural awareness may be important because behavioral patterns that are viewed as problematic in our own culture may be the norm in other cultures”. Due to limitations in diversity within most helping professions, a learner’s provider is often from a different cultural background.

Thus, it is essential to understand the traditions of that culture. As an example, physical punishment may be common practice in some black communities which has been perceived to be deeply rooted in racial trauma (Patton, 2017). It would be insensitive for a provider from a different cultural background to ignore that this practice is a cultural tradition, and thus blame or stigmatize black parents for their choices. Rather, “professionals can offer information about why the practice is harmful but have been told it is necessary, and offer healthier alternatives that produce better outcomes for children, families and communities” (Patton, 2017). Cultural sensitivity is facilitating the development of our programs by checking our own biases and how they may affect our choices in treatment.

Selection of Target Behaviors and Programmatic Materials

A few years ago, a client from Asian descent was transferred to me from another behavior analyst. When assessing the barriers to treatment, my client made minimal progress when asked to identify a fork. Believing that an object, rather than a picture might help, I asked the client’s parents for a fork. When obtaining the fork, the parents expressed that they do not use forks to eat. In their culture, hands and chopsticks are typical eating utensils. Thus, when considering cultural sensitivity, this includes selecting programmatic targets that are common in the client’s environment and the cultural norms.

The teaching materials should be as individualized as the treatment plan too. We should rely on diverse representation in the resources we use in treatment. Providers should use materials that represent the individual’s environment, which is typically a blend of many different ethnicities. When providing resources like visual schedules, do your cartoons or pictures represent the racial identity of your learner? If you are teaching body parts on a doll, do you provide toys that look like your learner? To be a culturally sensitive professional, one should give precedence to ethnic representation to allow the learner to feel validated and treat them with dignity.

The cultural assessment process should be used to inform treatment, specifically when designing the program for validity and selecting targets for skill acquisition (Fong et. al, 2016). When beginning a new lesson or treatment program, it is essential that providers select socially meaningful and significant target goals. However, in selecting these goals for treatment, professionals must consider the cultural norms and needs of the client.

About the Author: 

Nicole Gorden, M.S., BCBA, LBA has over 14 years of experience implementing Applied Behavior Analysis principles with the Autism Population. She currently works for Comprehensive Behavior Supports in Brooklyn, NY.

References:

Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. Littleton, CO: Author.

DuBay, M., Watson, L. R., & Zhang, W. (2018). In Search of Culturally Appropriate Autism Interventions: Perspectives of Latino Caregivers. Journal of autism and developmental disorders, 48(5), 1623–1639.

Fong, E. H., Catagnus, R. M., Brodhead, M. T., Quigley, S., & Field, S. (2016). Developing the Cultural Awareness Skills of Behavior Analysts. Behavior analysis in practice, 9(1), 84–94.

Fong, E. H., Ficklin, S., & Lee, H. Y. (2017). Increasing cultural understanding and diversity in applied behavior analysis. Behavior Analysis: Research and Practice, 17(2), 103-113.

Patton, S. (2017, April). Corporal punishment in black communities: Not an intrinsic cultural tradition but racial trauma. CYF News. http://www.apa.org/pi/families/resources/newsletter/2017/04/racial-trauma

A Spotlight On: “Executive Function in the Early Childhood Classroom”

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By: Stephanny Freeman, PhD and Kristen Hayashida, MEd, BCBA. Their new book: “Executive Function in the Early Childhood Classroom” can be purchased HERE

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

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

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

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

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

What skills are part of executive functioning?

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

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

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

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

Why do executive function skills matter?

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

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

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

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

Diamond and Lee (2011, p. 6)

Can executive function skills improve?

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

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

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

Blair (2017, p.4)

 

About The Authors

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

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

Focus on Generalization and Maintenance

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On more than one occasion, I’ve been in the situation that a student will only demonstrate a skill in my presence. And I’ve heard from other colleagues that they have had similar experiences. This is highly problematic. When it happens with one of my students, there is only one person I can blame: myself.  A skill that a student can only demonstrate in my presence is a pretty useless skill and does nothing to promote independence.

So what do you do when you find yourself in this situation? You reteach, with a focus on generalization. This means that, from the very beginning, you are teaching with a wide variety of materials, varying your instructions, asking other adults to help teach the skill, and demonstrating its use in a variety of environments. Preparing activities takes more time on the front-end for the teacher, but saves a ton of time later because your student is more likely to actually master the skill. (Generalization, after all, does show true mastery.)

Hopefully, you don’t have to do this, though. Hopefully, you’ve focused on generalization from the first time you taught the skill. You may see generalization built into materials you already use.

Another commonly cited issue teachers of children with autism encounter is failure to maintain a skill. In my mind, generalization and maintenance go hand-in-hand, in that they require you to plan ahead and consider how, when, and where you will practice acquired skills. Here are a few tips that may help you with maintenance of skills:

  1. Create notecards of all mastered skills. During the course of a session, go through the notecards and set aside any missed questions or activities. You might need to do booster sessions on these. (This can also be an opportunity for extending generalization by presenting the questions with different materials, phrases, environments, or people.)
  2. Set an alert on your phone to remind you to do a maintenance test two weeks, four weeks, and eight weeks after the student has mastered the skill.
  3. Create a space on your data sheets for maintenance tasks to help you remember not only to build maintenance into your programs, but also to take data on maintenance.

Considering generalization and maintenance from the outset of any teaching procedure is incredibly important. Often, when working with students with special needs, we are working with students who are already one or more grade levels behind their typically developing peers. Failing to teach generalization and maintenance, then having to reteach, is a waste of your students’ time.

Sam Blanco, PhD, LBA, BCBA is an ABA provider for students ages 3-15 in NYC. Working in education for sixteen years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. She is also an assistant professor in the ABA program at The Sage Colleges, and she is the Senior Clinical Strategist at Chorus Software Solutions.

Journal Club #4: RBTs and Interventions

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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 Practice, 10(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.

Learn the Lingo

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automatic punishment  Punishment that occurs independent of the social mediation of others (i.e., a response product serves as a punisher independent of the social environment).

Cooper, J.O., Heron, T.E., & Heward, W.L. (2007). Applied Behavior Analysis. Upper Saddle River, NJ: Pearson Merrill Prentice Hall.

It Takes a Team: 4 Steps to Building a Stronger Therapy Team

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For students on the Autism spectrum, having a strong and reliable therapy team to support individual needs can be an important factor in student success. When members of a therapy team are collaborating seamlessly, a student is more likely to have high quality support across all areas of development (communication, social, cognitive, play, motor, and adaptive skills).

mixed working group looking at laptopThe pervasive nature of ASD across these areas means that multiple disciplines are necessarily involved in effective intervention (Donaldson and Stahmer, 2014). When we work together and have a narrow focus, we can help our students make a great deal of progress. Gone are the days of a Speech Language Pathologist, Physical Therapist or Occupational Therapist taking a student away for traditional pull out therapy and leaving no time for debriefing with the classroom team.

Who comprises the therapy team is determined on a case-by-case basis. You may be wondering where to start with this sometimes daunting task of building a strong and supportive team. Below I will discuss some strategies that are evidenced-based and the ways that I incorporate them into my busy life as a speech language pathologist.

Pairing
One of the first things that I always try to do is build rapport with staff, which is known as a behavioral principle called pairing. It is important to build rapport and/or pair with team members, especially if you are new to the team or if other new members have joined. It may sound like very basic advice, but as clinicians we are very busy and sometimes we feel that we do not have time for this piece. I am urging you to put this time with staff on the top of your priority list. Once you have a good rapport with team members, it allows you to share ideas and collaborate more easily and more effectively.

Sharing
The next tip I have is to share the goals your student is working on. If you are the teacher, share the student’s IEP goals with the paraprofessionals and explain why you are teaching particular tasks. Knowledge is power! If you are the occupational therapist, please share your student’s therapy goals with the team. Therapy takes place all day, across settings and across instructors. If the team does not know what the goals are, they will have no idea how to address them across the school day.

Reinforcement
Students and professionals benefit from reinforcement! People feel good about the work at hand when they receive positive reinforcement. Let the paraprofessional know that they are doing a great job with their student(s). Everyone likes to get praise for a job well done!

Data
Another way that we can assure that our collaboration is helping the student is by collecting daily data on skills from all domains (i.e. behavior, academic, communication). When we, as a team, create a data sheet that captures the skills and specific targets we are addressing, we can use this across the student’s day. When we take this data and analyze the progress, we can all make informed decisions about a student’s programming needs. I have included a free team-based daily data sheet from Stages Learning. You can use this data sheet to track a variety of skills.

In my 14 years practicing in the field, the majority of people that I encounter are driven by a desire to see their students. However, even with the best intentions, we may face barriers in collaborating with other staff members. Follow the tips mentioned above and reach out to colleagues who seem to need additional support. I try to continually assess the needs of the teams I work with throughout the year. Maybe the team needs a refresher on a certain skill area – see if you can work this into your yearly professional development time. When we work together as a team, we can help so many students achieve their goals!

ABOUT THE AUTHOR

rosemarie-griffin-headshotRosemarie Griffin, MA, CCC-SLP, BCBA is a licensed speech language pathologist and board certified behavior analyst. Currently she splits her time between a public school system and a private school for students with autism. She is passionate about lecturing on effective communication services for students with autism and has done so at the local and national level. Rosemarie also enjoys spending time with her family, playing the harp and shopping.

Article originally posted on Stages Learning Materials Blog.